For 29 years I have been plying my trade in the middle of the night or in the wee hours of the morning. Strange things happen at these hours, not only around us but also within. As a result of these years of observation and experience, I have come to the belief that the proper combinations of stress, Mountain Dew, exhaustion and aggravation can render one into a dream-like state. In this condition the real becomes the sublime and the world takes on an eerie, ethereal quality. I was in this condition the morning of the following call.

Ribbons of crimson danced out from the top of our truck, playing arcade mirror games in the glass of the storefronts facing the street. All were asleep in these moments before dawn. The sky had begun to lighten and the first fingers of the sun's rays were starting to poke out from just below the inky horizon. The revelers from last night were sleeping it off, either at home or in their cars. Some of the more mobile and coherent had made their way to Denny's and were now chasing wallbangers with OJ and scarfing Excedrin with gulps of coffee between bites of their Moons-Over-My-Hammy.

It was too early for a siren, and besides, we were the only moving vehicle on the road. The major intersection was easy enough to negotiate with just lights and patience. Tony drove; I stared out the window so exhausted I wondered if I was dreaming this call. No such luck. The dispatcher alerted us that PD was on the scene and wanted us "extreme code 3." It was their way of saying, "Hurry the hell up, this is some bad sh*t here and we don't know what to do." I acknowledged dispatch with a sleepy and calm "10-04." I probably sounded cool and aloof when all I really was, was exhausted. The pleading of the police on scene did not cause us to drive any faster; they just provided a heads up that things were not hunky-dory.

The call had come in as a traffic accident. Further updates from the frantic cops informed us it was an accident involving a bicycle. That little bit of added information caused me to sit up in my seat and shake off any remaining fog. My regular partner Dave was on a "Kelly Day" and he was a bicyclist. It would not have been far-fetched for him to be taking an early morning ride along the ocean. Although he lived about 20 miles from the station, his long rides had him up in our zone and frequently had him stopping by.

We were only about a minute away when the final update came in. In fact, I remember the entire response only taking about six minutes from call out to arrival. Things just seemed to be in slow motion that morning. That was about to change.

We drove eastbound and once over the bridge hung a quick left at the light. We were in Gotham by the Sea, a small spit of a town with hotels, restaurants, a fishing pier and their own proud police department.

As the truck swung north the scene unveiled. On the left, standing off the road in front of a row of cars parked in front of the seaside motels, was the "Oh-My-God-Squad." This time all of their murmuring and fretting would be warranted. Facing us, parked in the middle of the street in the turn lane that separated the north and south bound traffic lanes, was a garbage truck.

We parked, got out and walked to the rear of our squad truck and gathered our equipment. Tony grabbed the airway/oxygen bag and I got the trauma box. We started off together toward the back of the garbage truck where the cops were standing over the victim. They formed a circle around the covered body doing their best to further obscure the view. The streets were moist, with a shimmer caused by oils floating to the top of the settled morning dew. Advancing sunbeams added to the evolving road art. Our pace slowed as we realized there was stuff on the street we were subconsciously doing our best not to step in. It resembled the curd-like substance that forms on the top of the grease collection barrels stacked behind most restaurants. I figured it was some greasy slop that washed out of the garbage truck during a panic-breaking maneuver. We became doubly motivated not to step in it in a vain attempt to keep our boots clean and us from falling.

Tony and I pulled off this silly dance that went like this: step, tiptoe, pirouette, squish-damn, side step, tiptoe, squish-damn, squish, squish, damn, damn. We attempted all of this while balancing our silent and ungainly partners, the oxygen/airway bag and trauma box, doing our best not to be slip-sliding away.

We got to the back of the garbage truck and saw the mangled bicycle on the shoulder of the road where street meets parking lot. It was the same type of bike Dave rode. The body was covered with a yellow, plastic emergency blanket provided by the cops. Sticking out from the edge was a hand ensconced in a knit-backed bicycle glove. Damn, they were the same type of gloves Dave wore. There was only one way to end this and that was to pull back the blanket. Just before I did one of the cops offered up a warning, "Not good."

We pulled the blanket back in a very controlled fashion. I handed a corner of it to one of the cops so as not to provide the drama of a grand unveiling for the crowd, just enough for me and Tony to see what we needed. I recognized a hand and that hand attached to an arm but as the arm approached the shoulder things started to get hazy and confusing.

