Posted 09 April 2007 - 11:57 PM
[Okay folks, this is pretty weird. This is how it seemed. This is my story. It's long, get a coffee.]
Last year I survived a fatal car crash. What I mean by that is that by the time they broke out the back window and got me out I had no pulse and no respiration. I remember the violent tumbling around in the car finally coming to rest. I couldn't breathe. That's not completely true -- actually, I could breathe out -- I was able to speak a little. I just couldn't breathe in, couldn't draw breath. First thing I said was "I can't breathe!". I had a strange resolve: I knew my life was over. Oddly, it wasn't frightening or even sad really, just very final. I think I said "I'm all done", and then "I love you". My girlfriend was driving the car, she was obviously alive -- I must've looked bad because she was screaming and crying. Everything went black.
I came to -- lying on a dirty floor underneath a rickety table. People were sitting and talking loudly, I couldn't understand the language being spoken, there was a strange smell of smoking or cooking I couldn't identify, although it seemed vaguely familiar. I couldn't seem to move, my head was foggy, where could I be? A Lebanese hash bar maybe, what would I be doing here? What have I gotten myself into this time? I felt like I must be wedged in between the wall and a chair or something. My vision narrowed, I felt faint again, and a little sick, something tasted bitter. There was something in front of my face -- something in my mouth. I began to hear again -- I hadn't been cognizant of being deaf, but all at once, I could hear several things: a faint electronic beeping sound, a sort of rhythmic pumping and a man's voice speaking softly. Other people were speaking English. A nice, American looking man leaned into view. He smiled, raised his eyebrows and said "hello there".
I had the sensation of wet pistol grips slipping from my hands. This seemed strange, and there was no sound of anything dropping. It didn't make sense. I was really thirsty. At Johnson's store, I remembered they had a red metal galvanized cooler that held soft drinks. You could open one of the doors on the top, reach down in to the water that kept the soda bottles cold. The big, wet, green bottles of Fresca had knurling in the glass to provide a better grip on the bottle. Shring, pull out a cool, wet bottle and pry off the top using the opener built into the side of the cooler.
"Don't try to speak, you have a tube down your throat", he said it clear enough, but it didn't seem to make any sense. He was still smiling, "can you blink your eyes?", this made sense though, and I blinked my eyes. He smiled again, nodding, "great!" I was in the hospital. A million questions came to mind. Where am I? What happened? Am I OK? Where is Nikki? My head began to race. The accident. Obviously, I was alive. I tried to sit up. Something hurt in my throat, and in my right shoulder. There was a loud beeping sound. "It's okay, it's just the vent, try to relax", said the nice smiling man in a calm, measured voice. I was in big trouble. The pain was spasming in my shoulder like electric springs uncoiling. If only I could drink something with lemons. Lemons and ice chips. I felt very sleepy.
I seemed to be lying on my side, curled in a loosely fetal position. I think I had a helmet on that had a small pulley on the top. Through this pulley was a tightly strung guy wire. The sound of tugboats powering up their strong engines could be heard in the distance. Short bursts of throttle -- maneuvering bursts. I remember once falling asleep in the grass, on the hill by the fort in Sausalito, waking and hearing the same sound. The only thing was, there was an absence of the classic, deep braying sound of the bells or buoys or whatever they are that you always hear in movies that take place around San Francisco Bay. It was fairly dark, but there were a few colored lights visible to me. If I tried to move, the wire seemed to increase its tension, holding me in place. I had been in the hospital, but this seemed more like punishment. Just then a strange kind of pain rose in me. It was kind of a ripping and burning pain, but the funny thing was it seemed to hit my arm, my groin and the bottom of my foot all at once. It seemed almost as if a length of tiny barbed wire, somehow healed into my skin were being pulled slowly out. I remember once walking through the woods, and finding the remnants of an ancient fence. A rusty old piece of barbed wire had become a part of a big spruce tree -- disappearing into it's trunk and emerging on the other side. Sap could be seen, having oozed like blood from the smiling wound.
One of the problems of being on a ventilator is that you can't yawn. You can't just have a nice deep yawn, or sigh or even just hold your breath for a moment. Otherwise, the machine will begin squawking, sounding its alarm, I suppose, to alert the nurse or somebody that something's not just right with your breathing. It's funny though, how easily the staff gets desensitized to these kinds of alarm sounds. I remember coming back on the ICU in my wheelchair after I had gotten quite a bit better. I had come back on the ward just to visit. Hearing the more or less ignored bleats from the many ventilators reminded me of the individual worlds of trauma into which newly conscious patients have found themselves. It's the new deal: so you're not dead but breathing has become your number one priority. I can remember, again and again almost dropping off to sleep only to be rudely awakened again by the relentless retort of the ventilator. When you're in the world of the squawking ventilator, it's hard to imagine wheeling around in a comfortable new wheelchair, wearing ordinary clothes, visiting nurses in the ICU.
One of the good things about the ventilator is, however, that not only is it keeping you alive -- keeping the air going in and out of you, but it does stuff like measure the CO2 coming out, so that it knows that your body is doing the right thing with the air that it's supplying. There was definitely a time when I could really rest, assured that going to sleep would be okay -- that I'd live through it, that the ventilator would keep the air flowing in and out of me properly. I don't know how long it was that I remained connected to the ventilator. I know the next thing they began to talk about was using this thing called the heated trach collar. It's basically just a little mask that is loosely fitted around your neck which brings oxygen to the vicinity of your trach fitting. This trach fitting I'm talking about is a hole in your throat just like those guys have who have throat cancer. If they place this weird buzzer thing there, they can talk, but it sounds real funny. So the tube brings oxygen there, but you have to do the breathing -- in and out on your own. You still can't really talk, but your mouth is freed up to be able to mime things at least, or even to taste something wonderful like a popsicle. Now, you're able to yawn or sigh as you wish. It's funny the things that seem a big deal when you've stopped being able to do them.
