Trauma care provides the latest advanced treatments for traumatic injury and illness.
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Lewis Dilts was dozing on the floor of the minivan, with a pillow and blanket, the steady sound of cars whizzing past on the highway.
His 18-year-old body was worn out. His day had started at 4:30 a.m., spent in 90-degree blistering heat building a massive chicken coop in North Vernon, Ind.
He and four other teenage boys -- all who had just graduated from Bishop Chatard High School -- were working the same job, laying concrete and putting bricks underneath rebar.
Lewis desperately needed this nap. So, on that 90-minute drive back home to Indianapolis with those four other boys in the van, the steady, tiny bumps and bounces had lulled Lewis right to sleep.
But that nap didn’t last long.
Lewis was jolted awake by the sound of Patrick Brogan yelling. He awoke to the van shaking.
He tried desperately to grab on to something, something to keep him from being jostled and jerked about as the van became the enemy.
Then. It all went black.
And in that blackness, the nightmare began.
On June 30 at 4:45 p.m., that van with five teenage boys skidded through a median on Interstate 74 in Shelby County, causing it to roll over, flip as many as 10 times and become airborne.
Lewis, a star high school quarterback and baseball player headed to Manchester University, was thrown out the back window. He landed on the windshield of a car that had struck the van and then bounced off and was tossed again.
“The next thing I remember was waking up sideways on the side of the road,” Lewis, now 19, said from his family’s Indianapolis home this week. “I don’t even know how to describe the pain. The worst pain you could possibly think of.”
Lying there on the side of the road, Lewis wasn’t sure he would make it. It felt like torture. He started wailing.
Still buckled in the front passenger seat, then 18-year-old Patrick Brogan awoke in a van that was upside down.
His mind was racing. He saw his twin brother Tim unconscious with half of his body in and half of his body hanging out the shattered back window. Tim had been unbuckled and asleep in the van like Lewis when the crash occurred.
Patrick saw Luca Ruby, then 19, lying in the middle part of the van lifeless and unconscious. He had been sitting in the bucket seat behind the driver, with his lap belt on but his shoulder strap off.
Outside, Patrick saw the driver of the van, Doug Hirschfeld, then 18, sitting on the side of a grassy hill in shock. He had been wearing his seatbelt.
Patrick crawled out the front window and started running around the van. And then he heard the wails.
“Lewis was on the road screaming,” Patrick says. “I went to him and said, ‘Hey, it’s going to be OK.’”
But Patrick didn’t really know that. He didn’t feel like it was going to be OK.
Emergency personnel saw Patrick running about and stopped him. They weren’t sure of his injuries. Someone handed him a sweatshirt and told him to lie down near Lewis.
“I kept asking, ‘Is my brother OK? Is he alive?’” Patrick says. No one would give him an answer.
Then Patrick heard a LifeLine helicopter. He didn’t know it then, but Lewis and Tim had extreme, life-threatening injuries. Lewis was heading to IU Health Methodist Hospital by ambulance.
That LifeLine helicopter -- it was for his brother Tim.
The evening was a perfect one to grill out. Tim and Beth Brogan and their youngest daughter, Maureen, were all at home. Their older daughter Molly was at Purdue University taking summer school classes.
Their sons, Patrick and Tim, were heading back from their summer construction job.
The Brogans were hanging out in the backyard, ready to fire up the grill, laughing and relaxing when the phone rang with an unknown number. Maureen answered to a strange woman asking for her mom.
“There’s been an accident. Patrick gave me your number. It happened on I-74. It’s very serious. The van flipped. No, don’t come out to the accident. Go to Methodist. Just go to Methodist.”
Beth started repeating everything that woman had said to her over and over, out loud to the family. The woman, who turned out to be one of the first responders, handed her phone to Patrick so he could talk to his mom.
He was OK. Beth let out a sigh of relief.
“Is Timmy OK?” Beth asked Patrick. “Where is Timmy? Find him.”
Patrick kept giving his mom the same answer.
“I can’t look at Timmy. I can’t look at him, mom. Sorry. Sorry. I can’t see him. I don’t want to look at him.”
Trauma surgeon Dr. Jennifer Hartwell was standing near the emergency department at Methodist when her pager went off after 5 p.m.
A Level I trauma patient was on the way. Dr. Hartwell barely had time to register that when her pager went off again. Another Level I trauma patient was headed to Methodist.
Lewis arrived first, then Tim.
“What I recognized immediately was both of those boys needed to go to the operating room,” Dr. Hartwell says.
They needed emergency surgeries. They were bleeding profusely. Lewis had a huge cut on his abdomen.
“I knew he had blood in his belly,” Dr. Hartwell says. And she saw rectal bleeding. “He had signs of internal bleeding from the outside.”
Lewis was the first taken up to surgery. Tim went up to surgery as soon as he arrived.
“The tough part about that night was having those two really, really sick kids come in at the same time,” says Dr. Hartwell, “and both needed surgery.”
Methodist, the largest Level I trauma center in the state and the 15th largest in the nation, was able to accommodate.
Two other trauma surgeons were called in immediately, Dr. Stephanie Savage and Dr. Ben ZarZaur. General surgeon Dr. Leonidas Koniaris also came down to help. And very quickly, the orthopedic team, urology team and interventional radiology were involved -- and dozens more.
