Their clothes are bloody, ripped and muddy, their socks sucked from their feet. He has a punctured lung and crushed shoulder, her leg is gashed open from knee to ankle. Shards of glass puncture their bodies.
In the darkness and haze of pain, the four people strapped in the small ambulance remember little. All that matters is living to see the next day.
The two nurses, paramedic and rescue squad captain pray they can get the patients from Ider, Ala., to the hospital in Chattanooga through the debris-littered roads and communities darkened in the disaster.
The vehicle's transmission - punctured by debris - sprays out fluid, coating the car that brings up the rear of the caravan.
Time seems to stand still in those 90 minutes.
In the last 12 hours these eight people have all seen things they never thought they would see in their lifetimes. Dead bodies strewn across fields. Entire communities wiped out. Their homes and everything they own scattered into the night.
No one in the ambulance knows how many have died - hundreds in Alabama, Tennessee and Georgia - or realizes that dozens of tornadoes have leveled wide swaths of the tri-state area.
Like so many others that night, their story is one of survival, of caring, of miracles and prayer.
Across the three states, first responders, neighbors and community leaders work to clear the debris and help the injured. They hand out dry clothes, hug the injured and weep for lost lives. They reach out to help friends and strangers, each an untold story of caring and heroism during one of the worst nights the area has ever known.
For all the healing that has taken place in the year since then, it is a day they will never forget.
A line that will divide their lives.
Before the tornadoes. After the tornadoes.
That morning, Jason Heard gets a text from a friend at 5:30 a.m., warning him the first storms will hit soon. Jason, his wife, Jana, and their four children head to the Ider Rescue Squad where he is captain.
It will be days before they go home again.
Big and burly at 6 feet 3 inches, 40-year-old Heard has been a member of the rescue squad since he was 18. In his day job, he's a full-time paramedic. He thought he had seen the worst life could throw at him.
Until April 27.
He remembers the darkness, the familiar roads of his hometown that look like a moonscape. The calls keep coming on the radio, the pleas for help from people trapped under houses, their family members killed.
The Ider Rescue Squad dispatcher who was working the radio lost his home in Ider. Farther north, in the Flat Rock area, both the dispatcher's brother and sister-in-law were killed.
Almost everyone had family members who lost homes, who knew people who died.
Heard fights tears when he remembers. His voice breaks.
"I've never really talked about it until now," he says, nearly a year later. "This was devastation you could never expect, devastation you could never plan to deal with. The bodies were laying everywhere. You had to figure out which ones you could help and which ones you couldn't.
"We transported people in the back of pickup trucks and on pieces of plywood. It brings tears to your eyes when you think about the lives that were lost. The lives that were saved."
The day began like normal for 58-year-old Anita Flynn, a nurse at Parkridge Medical System. She was scheduled to work, but as the storms moved through the area and the weather situation worsened, Parkridge canceled its elective surgeries.
Flynn drove home to Ider around 2:30 p.m. Then came the call from Ider Rescue Squad, where Flynn has volunteered for more than 20 years. Her husband, Michael Flynn, is the mayor of Ider.
The Shiloh community is hit. At the time, Flynn doesn't know it, but the homes of her husband's parents and brother were destroyed.
Someone opens up a funeral home to serve as a temporary morgue. Flynn helps triage patients, unload bodies, clean the ambulance. As squad members work, they get a call to take cover; another tornado is headed for DeKalb County.
"You can't describe what it felt like," Flynn says.
Soft-spoken and calm, the gray-haired grandmother has been a nurse for only 12 years. She began her training with a first-aid class and continued taking classes until she had her nursing degree. Each time before she heads out on a call, she prays that she will be able to help the patients.
"I was praying a lot that day," she says.
The next tornado hit south of Ider on state Highway 117.
"We tried to get there every way we could, but all the roads were blocked," Flynn says.
Brenda Taylor remembers the taste of insulation. The sting of pain from shards of glass. The weight of the walls on top of her as she lies buried under the remnants of her house.
In the deathly stillness after the storm, she takes roll call, praying there will be an answer after each name she yells into the darkening night - her husband, her mother, their daughter, son-in-law, grandson, granddaughter and family friend.
Seconds earlier, the family saw the tornado sweep over Pea Ridge to the west. They piled into the bathroom; Brenda's husband, Frank, was the last one in as he pulled the door shut.
The pressure in the house changed, the air sucked out and the house lifted like a Lego model home.
Stuck in the debris, Brenda's work cell phone has a hole in it, punched by some flying debris. Her other phone still works. She calls 911. It is just after 6 p.m., Eastern time.
"We're trapped under our house. We're hurt," she tells the dispatcher.
"I felt relieved we had made contact with the outside world," Brenda remembers nearly a year later. "We thought help was on the way. We had no idea how long it would be before we made it out."
Frank is buried under an antique piano that had taken five men to move into the house. Parts of two walls are piled atop the piano.