Another funny thing about having a tracheostomy is that, in order to speak, you have to cover the little hole, so that air can be forced past your larynx up into your mouth. If the air flowing to and from your lungs is passing out through a temporary hole in your trachea (a tracheostomy) then no air is passing over your voice box so you can't talk. With me, they began with quite a large "trach". When you have breathing difficulties, having access to your lungs through this type of opening is a great advantage when you need to be suctioned. Having your lungs suctioned is a terrible thing when you're conscious. If you aren't able to cough up your own phlegm, it can become a big problem. Typically, a respiratory therapist must insert a catheter through your trach hole, down into your lungs and suction out the crap in there. As you recover, they replace the trach tube with successively smaller ones. One of the intermediate sized trach pipes I had, had this little plug that went in the hole. This stopper was tethered by a little cord so that you wouldn't lose it while it was out. With the plug in, air passes by your larynx, you can talk; with the plug out, hanging, most of the air passes out through the trach pipe so that you can't speak. After the danger was over, and it seemed as though I would live for a while, my girlfriend would do a funny thing when people were visiting. I'd be talking on and on, as I usually do if I can get an audience. She would wait until an opportune moment arose during my discourse and simply pluck the stopper out, effectively silencing me in mid sentence. My mute button! It always got quite a laugh. She could now "get a word in", for the first time in years.
It had been a busy day. I had just finished the taxes and we had left town to meet a fellow in Waterville. Somehow or other, I had gotten myself an interview, or maybe audition is the right word, to read a book for an audiotape. This would mean that if I got the job, then it would be my voice that would be talking on a book on tape. We had met a friend for dinner further south and then gone to a Jungian seminar at Bowdoin College. I didn't want to spend the money to stay in a hotel even though it was getting late -- we didn't get onto I-95 until almost midnight. It was a good thing that someone had been following us when my girlfriend tried to avoid hitting a huge skunk that had waddled out in front of us. We were both sober, weren't speeding nor searching for something on the floor of the car, we simply lost control and got into the soft shoulder, slid for a while and then tumbled, diagonally, end over end. I don't remember the skunk or the accident really, except for the very end, as the violent tumbling finally came to an end. The person that had been following us must have called 911 and I think they stopped to help. Imagine what would be like to be trapped inside a car beside your crushed, dead boyfriend. It was the first time that I can remember that it seemed like I did the right thing at the right time. "I can't breathe. I'm all done. I love you.", I was like John Wayne. It was more of a surprise than anything else. I don't remember being scared, it was startling really to realize "oh, this is how I'm going to die". There was no negotiating it. Then everything just went black. Imagine what she must've gone through.
They got my heart going again with those paddle things. They wouldn't let her near me -- that's what the EMTs do -- they separate you. She didn't know if I was alive, or dead or what. I guess when the life flight helicopter came, she must've thought at least there must be some chance. It took her almost an hour in a conventional ambulance to reach the hospital that they brought me to in 17 minutes. She was released from the emergency room after a short triage of her hand. She had gotten glass embedded in her knuckles. I can't imagine what she must have been going through. I mean, she was driving the car and, even though it wasn't her fault, there she was, wandering around the hospital emergency area, wondering just how cracked up I really was.
They let the anisthesia wear off enough so that I began to come to, at about 10 o'clock the next morning. I know this must sound crazy, but I can't really remember they're telling me that I would be paralyzed, probably for life. I guess one of the first things I asked Nikki was "when can we get out of here?" Clearly, I hadn't yet fully grasped the gravity of the situation. For one thing, I had nowhere to go -- I would no longer fit into the quaint, 150 year old house of many steps, tight corners and narrow hallways that we had lived in. Rough estimates of the minimal upgrades necessary to make our house accessible were around $50,000. The next question is: how and who would be willing to take care of me? We were at a crossroads. Had we had enough preparation in life to surmount this kind of a challenge together?
During the next few weeks, I was learning things like how to cough, how to use the weight of my head to attempt to balance while sitting up and to use the almost arthritic curled up tone of my hand to grasp an item such as a bottle of water. Nikki, during that same few weeks began the arduous task of learning what it takes to care for a C-5 quadriplegic, scouting around our town for a suitable house to buy and finding someone capable of building a ramp on moments notice should we find the funds to buy such a house, researching and selecting the right vendor to build us a vehicle I could ride in -- a way I could leave the hospital. Somehow, I imagined that this was what everybody did in our situation. As it turns out, 95% of the folks I've met with spinal cord injuries never find a home; they wear out their welcome at the hospital and then find themselves in a nursing home taking lots of depression medication.
In the last few months before we had the accident, I had been looking seriously for a cruising sailboat. This is a boat you can live on that can handle the high seas. I was reading all I could about sailing, celestial navigation, living at sea for weeks at a time and adapting to a life on the ocean. I had put a little money away and had a small source of independent income. I hadn't really told Nikki or my son of my plan, just made casual references to it while imagining how easy it would be to sell the idea of a life long vacation and a classroom as big as the world itself to the most important people in my life. Someone recently told me that on any particular day a person has roughly 30,000 things he can do. When you break your neck, then maybe you only have 20,000. The question I have to ask myself is do I want to enter the dark world of gloomy rumination over the 10,000 things I can't do, or get busy living the 20,000 things I can do which I'll never find time for! I choose life.