‘That boy’s dead’

Raised in an affluent, loving family on the Main Line outside Philadelphia, Matt Miller was a straight-A student with a sculpted body that even a Greek god might envy.

He had a devoted girlfriend and the brightest future — shooting for medical school.

Matt was not without his vanities. He loved to wear sleeveless shirts to show off his shoulders and biceps, and his teammates on the Virginia swim team nicknamed him “Sleeves.”

At college last fall, the 20-year-old pursued a new love — triathlons.

On Sunday, Nov. 2, a gorgeous autumn morning, Matt set out on an 85-mile training ride with two classmates.

They had the hubris of youth — they were going to pedal up mountains.

After their steepest climb, to an elevation of 2,640 feet at Reed’s Gap, they paused to peel off a layer of clothing, eat an energy bar, and briefly savor their accomplishment.

That is the last thing Matt remembers of that day.

The trio then cycled north on the Blue Ridge Parkway, a two-lane ribbon in the sky.

Passing them going south was a caravan of 30 classic cars, taking a foliage tour.

About 10:30 a.m., at milepost 12.2, Matt lost control of his bike. He swerved across the double yellow line, and, as he fell, flew face-first, like a torpedo, into an oncoming Porsche, the second-to-last car in the caravan.

The driver of the last car saw Matt hit the Porsche, flip in the air, and land on the road — motionless, still clipped in to his pedals.

“That boy’s dead,” he told his wife, next to him in their 1970 MGB GT.

Just a moment earlier, celebrating at the summit, Matt Miller, so fit his resting pulse was 42, had believed he could overcome any challenge that life presented.

Barely alive

The driver of the MGB just happened to be Mark Harris, an anesthesiologist at Martha Jefferson Hospital.

In all his years in classic-car caravans, Harris, 60, had never gone last, in the sweeper position, with the responsibility of stopping for any cars that broke down and radioing up the line for help.

Had he been in any other position, he likely would have motored on toward brunch at the Peaks of Otter lodge, never knowing what had happened behind him, especially because the walkie-talkie given him that morning didn’t work.

But he was last. And he was out of his car and at Matt’s side in seconds.

Matt was alive, but barely.

“He was not breathing,” Harris recalled, “and he was making the kind of posturing that indicates significant brain damage. He was bleeding out of his mouth and from his ear, which indicates a skull fracture. His face was completely crushed.”

Harris assessed his options and made a “battlefield decision” to move aggressively.

“If he had a neck injury he might be paralyzed,” Harris recalled. “But if I didn’t do something to get him breathing again, he’d be dead.”

Harris cradled the bleeding youth in his lap.

“His jaw was fractured on both sides and was completely loose,” said Harris. “All his teeth were smashed.”

Matt was unconscious. Harris turned him on his side so all the blood would spill into the doctor’s lap rather than down Matt’s throat. He cleared out all the broken teeth with his fingers, and then — what few people would have known to do — tugged Matt’s shattered jaw forward.

“It’s a painful stimulus,” Harris said. “The idea is if you provide a painful stimulus, they will breathe on their own.

“I hurt him as best I could to get him to breathe.”

Matt started to breathe.

“All these are basic strategies of airway management,” Harris said. “They’re not exceptional. They’re things I happen to use on a daily basis in my medical practice.”

That’s one way of looking at it. Here’s another, from Matt’s father, Mike Miller:

“That Dr. Harris was in the last car, that he was an anesthesiologist, the best person in the world to open an airway, that he was there to save Matt’s life — that is, plain and simple, a miracle.”

Ambulance arrives

Matt’s fellow riders, Rudy Kahsar, president of the UVa triathlon club, and Chris Morrow, saw the accident happen. The three had been riding single file, with Matt in the middle.

Rudy, in front, heard “a little something” as Matt struggled for control of his bike, and looked back. All he can figure is Matt got distracted by the vintage cars, drifted to his right, off the edge of the pavement, and overcompensated, losing control.

The Porsche had no time to veer or brake, and for a split second Rudy and Chris saw the inevitability of what was about to happen.

They reached their friend as Harris did. He told them to dial 911, which they did so many times in the next few moments that the 911 operator told them to stop calling.

Pulling Matt’s jaw had triggered his fight-or-flight mechanism. Matt’s brain sensed pain and started the body breathing to prepare for flight.

And that was what Matt tried to do — get up and flee.

Harris used his own legs to wrap Matt’s legs in a scissors grip, to keep him from getting up and running, just like a wounded deer, into the woods, where he certainly would have died.

Rudy and Chris helped hold Matt down and tried to speak to him, but he was unresponsive. Rudy took off Matt’s helmet, covered in blood but undamaged.

