“There’s never a time, even when I’m laughing at a party, when I’m not thinking about it,” Pam Uhr says.

It was a hot summer day a few weeks before the end of her junior year of high school. Uhr and her friends had spent the afternoon at a swimming hole near their central Texas town. She was driving home on a country road, two friends as passengers, when her front tire slid. She overcorrected. The car spun. A car coming over a blind hill slammed into her passenger side, and everything went black.

She woke in a hospital. None of the doctors or nurses would say how the two boys in her car were doing. Her dad finally told her: they were dead.

Years later, after Uhr married and had three boys of her own, she found herself consumed by the thought that her three young sons would die as some kind of cosmic payback.

I nod my head as I listen to her story. It sounds a lot like the other stories I’ve heard over the years about accidental killings. First, immediately after the event, comes shock. Then the shame-filled memories of what happened. Then thoughts of impending karmic justice, which hang over the accidental killer’s head like the sword of Damocles – at every moment, even when you’re laughing at parties.

Can people move on after an accidental killing? I think about this question a lot. I’m an accidental killer too.

I was 19, just a few weeks out of Marine Corps boot camp, and had just begun my freshman year at a Bible college in West Virginia. It was Sunday evening, and my roommate and I were dressed for church according to college rules – jacket and tie. We were two young men steeped in the fundamentalist-evangelical world of our youth, heading for what many evangelicals consider the holiest of services, Sunday night.

I was driving my recently fixed-up 1973 VW Super Beetle. Around 5.30, as we rounded a curve in the road, the glare of the setting sun hit my eyes. I squinted and tried to shade my eyes with the car’s visor. I felt vulnerable in the passing lane, so I attempted to move into the right lane. As I moved right I saw a red Jeep already in that lane. I swerved back into my lane, but I swerved too far.

The driver’s side of my car slammed into a steel plate in the concrete median. The plate instantly crushed the front of our car, locking the tires in place and fracturing my kneecap, and we were thrown into the oncoming lane.

The next thing I remember is sitting in my stopped car, checking to see if my roommate in the passenger seat was alive. He seemed to be OK. I got out and felt sharp pain in my leg. All the traffic had stopped. There was another car smashed up on the side of the road. Then I saw a motorcycle, lying on its side.

A woman wearing a helmet was a few feet away. Her neck was bent at a strange angle and somehow I knew she was dead. I saw a man lying on the ground, and I went to him. He was on his stomach, and I could see blood flowing from between his legs on to the asphalt.

He looked up and said, “Fuck you, man.” I said I was sorry. I probably said it a thousand times in those few moments when our eyes met. I took off my red necktie and attempted to stop his bleeding.

Later, at the hospital, nurses got the windshield glass out of my hand and put my knee in a stabilizer. They said it would hurt for a while. It did hurt, and I wanted it to hurt. I wanted to feel something other than the feeling that I should be dead instead of that woman.

I went back to the dormitory that night. My roommate was there, shaken but not badly injured. I slept, and the next morning the dean of men came to see me. I was still lying in bed. He pulled a chair up and opened his giant King James Bible. He read a passage from the Hebrew Bible about the mysterious Cities of Refuge, ancient safe havens for people who had accidentally killed someone. The perpetrator would flee the avenging family of the deceased, escape to a City of Refuge, and live there until the Jewish high priest died. When the high priest died, accidental killers could go back to their homes, no longer at risk of revenge murder.

After reading this scripture, the dean said, “God made provision for what happened to you.” I don’t remember my response. I only remember being confused why he read that particular passage to me.

I didn’t go to any counseling and none was offered. I didn’t talk about what had happened with anyone. I felt guilty for surviving when a woman had been killed, and I knew I would carry that weight with me forever. I remember staring at a white wall and feeling like I was rushing toward it. If I took a nap, I would jerk awake from the sensation of hurtling uncontrollably toward the motorcycle.

I hobbled around on crutches for a couple of weeks, and by the next month I was driving again. The first time I drove I experienced symptoms of post-traumatic stress – reliving the helpless, locked-in feeling of the crash as I drove through a construction zone.

Several months later I was sued for $2.5m. I gave a deposition about what happened, and because I was a poor college student, because my father was a poor pastor with six kids, and for other reasons I do not know, the suit was dropped. It may have been because I hadn’t been drinking or speeding at the time of the accident.

But I knew what I did was wrong – evil, on some level. I had killed a woman. I knew there was nothing I could do to undo it. There was nowhere I could go to get away from the feeling that I was no longer good. There certainly wasn’t a City of Refuge where I could live out my days until Billy Graham or the pope died.

