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Epilogue

Gary guided the truck off of the highway just outside of Hebron and onto a dirt stretch called Monument Road.  Kim, Helen, Dr. Bunting and I were squished into the king cab of his big pickup.  Now Gary pointed it toward a nondescript clump of trees in the distance toward a place he had not been for thirty years.  He knew right where it was, though, and had thought about it a great deal over that time. 

             “It’s only a few miles from here,” he said to Kim and me.  I considered the clumps of trees in the distance toward where we were headed, and considered the last time I was there.  I felt anxiety rise in me.

            I had seen it in my mind so many times, an image created from the one dimensional colors of the handful of photographs I had perused in the intervening years.  I had pictured a scraggly line of trees flanked by barren fields, and dark and gloomy skies.  Something forbidding and not quite part of the world where decent and caring people live, like a graveyard in a Charles Dickens novel. 

            Gary took a left turn and continued up a dirt road that paralleled an empty field surrounded by barbed wire fences.  That time of the year the corn hadn’t been planted yet and the brown dirt surrounding us spread out towards the ends of the earth, as far as we could see.  Then he made one more turn and slowed the vehicle down, stopping beside a small earthen dike leading toward a small tree-ringed pond.

“This is it,” he said.  We all got out.

Kim and I slowly walked a distance to where the trees met the field and stood in silence looking over it.  It was like walking into some kind of time transporter, to another place.  The empty field was level plowed dirt as far as we looked.  It would have looked like this that day, roughly, empty and devoid of vegetation.  I tried to grasp what I saw, but this was nothing like I had expected.

I had thirty years worth of dreams about this place, and the horror it would bring me to behold it.  But now here I was, and I was transfixed.  What I found defied my every expectation. 

            What I found was a lovely pond ringed by a beautiful and healthy strip of forest, mere yards from a section of the Oregon Trail.  Pioneers heading to the California gold fields may have stopped at this spot at some point to refresh themselves in the shade of the trees or the clear water of the pond. 

As we approached the woods, two large deer suddenly bounded from the trees on the opposite side of the pond and ran across the gently rolling ground to the shelter of another thicket nearby.  The peace and tranquility that I felt at that moment so defied the picture of what I had known to be the truth for so long that it was hard to believe that this was really the place. 

Kim and I walked along a faint cattle track that wound around the outer perimeter of the pond, just inside the ring of plum thicket that surrounded the woods.  Kim continued to walk through the trees and I made my way through a gap in the thick plumb bushes and then out onto the open field, taking it all in.  I looked around, trying to identify the crash site, but from that spot, there was no trace.  I again wondered seriously if this could really be the place.  I figured there would be some sign, some indication of what we went through.  Some monument that for a few dark hours we had laid there and fought for our lives.  But it seemed like it was all gone. 

I turned and went back into the woods to look for Kim.  As I got to a corner of the pond, I suddenly noticed what appeared to be a gap in the tree line that surrounded it.  I walked over to the spot and could see that much of the growth there appeared to be newer than the rest in the area.  I worked into the gap and found myself in a tiny clearing a just few feet from the pond.  Long dead branches and the remains of a couple of knocked down large trees lay around the area.  I walked over to one dead and bare stump that was still standing.  All that was left of it was a scrubbed clean trunk about twenty feet high.  At the top of it, the wood was jagged and torn. 

Suddenly I knew why. 

I realized with a thump in my chest that thirty years before, it had ripped the wing off our airplane as we sheared through it.  The path we had traveled began to resolve around me as I stood there and soon became clear.  I could suddenly make out the entire thing.  It was here, after all!  It had happened right here!

My head spun.  I had to find Kim and tell her!  I turned and hurriedly walked back along the cow path through the trees looking for her.  Then saw her.  She stood a few meters away from the clearing I had found, in the shade of a few trees.  She was looking intently at an object that she held in her hand.  Dr. Bunting stood a few feet away.  They glanced up at me as I approached a stunned look in her eyes.

“Look at this…” she said and handed me the object.  “I found it on the ground right here.”

I took it.  It was a shiny metal chunk.  It was obviously deformed as if it had been smashed by something.  It was heavy chrome, so whatever twisted it, had done so with considerable force.  The realization of it took me and I looked disbelievingly at Kim, and then looked over at Dr. Bunting.

“It’s called a pitot tube,” he said.  “It’s used to measure airspeed.”

