The mortuary approach to emergency medical care was appallingly simple and un-
informed. My Boy Scout first aid training having been deemed sufficient, our main
response to injuries and illness was high-speed transport to the nearest hospital. We
routinely pushed that big Cadillac past a hundred miles an hour on highways, and when
short-handed I ran calls alone, enlisting relatives and passersby to help load patients.
Sometimes we rolled far enough south for wrecks on the interstate that an Austin am-
bulance reached the scene too, setting up a competitive scramble; once I scored a body
for us by running with a gurney faster than the other crew. Luckily everyone we carried
either was hopelessly moribund or survived in spite of these inadequacies.
One July dawn I crept north out of Georgetown on I-35, hugging the steering wheel
and peering through dense fog a few feet in front of the ambulance. I had driven some
dozen miles, queasy with anxiety, when several wrecked vehicles emerged around me
in the mist. Among them was a tractor-trailer and behind it a Chevrolet Malibu. The
car had plowed under the truck with enough force to shear off its top and windshield,
then been hit by a pickup and jarred free. Moving gingerly among disjunct bumpers and
mangled fenders, over glittering shards of glass and metal, I yelled, “Hey, someone help
me!” A woman's panicked voice pierced the chaos: “I can't see . . . what should I do?”
The Chevy's left front door was jammed, so I leaned in and checked an unconscious
young man slumped against the dash, his nose sliced off and face streaming blood. I got
close enough to hear breathing and felt a pulse in his neck, then climbed over what had
been the rear window and into the car.
A teenage sibling was slouched into the right backseat corner such that his head
seemed tucked out of sight, so I pulled the kid upright by a wrist and discovered his jaw
still attached to a ragged neck stump, as was the empty back of his skull. Everything
else was splattered over the trunk of the car, the largest bloody gray pieces of brain,
bone, and flesh no bigger than pocket change. I groaned and took a deep breath, then
lowered him back down, climbed out of the car, and convinced the shaken truck driver
to help me get the other boy onto a gurney. That afternoon people gawked with curiosity
and revulsion at the wrecked Malibu, which had been towed into town, and twice that
next week I awoke to the same nightmare. In my dream the foggy scene played out in
colorful detail, except that the shattered young man was my brother, Will.
Another morning that summer a sheriff summoned me to follow him west out of town.
We wound our way through several miles of brush country, a rolling jumble of rocks and
prickly pear mostly used for ranching and deer hunting leases. Eventually we turned
off at a gate, were met by an elderly man in a pickup, and caravanned several hundred
yards down a dirt track. The battered, faded blue Oldsmobile was barely visible from
the road, tucked down a gully, and in the backseat, as if she'd only fallen over asleep,
was a middle-aged woman with short curly hair. A piece of garden hose extended from
the tailpipe forward through the front left vent; the windows were closed. Only days
earlier this lady had cheerfully sold me snacks and toothpaste at a convenience mart
in nearby Round Rock; now she lay on tattered upholstery, arms extended awkwardly,
hands dangling. Her blouse was unbuttoned and bra loosened, shorts and underwear
pulled down onto her calves.
After we'd opened all the doors and I touched the woman's tepid neck to make sure
there was no pulse, the sheriff picked up an envelope from the floorboard. He read the
letter without a word, passed it to me, then looked away while lighting a smoke. Two