I'm so very sorry this happened to you. What a tough situation to endure. Here are a few thoughts that I hope will help you as you work to heal.
I have been a nurse for almost thirteen years and I have seventeen years experience as an EMT. When EMS personnel roll up on a scene, they immediately size up the situation--the number of patients, the severity of their injuries, the level of difficulty involved in extricating them from the vehicle, etc. If it appears that the call is multi-trauma with complications, extra manpower will usually be summoned, and that can include flight transport.
It isn't likely that your friend was neglected. What is a more realistic scenario is that he had already expired by the time help arrived, or that according to triage principles, he was deemed to have unsurvivable injuries. Then the focus would have shifted to you as someone who still had a chance.
The fact that he did not make it to the hospital alive seems to support the premise that his injuries were beyond helping.
If your friend had already passed away, this is not something you would have been made aware of at the scene. In fact, it is highly likely that your rescuers would have tried to shield you from such upsetting news. They may have gone through the motions to spare you from further emotional trauma so that you would not become hysterical and combative with grief or go into psychogenic shock, any of which could have compromised YOUR status.
Their goal at that point would have been to extricate you and get you safely on your way to a trauma center or ED.
I want to also remind you that you most likely were in some degree of shock. If not physical, then emotional. Accident survivors often have fragmented memories influenced by pain, adrenalin, altered levels of consciousness, exposure to the elements, emotional defense mechanisms, chemical reactions within the body, any meds they may have been given, and a host of other variables. It is not at all uncommon for an account which seems very real to patient to be contradicted by impartial evidence or explained as the product of distorted thinking caused by the factors I mention above. For example, a patient can believe that there were gunshots fired and later find out that the sharp noises were the explosive snapping sounds of a car's roof posts being snapped by a Hurst tool so rescuers could get to a trapped person inside. The mind does strange things when it's in overload.
You have no reason to feel guilty. Survivors often do, though. It goes with the territory. We want to make sense of the senseless and reality doesn't always cooperate. Unfortunately, that doesn't stop us from trying.
Here are a few practical suggestions that might help you with your grief:
First and foremost, get some counseling. Find a support group. Talk with several people you trust. Face the fact that a part of you is still back at the crash scene hoping to save your friend. Your head knows that battle was lost, but your heart keeps insisting on a better outcome. It takes time to really grasp the truth, and it goes a little faster with help.
If you are so inclined, see if you can get hold of the autopsy report. Certain types of injuries are simply not surviveable. If you want more information about this, PM me and I'll try to help.
If you can, talk to the EMS people who were there. Don't go in with guns blazing. And do be prepared for the fact that they may have been told not to discuss the call. Not out of fear, but because of HIPAA regulations and other legal concerns. But if the conditions are right, they may be able to help you understand a little better what happened that night.
Keep a journal of your thoughts and feelings as you work through this tremendously sad and stressful situation. Talk with others who have endured similar trauma. Give yourself a lot of time and space to come to terms with your loss. Try to sleep and eat well, and allow yourself enough downtime to process what is happening to you. Write down dreams. Read the accounts of other people involved in this type of tragedy, including rescuers, and see if your thoughts and feelings resonate with those of other sufferers. Balance the introspection and downtime with exercise and connection with others. Do lighthearted things now and then in the name of restoring your perspective.
It makes perfect sense to be angry when someone you care about is taken from you. A natural reaction is to try to find a target for that anger and the EMS folks are the most available. The truth is that rescuers often feel guilt over the people they can't save. The younger the person, the worse the feelings. Rescuers go into that line of work because they want to DO something, to make a difference. When they can't, it hurts.
Again, I'm so sorry that you went through such a horrendous experience and the loss of your friend. Please take good care of yourself and come here for moral support.