“From...the plane?” I asked in barely a whisper, still not quite getting the meaning of the artifact I now held in my very hands.  He nodded.

I stared at it for a second, still in shock. 

Never in my wildest imagination of this trip did I ever think I would ever actually hold a piece of our plane.  I believed it all had simply vanished like a cloud into the passage of time and could not have possibly left any trace.  I got hold of myself and directed Kim to follow me back to the tree.  As I did I scoured the ground in case there were more artifacts.  I stopped upon coming across a small jagged piece of clear, curved plastic.  I knew immediately it was from our windshield.  I bent down and picked it up, studying it intensely.  My head reeled.  I felt like I was going to faint.    

I am still trying to formulate the impact that that moment had on me and it is hard to put into words, but that moment was the instant that I really knew the truth.  It was the moment I really became part of this whole thing and realized it had happened to me...all of this really happened to me.  Up until that moment, I don’t think I ever really understood that. To hold those pieces of that plane in my hands changed my whole perspective forever.  They were the physical link to the puzzle that made it real - truly real - for the first time in my life. 

It was as profound a moment as I have ever experienced.  I have no other to compare it with.

I had come here to try and find for myself what it was my dad had seen when he went into that field - foreboding, black, and thick with fog, like some horror movie.  To try and relive what he must have felt when he had stumbled across what was left of his wife.  To try and grasp the sensation he learned as our blood smeared his clothes while he tried to save and protect us.  I had come here to get in touch with that horror and maybe get a taste of it so that I could know the truth of what had happened.  So I could break through it and try to make sense of it all. 

But what I realized instead was that it simply wasn’t there.  It was just a pond, and a forest, and a field, and the spring breeze, and the birds.  It was just me and Kim walking through the trees.  It was my new friends as they watched us.  The horror was long gone.  It had vanished long ago like the fog, maybe as my dad left with us, maybe by the wash of Larry’s rotors, maybe by the departure or the CAP team, or the wake of Gary and Dick’s truck, or the wind from Looking Glass’ engines. Maybe it only existed in the minds of those who witnessed that night from the same perspectives.  At any rate, it was gone by the time I got there. 

I felt as though I was too late when I realized that, and for a moment I was crushed because I thought that I wouldn’t be able to tell the story without it.  But then, as I stood in the shade of those trees, listening to the breeze and the birds, I suddenly realized that I didn’t need it to tell the story.     The horror wasn’t the story.  The words on this page are.  The words from all those people.  The impact of what came after.  The life of my mom.  The healing that Jon spoke of.  ATLS.  That was the story.  Not the pain.  Not the dark.  Not the death.

The life. 

To my surprise, I was uplifted by the life I now saw all around me, like I was observing it for the first time.  Suffice it to say that my own life took an entirely different meeting at that moment and it made me understand finally why I was standing there: 

I was just supposed to tell this story - any way I could. 

As I stood there, the truth was like being hit by an unexpected wave.  I was stunned and amazed.  Joyful and horrified.  I simultaneously wanted to scream and laugh and dance and spin around and fall to my knees and pound the earth in rage on the very spot where my mother lay dead and bloody so long ago…but I couldn't make any decision of which one to do. 

So instead I just stood there immobilized by the enormity of it, holding an old chunk of metal and a broken piece of plastic that had no meaning to anyone at that moment but me and Kim.  All I could do was gaze around at it all and take it into my frazzled mind where it sloshed around like water in a bucket. 

And yet in the midst of it all I was aware of a peace and calm slowly draping itself over me, the likes of which I had never before known. 

Like a gift from my mother.

After awhile I forced myself to breathe, and then I found that I was able to move again.  I looked over at Kim, then at Helen and Gary and Dr. Bunting with tears in my eyes.  And I smiled.  I affirmed for myself in that instant what it was that I had to do.

So I tell you the story…

And I am glad.

The end.

-Long and Winding Road

We all turned out okay in the end, I guess.  “Okay” being a relative word.  Life wasn’t always easy, but is it ever?  Through it all, we stayed together, and that is what’s important.  I think mom would be content.

Chris is a successful real estate agent and businessman, and he and his wife Debbie are happy and have wealth beyond dollars. 

Rick lost himself in the written word shortly after the crash and emerged after high school an academic.  He began college at Nebraska Wesleyan University before ending up at Brown University where he got a Masters degree in Education.  He is teacher up near San Francisco with his wife, Mary.  