Tony and I had to take a moment to sort out what we were seeing. The hand/arm combination (and there was only one identifiable) led up to a mass of ground flesh. I mean literally ground meat. What we were looking out would have been more appropriately viewed in a butcher's case than in the street at 7 am. Was this Dave? I could not tell. I mean I REALLY could not tell. I was only inferring the fact that it was human at all. All the skin had been removed from the body except for the hand/arm combo. But more than being skinned, there was something more confusing here.

We were looking for a face, Dave's face. It took us a few minutes to realize that a pile of flesh separate from the main pile of carnage was probably the face. It is hard to imagine relief in a moment like this but that is what we both felt. The body had a mustache and Dave did not. He was not off work long enough to grow one as thick and full as what we saw on the meat pile. With a few more minutes of shocked staring and contemplative wondering, we could make out pulverized bones and torn bits of flesh.

We soon concluded that the pile of skin we assumed was just face was actually the entire head, smashed flat. It was no more than an inch or two thick with pulverized skull bone inside. We had seen enough.

The cops who had been holding up the blanket in a curtain-like fashion re-covered the body and that's when Tony and I moved on to the other victim here, the truck driver. We asked the cops about him and they pointed toward the cab of the truck. There we found a middle-aged guy frozen in position. I mean really frozen, with the "thousand-yard-stare." He had a white-knuckled death grip on the steering wheel and could not talk. To add a surrealistic twist to this whole thing, the driver's 13-year-old son was sitting in the passenger's seat. The morning was supposed to be some father and son bonding time.

We spent a long time talking to the driver, gently coaxing him out of his catatonic state. We urged him to allow us to take him to the hospital, if for nothing else than to get him and his son away from the scene. It was not working; he would have no part of an ambulance ride.

As we walked/danced our way back to our rescue truck and put our stuff away, something else struck us. The grease curds we had danced unsuccessfully around were the victim's brains. We sat in the cab of our squad truck to write the report. As I wrote Tony surveyed the scene. "Hey look," he said, "looks like brains and stuff are all on these cars and the plate glass window of the motel." Sure enough, white/gray, greasy blobs speckled cars and windows and buildings. Some in the crowd were getting sick and vomiting at the roadside.

One of the cops walked back to our truck and gave us a preliminary report. He said that according to witnesses, the garbage truck was driving down the road at about 5-10 mph. The bicyclist came up behind him and as he was passing the truck, he slipped and fell between the tandem dual rear set of wheels and it ground him up, skinned him like I described and popped his head like a pimple. Everybody says the garbage truck never swerved; it just moved in a straight line. The cop thought it looked like the bicyclist just made a mistake. He added that the driver was in pretty bad shape but they got him out of the truck and he was sitting in a squad car. After the accident, the dad jumped out but the kid stayed in the truck. The kid never saw the body. "Thank God," I said. There was nothing left to do but pack up and end our shift, but something followed me home that morning.

Writing is a lot like making sausage. You might love the end result but you never want to watch it being done. I will spare you the messy details but suffice to say that I felt a need to write this article and when I did, things started to become clear. This call created a ghost for me, not one that I felt haunted by or caused me to lose any sleep over, just something in the back of my mind that created a slow haunt.

There were two things that stood out about this call, the horrible results of the crash not withstanding. The first had to do with the long-reaching effects the trauma had on those associated with the call. The second, I finally realized after struggling to put these words to paper, was that I had successfully coaxed my ghost from hibernation some twenty-five years after the fact.

The bystanders got to walk away and start getting over the Wes Craven scene the minute they turned their backs. As paramedics we go back to work and if things get tough for us there is CISD or department-sponsored counselors. How about the driver and his son? I would think therapy would have been the first order of business, maybe a career change, who knows? The problem in this case was the widow. Now arguably she had experienced the worst day of her life that Sunday and it is natural to want to seek answers and place blame. That I understand. In my opinion, seeking out a different answer than the one officially arrived at by all investigating parties only served to delay healing and create more pain. The widow decided to sue the truck driver. She could not come to terms with the fact that her husband made a mistake and died. The fault was his, as best all involved could determine. These conclusions offered no peace for her. I suppose one could argue that there was a monetary motivation based on the putting of blame or finding fault, but at what other cost?

