What Are Hospitals Like During the Covid-19 Pandemic?

Introduction

Today’s topic: what’s it like to visit an urgent care clinic right now, during the pandemic? What are things like at a hospital? And what’s it like to get a Covid-19 test? Unfortunately, I’m now in a position to report on all three.

I’m unable to type right now so I did something different: I recorded a vlog without having a script, and then transcribed the audio track using my phone. Please excuse whatever transcription errors I missed here.

Here’s the vlog version if you prefer that:

And now, with no further ado, the Q&A.

Why would anybody want to go near a hospital right now?

In my case, I had a pretty bad accident. I put off treatment for a couple days until it became clear that I needed it. Before I started making appointments I asked a buddy of mine who’s an MD, “Is this a really bad time to go to the hospital?” (Obviously he does this every day for work, and then goes home to his family.) He said, “You know, hospitals are really well-run: they’re kept very clean and they have protocols in place. It’s probably safer than a grocery store.” I agreed, and my wife made me an appointment at an urgent care clinic in Oakland.

Is it hard to get an appointment?

Of course this depends where you are, but in the Bay Area the hospitals etc. are really not doing much, as so many people avoiding these places. Getting an appointment was really easy.

Is the traffic lighter getting there, and is the parking easy?

Yes! Our drive to Oakland was done in record time. I don’t know about parking because my wife dropped me off—they aren’t letting visitors inside, you have to leave your patients at the curb. When we went to San Francisco for the second appointment (more on this later) it was even weirder because the Bay Bridge, which is normally, any time of the day, totally clogged up, was just smooth sailing. It’s kind of weird to see a city like San Francisco completely empty. I mean, normally there are horns honking, cars everywhere, people flagging taxis … in a more suburban area like Albany, where I live, it’s not that different from normal—you get more people walking but that’s about it. To see a major city seemingly abandoned like that is pretty eerie.

Is there a rigorous Covid-19 screening protocol before I can enter the building?

The first place I went to, I was able to go through the lobby and up the elevator on my own though they had a big thing of hand sanitizer as soon as you hit the lobby. At the entrance to the clinic on the second floor there was a guy with a table and he took my temperature and made me use hand sanitizer so he could make sure I’d done it, and he made sure I wasn’t obviously symptomatic before allowing me to proceed.

Will the person doing the screening make corny jokes to try to put me at ease?

Well, that’s going to vary but in my case the guy did. After taking my temperature he said, “Okay, 97.3 on your FM dial!” I wonder if he makes that joke with everyone. Actually though, it was pretty useful because if he said something like, “The New Alt: 105.3” or “107.7: The Bone” then I’d know I had a high fever, probably had Covid-19, and would be sent packing.

Do I bring my own mask or will they provide them?

I had heard they were going to give me my own mask but it’s kind of a Catch-22: until they hand you a mask you have to be wearing one. But after it’s been in the hospital I don’t really want the mask anymore, so I wore my skuzziest, dirtiest mask. At the urgent care Center in Oakland the guy had me switch it out and got me one of those cool rectangular blue ones that hooks behind your ears. I kind of wish I’d kept it but I pitched it with my old one. At the second place, the hospital, they were offering masks but I totally forgot to switch, so again I was wearing like my skuzziest mask, the one I’d dropped in the dirt, and wore it the whole time so I must have looked like some sort of derelict.

What social distancing measures will the doctors and nurses take? What kind of PPE?

Most of the time there was only one person in the room with me. Briefly there were two nurses in there but that was all right. The risk of infection, as I read recently here, depends on three things: your proximity; whether indoors or outdoors; and, how much time you’re in that proximity. If you’re closer than 6 feet from somebody, outside, on a trail, for like one second, you’re not going to give that guy Covid. So when I pass someone ten feet away on some trail and I’m not wearing a mask, and he looks over and scowls like I just sacked his ancestral village, I get a little testy. Two nurses in the room with me for two minutes at the same time, everybody wearing a mask … I’m not worried about it.

As far as PPE, the doctor wore a Plexiglas face shield, kind of like what a what a riot cop would wear but not quite as burley. It reminded me of the sneeze guard on a salad bar. So between that, and surgical gloves, and a mask, the doctor was well protected.

It’s actually kind of funny because my hand is pretty bandaged up and the doctor needed to check out my wounds, so she was trying to take Band-Aids off while wearing rubber gloves and she just couldn’t get anywhere. I was like here, let me help you out. How often do you get to help a doctor like that?