Kim also went on to get a Masters degree in Human Resources.  She is married and living happily with her husband Tim in Reno.  She just gave birth to her first son. 

We all have people we love and who take care of us.  And we remain close despite of, or maybe because of, the tragedy we have all experienced. 

Larry Russell thought about us a few times in the intervening years.  Not long after he went looking for us, he was coming in for a landing at Lincoln in his helicopter.  The locator beacon antennae that he had outfitted the helicopter with, the same one that had detected our signal, snapped off and flew into his tail rotor, shattering it and spinning the helicopter in what they call an auto-rotation.  He managed to get it down, but it was a harrowing experience.  He still has pieces of the rotor, as a memento of survival.  He and the helicopter were flying together again in a few weeks.

A few years after that, he was flying a mission for the Lancaster County Sheriff department, and passed over a mountain ridge in Arizona in a Piper Cherokee when he hit what is known as a mountain wave.  This happens when air cools rapidly as it crosses a ridge, and cascades down the other side, like a waterfall of air.  Aircraft flying into one are helpless and at their mercy, as was Larry.  One moment he was flying along and the next maps, cups, and McDonalds french frys were levitating around him as he suddenly plummeted down the face of the mountain.  He kept his wits and put the plane into a circular decent to slow it down, then at the last possible instant, managed to break free of the mountain wave and keep flying.  It was only luck that the whole thing occurred over a deep valley; otherwise the results would have been much different. 

His passenger, sleeping in the back, never knew anything had happened.

Jon Morris stayed on with the CAP and remained a cop with the Lincoln Police.  He went on many more missions with the CAP, but the memory of our crash always stayed with him.  Another mission occurred a few years after our crash when he was on a recovery mission involving a commercial airline accident.  After several hours on the scene, he was asked to take a look at the body of the copilot, who had just been recovered from the wreckage.  It was only upon seeing him that he realized he was looking at his brother in law, who flew for the airline.  He had to break the news to his wife.  It was all part of the job with the CAP.

Jim Nitz stayed active in the Lincoln CAP, although he left Lincoln to move to North Platte to become a Disaster Planner for Lincoln County, Nebraska, where he lives. 

Helen Boman, Dr. Bunting, Gary, Dick, Blanche and Evelyn stayed in Hebron.  Helen was still a nurse at the Thayer County Medical Center when I finally met her.  We remain great friends. 

Dr. Bunting retired and lives with his wife in a little nursing home directly across from the hospital.   

Dr. Pembry moved away from Hebron to live in Omaha several years after our crash.  His own son was killed in an airplane two years after mom, and not far away.  He was flying a crop duster near Hebron and had just finished a run when the wind shifted and blew the pesticide into him.  He lost consciousness and crashed into the field he was spraying.

Gary is still the postman for Hebron, and he and Dick are still volunteer firefighters for Thayer County.  Blanch and Evelyn are retired from the hospital.

Clarke and Sharon Mundhenke stayed in Lincoln.  Clarke left being a pastor at Trinity Chapel and turned towards working the local hospitals as a chaplain full time.  He keeps busy.

Bruce Miller stayed in Lincoln and was the Chief of Staff at Lincoln General for many years.  Bruce retired from medicine, but he continued to be a pilot.  He and my father remained great and lifelong friends, as am I and his son, Greg.  Our lives were strangely parallel.  But that’s a different story… 

Ron Craig also stayed in Lincoln to practice medicine.  He became part of my family’s club when he was flying his airplane out of Winslow, Arizona in 2006.   The engine died at 300 feet as he was taking off.  He managed to point the plane at a road, but it crashed into the desert just beyond and was destroyed.  He and his wife walked away with only bruises.  I would say miraculously, but I know there were no miracles - just a damn good pilot at work.  He was flying again within a month.  My kind of pilot.

Jill died suddenly of an aneurism in 2010.  She was young and healthy and no one can understand why she is gone either.  I think of her sons a lot, and am saddened to know the pain they are now learning.  I pray for them.  I miss her. 

Shelley is still my friend.

I don’t know what became of Ricky Arnold or David McLaughlin.  To me, they are two specters that appeared from nowhere to save us, then disappeared back into the mist.  I have heard that David lives in some tiny town somewhere in Nebraska but the letters I have sent have not reached him, I assume.  I am still looking for both of them.  I would like to shake their hands.

