The first responders in Wilson County who came upon the wreck site on that spring night in 1987 must surely count it among the worst they ever saw.
Not because it was a single car accident on a country two-lane. They see lots of those.
Not because it involved teenagers. Unfortunately, they see lots of those, too.
Not even because it was bloody, because it really wasn’t.
What they found when they reached the scene was a high school boy, still in the seat of the wrecked car, impaled on a wooden, splintery, 6-inch thick fence post — basically a rough-hewn small tree.
The post went through the trunk of the car, through the back seat, then through the front passenger seat and hit the dash in an uninterrupted path. That path passed through the boy’s body and pinned him to the car seat.
His name is Mike Harper.
Note the present tense: “Is.”
Because Mike Harper didn’t die that night.
Instead, his story became one of the most amazing stories of survival in the history of Vanderbilt University Medical Center.
He remembers it all.
Night ride
It was a warm spring day; school was almost out; and Mike and his friend Chad had been hanging out that afternoon. Mike, who is from the Donelson area of Nashville, was 15, and Chad was 16, which meant that he was old enough to have a driver’s license.
Chad had been given the keys to his family’s Audi 5000, and a little later that evening on a deserted two-lane country road, the boys got an idea: Let’s see if we can get this car to 100 miles per hour.
Bad idea. Even worse execution. Chad lost control of the car, and it spun into a row of fence posts, backward.
“You could see pieces of fence flying up in the air,” Mike said.
What he didn’t see, at least at first, was that a post had come through the car, through the back of the passenger-side car seat, and … through Mike. As the car settled after the wreck, there were several feet of the post sticking out of his body both front and back, but, again, he didn’t know that quite yet.
Chad, who was unhurt, asked Mike if he was OK.
Mike heard something he wasn’t supposed to hear: Someone on the scene said, “I don’t think this kid is going to make it.”
“I said, ‘I’m stuck,’” Mike recalled. In that moment before he realized what had happened, “I felt like I was being pushed into the door.”
Amazingly, he was conscious, and though he was uncomfortable, there was surprisingly little pain. But then he lifted up his T-shirt to see why he felt stuck and saw his skin folded under where the post came through.
In that first fog of realization, neither boy could quite believe what they were seeing, but when he saw his friend was badly injured, Chad frantically ran to get help, looking for the light of any house that might be nearby and also flagging down cars.
Several people who encountered a terrified teenage boy shouting about his injured friend called 911, and before long first responders were on the scene.
By this point, Mike was scared. He heard the concerned tones of the paramedics. He heard something he wasn’t supposed to hear: Someone on the scene said, “I don’t think this kid is going to make it.”
It was a reasonable thing to think, given the circumstances. It took almost an hour for Mike to be extracted from the car, still pinned to the back of the car seat by the fence post.
By that point Vanderbilt LifeFlight had arrived.
Not a routine trauma
One of the flight nurses on duty that night was Tom Grubbs, RN, EMT-P, and when the helicopter landed in a parking lot about a mile away (the closest point for a safe landing), he knew this was no routine trauma. Still, even with all his experience, there was no way to prepare for what he saw.
As Grubbs and John A. Morris Jr., MD, professor of Surgery, described later in a case report they co-authored in the Journal of Medical Transport, LifeFlight’s BK 117 helicopter had a 4-foot wide passenger compartment, and the post through Mike’s body extended about 3 ½ feet, leaving only about 3 inches of clearance on each side. The ambulance that was in place to ferry Mike from the crash site to the helicopter had about the same clearance.
Beyond the devastating medical issues everyone was dealing with, just making sure that Mike, the car seat to which he was still pinned, and the post could all fit was a problem.
Mike remembers how paramedics solved the problem: with a chain saw. They cut off both ends of the post.
“That was the first time I felt any pain,” Mike remembered. “As they were cutting, I could feel the post vibrating inside me.”
Once he was safely loaded onto the helicopter, the flight from the scene to Vanderbilt took nine minutes. Mike remembers that the other flight nurse on duty that night, Gayle Johnson, RN, sat near his head and worked to reassure him over the whir of the rotors.
“She was super nice,” he said. “She just talked to me the whole way, trying to keep me awake.”
When LifeFlight landed, Grubbs and Johnson gave report and turned Mike’s care over to the waiting trauma surgery team. No one in the OR had any idea what awaited them.
“Tiger country”
Meanwhile, Mike’s parents had been notified that he had been brought to Vanderbilt University Hospital, and they had rushed to the hospital in time to briefly see Mike before he was taken to the OR.