What’s the closest you had to get to anybody?

Obviously the doctor was right in there, dabbing with this very cool goop called MediHoney, which has some kind enzymes in it that kind of eat up the bacteria that might be growing the cuts. Kind of like putting maggots in your wound except smaller. So she was kind of close, but I not for very long. The most uncomfortable part was when I went across the hall to radiology. The X-ray tech had to position me with the backdrop and everything, and I say uncomfortable not because I thought he was going to give me Covid-19 but because he was asking me to put my bad arm over my head and all these other horrible things. That took a while too, but it was a giant room and he’d frequently scurry behind the control console to not get radiated, obviously.

How come every single member of the medical profession (except for the doctors) has tattoos now?

I don’t know why, but they all did, like, to a person, and one of the nurses had like this really cool tat on her forearm that looked like a face but it was like really well done. It was kind of distracting because I kind of wanted to say, “Wait, can you hold still for a moment, because I want to peer into the eyes of this person staring out from your arm.” But of course I didn’t want to waste her time or anything. Maybe this is just a value-add, you know … giving you something interesting to look at during your treatment.

Do you feel like you’re taking medical resources away from Covid-19 patients or people injured during protests?

Short answer: no. Again, there’s nobody in there, no one is scheduling elective surgeries right now. It’s just starting to get a little closer to normal but there were more staff than patients by a huge ratio. It was totally dead in there, just going through the empty hallways, like a ghost town. It’s almost like when you’re trying to support your small business so they don’t go under ... I’m giving this hospital some business. (Not that I would have chosen to, honestly.)

Do you think it’s in good taste to use terms like “dead” and “ghost town” under the circumstances?

Aw, lighten up!

Is the service really quick now, since you’re practically the only patient in there?

Oddly, no. I thought this X-ray thing was going to be pretty quick but I was there for hours. It was like usual: you’re seen by the nurses, then they leave, then the doctor comes in, leaves, comes back, then they’re ready for you down at X-ray, then you wait for those results to get sent to the doctor, then the shift changes and whatever and you get a new doctor, so I was sitting around for quite a while. I’m not sure why that is … maybe they’d sent too many of their staff  home.

Do they still give you a ridiculous orders like taking your shirt off well in advance of the doctor showing up so you have to sit there in an over-air-conditioned room for like 45 minutes shivering with no shirt on for no good reason?

Yes.

Is there any consequence whatsoever in completely ignoring the instruction to remove your shirt well in advance of the doctor actually showing up?

None whatsoever … I sat there with my shirt on. I’d planned ahead and wore a shirt with snaps down the front so when the doctor showed up, I popped down all the snaps in a row and whipped the shirt off in a jiffy. It’s important for patients to advocate for themselves.

Did everybody you talked to in both medical facilities ask you if you smoke or if you have ever smoked?

Answer is yes: all of them did. I got this question constantly, just as I did last time I was in the hospital for a broken femur.

Why do they ask this?

I’m glad you asked because I’ve posed this question too. The answer is, smokers just don’t heal very well from this kind of thing. Smoking doesn’t just wreck your lungs and your respiratory system—it stresses your entire body and puts it on the back foot no matter what it’s trying to recover from.  So don’t smoke!

Is it hard to schedule a surgery right now?

                                                                      

Hopefully you’ve never had to schedule a surgery but normally it’s a bit of a hassle, this little dance you do over several phone calls with the surgery scheduler whose full-time job is figuring out this puzzle with surgeon’s time so tight. But this was a piece of cake. The orthopedist recommended surgery, I agreed (I’m not going to second-guess the person who went to medical school) and he’s like, all right well, how about Tuesday?

Do they make you get a Covid-19 test before you can have an operation?

Yes, they actually will operate on you in a part of the hospital where there’s nobody with Covid-19, to limit any chance of exposure. So you have to get a test.

Is it hard to get an appointment for a Covid-19 test for an upcoming surgery?

Nope! Again, a piece of cake. They put in the order on Thursday and I got an appointment for Friday. So if you’re looking to get a Covid-19 test and you’re not getting any luck, just go get in a bad accident and injure yourself, and Bob’s your uncle!

Do you have to go to the same tent where all the symptomatic people are to get your test?

That’s a great question, because obviously you don’t want to be exposing yourself to the virus. Fortunately, they have a whole tent setup for asymptomatic people, which is pretty cool of them.

Do they really have a drive-thru Covid-19 test, and will they really serve you microbrews on tap there?