Dad remarried again to Lilly, and he lives in Los Angeles near us and his first grandson.  He will always be a doctor.  He still wears his white coat, and I hope he always will.  He flew a few times after the crash but will never land again.  He says he made his last landing in that field.  It took thirty years for us to go back in our minds to that night in the field and really work it out.  But I know it has been good for both of us.  We got to know each other like we never had.  We are lucky. 

As for me, I wrote about that part of my life.  Learning about it gave me the opportunity to meet some amazing people and reengage the others I did known who were there.  It gave me the opportunity to share with all of them an experience that connected us to one another one cold February, long ago.   

And in doing so I made some additional discoveries I had not anticipated.  Discoveries having nothing to do with ATLS and that are not taught in any course. 

I learned for certain that life isn’t fair…like fairness has anything to do with anything.  We come into this world as perfect little beings, and then are gradually contaminated and corrupted and pulled apart by life.  If we are lucky we get to grow old, wear out, and die.  We spend the time in between trying to figure it all out, but we never do.  We try to avoid the thief of time and that’s the best we can hope for. 

But, through it all, there is goodness and beauty. 

I have my family, who teach me about love every day.  I have friends.  I have mountains to climb and rivers and oceans to swim.  I have clear blue sky to soar through and a wonderful world to explore.   I have air to breathe and I breathe it.  I have life.  It'll never be perfect, but it doesn't have to be.

I took the things I learned and used them to unlock some old doors; let the bats out, clean the cobwebs.  It has indeed been good for me, this journey to the truth.   

Better than I will ever know.  Each day that I find myself above the surface of the earth is indeed a good day, and a new blessing.  I have no illusions about death.  I don’t fear it.  I have dodged it once or twice, but I respect it.  And I know someday it will find me, as it did my mother.  As it does us all.  But when it does, I intend that it will find me thoroughly used.   

And maybe, somehow, its cold touch will finally bring me back to the arms of my mother. 

And everything will be alright.

-ATLS

“Twenty eight years have gone by since that first course in Auburn and ATLS keeps on spreading and growing,” dad said to the audience, looking up from his notes.  “Sort of like a real good malignancy.”

The crowd chuckled, and dad felt the mood of the room lighten.  Dad loosened up a little and continued: 

“What we thought would be a course for rural Nebraska, became a course for the world in all types of trauma settings, from the rural hospital to the level one trauma center to the military. 

“Ireland,” he said giving acknowledgement to this crowd, “joined the ATLS family in 1991.  Paramedics and the nurses all over the world now also have ATLS based courses tailored to them and their specific treatment scenarios. Everyone involved with the trauma victim speaks the same “ATLS” language. This ability to communicate and anticipate at all levels decreases morbidity and mortality in the ‘golden hour.’”

 That was what it was all about.  Dad left Lincoln and surgery and ATLS after over a decade later in 1987, choosing he needed to slow down and take it easy.  He moved to California in obscurity and was content to work his way into workers comp cases.  But ATLS continued through all of those years, very similar to the first course that he, Ron, and Jodie wrote.

Several years later dad started to go down to Ayacucho, Peru in participation of medical missionaries there.  The missions gave him a great deal of satisfaction, as well as a chance to do surgery again.  The conditions made the work very challenging, and often included having restraint or traction devices, or instruments made by a local blacksmith.  He tried to go down every year or so, and for many of the patients that he saw, he was their regular doctor.  Peru had adopted ATLS in the years prior to him going there, but the hospital was still quite primitive by American standards. 

During one of his trips, about 100 miles from the hospital in the mountains near Cusco, a fire fight occurred between the Peruvian Marines and the local insurgents known as the Shinning Path.  Two of the marines were wounded during the battle and were subsequently brought to the hospital.  One had an AK-47 gunshot wound to the abdomen and right arm.  The other had stepped on land mine during the melee, partially amputating the left leg, and sustaining a severe soft tissue injury to his other leg.

 In the rather primitive ER, dad helped stabilize the patients.  The benefits of ATLS immediately were obvious to him.  The Marine personnel and native doctors spoke Spanish, working along with Americans doctors that spoke English.  There was only one doctor who was bilingual.  It was the ‘language’ that was standardized in the ATLS course that became the common thread that was used by both groups to communicate outside the realms of their native languages, enabling efficient, effective assessment and stabilization of the Marines.  They both lived.

