Trauma system kicks into gear to save a life

Joshua Bradley and familyMinutes after firing up his burnt orange Harley Davidson motorcycle, Joshua Bradley lay sprawled on the pavement, pinned beneath a pickup truck, bleeding and unconscious.

His life hanging by a thread, the energetic 23-year-old electrician had collided with another vehicle as he rode home from a job site in Mount Pleasant, Iowa.

“In one sense, it was my lucky day,” Joshua says. The pickup (which was not directly involved in the collision) happened to be driven by an off-duty nurse, who pulled him out from under the truck and began stabilizing him until paramedics arrived to assist.

“The paramedics said I fought like crazy but I have no recollection of that,” he says of the incident on August 14, 2013. “I don’t remember a thing.”

Joshua, from New London, was briefly evaluated at the Henry County Health Center before being transferred by emergency helicopter to University of Iowa Hospitals & Clinics in Iowa City, where multidisciplinary trauma specialists immediately began assessing his injuries and developing a plan to save his life. As they worked, Joshua’s spouse, Delaina, and other friends and family members arrived to begin a prayerful vigil that would last many months.

UI trauma surgeon Dionne Skeete, MD, a team leader in Joshua’s care, recalls the urgent challenge at hand: Head trauma, a nearly severed left foot, a torn aorta, multiple lacerations and contusions to internal organs (lungs, spleen and kidneys) and hip, spine, and skull fractures. His chances of survival were 50-50.

Few arriving patients are as critically injured or less likely to survive, says Michele Lilienthal, RN, program manager for UI’s trauma and burn services.

Adds Skeete: “Without the combined, immediate expertise of heart and vascular surgeons, neurosurgeons, orthopaedic surgeons, and anesthesiologists, Joshua had no chance.”

Fortunately, Joshua survived the emergency surgeries and other measures taken to save his life. He spent five weeks in the Surgical Intensive Care Unit and three more in a standard hospital bed before being discharged on Sept. 4, 2013, for rehabilitation therapy in Burlington.

Later, in mid-October, he returned to UI for a skull repair surgery.

According to Skeete and Lilienthal, Joshua’s case was a great example of Iowa’s trauma care system working as it should. Success was achieved thanks to remarkable contributions from beginning to end: People on the scene of the accident, staff at the Henry County Health Center, and many UI specialists in the areas of orthopaedics, neurosurgery, heart and vascular care, cardiothoracic surgery, trauma, anesthesiology, nursing, physical therapy, occupational therapy, social work, dietary, and speech therapy.

“The doctors had every reason to think I wouldn’t make it,” Joshua says. “I was supposed to die.”

Today, other than a prosthetic left leg, Joshua is back at work and fully recovered.

In a thank-you note to the UI team, Joshua and Delaina described the happy outcome as nothing short of a miracle. “We could never thank you enough or repay you for what you have done,” they wrote, “but know that God is gracious and is there in all that you do.”

Joshua is still an avid motorcycle enthusiast—he’s the proud owner of a new jet-black Harley—but now he rides with a newfound sense of safety, which includes a motorcycle helmet. It’s an important piece of equipment he wasn’t wearing at the time of his accident.

“Back then, I was thinking I’ll never be in an accident, so I don’t need a helmet. And then it happened,” Joshua says. “If I had been wearing a helmet, maybe my head injuries wouldn’t have been as bad.”

Because of Joshua’s accident, many of his friends who ride motorcycles now wear helmets, “even the older guys who’d been riding for years without them,” he says. “It just makes sense. I was so lucky—and you can’t count on luck if you’re in an accident.”

Helmet use is an important prevention measure motorcyclists can take to protect themselves and their passengers. 

Today, Joshua has one more very important reason to always ride with safety in mind. Joshua and Delaina’s first child, a baby boy named Kyus, was born in February 2015.

“We couldn’t be more excited,” Joshua says.

—Spring/Summer 2015