Two-part answer: yes, they really do have a drive-thru Covid-19 test, but no, they don’t serve microbrews on tap, at least not here. Maybe in Texas they’re doing that, or maybe in Oregon, but not in California.

That question about microbrews ... is that kind of a sore subject?

Yeah, it actually is and I wish you wouldn’t bring it up. Right now, in the days before the surgery, I can’t have Advil (as it thins the blood) so I have to take Tylenol, and I can’t have any alcohol with that because I care about my liver. So even though a lot of people are advising me to treat my symptoms with beer, I can’t, and I had to I had to give up a 32-ounce growler of Fieldwork IPA because it was going to go bad in my fridge. So that hurt, I think that hurt even more than my injury.

Don’t worry, the beer found a good home. The pal I gave it to later Beck’sted it from his patio.

Do they allow you to bring a pet in your car for the drive-thru Covid-19 test?

This is actually on my paperwork for the test: they specifically forbid you to bring a pet. If you have a pet in your car, they will turn you away, which kind of makes sense, right? Because if Rover is in the in the car with you and someone takes like this q-tip that’s like a foot long and sticks it so far up your nose you’re reminded of a sword swallower, Rover’s probably going to take action. Rover’s like, “Okay, that person’s killing my master—this is my finest hour, I’m going to save the day!”

Did you want to bring your pet to the Covid-19 test?

I have a cat. Needless to say a cat has never protected its owner so there’s no risk there. I probably could have filed the paperwork to have the cat registered as an emotional support animal, but only if they never met this cat. She’s useless. I’ve been laid up since Saturday and this cat will not get on my lap, will not even come around. It’s like I’m damaged goods, the cat is avoiding me like the plague. So no, I was not even tempted to bring her, not even to punish her, because she can’t change her stripes.

What was it like getting the Covid-19 test?

I was in the backseat of the car (I can’t drive right now) and somehow I’d been led to believe the person was going to get into the car but I think I must have been a little bit of a little bit confused. Instead the tester had me roll down the window and then she leaned in and first swabbed all over my mouth so needless to say I was not wearing a mask for this but obviously the tester was wearing a face mask, shield, the whole thing. Then she said, “I’m going to go up your nose.” And she sticks this thing up in there, gets it like an inch up my left nostril, and she’s like, “That one’s a little tight, I’m going to go through the other nostril.” I’m thinking great, what if this other one’s tight too … then what?

But the other nostril was apparently okay so she said, “This is going to last for 10 seconds,” and I’m really glad she gave me the countdown because it was weird, I mean it was like way in there, and I don’t know if you’ve ever had this happen where you’re eating pasta or rice so fast that you get a piece that goes way up in there so it’s stuck like halfway between your nose and your mouth and it just sits in there and kind of hurts, like when you hit a raw nerve with a drill when having a cavity filled without Novocain (which is how you should do it because it doesn’t hurt that bad) so it’s annoying and you’re thinking like “Oh god, I got pasta up my nose!” and then you get a Kleenex and you just blow your nose like super hard and then you feel the noodle bit flying out of your nose, when you look down you’re like, “There it is!” and it is just such a relief. So if you’ve ever had that happen, that’s kind of like what it’s like getting this Covid-19 test. They put the swab so far in there and kind of wiggle around and I’m kind of going “Uuuugh! uuuugh!” (but silently) and she’s counting, “All right, I got 5 more seconds” so I’m thinking “I can handle this!” and then it’s over. So, all told, we got there and sat around for a couple minutes while they did whatever and then from the time like the swab came out till I was done was like two minutes and then we hit the road.

How quickly did you get back the test results?

It was about 15 hours—pretty quick! They called me the next morning and let me know.

Do you have Covid-19?

No, I don’t. At least, I’ve tested negative.

Did they give you the antibody test so you can see if you’ve ever had Covid-19?

I asked about this and they said the antibody test gives so many false negatives (or was it false positives?), its accuracy rate is about 50%, so it’s just completely useless and they wouldn’t bother getting me that one.

If you test positive for Covid-19 do they still go ahead with the surgery?

I thought the answer to this would be no, they’d have to reschedule, but actually, given the severity of my injury, and since it’s not considered elective, they would move forward with the surgery even if I have Covid-19. They just would send me to a different facility where they have a “negative pressure” operating room where they can basically make it safer. I was kind of surprised about this and asked my doctor friend, who said, “Yeah, they should just operate, like why should they be so worried? They’ve got their PPE and this is the environment they work in; what’s the big deal?” I was kind of surprised … I was thinking it would be the patient at risk in that case. But I guess if you’re not showing any symptoms, it’s full steam ahead.