“From the beginning of the course over 500,000 students have trained in 46 countries within 25,000 ATLS courses.”  Dad concluded to the crowd before him. 

“24,000 trained Physicians graduate each year from these courses,” Dad said, wrapping up his speech with a smile.  “It looks like we’re on a roll.  I think we might want to introduce it to the moon and Mars next.     

“Compared to what happened in the recent tsunami in Asia,” he concluded with seriousness,  “The terrorist attacks of 9-11 in the US, the disaster on the Gulf of Mexico coast from hurricane Katrina, and the other natural and man made disasters that have occurred in the past thirty years, my family’s experience out in that field was just child’s play.  Hopefully what we have done, all of us who have become a part of the ATLS family, has played a part in saving some of these souls.” 

“Thank you.”

The hall erupted in applause, echoing like thunder across the room.  Everyone was on their feet, and beaming at him.  He felt a little overwhelmed by it.  But he was certainly grateful for the acknowledgement after all these years, even though he never did any of it for fame or money.  He just threw it out and watched to see if it would stick.  He was glad it did, but always knew it was way bigger then just him.  None of it could have happened without the help and interest he got from Ron and Jodie and all of the others.

The President of the college came up on stage and shook his hand vigorously.  Dad smiled, and looked out at the crowd, still applauding.  For a moment, he thought of mom, and was both sad and grateful for her.

-Skip and Irvene

Another doctor who came quickly came on board early on was a noted peripheral vascular surgeon in Lincoln named Paul “Skip” Collicott, who also happened to be a member of the distinguished American College of Surgeons.  Dad and Ron both knew him personally and as a colleague, and also knew that he had the political connections and know how to get things going in moving the ATLS concept to a higher level.  They all knew that the College’s endorsement was critical to get ATLS accepted in any kind of broad way.  Fortunately, Skip quickly became a true disciple of ATLS and gladly took the lead in presenting the course to the College in short order. 

By then, word of the innovation of ATLS had gotten around the Lincoln medical community and people liked what they heard.  More and more doctors approached dad, Jodie, and Ron about the course, joined in, and began to write chapters about their various specialties and the application of those specialties to the ATLS concept for the syllabus. 

Also among those that joined in the fray early was a Lincoln Mobil Heart Team nurse named Irvene Hughes.  She was so taken by the story of what had happened to dad and what was transpiring before her with ATLS that they asked her if she would write the introduction to the course, where she told dad’s story and how it had led them all to that point.  She became the Manager of the ATLS program for The American College of Surgeons Committee on Trauma and remained in that post for the rest of her professional career, spanning from 1982 to 2006.  

The concept of the ABC’s of trauma was further refined through the contributions of everyone and became the definitive way to prioritize the order of assessment and treatment.  Nothing new was added, and there were no research related discoveries or scientific revelations associated with ATLS.  They all just took what was known and organized it in a different, more efficient way for treating the trauma patient.  Simplicity was the key, and as they worked, that key was being turned and would soon open a door bigger than any of them could have imagined. 

Then it was done.  The prototype course for ATLS was field tested in Auburn, Nebraska in 1978 with the help of several groups and individuals who had by then become convinced of ATLS’ relevance and importance to trauma medicine.  It seemed to work.  Armed with the early successes, Skip took the course and presented it to the University of Nebraska, who was also duly impressed and supportive. The University faculty threw their support behind ATLS by providing surgical training facilities to truly field test the concept.  Next, Skip got The American College of Surgeons Committee on Trauma involved, and they too were impressed by what they saw. 

Dad and his friends took the finished course to the thirteen regions of the College and presented their work.  All of the doctors there were intrigued and inspired at what they were presented.  Could it really be that easy?  Could there really be a simple way to standardize trauma care and make it quickly available to all rural doctors? 

It appeared so. 

And, while they were at it, if it was good for them, why not the rest of the world?  The College quickly arborized the course within each region, and ATLS was officially born.  The United States military was one of the first major organizations to adopt it, and they still use it as the basis of combat care for their wounded troops. 

From its inception, the basic concepts have never changed for ATLS and it turned out to be more successful in its application than dad, Ron and Jodie ever hoped for.  Other states in the nation and Canada began to adopt the course through the American College of Surgeons and began to teach the concepts of ATLS to their respective trauma physicians.  ATLS continued to prove incredibly effective and from the US and Canada it moved to other countries all over the world.   

