PTSD sufferers have to work hard to persistently avoid memories, thoughts, feelings, and external reminders such as people, places, conversations, activities, objects, and situations that they closely associate with the traumatic event. For 47-year-old Patty, a teacher whose husband of twenty-five years, Michael, was killed when she lost control of her micro-car and it slammed sideways into the rear of a stopped semi-truck, avoidance meant unplugging from what was formerly a rewarding, colorful life.

Prior to the accident, Patty disregarded the sage advice she’d given her sons, Jordan and Kyle: “Ignore your phone while you’re driving. Whoever is calling can wait.” That rainy Thursday night in November, Patty and Michael were driving home from their weekly dinner date when her phone rang.

An uptight combination of irritation and worry, Patty had been distracted all evening, checking her voicemail to see if she’d missed a call from Jordan, whom she had not spoken in a few days. He’d been non-committal about coming home for Thanksgiving, which was two weeks away, but mega-planner Patty liked to have all her ducks in a row. More than that, though, if Jordan wasn’t planning to join the family, he’d better have a good reason why.

She was only momentarily distracted as she reached for the floorboard and tried to grab the phone from her purse, but that was enough time to veer into oncoming traffic. Michael yelled and jerked the steering wheel. Startled, Patty over corrected and went into a slide-and-spin on the rain-slicked road.
Seconds after the deafening collision, Patty opened her eyes—she didn’t even realize she’d closed them—to find that she had thrown her right arm across Michael’s chest, just as she would have instinctively done had the passenger seat been occupied by one of her sons. Her husband’s head was cocked to the side, and his throat gurgled. She watched in horror as a nearly-translucent blood-tinged bubble formed on his lips and popped.

Patty gasped, screamed, “Michael! Baby, look at me!”

He didn’t turn to her, but she was nonetheless relieved to feel his chest rising and falling . . . Wait. Was it moving? Or was her hand shaking? . . . She couldn’t tell for certain. As if in answer to her unspoken question, blood ran out of his nose and over his lips, the rivulets streaming over the Dallas Cowboys insignia on his sweatshirt.
As Patty watched, Michael’s body relaxed, and his head came to rest on his left shoulder. She took his face in her hands and tilted it up so that she could see his eyes, but they were rolled back in his head, and the whites were full of blood.

“N-n-no! No, no, no! Michael, no!” She recoiled at the sight, covered her face with her hands, then, thinking that was happening could not be real, she checked him again. Patty felt for a pulse on his neck, then his inner wrist, and, finding none, she screamed in horror.

Emergency vehicles arrived within minutes. Patty was too hysterical to respond to the medics. The rescuers’ voices seemed loud as they talked about her and Michael as if she could not hear them. A fireman cut her seat belt away, and she felt herself being removed from the car and lifted onto a stretcher. She was surprised at the biting cold and momentarily confused about what month it was; why it was so chilly outside. Someone put a heavy blanket over her, pulled it up to her chin, and light rain pelted her face. Patty stared at the fog encircled street light as the gurney gently bump-bumped over to the ambulance, then seemed to elevate and collapse at the same time as the medics slid her into the bright light and warmth.

Some time later, Patty was determined to be physically stable; regardless, she refused to leave the scene to be checked more thoroughly at the E.R. She watched through the ambulance door windows while firefighters maneuvered her tiny car away from the semi. As they used a scissor-like tool to cut away the crushed metal that had been the passenger door, a horrible realization invaded the blurry edges of Patty’s understanding: the firefighters were not in a hurry.

She knew from taking his pulse that Michael was dead—Wait, no, that can’t be right. Why aren’t they being more careful? That big tool they’re using could . . .They need to be careful or else they’ll… No, this can’t be happening. I am going to wake up any minute.

Moments later, the micro-car resembled a shredded tin can. The firemen stepped away from it. Some of them crossed their arms, pulled their collars up against the drizzle and cold. They chatted, gesticulated, shook their heads, and appeared to be waiting for something.

