In 133-Vehicle Pile-Up, Bleeding Paramedic Helps While Hurt

Trey McDaniel, paramedic, as told to Sarah Yahr Tucker

August 02, 2023


Emergencies happen anywhere, anytime, and sometimes medical professionals find themselves in situations where they are the only ones who can help. Is There a Doctor in the House? is a Medscape series telling these stories.

It seemed like a typical kind of day. I was out the door by 6:00 AM, heading into work for a shift on I-35 West, my daily commute. It was still dark out. A little bit colder that morning, but nothing us Texans aren't used to.

I was cruising down the tollway, which is separated from the main highway by a barrier. That stretch has a slight hill and turns to the left. You can't see anything beyond the hill when you're at the bottom.

As I made my way up, I spotted brake lights about 400 yards ahead. I eased on my brake, and next thing I knew, I was sliding.

I realized, I'm on black ice.

I was driving a 2011 Toyota FJ Cruiser and I had it all beefed up ― lift tires, winch bumpers front and back. I had never had any sort of issue like that.

My ABS brakes kicked in. I slowed, but not fast enough. I saw a wall of crashed cars in front of me.

I was in the left-hand lane, so I turned my steering wheel into the center median. I could hear the whole side of my vehicle scraping against it. I managed to slow down enough to just tap the vehicle in front of me.

I looked in my passenger sideview mirror and saw headlights coming in the right lane. But this car couldn't slow down. It crashed into the wreckage to my right.

That's when it sunk in: There was going to be a car coming in my lane, and it might not be able to stop.

I looked in my rearview mirror and saw headlights. Sparks flying off that center median.

I didn't know at the time, but it was a fully loaded semi-truck traveling about 60 miles an hour.

I had a split second to think: This is it. This is how it ends. I closed my eyes.

It was the most violent impact I've ever experienced in my life.

I had no idea until afterwards, but I had slammed into the vehicle in front of me and my SUV did a kind of 360° barrel roll over the median into the northbound lanes, landing wheels down on top of my sheared off roof rack.

McDaniel in a post-accident interview and his wrecked SUV.

Everything stopped. I opened my eyes. All my airbags had deployed. I gently tried moving my arms and legs, and they worked. I couldn't move my left foot. It was wedged underneath the brake pedal. But I wasn't in any pain, just very confused and disoriented. I knew I needed to get out of the vehicle.

My door was wedged shut, so I crawled out of the broken window, slipping on the black ice. I realized I had hit a Fort Worth police cruiser, now all smashed up. The driver couldn't open his door. So, I helped him force it open, got him out of the vehicle, and checked on him. He was fine.

I had no idea how many vehicles and people were involved. I was in so much shock that the only thing I could do was immediately revert back to my training. I was the only first responder there. No ambulances on scene yet, no fire. So, I did what I know how to do ― except without any tools. I tried to triage as many people as I could.

I was helping people with lacerations, back and neck issues from the violent impacts. When you're involved in a mass casualty incident like that, you have to assess which patients will be the most viable and need the most immediate attention. You have greens, yellows, reds, and then blacks ― the deceased. Someone who doesn't have a pulse and isn't breathing, you can't necessarily do CPR because you don't have enough resources. You have to use your best judgment

Meanwhile, the crashes kept coming. I found out later I was roughly vehicle #50 in the pileup; 83 more would follow. I heard them over and over ― a crash and then screams from people in their vehicles. Each time a car hit, the entire pileup would move a couple of inches, getting more and more compacted. With that going on, I couldn't go in there to pull people out. That scene was absolutely unsafe.

It felt like forever, but about 10 minutes later, an ambulance showed up, and I walked over to them. Because I was in my work uniform, they thought I was there on a call.

A couple fire crews came, and a firefighter yelled, "Hey, we need a backboard!" So, I grabbed a backboard from their unit and helped load up a patient. Then I heard somebody screaming, "This patient needs a stretcher!" A woman was having lumbar pain that seemed excruciating. I helped move her from the wreckage and carry her over to the stretcher. I started trying to get as many people as I could out of their cars.

Around this time, one of my supervisors showed up. He thought I was there working. But then he asked me, "Why is your face bleeding? Why do you have blood coming from your nose?" I pointed to my vehicle, and his jaw just dropped. He said, "Okay, you're done. Go sit in my vehicle over there."

He put a stop to me helping out, which was probably for the best. Because I actually had a concussion, a bone contusion in my foot, and a severely sprained ankle. The next day, I felt like I had gotten hit by a truck. (I had!) But when you have so much adrenaline pumping, you don't feel pain or emotion. You don't really feel anything.

While I was sitting in that vehicle, I called my mom to let her know I was okay. My parents were watching the news, and there was an aerial view of the accident. It was massive ― a giant pile of metal stretching 200 or 300 yards. Six people had perished, more than 60 hurt.

That night, our public information officer reached out to me about doing an interview with NBC. So, I told my story about what happened. Because of the concussion, a lot of it was a blur.

A day later, I got a call on my cell phone and someone said, "This is Tyler from Toyota. We saw the NBC interview. We wanted to let you know, don't worry about getting a new vehicle. Just tell us what color 4Runner you want."

My first thought was: Okay, this can't be real. This doesn't happen to people like me. But it turned out that it was, and they put me in a brand new vehicle.

Toyota started sending me to events like NASCAR races, putting me up in VIP suites. It was a cool experience. But it's just surface stuff ― it's never going to erase what happened. The experience left a mark. It took me 6 months to a year to get rid of that feeling of the impact. Every time I tried to fall asleep, the whole scenario would replay in my head.

In EMS, we have a saying: "Every patient is practice for the next one." That pileup ― you can't train for something like that. We all learned from it, so we can better prepare if anything like that happens again.

Since then, I've seen people die in motor vehicle collisions from a lot less than what happened to me. I'm not religious or spiritual, but I believe there must be a reason why I'm still here.

Now I see patients in traffic accidents who are very distraught even though they're going to be okay. I tell them, "I'm sorry this happened to you. But remember, this is not the end. You are alive. And I'm going to do everything I can to make sure that doesn't change while you're with me."

Trey McDaniel is a paramedic with MedStar Mobile Healthcare in Forth Worth, Texas.

Are you a medical professional with a dramatic story outside the clinic? Medscape would love to consider your story for Is There a Doctor in the House? Please email your contact information and a short summary to .

Read more in the series:

A Death Valley Crisis Forces an MD to Use All Her Training

MD Rushes in After Lightning Strikes Four People at White House

Sudden Bedtime Aneurysm Turns MD Couple into Doctor-Patient

Doctor Spots a Gunshot Victim Staggering Down His Street

Doctor Saves Choking Girl at a Baseball Game, Field of Dreams-Style

Read the entire series here.

For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.