-ABCs

Just like me, my dad had been paralyzed.  With Ron’s words, he got up and began to walk again.  He began to really talk.  His mind began to engage and soon the ideas were flowing from the two of them. 

They had determined early in the conversation that what was really needed was fairly simple:  There was a basic lack of consistency in trauma care and they needed a system to address this inconsistency.  In other words, they needed a method to educate rural physicians in a systematic way to treat trauma that was applicable to all facilities all over the state.  All of the doctors at these facilities were perfectly competent to treat their patients, but many were using out of date or obsolete methods because there was no consistent system, and if there was, there was no way to deliver it. 

The two of them soon managed to get together with a nurse who worked with the Lincoln Mobile Heart Team named Jodie Upright very early in the discussion.  The Mobile Heart Team itself was a recent innovation that dealt with, as the name implied, cardiac trauma and the standardization of cardiac care. 

The three of them hashed the issue out, comparing their own experiences, and quickly decided there was indeed a need for this new system.  They were all aware that if this was possible, it would call for the creation of a training course for the small hospitals – ones like the hospital in Hebron.  These kinds of facilities were literally all over the state, and dad, Ron and Jodie all had the same conclusion through their individual dealings that very little consistency in trauma care existed among any of them. 

And that’s what had caused the problems dad had encountered in Hebron, that lack of consistency.  It wasn’t the standard of care.  Most of these facilities, including Hebron, could handle the emergencies, and most patients didn’t suffer inadequate care.  They probably could have handled us just fine if dad hadn’t lost it.  But in trauma, there could be, and should be, a standard.  A system to deal with all kinds of cases in a similar and by-the-numbers fashion.

They were all aware of and familiar with the work of another Lincoln physician named Steve Carvith, who had created a course with a similar objective called Advanced Cardiac Life Support, which addressed similar issues in cardiac care.  Jodie had worked with Doctor Carvith on that project, so she was a good source of knowledge for how it came about and the format used.  ACLS was a great idea and provided the level of consistency in cardiac care that dad, Jodie, and Ron were looking for in trauma care. 

Influenced by the concepts, and realizing that if something works, you should go with it, they decided to use a similar format, and call the new course Advanced Trauma Life Support (ATLS).  Not too original, they knew, but it seemed to catch on with them, and had a solid sounding ring to it. 

The first thing they knew they had to do was to become experts on the conceptual framework that Steve had developed, so over the next several months they all took courses, and became certified ACLS instructors so that they could learn intimately how the course was organized.  It was hard work and a huge commitment to their professional and personal lives, but they had all become entranced by the project, and to them it was well worth it. 

As they went along, they began to see the enormity of what they had started.  They could see that a lot of help would be needed, if this was going to work.  Intensive training was the key to it, and to do that a syllabus had to be created and arranged into a framework that presented a logical and consistent approach to all manner of trauma. 

Somewhere along the way they had realized that the problem in many trauma cases was the wrong order of treatment.  If a patient was bleeding profusely, sure that looks horrible and could certainly kill them, but the crushed chest you are ignoring while you treat the ghastly looking gusher of blood will kill them quicker than the bleeding itself.  Simply put, a doctor had to understand the necessary order of treatment and treat people appropriately. 

They got the idea that it would be more effective if a doctor could quickly evaluate a patient as soon as they came into the ER, know the severity of the various injuries based on known facts, and fix the worst ones first, and before attacking the next problem.  This, rather than look at every system involved and every problem, figure out which one to treat, and then began treatment - which was pretty much the way it had been done, and was based on the individual doctor, who was, after all, human and limited by his or her level of training, knowledge, and experience.  This created inconsistency. 

They began to call their new concept of the correct order of treatment the ABC’s of trauma.

As they expected, this idea created a bit of controversy and rumbling from the establishment as word of the ABC concept spread.  As it is with many things, it is very difficult to get people, even highly educated and progressive people, to step out of their comfort zone, get away from what they knew, and try something new.  It is no different with doctors; at least it wasn’t at the time.  Doctors see themselves, and rightly so, as the captain of their respective ships.  The call may be right or wrong, but it was still their call.  Some complained that the standardization of the process took the ability away from them to make good decisions. 

Some just had big egos.  But even the staunchest of critics couldn’t argue away the simple logic of the concept, and it began to catch on. Soon that simplicity was implemented into the creation of the ATLS course as its central dogma.  Everything else would be based on the ABC’s.