Patty’s perception was that nothing was happening, and she switched into bossy mode. “Why is my husband still in the car? How can they help him if they don’t get him out?”

The EMT monitoring her in the ambulance spoke softly. “Ma’am, your husband is deceased. He will be removed from the vehicle when the medical examiner’s team arrives.”

Patty’s voice was so squeaky-high that she didn’t recognize it as coming from her. “Are—are they going to put him in—one of those black zipper bags?”
“Yes, ma’am. He will be placed in a body bag for transport.”
Patty shook her head vigorously, muttered to herself, “This—this can’t be happening. It can’t. No. No.” She patted her pockets for her phone. “Where’s my—my—you know, my—”
Wordlessly, the medic reached onto a shelf behind the cab and handed Patty her purse. When she could not find her phone, she dumped the contents on the floor of the ambulance, then retrieved her phone and glanced at it.
On the screen, a message: One missed call.

Jordan and Kyle arrived on-scene as the medical examiner’s transport squad unrolled a body bag and placed it on a gurney beside the car. A cop gestured toward the ambulance where Patty’s sons stood outside it with her. The young men flanked their mother, a heavy blanket draping the three of them, their faces a mixture of anguish and disbelief. Two members of the medical examiner’s transport team held up a sheet as they created an impromptu curtain to block the family’s view of Michael’s body being removed from the vehicle.
The days immediately following the accident were a blur. Family and friends from near and far comforted Patty and her sons. Patty’s sister, Jolie, took charge when no one knew what to do. This is what the women in their family did, and they were good at it. She also served as Patty’s guard dog when the inevitable queries of “How did it happen?” were made.
It was a question better left unasked.
Patty didn’t want people to know that the phone distracted her; that she’d lost control of the car; and that Michael never wanted her to have that goddamned car in the first place.
The months-old fire-engine-red micro-car was no longer “Patty’s cute little car” or “Patty’s birthday gift to herself.” It was “that goddamned car.”

In the months prior to the tragedy, Patty and Michael fought about Patty’s purchase of the micro-car. A biology teacher, Patty was in love with the idea of driving an environmentally friendly car, plus she loved that it was built for two. Just two. Ecstatic to shake off the aged minivan she’d driven for years, her new car was more than a replacement for the “soccer mom” minivan that had wheezed its last. Patty’s Cute Little Red Car was a symbol of being kid-free, yet still young enough to run around and have fun.

Michael, on the other hand, regarded the micro-car as a death machine, and that’s exactly what he called it. “I just want there to be more metal between you and whatever’s ahead of you,” he’d insisted. “What’s wrong with getting an SUV? You can still buy a bright red one.”
Patty huffed, “I am 47 years old, and that is more than old enough to make my own decision about a car. I make my own money and whether you approve or not, I’m buying myself a cute little red car for my birthday. At least one of us still wants to have fun.”
When Michael came home that evening and saw the micro-car in the garage, he threw up his hands in surrender and didn’t say a word about it. He wasn’t thrilled, but after twenty-five years, he knew better than to get in his wife’s way when she made up her mind.
In spite of his determination to say a whole lotta nothin’ about her purchase, Patty goaded him for a response until he lost his cool. “Fine! You did what you wanted. As usual. Do me a favor? Make sure your life insurance is paid up. If you die in that thing, I’ll just trade you in for a newer model.”

That rainy night in November, they’d spat about which car to take to their usual date-night restaurant. When Michael balked at riding in her car, Patty accused, “Your pride is hurt because I made a decision without you, and I didn’t need you on the title to buy it. Suck it up and deal, Michael.”
As usual, Michael gave in to her iron will. “Fine, we’ll go in your death machine. I’ll drink enough tequila that I can’t see the Grim Reaper coming for me when I die.”

Patty went back to work two weeks after Michael’s death. She was emotionally flat, unable to think well enough to construct lesson plans, and prone to breaking down in class then bolting from the room, leaving the students unattended. Still, trudging through work was preferable to being alone in their house. She craved the routine and structure of the school day; she thought of being at school as wearing “her teacher self.” Maintaining the façade was exhausting, and she wasn’t doing nearly as good a job at it as she thought she was, but she clung to the familiarity.

