Itinerant Philosopher

After spending most of 2020 in Covid-Coop-up, Joy and I were looking forward to 2021 being a year when we could resume traveling and experience new adventures. 2021 started off with a bang, just not the kind of trip and adventure anyone would want.

Joy and I spent December and January in La Selva Beach (half way between Santa Cruz and Carmel, California). We were helping our friends finish off a newly-constructed over-garage apartment. One of the projects was to enclose the breezeway between the house and the garage with a polycarbonate roof (the same material used to build commercial greenhouses). This involved a lot of high ladder work, one of them a ten-foot A-frame ladder.

I was standing near the top of that ladder when its hinky leg gave way. My memory of the fall is a montage of blue sky through the rafters, the white wall of the house, and then a sudden flash of excruciating, overwhelming pain in my back and stomach. When the 10 foot ladder toppled over, I fell backwards and landed on the top of a four-foot A-frame ladder that Joy had been using to hand tools up to me. We’re convinced that little ladder saved my life. If my fall hadn’t been interrupted, I would have fallen a long way, landed on concrete, and likely hit my head.

A 911 call brought a fire truck and an ambulance. It’s a weird feeling to be lying on your back, hearing a siren approaching from afar, and knowing it’s for you. The medics immediately put a neck brace on me, slid a backboard underneath me, and had me wiggle my fingers and toes. Once they’d determined I wasn’t paralyzed, they asked me if I hit my head or lost consciousness. Everyone was amazed and grateful my head had come through the accident unscathed.

The EMTs began taking vitals while also thoroughly scanning my body for any obvious injuries (broken bones, gashes, etc.). I heard one of the them call out “BP 260 over 100.” The 260 freaked me out. I didn’t know blood pressure could get that high. It turns out, when you’re in massive pain, your blood pressure sky rockets. Over the next several days it was often in the 240s over high 90s. But on occasions, when I’d been laying perfectly still for a while, I’d glance at a monitor and see my BP was close to the normal range. At one point it was 122/73. Because BP is a key indicator that something is going wrong, the paramedic repeatedly took my BP during the long ride to the hospital. The entire time I was in the trauma unit they took my BP every 15 minutes. That timing eased off to once/hour when they moved me to ICU and once every 3 hours when they moved me to the post-op unit. Plus, someone would take my BP before moving me from my bed for a gurney-ride for CT scans or X-rays. I calculate that over the course of this adventure I had my blood pressure measured close to 150 times. And that doesn’t count the bed-side monitor that was constantly tracking my vitals.

When the EMTs began loading me into the ambulance, they told Joy she couldn’t come. In fact, because of Covid, no visitors AT ALL at the hospital. Fortunately, Joy had the insight to find my phone and reading glasses and hand them to the EMTs.

The EMTs were justifiably worried about internal injuries as well as spinal injuries, so rather than routing me to the nearest emergency room, they took me to the nearest trauma center – 45 minutes away in Salinas. Blunt force accidents can cause serious internal injuries, particularly to organs. (That’s what happened to Princess Di.) When we finally arrived at the trauma center, it was just like in the TV shows. I was swarmed by a team of medical professionals, everyone barking orders and info at each other, several sets of hands touching and probing. They asked if they could strip me naked, and even before I could begin to answer, shoes and socks were off, pants and underwear gone. (The EMTs had cut off my shirt at the accident scene.) Portable imaging devices were wheeled over and the non-stop electronic beeps and alarms began.

Over the next few hours, trauma staff determined that I’d fractured a few ribs, had several not particularly concerning gashes on my arms and legs, but most concerning, an internal injury — my liver had been lacerated and there was some internal bleeding. The doctors told me it was a level 3 laceration. They’d need to do an angiogram to determine if it was small enough that it would heal itself, big enough that they’d need to cauterize via the catheter while they were in there, or, worst case, open me up for a full-on surgery to sew it back up.

While I waited for the angiogram to happen random medical people would periodically stick their heads into my curtained area and ask me if I were “Willows.” Each time, I’d answer, “No, Navarrete.” It turns out “Willows” was my trauma name. They assign you a random name just to get you into the system so they can track what drugs you are getting, what the exam results are, etc., because they don’t want to waste time asking you questions like your legal name and address. I didn’t get a medical bracelet with my actual name until just before they moved me out of ICU.