Would now be a good time to finally get a surgery for that chronic dandruff?

You know, as disgusting as my dandruff is—and it’s really bad, I’ll admit, it’s just a disgrace—I think I’ll wait until the pandemic is over before I go in for that scalp transplant.

More reading on the pandemic

• Shelter-in-Place FAQ
• E-Book Options During COVID-19 Lockdown
• Is Cycling Safe During the COVID-19 Pandemic?
• The Toilet Paper Hoarding Conundrum
• More COVID Chronicles – Baking in Place
• When Will the Pandemic End?
• How to Talk to Your Cat About COVID-19
• Teleworking During the COVID-19 Pandemic
• Why Don’t The Dutch Wear COVID Masks?
• Travel Tips During the COVID-19 Pandemic
• COVID Wristbands

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For a complete index of albertnet posts, click here.

How To Report Your Bicycle Accident

Introduction

This post describes best practices for reporting your bicycle crash to your family. (This is not an emergency response protocol; that’s another matter entirely.)

Before we begin

In no way do I seek to mock, trivialize, or brush off the potential seriousness of bicycle accidents. Of course they can be pretty bad, as I know from painful experience. This guide concerns those crashes (the majority) where serious injury does not result.

(Levity aside, don’t mess around with head impacts. If your helmet touches the ground, somebody else needs to evaluate you, period. I have seen a concussed cyclist in complete denial, which isn’t a surprise given the fuzziness that can accompany head injury.)

One more thing. This post will make it seem like I crash my bike a lot. I don’t. I’ve been at this sport for almost 40 years, and have logged over 200,000 cycling miles, including more than 200 races. Of course I’ve had my share of accidents but in the words of the venerable Marshall Mathers, I’m “still alive and bitching.”

Okay, all that being out of the way, let’s continue.

Do you really need medical intervention?

First of all, if the medical establishment gets involved in your crash, you will have a lot harder time “controlling the narrative” (to quote a legendary cyclist/doper). So the issue of medical attention becomes something to manage as part of your notification protocol.

Sometimes a bike crash is frightening to an onlooker who naturally fears the worst, and summons more help than is necessary. I wiped out in a criterium back in 1983 and got some nasty road rash, but nothing more. Alas, it was raining, I was soaked, my body fat was minimal, and post-crash I was lying on a wet lawn, so I was shivering. Somebody took this for me going into shock. The race medic flew into action, cutting up my cycling shorts with those razor-like shears they carry. My johnson dangled out, and—looking up at all these spectators, two of my brothers included—I reached down and discreetly covered up. (My brothers teased me about this for years. Had I not made that adjustment, of course, I’d have been teased for being an exhibitionist.) I was carted away in an ambulance, which caused quite a sensation. At the awards banquet that evening (this having been the final day of a stage race), everyone seemed surprised to see me back on my feet already. The race director said, “I thought you’d broken your hip!”

Other than the johnson part, I confess I wasn’t much bothered by all the attention. That’s because I was only 14 and didn’t understand the emotional duress this episode caused my mom. (When my brother crashed in a race later that season and broke his wrist, she resolved never to attend a bike race again—and she never did.) My dad, of course, seemed to take my crash in stride. He was the one who accompanied me to the hospital, which I didn’t wonder at back then, but now realize is probably because my mom was too freaked to take part. My dad had to fill out this form explaining how the crash happened, and to the question, “List any object the bicyclist came into contact with,” he drolly wrote, “Pavement.”

Of course my brothers gave me no end of flack about the outrageous drama queen behavior I had employed just so I could ride in the ambulance. They chided me for the unnecessary financial burden I had inflicted upon the family just to gratify my narcissistic thirst for attention. They way they went on, you’d think I had Munchausen Syndrome. But they did have a point: if it’s possible, you should decide for yourself whether medical intervention is truly necessary. Any one of my brothers would have loved to clean out that road rash with a toothbrush at home, which would have been only slightly less efficient than the nylon brush used in the ER. One rule of thumb: without a head impact, and in the absence of any obvious sign that you need an X-ray, maybe you should just limp on home.