Everyone knew there was no choice but to remove the impaled fence post from his body, but everyone also knew there was a real chance that removing it would lead to massive bleeding and reveal devastating internal injuries. Mike’s parents knew that in this brief moment, they might be saying goodbye to their son.
By this point Mike was intubated and could not speak, but he could hear. And he heard his mom and dad tell him they loved him.
There are so many potentially dangerous complications lurking in that part of the body that trauma surgeons have a nickname for it: “tiger country.”
Morris, who in addition to his role as professor of Surgery was also director of the Division of Trauma and Surgical Critical Care, has cared for tens of thousands of trauma patients in his career, but Mike Harper has never left his memory.
“Here’s what goes through a trauma surgeon’s mind when he sees an injury like that,” he said. “Aorta and vena cava — major arteries in immediate proximity to the entrance. To say nothing of the pancreas, bowel, spleen.”
There are so many potentially dangerous complications lurking in that part of the body that trauma surgeons have a nickname for it: “tiger country.”
Normally the surgical team would have access to radiological images of the affected area, but in this case, there was no way to take any CT scans or X-rays. Because he was pinned to the fence post and car seat, Mike would not fit into the machines. The surgical team would be flying blind.
Gaining sufficient leverage
Before any potential damage to organs or blood vessels could be addressed, of course, the fence post had to come out.
“My main fear was that he would exsanguinate immediately,” Morris said. That is, bleeding would be so rapid and unstoppable that Mike would quickly bleed to death.
As the post pulled free, everyone braced for the torrent of blood they expected to see.
Everyone held their breath as, under the bright glare of the OR lights, Morris gripped the fence post and pulled.
It didn’t move. Stuck fast. Deep breath. Going to have to try again.
A large incision was made around the entrance point to help loosen the stubborn post.
And then: “For the only time in my career,” Morris said, “I had to stand up on the operating table to get sufficient leverage to pull the post out.”
As the post pulled free, everyone braced for the torrent of blood they expected to see.
There wasn’t one.
In fact, there were virtually no internal injuries.
As the post penetrated his body, Mike’s internal organs simply rolled aside and made room. Had the post been slightly to the left, Mike would have had a gaping wound to his side and bled to death. Slightly to the right would have meant likely fatal internal injuries.
As it turned out, there were some internal injuries, but everything was relatively minor and amounted to routine repair.
“We had to clean up a lot of splinters,” Morris said.
A Jet Ski promise and baseball games
In the dispassionate language of the journal article Morris and Grubbs wrote, “The patient experienced an uncomplicated postoperative course.”
Mike was in the hospital for nine days, recovering from the wound. He remembers waking up again and again from fitful hospital sleep, dreaming repeatedly about the impact of the post. After a few days, the bad dreams stopped.
He remembered something else from those hospital days. Mike, who loved to spend time with his two brothers (he is the youngest of three boys) and with friends at a family lake house, had been lobbying his dad to buy him a Jet Ski.
“When I was in the hospital, my dad said, ‘If you pull through this, I’ll get you a Jet Ski.’”
Later that summer, after two or three months of recovery, Mike was on the lake on his new Jet Ski, and he was able to play baseball again before the summer was out.
“Very fortunate”
After high school Mike went to college at Western Kentucky University; so did Chad — the two are still friends.
Mike has worked at jobs in mortgage and finance his whole career, and he is currently a wealth management lending officer at Bank of America.
He has had no lasting health problems as a result of the injuries from that night.
He has had, as most people do, a few encounters with the health care system over the years. He has had several orthopedic surgeries and recently had a heart bypass, and he said at every appointment when a new health provider is going over his health history, he knows to allow a little extra time.
“They ask if you’ve ever had surgery. You say yes. That leads to 15 more minutes,” he said.
He has scars, front and back, from the entrance and exit wounds of the post — visual reminders of the trauma but also, in his younger days, an opportunity to have some fun at the beach.
“I would tell people the scars were from a shark attack,” he said. “Then I would tell them the real story.”
What he doesn’t need to add is that shark attack victims could only wish they had a real story as good as Mike Harper’s.
We said earlier that Mike remembers everything. That’s not quite right.
Mike doesn’t remember the names of all the people who took care of him while he was at VUMC so long ago, but he does have a message for any of them who read this.
“I’ve been very fortunate to stay on this Earth,” he said. “I still think about those doctors and nurses at Vandy back then. They were amazing. I would like to thank everybody. Throughout my life I’ve thought about them all and feel very fortunate.”
