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November 26, 1995, 2:46 a.m., MIDDLETOWN, DELAWARE

The police radio jolted the emergency medical team awake. "Shots fired," the dispatcher announced, and she gave an address on Adams Street.

Judy and Steve were instantly on the move. Within minutes, they were racing through the chilly November night to a neighborhood on the edge of town. A veteran police officer named Mike was waiting at the two-story, brick house, and a middle-aged man stood on the front porch, frantically waving his arms. "He's in the back yard," the man shouted over the blare of approaching sirens and a dog's hysterical barking. Flicking on their flashlights, Judy and Mike ran to the back of the house while Steve grabbed medical equipment from his car.

The thin beams of light streaked across a concrete patio, and at the edge of the pavement, they found a man lying face down in the grass. A shotgun lay beside him. Blood had sprayed the house's siding and the gray concrete, and some had pooled in the crevices of the patio's stone edging. Dirt and grass surrounding the body were covered in gore. Surely, they thought, this man is dead.

But then Mike saw a sign of life. "He's breathing," Mike shouted. "I can see his breath in the air."

Judy ran to the wounded man's side. "Oh, shit, he's alive!" As she knelt beside him, she noted fresh stitches underneath a torn bandage on his left hand. She had seen this young man just hours before. "My God, this is that same guy with the knife wound we took to the hospital earlier this evening," she said. "Oh, God, why did he do this!"

As she turned the patient onto his side, she saw that he had shot himself in the face. It was difficult for her to assess his injuries because his face was so mangled, but he looked as if his nose, mouth, and eyes had been blasted away. Surely he was beyond saving. He had to be drowning in his own blood.

And even if he could be saved, Judy thought, what kind of life would he have? But she pushed those doubts aside. It was her job to try to save him.

As Judy worked frantically to stabilize her patient, Steve called for a helicopter to transport the patient to a trauma center in Baltimore, about fifty miles away. Mike and others who had responded to the dispatcher's call stood over the wounded man, shining their flashlights down to give the paramedics light. The patient grunted in alarm or pain, and Judy talked to him while she worked, trying to keep him awake.

After the patient was stabilized, he was airlifted to the shock trauma center where a crowd of medical personnel awaited their arrival at the landing pad. As the stretcher was lifted out of the helicopter, the young man's shredded skin and muscle tissue flapped grotesquely in the wind from the propeller. There was an air of orderly chaos with doctors and nurses surrounding the stretcher shouting orders at one another as the patient was whisked down the long hall to the trauma center. He was still conscious and trying to communicate.

Judy knew she had done all she could, and she was relieved that the young man was still alive. But, she wondered, what kind of life would he have now? Had it been an act of mercy-or cruelty-to save him?