How to get home

Even if you do need medical attention, this does not always warrant an ambulance. Back in the late ’90s, I had a fairly dramatic crash on the Golden Gate Bridge. I was able to get a ride home from a work colleague (details are here), which was a lot better than having to call my wife. If you can possibly manage it, avoid phoning your spouse/other to ask for a ride home. Engaging him or her causes several problems. First, this non-trivial inconvenience doesn’t put you on the best footing for the other inconveniences your crash may cause later (e.g., extra laundry, excessive groaning or whining). Also, if your spouse/other comes to get you, he or she will have the entire drive to fear the worst, even if you’ve assured him or her that everything is fine. (As I’ll get to, that assurance is not always 100% accurate.) And, if your spouse/other has to leave work to fetch you, his or her colleagues will wonder and worry. It’s all so inefficient! By contrast, the colleague who picked me up got a good laugh out of it because my well-being had no bearing on his.

The idea here is to forestall your spouse/other’s knowledge of your crash as long as possible, so that she can see for herself that you’re fine before even knowing you crashed. After the Golden Gate Bridge incident, I needed stitches, but I waited for my wife to get home so we could go to the ER (on foot) together. I hid the gauze on my (seriously bleeding) chin by assuming a pensive pose, like I was stroking a goatee, while we had a 5-minute conversation. Only after this did I say, as if suddenly remembering, “Oh, hey—I took a little spill on my bike this evening and need to get a few stitches. You wanna come with me to the ER?”

After another crash, when my bike suffered a broken crankarm, I got a ride in a Samaritan’s pickup truck to the nearest train station. While riding home one-footed from the station near my house, I stopped at a bakery for pastries, so that by the time my wife realized I’d crashed, she’d already know I was well enough to run a gratuitous errand. In fact, I wasn’t totally fine—I’d cracked some ribs, though I didn’t learn this until later. Though it was a pretty high-speed crash, it left very few marks on me.

In another case, I crashed on a descent near Oakland and hitched a ride home in a a friendly motorist’s van, my bike being again unrideable. I came into the house through the garage, announced to my wife that I was home, and then on the way to the bathroom whispered to my young daughter, “Bring me the first-aid kit from the kitchen cabinet.” I managed not to howl in the shower while scrubbing out my road rash, but it was all for naught because my daughter, halfway down the stairs, yelled out, “Hey Dad, why do you need the first-aid kit?” I should have explained the tactic better.

In general I don’t mind hitching a ride with a motorist, as their willingness to help is generally a good indicator of trustworthiness. That said, if somebody hits you with his or her car and then offers you a ride, you might think twice. After all, if he or she could be drunk, stoned, crazy, or some combination of these.

Now, the rules are a bit different if you’re not yet an adult. The best case here is that you have a friend with a car who can drive you to the hospital and/or home. In 1986 I crashed in a criterium in Denver, and the race medic directed me to the nearest ER for a few chin stitches. (Actually, since I wasn’t yet 18, he recommended the local children’s hospital, which had a much shorter wait. Good call, that!) My friend Bill drove me in his Volvo wagon. Unfortunately, he was in such a hurry to get going, he started to drive before I was all the way in the car, and managed to run over my foot. D’oh!

If you’re not yet an adult and don’t have a friend with a car, your parents are pretty much the only option (unless you have a local aunt or uncle). In this case you’re bound to scare the crap out of your parent(s) if you don’t play it just right. So do not have somebody else call if you can possibly avoid it; that implies that you’re out cold or otherwise can’t talk. Make the call yourself but do not say, “Oh my God! I’ve  just been in a terrible bike wreck!” (I have heard this said, by a young rider who was plenty frightened but wasn’t actually injured.) If you’re conscious and able to talk, chances are you can manage some composure for the duration of a phone call. An ideal explanation, given in as calm a voice as possible, would be, “Hi [Mom/Dad]. How’s it going? [Wait for answer.] Cool. Well, hey, um, I’ve got a bit of a problem with my bike. Could you possibly give me a ride home? [Wait for inevitable questions.] Well, yeah, I took a bit of a spill on it. I’m totally fine … it’s just that my [wheel/whatever] is all out of whack. [Wait for more questions.] Oh, yeah, I’m perfectly fine. Maybe a bit of road rash. Nothing to worry about.”

My own daughter called me last Sunday and said, “Hi Dad. Is there any way you can come get me? I had a crash on the bike path and I can’t get my handlebars straightened out.” On the way to fetching her I was only mildly worried. (Her bars, I’d like to point out, were perfectly straight, at least by the time I got there.) I give my daughter a B+ for this performance. She’d have earned an A, except there was a bit of a quaver to her voice. (Don’t worry, she’s fine.)

