Shane's "worst day ever at work" started when the helicopter landed at a rural hospital up north.
A mother driving a minivan had lost control. The vehicle rolled multiple times before settling in a ditch. None of the kids was strapped in.
First responders found the children jettisoned in every direction, splayed across the ground before ambulances arrived and transported them to the hospital.
Shane, a flight nurse, came to the ER to pick up a five-year-old girl. She was in the worst shape, having suffered massive head trauma.
"The image that's burned into my mind is the doors opening at the ER and to see so many nurses and doctors. It was just chaos," he says. "Like a scene out of a movie, but worse because it's really happening.
"She's laying on a pediatric cart in the ER with multicolored straps. It sort of makes it look like a kid's toy. She's covered in blood, obviously head injured. She's seizing and her arms are moving in a way that's not normal. Her eyes are rolled into the back of her head like there's a disconnect. It's as if you're not seeing the person, just a broken body."
Shane and crew flew her to a big city hospital.
He still doesn't know what happened to the little girl. She was on life support the last he heard.
Shane, not his real name, will only talk about his job under the cover of anonymity. He doesn't want to draw attention to himself.
It’s these kinds of images that stay with him, that never seem to evaporate into the ether.
There was the tuber pulled by a boat into the concrete column of a bridge. Shane tried to save him, but he didn’t make it.
Then there was the more fortunate swimmer. He was run over by a boat. He lived, yet lost both legs.
There's also the memory of a 19-year-old girl who was a passenger in a head-on collision. A car crossed the center line. The driver was killed. The young woman hit the dashboard so violently her femurs pierced her kneecaps.
"You asked how I do the job," he says. "I don't really know the answer to that question. I know that I did have to see a counselor after the ordeal with the minivan and the kids.… I didn't even realize it was having such an effect on me until people pointed it out. When I did talk to the counselor, it was like a festering wound, like I couldn't see it until I sat down and talked it out."
Get all the therapy you want, but the job becomes a part of one's own human journey, he adds.
"There's a running file of images. All the stuff that's shocking," says Shane. "You're seeing somebody in that moment who's barely hanging onto life. And there's something about that. I don't know what it is. But it's big. It's profound. It's scary. It's sad. Somebody barely hanging by a thread, you don't forget that."
Not everyone will survive. Shane understands that, though he thinks he's gotten better at sorting it all out.
"Every single time that a call doesn't go right, every single time that they die, you sit there and rehash everything that you did," he says. "Was there something you could have done differently? Could have done better?
"After that period of time, what I've learned to accept is that I did everything I knew how to do, as quickly as I could do it, with the help of another person who's highly skilled, trained, and experienced. Yet that person didn't live.… Sometimes they die, and that sucks and that's a weird thing to say, but that's the truth. Sometimes they die."