Traumatic Brain Injury – a story, I don’t remember

I’m going to attempt to piece together what I can because I only have two short memories of the day of my injury.

The day is June 2^nd, 2017. I was stationed in Clark, Wyoming on a contract wildland engine awaiting a fire call. There were three of us crew members living in a remote area and training for and awaiting the next wildland fire dispatch. We went to the bar in the morning for coffee (the only place within 40 miles to purchase things, and we did this almost every morning to socialize and get some breakfast and coffee).

When we returned to the shop to get started with our maintenance and training day, we had truck upgrades on the docket. I’m not super mechanically inclined, so I was just the helper for the day. My boss, Mike and my good friend and co-worker Levi, were installing new air-ride seats in our type 4 wildland fire engine (pictured above).

From what I understand, I went to pick up something from the rear of the truck and was carrying it in my arms. All four doors were open on the fire truck and I was walking from the back of the truck to the front of the truck, on the passenger’s side. Mike and Levi were both inside the truck and there was an air hose stretched across the shop and into the truck. Apparently, as I was walking around the open truck doors, I stepped on the air hose as Mike was pulling it into the truck. I tripped, going head first, and my head contacted the corner of the open front door. My head hit the truck door and I ended up on the concrete floor below. I hit the door so hard that it swung all the way open and slammed back shut due to the force.

The corner of the door split my scalp wide open and (this was discovered many months later in some imaging and testing) I sustained a coup/contrecoup kind of concussion. This is an initial strike of the brain inside the skull, followed by a strike on the opposite side. My brain impacted the inside of my skull when I hit the truck, and it hit my skull again when I landed on the ground.

I don’t remember anything that happened in the shop. From what Mike and Levi told me, I was able to sort of get up slowly to my knees as my head was bleeding profusely. It was like someone turned on a red faucet. Mike grabbed some blue shop towels and applied pressure to attempt to stop the bleeding. Levi got his trauma bag and an ice pack. We covered my head wound with an abdominal trauma pad (a really, really big piece of gauze) and an ice pack to control the bleeding. I was still kneeling on the ground next to a very large puddle of blood. Levi helped me get into his truck and then we decided that Mike would drive us in his truck.

Levi helped me into the passenger’s seat and he got in the back, behind me to make sure he would have a good span of control in case something else happened in the 40 mile ride to the nearest hospital. I don’t remember any of this and apparently I was pretty spacey. I asked to wear sunglasses because light and sound made the awful headache that I had even worse. But this also made it difficult for my two crew members to keep track of how I was doing.

We arrived at the Cody hospital and I was able to walk myself in, still clutching the bloody trauma pad on top of my head. The doctors found me a room and Mike came back with me. They asked me a few questions and then cleaned and stapled up my head. There are a few pictures and a video somewhere of me getting my wound closed (this is the only way my brain has been able to piece together what happened). The hospital staff in Cody must have thought I was doing just fine – they released me back to work after about 2 hours in the Emergency Room.

*(if you guys want to see the graphic photo, let me know, I’ll give it to ya!)

That night, I went out with friends to the rodeo. I don’t remember any of that night except for somebody asking me if I was alright and me lying and saying I was fine. I felt very out of it and unsteady at the time (but who knows if that is indeed a good memory, or something my brain put together).

In the following week, I was told to stay in the darkness and rest. I was having terrible headaches and I couldn’t keep any food down. All I wanted to do was go back to work, but I did not have the energy, concentration, or ability to be active for any period of time. This continued for two days. After we noticed that my symptoms were not getting any better, the boss’s wife drove me to a different hospital; the next closest, 85 miles away. I remember wanting to throw up the whole way there.

Once we arrived in the ER, they barraged us for the worker’s comp information and eventually got me to see a doctor. He set me up in a gown and a bed and on a machine to monitor my stats. As the boss’s wife and I waited and waited, the monitor kept going off because my blood pressure was getting low. The doctor eventually turned off the annoying sound (I also later learned: decreased blood pressure can be a symptom of brain swelling because the body is trying to decrease the pressure in the brain). I was given a CT scan of my head (3 days after the incident) that was explained to me as “unremarkable.”

I was sent home with some nausea medication and told to go back to work. Here’s where all of the problems started. Not only because I was having continued symptoms of a brain injury, but because I wanted to be stoic: I wanted to be okay, I just wanted everything to go back to normal so I could return to the job I loved. This didn’t help me one bit.

We did a small control burn in Clark, Wyoming about a week after my injury, and I can remember in a critical time, I was given an order by my boss and I did not complete it correctly. I barely remember this, but only because I remember getting yelled at for something. It was no risk to safety at the time, but I should have known better. This is where the start of the lessons learned begins: if you have a crew member that is not acting as they usually do (especially after an injury or critical incident in their life), take them off the job and get them to at least talk about it, or get them professional help. Or if you do not feel good, say something!

About two weeks after my injury, we were called to respond to our first fire of the season down in Colorado. This was a medium sized fire, in the hot June sun, near a coal and gas processing area. We were kicking some butt, doing some difficult and dangerous tasks, and getting the fire wrangled in. We were doing the job we loved, learning, and effectively completing our tasks.

We were in and out of the truck and working with attack lines (short hoses off the truck) and trying to put out spot fires that the wind kept causing. I was still making mistakes and getting frustrated with myself! I only remember bits and pieces of this assignment (again, because of photos and helmet camera videos mostly), but also because I remember being yelled at for making mistakes.

We were only on this fire for a couple of days, but upon being released and starting our way home, we realized that all three of us crew members were getting sick and fatigued and vomiting during and just after this fire. These were all symptoms listed for SO2 and H2S poisoning; two byproducts of coal and gas processing. At some point during our efforts to fight this fire, we were exposed to one or both of these gasses and were feeling the short term effects from it. This was later determined to likely be a factor in why my brain injury symptoms were prolonged and magnified.

In the weeks following, we were involved in a political battle where the fire region we were in was not sending out the appropriate resources, and we ended up being stuck at our home base with no work for about a month. I’ll get a little more into detail with this in the next blog, as it leads to my severe depressive state I found myself in before we got assigned to another fire.

All of the facts I have stated here are what I can remember about the incidents. It may have happened a little differently than what I remember, but that is all I have to go off of.