“People just started appearing,” says Dr. Anthony Sorkin, an orthopedic surgeon, specializing in trauma. “People came in when they didn’t have to. People stuck around because they knew these kids were sick. There were nurses everywhere. This was really a shining moment for the operating room at Methodist.”
It wasn’t chaotic, as might be expected. It was more like an orchestra, Dr. Sorkin says, with everyone working together for one purpose. Each operating room had 12 to 15 people in it, some recording life-saving stats, others reading off numbers of units of blood given and anesthesiologists keeping tabs.
Instead of the usual three to four, there were eight people all gathered around the operating table, trying desperately to save those boys’ lives.
“It is in those initial 12 hours after a crash when decisions are made that allow a patient to live or die,” Dr. Sorkin says. It was in those 12 hours that the Methodist team hunkered down.
And it was in those first hours that Lewis’ mom and dad, Brian and Sarah Dilts, found out how bad their son really was.
They were in the waiting room, where hundreds of teens and parents, Bishop Chatard teachers and administration and family friends had gathered.
Dr. Hartwell walked out to talk to the Dilts, also the parents of Leo, 15, Sally, 14 and Willie, 8.
“I remember she looked at me and said, ‘He’s a sick boy,’” Sarah says. “He’s a very sick boy.”
Sarah looked at Dr. Hartwell, looked right in her eyes: “What do you mean? Out of the woods?” Sarah asked her.
And as Sarah looked in Dr. Hartwell’s eyes, she saw tears as the surgeon answered: “I’m doing everything I can to save him.”
By that time, Lewis had already been given 43 units of blood. He was bleeding so profusely he had to be put in a body bag just to hold all the blood that was seeping out.
Lewis and Tim had both been in interventional radiology trying to determine where the blood was coming from. Within the first 24 hours, Tim was given 70 units of blood.
Both boys had broken bones and vertebrae. Tim lost portions of both his lungs. Both boys lost their spleens. Tim had traumatic brain injury. Lewis had severed arteries when his pelvis shattered. And so many more injuries, too many to name.
By the time both families got to see their boys, it was the wee hours of the morning of July 1.
“They brought us back into the ICU and they were still hooking up bags of blood, non stop,” says Brian Dilts.
Lewis was intubated and swollen. He was cut and had severe road rash.
Tim and Beth Brogan were amazed as the nurses took in the red chests of blood one after another and gave it to their Timmy.
“I was always saying, ‘There is hope. There is hope right?’” Beth says. “And they would always say, ‘Yes, there’s hope.’”
Turns out, there was not only hope for Tim. There was hope for Lewis.
Both those boys, in what doctors say is nothing short of a miracle, survived that horrific crash.
For Tim, the first sign the family got was a hang loose hand signal. Weird. He wasn’t a “hang loose kind of kid,” Beth says.
Tim also had a squishy ball he would squeeze in his hand and throw to people at their request.
For Lewis, there was the time he started typing in the air. That’s when Brian knew his son wanted to know if his cell phone was there. There was also the day Lewis pointed to his neck. He wanted to make sure the Saint Christopher medal that he wore every day had been saved. It had.
But, perhaps, the most touching moment was when Sarah – a speech therapist – had Lewis try to spell by writing on her hand.
As she held out her palm, Lewis spelled “T-i-m-m-y.”
Had Lewis seen Timmy hanging out of the back of that van unconscious as he lay there on the side of the road?
“We let him know that Timmy was here, too,” Sarah says. “We let him know everyone had made it.”
Patrick was the lucky twin. He had a cut on his head stitched up that night at Methodist – without pain medicine -- and was released.
But the trauma from the accident was just as severe for Patrick, emotionally.
Sometimes, with Tim’s injuries overshadowing his, Patrick will joke that he feels like people forget he was even in the van that evening.
Tim had a T-shirt made for Patrick. On the front it says: “I Was In The Accident Too.”
The driver of the van, Doug Hirschfeld, was treated and released at Methodist. He just finished his freshman year at Indiana University.
Luca Ruby, who also was critically injured and remained in intensive care after the accident, just finished his first year of college at Manchester University.
After taking the fall semester of his freshman year to recover, Lewis joined Luca in the spring and finished a semester at Manchester. He will go back in August, majoring in accounting and playing on the baseball team as a catcher.
Tim, a kid with a genius sense of humor and goofy demeanor, is heading off to his first year of college at Hanover College, where he will major in pre-physical therapy.
He had planned to go into computer science but he really liked his physical therapy after the accident and wants to focus on kinesiology.
Patrick just finished his freshman year at DePauw University. He’s set in the upcoming year to finalize a major – either environmental biology or environmental geoscience. He often thinks about the accident.
“A lot of times, I wonder, ‘What if someone were to have actually died?’” Patrick says. “It’s kind of crazy how we’re all still alive.”
Crazy. And great. And miraculous.
“They both came as close as you can get, in my opinion, to not making it,” Dr. Sorkin says. “But they not only made it…they really made it.”
Tim says he doesn’t think too much about why he lived. Or why he didn’t die.
Lewis is a bit more philosophical. Just this month, at his landscaping job, he walked back to a reservoir and looked out onto the water.
“I was like, ‘This is the best view ever. Look where I am right now. This is awesome,’” he says. “A year ago, I wouldn’t have done that. Now I just think, ‘Live everyday like it’s your last.’”
Trauma care provides the latest advanced treatments for traumatic injury and illness.