Brenda's mother, Betty Slatton, has a board with nails against her neck and the commode on her leg.
Kimberly Bird, their Nashville friend, is buried under the debris, battered and bruised.
Only their daughter, son-in-law and grandchildren escape relatively unscathed.
"We knew Frank was hurt really bad. We knew Mom was really bad," Brenda says. "We started calling, 'If anybody can hear me, help. If anybody can hear me, help.'"
As their daughter, son-in-law and nearby neighbors pull the debris from them, Brenda remembers looking in shock across the landscape.
How could this mess of broken trees, tangled power lines and leveled homes be their neighborhood?
Neighbors use a four-wheeler to ferry the Taylors to a nearby home, then load them into another vehicle to drive to the Ider Rescue Squad.
Frank remembers the excruciating pain of his punctured lung, four broken ribs and a crushed shoulder.
Brenda has two broken ribs and bruises. Slatton's leg is cut to the bone from her knee to her ankle. Bird is bruised, cut and bleeding.
"We looked like we had been in a rock fight," Brenda says.
By this time, Anita Flynn is back at the rescue squad, helping to treat patients. All the bays in the squad are emptied to make room for the injured.
The Taylors concern Flynn and another volunteer nurse. The couple need to get to a hospital now.
"Frank was really bad; we were worried about him because we didn't know about his internal injuries," Flynn says. "We had to get him to a hospital somehow."
Someone pulls off a pair of dry sweatpants to hand to Slatton, whose clothes are wet and muddy.
Calls are made to the Fort Payne and Scottsboro hospitals, seeing if they can take Frank Taylor and Slatton.
"We won't be able to help you here," comes the reply. Both facilities are overwhelmed by the hundreds of injured who are coming.
The roads south are impassable anyway. None of the roads are open across Sand Mountain to Interstate 59.
Heard continues to make calls, while Flynn talks to the Taylors about their options. She knows the couple; they all go to the same church.
Heard calls the fire department in Jackson County.
"Any way we can get an ambulance to Chattanooga?" he asks.
By this time, tornadoes have hit Jackson County - Flat Rock, Higdon and Bridgeport - killing eight and causing widespread damage.
But Jackson County officials come back with an all-clear signal - the road through Kimball, up to Interstate 24 and west of most of the destruction, is passable.
Normally, the drive northeast to Chattanooga is about 35 miles, but the route they have to take this night is more than 60.
The Ider Rescue Squad ambulance - a 1995 model with more than 150,000 miles on it - has been in service all day, inching its way through the littered debris, downed powerlines and toppled trees. It is a basic rescue unit, not equipped with advanced life support.
The smallest ambulance available, it is the only one able to navigate some of the roads.
At some point, it picks up a branch in its undercarriage. Workers jerk the branch out, unaware it has punctured the transmission.
But the vehicle has one more drive to make that night.
Frank Taylor goes on the only stretcher in the ambulance. Brenda Taylor, Slatton and Bird are strapped into the three jump seats along the side. Slatton's splinted leg is propped out in front of her, just behind the stretcher.
"I was just hoping they were OK," Flynn said. "I didn't know how bad they were, but they were all alert and conscious."
Flynn, another nurse and a paramedic crouch on the floorboard, squeezing into almost non-existent space. Flynn tries to block out the scenes from that night that replay in her head over and over. She doesn't remember a lot of conversation.
"I think we were mostly just in shock," she says.
Frank remembers little but the pain. Brenda kept checking on Frank, on her mom, asking if they were still OK.
"In that moment in that ambulance what you are worried about is life," Brenda said. "We were all very afraid."
In the driver's seat, Heard remembers the darkness. They drive through community after community, familiar landscapes Heard has known his entire life. Some of the roads are partially blocked by debris, deserted and empty.
It's an all-black night.
Flynn's husband, who is driving the car behind the ambulance, calls Heard on his cell phone. Fluid is spraying out of the ambulance, he tells Heard.
"We was running as hard as that truck would run," Heard says. "I was scared to stop; we had to keep going."
He doesn't tell anyone else in the ambulance that he feels the transmission slipping, knows they may not make it up the next hill.
A true rescue squad captain, he is already planning whom to call for another vehicle. Maybe they can just call 911 and a Chattanooga ambulance can pick them, he thinks.
The transmission slips as they head up a hill on Third Street. The lights of Erlanger hospital come into view and relief washes over Heard.
He pulls up close to the emergency room as the engine quits. Not quite close enough to the doors, he tries to pull up farther.
The vehicle won't move another inch.
Inside the ER, patients fill every seat and line the walls. For the first time, Flynn realizes, stunned, how widespread the tornadoes have been and how many people are hurt.
The clock glows red: 12:10 a.m.
Brenda remembers thinking it is the next day; they have lived another day.
"Anyone who doesn't believe in miracles should have been there that night," her husband says.