When she had a good day—which meant she’d made it through without breaking down even once, at least not in front of the students—she could almost forget that her husband was dead, and that she killed him with that goddamned car.

Once a social butterfly, Patty stopped eating lunch in the teacher’s lounge with her friends. She dreaded questions about her well-being that they’d ask in that voice, their eyebrows forming question marks, and the thought bubble over their heads that only Patty could see: “If I were you, I’d kill myself.”
The heavy cloud of grief darkened every aspect of Patty’s life. As a mentor, department head, and outspoken (of course) leader, Patty found much satisfaction in being an educator. But since returning to work and discovering herself to be a fundamentally broken person, she discovered a new normal that included increasingly terse emailed reminders from her principal about missing lesson plans and unreturned parent phone calls.

Although always prefaced with, “I know you’re still getting back on your feet,” Patty found the emails harsh, cruel, and just one more reminder that Patty-before-the-wreck was as dead as Michael. She stopped opening her emails and avoided the message board in the workroom.

Seven months after his death, Patty could not get the image of Michael’s bloodied face out of her mind. She avoided sleep out of fear of the recurring nightmare in which she is thrown from the car and finds Michael’s severed head in a ditch.

She bought a used SUV—the color didn’t matter—but drove as little as possible.

Patty no longer attended Kyle’s sporting events because she believed that all the other parents were pointing at her, talking about Michael’s death and her role in it. In addition to being lonely and isolated, she became increasingly angry that Jordan and Kyle seemed to have bounced back and gone on living. Jordan followed his job out of state, and Kyle was excited to be leaving soon for a university hundreds of miles away. Patty felt abandoned by her children. She didn’t want to live by herself.
She could not bring herself to remove Michael’s possessions from their closet. She even sealed some of his shirts into plastic bags so they would retain his scent. She couldn’t move Michael’s toothbrush from his side of the bathroom counter, and she wouldn’t wipe up his whiskers that remained on the edge of the sink. If one were to walk into their house, one would believe that Michael was merely at work, as opposed to dead.

The first week of June, Patty’s sister, Jolie, came for a visit. While Patty was at the grocery store, Jolie deep-cleaned the master bathroom, threw away Michael’s toothbrush, and began boxing up his belongings. When Patty returned to find her husband’s whiskers no longer on the bathroom counter, she said things to Jolie that would prove to be difficult to take back.

The school year concluded the following week. After her students departed on the last day, Patty locked her classroom door and turned to leave. She jumped when she found Angela, her neighboring teacher, immediately behind her.

Angela, who had recently emerged from a painful divorce and an ensuing mental meltdown, gave Patty a closed-mouth smile as she held out a business card.
Patty took the card without thinking, read aloud the heading: “Clinical Psychologist,” and looked at Angela questioningly.

Angela shrugged. “What can I tell you, Patty? This man—Scott Matthews—everyone calls him Dr. Matt—pulled me out of myself and helped me figure out why the sun still comes up each day. I had assumed that it flamed out with my marriage, you know? . . . I’ve been watching you, and I think you need help. I’m worried about you. Please. Get some help.”

Patty grimaced and tried to return the card. “I’m not to that point, but thanks. I don’t go to other people for . . . that. I don’t talk to—”

“Listen!” Angela’s eyes filled with tears eyes as she took Patty’s hands in her own, folded her fingers over the card, and whispered, “I care about you. I know you’re in pain. But there is a way out, if you’ll take it.” She turned and walked briskly away, not giving Patty a chance to argue.

Two days later, after Kyle left to meet a friend for a movie, Patty attempted suicide by mixing anti-anxiety medication with alcohol. Kyle returned home to find his mother passed out on her bed, a suicide note on her nightstand. He called 911, praying silently that his mom would not die, too.

Patty survived. She was hospitalized until stable, released to Jolie’s care, and promised her anguished sons that she would seek help.