In the recurring nightmare of 12-year-old Carl Harris, he and

two cousins are in a speeding pickup truck on a curving road in

northwest Nassau County.

The truck runs off the road. It hits a tree. His friends are

killed.

When he wakes up, Carl feels the burning sensation in his

fractured left elbow and the pain in his broken pelvis, left hip

and left knee. And remembers it was not a dream.

It was a fatal crash that occurred on a Saturday evening last

October, on Murrhee Road near the small town of Hilliard,

minutes from Carl's home.

That crash killed the driver, 22-year-old Kevin Forrester. It

killed another passenger, 8-year-old Wade Leon Harris Jr. It put

Carl in a hospital intensive care unit, then in a rehabilitation

hospital and now in a wheelchair.

Now, five months after the accident, Carl goes to a physical

therapist three times a week, still trying to remaster walking.

But perhaps the boy's toughest struggle has been with the

nightmares, anger, irrational guilt and the other psychological

baggage that came from the crash and resulting injury.

That is where Kamela Scott comes in.

Scott is a psychologist at Jacksonville's University Medical

Center. Last year, hospital officials took the unusual step of

assigning Scott part-time to the trauma center, a specialized

unit next to the emergency department that handles the most

severe emergency cases.

Scott's assignment is to become full-time by this summer.

While other trauma center staff help patients heal from

physical injuries, it is Scott's job to help the patients -- and

their families -- overcome the related psychological wounds.

"We're probably one of only a half-dozen trauma centers in the

country to do this," said Joseph J. Tepas, a pediatric trauma

surgeon who pushed for Scott's re-assignment.

"We've got a good system here," he said. "If you show up in my

trauma center with a gunshot wound to the chest, we will save

your life if it's at all possible. But whether we save your

sanity or help you avoid depression . . ."

Scott's is an innovative assignment, said William Samek,

chairman of the Florida Psychological Association's Hospital

Practice Committee.

At some medical centers, there are psychologists and

psychiatrists who work elsewhere in the hospital and can be

called to the emergency department or trauma center when they

are needed.

"[But] a lot of hospitals don't call psychologists to the

emergency department, even as a consult," Samek said.

"Generally they don't call anyone. Or, when they do, it's a

psychiatrist who gives the patient a pill."

Scott's task is to find a more enduring way to deal with

post-traumatic stress disorder, a chronic mental condition that

affects people who have gone through extreme stress. Symptoms

can include anxiety, depression, nightmares, outbursts of angry

or violent behavior, and an inability to form close personal

attachments.

Soldiers get it -- young men or women who are haunted by what

they've seen in battle for years afterward. But it also can

affect a young girl who saw her mother get shot, or a boy --

like Harris -- who saw friends die in a motor vehicle crash.

Some psychologists say the condition can be more debilitating

for children, who may not have felt heartache before or have

trouble understanding the malice behind a shooting or the

carelessness behind a crash.

Also, because children have their whole lives ahead of them, it

can have far-reaching impacts. …