Several times they needed to move me from the bed to a gurney and then to an examination table for a follow-up Cat Scan, MRI, or X-ray, and then back again to the gurney and then my bed. They always put an “ISO” (isolation) mask on me. Once they decided I didn’t need the back board (a super-stiff board designed to protect your spine), shifting me between a bed/gurney/exam table was an adventure. They used these special “shorty blankets” that are just long enough to go from my shoulders to my thighs. Usually only two, but sometimes three, people would grab the edges of these blankets and use them to maneuver me. I was surprised, and a bit disturbed, how often one of the medical staff would tell one of the others, “No, grab from here, not there.” Didn’t these people know how to do this? Shouldn’t these people have done this hundreds of times? Every time they’d move me, it hurt like hell and I’d inevitably let out a gasped, “Mother Fucker! Oh, sorry for my language.” In retrospect, I must have already been feeling better if I’d progressed from a simple “Ow” to full-on profanity.

I was on a lot of pain meds, IV drips, etc. In ICU they started asking me about my pain levels. They have that helpful chart where 1 is a smiling face and 10 is someone crying. Every few hours the ICU nurse would ask me what my pain level was. The first time she asked, I wasn’t in so much pain that I felt like crying, unlike when they moved me from a gurney onto an exam table, which was shooting pain and definitely like an 8 or 9, so I told her “4.” She scolded me and told me that there was no reason to be a hero. Pain management is an important part of healing. Plus, in addition to all the pain meds and muscle relaxants, I could also take Oxy if I needed the extra boost in pain relief. I was very nervous about the Oxy, so I I told her, “Um, five?” She scowled at me and said, “I’ll be right back with the Oxy.” After that, whenever someone asked about my pain level, I’d tell them it was a “7” and that seemed to make them happy. For the rest of my hospital stay, they always included the Oxy with my meds. They even sent me home with a prescription for more Oxy, but I never took it.

Once the doctors had determined I was out of immediate danger, they moved me from ICU to a makeshift post-op observation area (the actual post-op unit was filled with Covid patients). I ended up in a large office suite that had recently been retrofitted into patient rooms — though, really, there were just five beds in a row, separated by curtains. With a bit of a sheepish grin the nurse placed a silver bell (the kind you see at the front desk of cheap motels) on my bedside table and told me, “Sorry, we don’t have a call button for you. You’ll have to use this.” When I did use it, I tried to tap it as lightly as possible so that I wouldn’t disturb the other patients.

Besides not having a nurse call button, there also weren’t any amenities to keep me busy. No TV. No window. Not even a wall clock. And I had my phone off to conserve power, so no Internet, reading, or solitaire games. Even my watch died, but only after it grumped at me for not being very active the day before. One of the ways I entertained myself was by playing with the monitor tracking my vital signs. I could really shift all my numbers by holding my breath or taking lots of shallow breaths. The other way I entertained myself was by watching for the prisoner in the glassed-off area to my immediate right. A few times each day he’d shuffle past, pushing his walker, flanked by two pistol-carrying sheriffs. I was jealous. He got to use a real bathroom. I, on, the other hand, had to use one of those pee bottles. It turns out that when you are on your back, it’s not anywhere as easy as you would think. After my first attempt, I had to ring my bell and ask a nurse for a new gown and a new set of “shorty blankets”.

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At one point my primary nurse confided that they were so overwhelmed by Covid cases that about half the nurses in this unit were usually pediatric nurses and they were struggling a bit with how to provide care to adults. This explained the uncertainty about how to use the shorty blankets. It also explained the three different times that one of those moves ended with my feet hanging completely off the end of the table because they’d positioned me too far down on the gurney. Each time someone commented, “Wow, you’re tall!” And each time I responded, “Uh, 5-11.” Which, I guess, is pretty tall when you’re used to moving kids

I was discharged after three days. They’d decided all my injuries were going to be self-healing, and really wanted me out of there. Too much risk of Covid, plus they were desperately short on beds. For the first month I was restricted to no bending at the waist, and lifting no more than ten pounds. It is astounding how many everyday things weigh more than ten pounds.

It’s now been just over two months since my accident and I’m happy to report that other than some lingering (but improving) nerve damage at the base of my back (near my coccyx), that I’m almost completely back to myself. Every now and then I feel a twinge in my ribs, but I no longer fear sneezes, coughs or hiccups. I’ve even done a 15 mile bike ride. And I’ve even already been up a tall ladder — to hand someone a hammer.

Let me end this long post with a heartfelt thank you to all the first responders and medical professionals out there literally risking their lives to keep us safe and give us medical care.