If you do need an ambulance…

The hardest call you’d ever have to make would be, of course, the notification that you’re about to be hauled off in an ambulance and need your spouse/other to meet you at the hospital. All I can recommend here is to accentuate the positive. Try to sound as chipper as possible, and lead off with whatever good news you can. For example: “I’m pretty sure nothing is broken but somebody called an ambulance, so I guess I’ll go get checked out.” If something is broken, you might say something like, “I’ve taken a spill on my bike but you don’t need to worry—my head is totally fine. It looks like I might have a fracture of some kind, though, so they’re taking me in an ambulance for some X-rays.” Do whatever you can to insinuate that the medical industrial complex is overreacting (“as usual”). Of course this will still be alarming but it’s a fair bit better than, “Oh my God! I’ve just been in a terrible bike wreck!”

Reporting your kid’s accident

Reporting your kid’s accident to your spouse/other is, needless to say, especially delicate, particularly if (like me) you’re the reason your kid rides bikes so much. If you take your kid to a bike race, ensure in advance that the folks in the medical tent have your cell phone number on file as primary, not your spouse/other’s. This isn’t just more practical, but it avoids undue stress in the case of an accident. It’s a lot easier not to worry when you’re onsite and can evaluate your kid for yourself.

After my daughter’s recent bike path crash, I wasn’t sure what to say to my wife, and in the end I said nothing. My daughter and I just waited until my wife noticed the Tegaderm dressings on her daughter’s forearms. By this point, we’d all been home together for at least half an hour so our daughter was obviously fine. “What happened?” my wife asked. “Oh, I crashed on the Ohlone Greenway,” our daughter shrugged. “That’s too bad,” replied her mom.

That’s about your best case scenario right there … other than not crashing at all, of course.

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A Tribute to Steve Tilford

Introduction

This post is a tribute to the late cyclist and blogger Steve Tilford.  I have a tale of his to share, which I wrote down shortly after hearing him tell it a decade ago.  It’s the kind of amazing story he’d have eventually told on his blog, if only.  If only.

Steve was tragically killed in a car accident this past week.  Friends and fans are reeling.  Fans include not only those who have followed his decades of cycling exploits, but those who have enjoyed his popular blog, stevetilford.com.  He was one of my cycling heroes as a teenager, and I’ve enjoyed his blog for years.

Getting to meet Steve

I met Steve only once, at a Coors Classic bike race reunion held at University Bikes.  (I snapped the above photo that night.)  The occasion was a party that longtime Coors Classic director Michael Aisner threw to celebrate the release of a DVD set—all the original Red Zinger and Coors Classic movies.  Aisner opened the party to the public and it felt like everybody in Boulder was there.  Afterward, he invited my brother Max and me along to get some pizza and beer with Steve Tilford, Steve’s partner Trudi, Todd Gogulski, and a few others.

We lingered for hours swapping bike race stories, until the busboy was practically vacuuming under our feet.  Steve’s stories were particularly good because for one thing, he was a natural-born storyteller, and for another, some of his stories were totally new.  This was a guy who never stopped racing, and whose everyday life was like some crazy story.  For example, just four days before this night, he’d been in a cyclocross race and veered off-course, rolled out onto a frozen lake, watched in horror as the ice broke, became completely drenched, and yet climbed back on his bike and raced six more laps—his hands totally frozen and unable to work his bike’s shifters—and won the race!  (Steve’s account is here; the cyclingnews story is here.)

I was planning a freelance article about the Coors Classic party, so I wrote down the best of these stories the next morning, as close to verbatim as I could get.  Some of them are on Steve’s blog, like this one about bunny-hopping a stream at 60 mph during the Milk Race, a huge stage race in Great Britain.  On his blog, Steve wrote, “I have millions of stories from my time in England. I could do a month of posts on them.”  I wish he had!  But this wasn’t a guy who lived in the past—he had too many new things to blog about.  Thus, my favorite of his stories isn’t on stevetilford.com, so I’m going to share it here as a tribute.

(I feel as though I have Steve’s permission, because I asked him that night if I could recount his stories in my article.  He said sure, and joked, “You can even make stuff up if you want—just make me look good!”)

