PROLOGUE
The Cruelest Month
The 1989 Harley-Davidson rushed south on Rancho Road past Charleston Boulevard, accelerating its two riders, a father and son, into the warm desert night. The Las Vegas weather in March often is chilled, windy, and wet, but the last night of the month was dry. It was thirty minutes before April Fool’s Day, 1995.
The father motored past a convenience store, service station and, just east on Charleston, the University Medical Center. The neighborhood was familiar. So was the tandem ride. The old man had been speeding his three children around on high-performance motorcycles since they were old enough to hang on.
He knew these streets better than those in his hometown. He had been a Las Vegas resident for more than 20 years and had spent much of his adult life within a couple miles of downtown. When you’ve ridden bikes at speeds topping 120 miles per hour, the act becomes second nature. Accomplished riders have something akin to a sixth sense that enables them almost to feel and avoid dangerous situations.
The driver put the big bike through its paces as he had done with so many motorcycles. Although he hadn’t competed in three decades, he had owned motorcycles since he was 15 and had drag-raced them against the best riders in the country. Along the way he had collected a truckload of trophies and more than his share of close calls. Clipping the Harley beyond the posted 35-mile-per-hour limit over dry asphalt was a simple enough feat.
As a token testament to safety and Nevada law, he wore a European-style half helmet strapped to his neck.
He shifted, the bike hit its stride, and in a moment the two men were traveling more than 60.
The young woman in the northbound Subaru had no time to react as she began her left turn from Rancho Road onto Mason Avenue.
Slicing through the night, the Harley rider locked up the brakes a heartbeat before broadsiding the Subaru. The impact knocked the automobile backward and sent the riders glancing off the car, over the top and onto the road. They landed together, the driver taking the brunt of the impact on his face, the passenger’s landing cushioned by the driver’s body.
It was 11:35 p.m.
Las Vegas Fire Department Station No. 5 stands at Hinson Street and Charleston, approximately one mile west of Rancho Road. When dispatch reported an accident with injuries on Rancho at Mason, the stationhouse came to life. Within seconds, paramedics Bryan Alexis and Ian Adams were dressed, in their rescue unit, and driving eastbound on Charleston.
They arrived at the accident scene within five minutes and were greeted by attendants from Mercy Ambulance, whose offices are in the neighborhood near the medical center.
Mercy paramedic supervisors Bob Kenney and Marla Malone were on duty that night and, hearing the call, rolled onto the accident scene almost out of reflex. They were the first paramedics to arrive and were joined moments later by Mercy paramedic August Corrales and his partner, Tricia Wacker.
Through absolute chance, within 15 minutes of the accident, six veteran paramedics were on hand to give aid to the fallen bikers and the slightly injured automobile driver. The older biker’s luck wasn’t all bad. He was still alive.
Although their actions sometimes look chaotic to the untrained eye, paramedics follow a set pattern when arriving at an accident scene to optimize efficiency and maximize victims’ odds of survival. After the initial triage observation, in which those whose injuries are deemed the most severe are quickly assessed, paramedics set their priorities. In this case, the woman in the Subaru was shaken up and showered with glass when her side window popcorned from the impact of the Harley and its riders. The motorcycle’s passenger was next to the sidewalk, moaning. He appeared to have a broken leg. Otherwise, the attention of as many as six paramedics was focused on the fallen rider. Wacker briefly attended to the wounds of the rider’s son before returning to the most severely injured victim.
“We had just dropped a patient off at the hospital and were getting ready to go out. We were just down the street,” Wacker recalled. “Immediately when we got out of the truck we did a scene survey. Knowing that he was critical, we just moved him to the ambulance and to the hospital as rapidly as we could.”
The Harley rider was nearly dead. His neck was cut from ear to ear, and his head was noticeably swollen. The half helmet had kept his brains from spilling onto Rancho Road, but had not saved him from bearing the brunt of the impact with the asphalt. His face was pulverized.
In his six and a half years as a firefighter and five years as a paramedic, Bryan Alexis had viewed dozens of fatalities and figured he had experienced every sort of grisly accident imaginable. But he had never seen a living person with a head so swollen and a face so devastated.
So distorted was the face that Alexis, his partner, and the other paramedics failed to recognize it.
“We pulled up and I quickly went over there, and I started to assess him,” Alexis said. “The appearance was just so bad. We tried to block that out. He was probably 10 to 15 feet away from the motorcycle. It appeared that he wasn’t going to make it. We immediately tried to immobilize him.”
Massive bleeding made the process difficult. The driver was unconscious. His heartbeat was faint, his breathing shallow. He was a few minutes from being beyond help. The clock was running in what emergency-room physicians and paramedics commonly call the Golden Hour, the precious time from the moment a serious accident occurs until the patient is delivered to the trauma unit. The paramedics set to work, cutting off the rider’s clothing and prepping him for the short ride to the emergency room. His arms and left leg appeared to be broken, but that was the least of the paramedics’ concerns.
What really startled Alexis was the throat gash.
“The laceration appeared to be from ear to ear, kind of like a Colombian necktie,” he said. “It was like someone cut his throat, but when I looked at the helmet he’d been wearing I saw that the strap around his neck is what caused the massive laceration. His teeth were broken. There was so much trauma. It was probably the worst I’ve ever seen. No, it definitely was the worst.”
There was no time to treat him at the scene, so the paramedics slipped a cervical collar around his neck, rolled him to one side, and placed a back board underneath him. Then they loaded him into the ambulance for transport to the trauma unit at University Medical Center with Alexis and Wacker in the back.
Had the accident occurred even a mile farther away from the hospital and Station No. 5, their speed might not have made a difference. En route, Alexis grabbed a large-bore needle and administered a massive infusion of saline solution, which has the same consistency as blood. It not only replaces the fluids that are rapidly being lost, but also helps slow shock in traumatized patients. With his blood pressure dropping, it was the only way to keep him alive until the ambulance reached the hospital.
Keeping him breathing was the other immediate problem. Normally, Alexis would use a laryngoscope to insert a tracheal tube down the throat of the patient. But the patient’s face and neck were too far gone. The veteran paramedic couldn’t see the precise area between the vocal cords to insert the tube.
But he had to act quickly or he would have a dead man on his hands. He did his best to locate the base of the throat and slipped in the tracheal breathing tube. With the tracheal tube inserted, the lungs were inflated, oxygen flowed, and blood was prevented from leaking down his throat. The free-hand medical attention kept the patient breathing, but barely.
“It was the first time for me,” Alexis said. “We just opened it up and went for it.”
“We had him packaged and in the rig in no more than ten minutes. When we arrived at the hospital, we took the patient with us and transferred him into a bed. We did our best, but I really didn’t think he was going to make it.”
Corrales said, “It was really a shared effort to take care of him. We didn’t know he was a celebrity, not that it would have mattered. What happened is just something we typically do. Listening to people talk about what the CATscans were, he did not have a high likelihood of survival.”
And all that time, none of the paramedics knew who they were treating. The face was unrecognizable.
When the younger rider arrived at the hospital, his ankle obviously broken, he asked, “How’s my dad? How’s my dad?”
“Is this your father over here?” he was asked.
“That’s my dad,” the young man said. “That’s Bob Stupak.”
Back on the street, as police accident investigators attempted to piece together events, the greater irony loomed large in the background. From where the rider had come to rest on the asphalt, glancing to the east he would have had a splendid view of his life’s greatest achievement as it rose more than 1,000 feet into the desert night.
But he could not see, of course. By early April Fool’s Day, the fallen rider was headed for a deep coma as trauma specialists worked to save his life.
Lucky Bob Stupak was dying almost as fast as he lived.