With 40,000 automobile fatalities in the United States every year, in addition to innumerable fatal firearm accidents, mechanical accidents, and friendly fire and civilian killings in our nation’s wars, there are thousands and thousands of accidental killers out there. Some of them are famous, like Laura Bush, who writes movingly in her memoir of how she lost her faith in God the night she accidentally killed a fellow high school student in a car accident.

Most of us, however, stay silent, consumed by shame and worried that the blood-debt we have incurred will somehow come due.

Not only am I an accidental killer, I’m also a veteran. I served as a chaplain in Iraq. After coming home, I learned about the emerging concept of “moral injury”. Moral injury refers to the guilt and remorse many veterans feel after participating in actions that break their moral code. If you get PTSD from being preyed on by someone trying to hurt you, you get moral injury from being a, sometimes accidental, predator.

People suffering from moral injury wonder if they can ever be part of normal human society. The upside-down moral universe of war serves up numerous opportunities to do things that make us question whether we are good any more. I’ve noticed that several of my combat friends are vegetarians or vegans now. They don’t want to kill anything any more. I find myself in this camp most of the time.

Although I did not fully grasp what my dean was saying the morning after my accidental killing, I have pondered the implications of his story for many years. Could there be wisdom in these ancient practices?

The psychologist Maryann Gray thinks so. Gray is an accidental killer, although she prefers the title CADI: “causing accidental death or injury”. I spoke with her on the phone and thanked her for what she has done for accidental killers. Her website has helped many CADIs share their stories. It is the only resource for accidental killers I could find.

The site is a virtual City of Refuge. Many visitors to the site tell their stories for the first time, and the site provides understanding, resources and the crucial sense that the accidental killer is not alone. Indeed, Gray has shown how accidental killers can find fulfillment in helping more recent CADIs navigate the first days, weeks and months after their accidental killing.

The ability to share one’s story with people who have been through a similar experience is itself healing – and rare. I remember sharing my story with a girlfriend many years ago, only for her to say, “That’s terrible. I don’t think I can think of you the same way again.” I learned then that I couldn’t tell this story to just anyone. I needed safety and understanding.

I believe accidental killers feel guilt, in spite of everyone telling us it wasn’t our fault, because of a deep-in-our-bones instinct that a life must pay for a life. Even if it was an accident, someone has to pay. Years after my own accident, I bought a motorcycle and rode it obsessively, reasoning that justice would be served if I crashed and died.

None of the accidental killers I’ve spoken with have ever told me there’s one clear path to healing. The path I’ve found for myself hasn’t been clear at all. It’s been shrouded in ancient practices of ritual reconciliation, not exactly an easy sell in our modern, evidence-based culture.

Ancient religions sought to restore harmony to the tribe or community after a death, which was always a major loss to the security and strength of a community. In the case of the ancient Jewish concept of the Cities of Refuge, accidental killers were offered reconciliation when the high priest died; it was as if his death paid the debt for every accidental killer in the land.

A few years ago at a veterans’ conference, I participated in a Native American ritual of cleansing after war. The ritual, which came from the Coushatta tribe in Louisiana, was dramatic and simple at the same time; the person leading the ceremony described how she was using an eagle feather to ritually cut off my skin so a new person could step out of the old skin and back into the community after war. There are similar Zuni Pueblo and Navajo healing rituals, and the US Administration for Native Americans encourages Native American veterans to consider these rituals a component of their healing journey after war.

My own religion, Christianity, is no exception in the importance it places on themes of blood debt. Christians regard Jesus Christ as having died for our sins, and liturgies and teachings about Christ’s atonement on the cross often emphasize a cleansing of sin, especially the kinds of sins and transgressions that are impossible to reconcile with a simple apology.

The numerous Christian denominations offer various approaches to effecting this reconciliation. Perhaps best known is the practice of confessing to a priest. But there are many other rituals: an altar call in a Baptist church, a prayer huddle with Pentecostal sisters and brothers praying in tongues – all can be places for people to experience release from the moral injury of an accidental killing.

I founded an organization, the Episcopal Veterans Fellowship, to educate members of my denomination about moral injury in veterans and provide community for veterans inside and outside the church. Every year we hold a conference about moral injury in veterans at a seminary in Austin, Texas. This past Veterans Day, we had 75 veterans and caregivers show up to learn about moral injury and how communities can help veterans heal. I dream of a day when there are similar conferences where accidental killers can experience the community healing the veterans at the conference experienced.

For me, there is never a time when I’m not thinking about the accident. There’s also never a time when I don’t remember kneeling in an empty church with a priest, his hand on my head, pronouncing these words: “Now there is rejoicing in heaven; for you were lost, and are found; you were dead, and are now alive in Christ Jesus our Lord. Go in peace. The Lord has put away all your sins.”