Steve’s story

Here is Steve’s story, presented just as I heard it, to the best of my recollection.  It’s about the 1985 Milk Race:

It’s the last big stage of the race and the last chance for somebody to win the race away from us.  We’re really worried about the Russians, who are supposed to be really fast on the hills, but when we get to the first big climb they all just get dropped.  I said to Andy Paulin, look, the Russians are all dropped!  And of course he’s a huge guy so it’s not like we were going that fast.  We get to this descent and are just flying down it, and when we come around this curve some guy is coming at us with his car.  Andy hits the car and just goes flying.  I figure he’s probably dead. 

Now, everybody says I laid my bike down on purpose so the crash wouldn’t be so bad, but that’s not really what happened.  When you break a leg and a collarbone, it’s not because you crashed gently.  I go sliding under the car and stop when my bars get stuck between the ground and the bumper.  I’m pretty f---ed up but I know it could be worse.  So when they put me in the back of the ambulance I can tell I’m about to lose consciousness, it’s like a black tunnel is collapsing over me, and I look up at Trudi and say, “What about Andy, is he gonna live?”  She says, “Oh, yeah, he’ll be fine.”  Now I’m slipping away but before I do I’m like, “Wait—what about me?”  But it’s too late, I don’t even get to ask.

            So they take me to this tiny hospital in the middle of nowhere where every other patient is an eighty-year-old man, and at first I’m stoked because I’m this young American guy among all these good looking English nurses.  I’m getting these nice sponge baths and everything, but then they tell me the doctor only comes once a week!  I’m pretty sure my leg is broken but all I’m getting is sponge baths.  Finally the doctor comes and tells me, yeah, it’s broken, and I’m looking forward to the plaster cast, but instead all I get is a nurse wrapping it in an Ace bandage!  Even so, I made out better than Andy.  He was at the other hospital and got sick of being there, so he just left, only to pass out at a train station that afternoon.  He made his way back to the hospital, but they wouldn’t let him back in!

Further reading

Here are a few links to Steve’s blog featuring (or mentioning) the Milk Race:

The British Milk Race

I Don’t Bounce So Well Now

One of the Coolest Race Moves I Ever Made

A close friend of Steve Tilford’s, Vincent, is maintaining the blog, providing news in the aftermath of this terrible accident, and offering friends a way to share their own stories.  You can click here for details, and visit the main site, stevetilford.com, for the latest updates.

The Femur Report - Part III

NOTE: This post is rated R for mild strong language and disturbing images.

Introduction

This post finishes up the dark story of my broken femur. (Of course it’s still broken, and it’ll be a long road back, but this will be the last time I’ll write about it.) If you’ve stumbled on this post without reading my last two, click here and here to check out my first and second installments.

As I said of my last post, please note that though I’ve reported this episode as faithfully as I can, I cannot vouch for the accuracy of every detail. Especially where vast pain is involved, memory gets distorted. But I haven’t deliberately fictionalized anything and in fact have tried to be as straightforward as possible in the telling.

Surprises

During my third day at the hospital (November 29), my pain only got worse. A nurse arrived unbidden at my bed and announced it was time for some pain killers. At first I was pleasantly surprised—this was the first time I hadn’t had to ask for them—but then I saw him popping two rather large white tablets out of a foil pack. “What are those?” I asked. He replied, “This is Tylenol.” I managed not only to keep from snorting but from saying something snide like, “Do you have any placebos I could use instead?” I kept quiet because I sensed I had little goodwill to spare with these nurses, but really the Tylenol was a joke.

The stretches between the real medication grew longer. I was now getting half the dose I had originally been given, and instead of every four hours it was every six. I overhead a nurse talking about a shortage. The pain had strange characteristics unlike anything I’d experienced before. Instead of the leg just aching and throbbing and giving stabs of sharp pain—though I did have all of these—I also had the sensation that my thigh was as big around as a barrel, and that the bandages running along my three incisions were a quarter-inch thick and made of plywood. My left wrist—uninjured in the crash—was also causing me a lot of pain; a nurse unwrapped the bandage from it to reveal that the whole wrist was a deep purple, with a stripe running along it of an even more saturated hue. Nobody could explain what that was about; perhaps it was a botched arterial line.

I was on the phone with a friend when a nurse came around to inspect me. She didn’t seem to need any input from me so I continued my conversation. Suddenly there was an intense, sharp pain in my male unit and I shrieked (into the phone, of course). All at once, the nurse had yanked out my urinary catheter! The pain was accompanied by a sensation of frightening wetness which I took at first to be blood, but which was actually just some leftover urine. My friend on the phone must have feared the worst and asked what happened. “A nurse just ripped my catheter out!” I told him. She looked at me sheepishly. “Sorry, I figured if I did it all at once it wouldn’t bother you so much,” she said. Sort of the ripping-off-the-Band-Aid strategy, I guess.