In 10 minutes, an ambulance from Wintergreen Fire and Rescue arrived.

“I thought it was an eternity,” said the doctor’s wife.

“It felt like forever,” said Rudy.

“It got there quickly,” said Harris.

R.W. Woody, the medic, responded without his partner — and was grateful to find Harris.

Matt was thrashing and combative, which Woody took as a sign of brain injury. He instantly radioed for a helicopter.

His partner arrived moments later, and the ambulance raced Matt the mile and a half back to Reed’s Gap, where the parkway was wide enough for a chopper to land.

As the ambulance drove away, Mary Ann Harris remembers her husband telling her: “I don’t think he’ll make it to the hospital.”

Parents hear the news

Matt’s parents, Nancy and Mike Miller, are UVa alumni who had flown in from Philadelphia for the Virginia-Miami football game on Saturday, the day before.

Matt’s older brother, Michael, also an alumnus and a student at Stanford Law School, had flown in, too.

Mike Miller had been annoyed that Virginia, in typical fashion, had lost the game in the final moments.

“I got a better perspective on things quickly,” Matt’s father recalled.

After the game, Matt had told his parents that he wouldn’t see them in the morning, that he’d be riding into the mountains.

“Just be safe,” Mike Miller told his son.

The Millers were approaching the Charlottesville airport around 11 Sunday morning when they received a phone call from a very distraught Emily Privette, Matt’s girlfriend since their senior year of high school, who had transferred to Virginia in September.

Rudy, desperate to reach Matt’s parents, had gotten word to Emily via a chain of phone calls. She knew only that Matt had been in a terrible accident and was being flown to the UVa Medical Center.

The Millers turned around and drove, in the longest ride of their lives, nine miles back to the hospital. When they arrived, the chopper blades were still turning.

The first person to greet them was a chaplain.

“I want to see a doctor, not a chaplain,” barked Mike Miller, a managing director at Vanguard, the mutual-fund company in Malvern, Pa., who says he probably barked many things that day that he now regrets.

They were ushered into a private waiting room, not allowed to see their son, not given any information.

A doctor finally came in.

“Could our son die?” Mike asked.

“Yes.”

The emergency room

A year earlier, in the fall of his sophomore year, Matt had decided he wanted to go to medical school.

At Virginia, undergraduates can sign up to shadow physicians around the hospital. But Matt had missed the deadline. So he called his father to ask for advice.

Mike Miller, who sits on the Board of Visitors of the Temple University School of Medicine, called its dean, John Daly, who — after a phone conversation with Matt — connected him with his good friend and chief of surgery at Virginia, John Hanks, who had missed a few deadlines himself over the years.

Hanks invited Matt to shadow him.

Many, many undergraduates start out in the shadowing program, Hanks said. But “nine out of 10” quickly decide medicine is not for them and stop coming. Others are blatantly angling for a letter of recommendation.

But Matt “struck it just right,” Hanks recalled. He was earnest, respectful, and interested. “He bonded with everybody. Even the med students liked him. We sort of brought him in on the team, as the mascot.”

Hanks happened to be working in his office that Sunday when Matt arrived in the emergency room.

“The trauma chief calls me and says, ‘There’s a guy that you know. He’s an undergrad,’ “ Hanks recalled. “I don’t know that many undergrads, and I can’t imagine who it is.

“Holy smokes, it was Matt.”

“He literally wasn’t recognizable. His face looked like a pumpkin, pushed in on the left side.”

J. Forrest Calland, the trauma doctor in charge of Matt’s care, who had finished his fellowship in trauma surgery at the University of Pennsylvania in 2007, said Matt’s face “was essentially soft, like mashed potatoes.”

Had he put his thumb inside the roof of Matt’s mouth and pulled, Calland said, Matt’s whole face would have moved forward.

Calland, like everyone else, worried about brain damage. What had happened to Matt’s brain, he said, “was the equivalent of throwing your laptop out the second-story window.”

Hanks, understanding the severity of the injury, found the family in the waiting room and took Mike Miller back to see his son. If the father had not known that this was his son, he never would have recognized him.

“It was unbelievable a face could take that shape,” the father said.

“We have to let the doctors do their job,” Hanks told the Millers. “At this point, there’s nothing we can do but pray.”

Hanks did one other thing that afternoon. He knew the best man to rebuild Matt’s face would be Stephen Park, director of facial plastic surgery at the university, who was leaving Monday morning for Tehran, Iran, to teach for a week.

Hanks asked Park to come in and operate on Matt’s face before he left. Park assembled his team.