After a few years the subpoenas started arriving and the march down to the lawyers' offices for depositions commenced. We went to two depositions about a year apart. Both times we read from our rescue report and offered little personal opinion about would, should or could. Following the depositions, we had a chance to talk with the driver's attorney and get updates on his condition and how his life was going. What made me the most angry was the pain and continued suffering the widow was doling out to all involved (probably unrecognized at the time) in a vain attempt to have the courts adjudicate blame, award damages and legislate closure. As for the driver of the garbage truck, this guy's life became a nightmare. Any progress he was making at putting some life back together for himself would all come crashing down with each round of depositions. All wounds would burst open with the reliving of the accident. The plaintiff's lawyers would graciously and repeatedly supply detailed descriptions and the pictures of the scene. No one on the plaintiff's side of the table could figure out it was time to move on. The lawyers smelled blood/money and the widow was going to exact her pound of unwarranted flesh.

As I started writing the next section I wrote my way to more false starts and down more dead end streets than I care to admit to. I was poling my esoteric boat down an existential river in the swamp of pain. I was adrift. I was finally able to cobble together a little bit about my feelings and explore some things that were painful, but I was only getting close, nothing in the 10-ring yet. Kathy, my really smart wife, did her best to keep me focused and on-track despite my predilection to distraction. I charged ahead amidst her groans and here are the results.

We sat on the couch while she read over and edited this story. At a certain point she stopped reading and asked me, "What is it about this call that has bothered you so much for all these years?" I ranted and raved for a bit while she poked at me with the idiot stick, which usually took the form of repetitive and incessant "but whys?" on her part. After a few minutes of this, which seemed like a painful hour of introspection, there was a sudden moment of clarity about why the memory of this call lingered for so long. My ghost. Bull's-eye.

I have always considered the brain a sacred (holy) organ. It is where we give birth to the exquisite and the profane. In the street were brains, brains smashed into the soles of our shoes, brains splattered on the parked cars and the plate glass window of the motel. Within the fat globules strewn across all creation that morning were the places where molecules became memories and atoms morphed into emotions. These were the magical places where the opening riff of "Stairway To Heaven" gets converted from sound into a calm, introspective feeling and your brain whispers to you, "All right." It is where our ordered collection of carbon-hydrogen-oxygen and nitrogen creates the miracle of awareness of existence. When I say "awareness of existence," I mean the brain's ability to think about its own existence or consciousness. I had to ask myself, were the memories of his mother tucking him in at night, the long heart-to-heart he had with his father, high school biology, scoring the winning touchdown, getting married and his son being born now crushed into the bottom of my boots? Was his consciousness (brain/mind/soul) now baking in the sun?

There are belief systems that state the soul resides in the liver while others claim it is the heart. One says it is the pineal gland and there are a couple that believe the soul exists in every cell of the body. I have always felt that the soul rests in the mind and the mind is a product of the brain. It is impossible for me to take all of this in and not think something else is at work here (call it divine if you will) that brings all of the forces into alignment to the point that the brain enables us to put a man on the moon, cure polio, write an ACLS manual and look into someone's eyes and say, "I love you."

During my years spent at the University of Florida, I was fortunate enough to take courses that included lectures on mind/soul separation. The classroom discussion was spirited and the professor enlightened, to say the least. I am not fooling myself into thinking that a couple of graduate courses imbued me with the ability to speak with any authority on the subject. What the classes did do is create a fertile landscape for my own questions to form. Where does the brain end and the mind begin? Is the mind the seat of the soul? These are my two big questions. On reflection, I have thought about these in one way or another for most of my life. This is my ghost. On a grand scale, the subject of mind/brain/soul separation is big enough to turn into one's life work. Google some of these subjects sometime.

We were never updated on the disposition of the case. I can only hope the widow found whatever she was seeking and moved on to healing. As for the truck driver, the last report we got was that he had been unable to return to work since the accident and had several psychiatric hospital admissions for depression. His wife divorced him. The son for the most part was unaffected by the accident itself.

As for Tony and me, I wrote this article and continue to be bothered by brains in the road. I have become an esoteric ape sitting and wondering how I can sit and think about thinking while I bang on a computer keyboard. Tony moved to the mountains and at his last sighting was still drinking Mountain Dew.

"There is no coming to consciousness without pain."
Carl Gustav Jung

Stephen Kavalin has been an EMT/Paramedic since 1980. He completed his undergraduate education in nursing at the University of Florida in 1992, and then became employed at Shands Hospital (Gainesville, FL) in the Cardiac Surgery Intensive Care Unit. During this time he also became the lead paramedic instructor and interim program director for EMS at Santa Fe Community College, Gainesville, FL. He later completed his Masters Degree in Anesthesiology at Barry University in Miami, FL and is currently employed as a Certified Registered Nurse Anesthetist (CRNA) at Winnie Palmer Hospital, Orlando, FL. He can be reached at KavalinEMS@aol.com .