Later, another nurse expressed surprise that I’d filled my bedside urine receptacle. “A lot of patients find they’re unable to urinate the normal way after they’ve been catheterized,” she explained. I hadn’t known this and now I was greatly relieved. From this moment forward, successfully peeing into that thing felt like a triumph. In fact, whenever I did it I got Homer Simpson’s voice in my head yelling, “Yes! Yes! Ohhh, Yes!”

Presently the physical therapist arrived for my second session of the day. Again, this consisted of taking a short march, with my walker, from my curtained-off cubicle down the row of other cubicles and back. It was oddly exhausting but I guess I did well enough, for she announced that I’d have one more session the next morning, and if I could manage a short flight of stairs, she would sign me off as complete—meaning I could go home.

This great news was followed by another challenge: after two and a half days, I had to defecate. I steeled my resolve and figured that based on the success of my expeditions with the walker, I could handle the restroom. I’d need help, of course. I asked a nurse, and she responded as if I’d asked her to help me rob a bank. “I’m not allowed to assist you with that,” she said. “You have to get a physical therapist.” Of course I had no way to summon the physical therapist, so I asked for a bedpan. The nurse looked at me with disbelief, as if she’d thought bedpans were a best-kept-secret of the hospital. “A what?” she asked. Nice try. “A bedpan,” I persisted. She stalled for time. “What size?” she finally asked. What answer was she expecting? “Small”? “Never mind”? I told her Large, and a bit later she came back with what I suppose was the large size bedpan, though it didn’t seem very large to me. Not that I was an expert: it had been sixteen years since I’d last seen one, when my brother Geoff was in the hospital. And of course I’d never seen him actually use it, so I had no idea what to do. Not that I was about to ask for a tutorial at this point. I had to wing it.

When I’d done my damage—serious damage, I might add—I found I couldn’t get the nurse to come over. With great effort I held myself suspended over that foul, fouled bedpan for what seemed like a very long time. Finally the nurse came over and I asked for help getting rid of it. She said she’d have to come back. They always say that. I asked her to please hurry.

She didn’t. To make matters worse, a couple of friends had arrived to visit. I could hear them being denied access, based on me being “detained,” and I think I heard them chuckling. And yet the nurse still wouldn’t come back. Finally she showed up, her face awash in reluctance, and she gave an Oscar-worthy performance of having never in her entire career seen a patient actually use a bedpan. Where I was desperate, she was hesitant. The two of us grappled haplessly there, trying hard to keep the sheet from getting soiled during the disposal process. It was like Tweedledum and Tweedledee trying to clean up after a grisly murder. Thus was my last shred of dignity finally expunged.

Visit

As the patient across the curtain from me asked for some air freshener, my friends were finally admitted to my cubicle. They’d come straight from work, which reminded me that there was still a world out there in which people worked in office buildings. Not long after, four more friends arrived—all of these bike people—bearing Zachary’s pizza and (for themselves) wine. Needless to say my spirits were buoyed; actually, I think salvaged would be the better word. At first I didn’t think I’d be able to eat any pizza, as my appetite had been absolutely nonexistent since the previous morning. I had one slice, and then, to my own astonishment (but nobody else’s), had another. Looking back, those two slices and a third one the following morning were almost all I ate while at that hospital.



Of course we all had much to discuss, such as the events I related to you in Part I of this tale. Before long we had a full-fledged, rollicking dinner party going. All this was of course good distraction from my physical pain; when I think of the visit I don’t remember suffering during it. As a bonus, for the first time in two days I couldn’t hear that infernal TV across the curtain in the cubicle next to mine—we were drowning it out. By the end of the visit I was pretty exhausted but was sorry to see my friends go.

My worst night

The evening dragged on and on. There was a violent action movie playing on the TV, four feet from my head. My leg was killing me. My head felt vacuumed out, my mouth completely dry. My mind wasn’t calm enough to allow reading. I was tired of listening to music and didn’t want to ruin any more of my favorite tunes through future association with this bleak time.

Then there was a shrill alarm from a nearby cubicle. I knew what it was, from my brother’s hospital days: an I.V. drip had gone dry, or was on the verge of it. It’s an important alarm, because if an I.V. goes completely dry, the vein collapses and can no longer be used. But what else did this alarm suggest to me, with its absolute ear-splitting, incessant shriek? It took awhile but I figured it out: it was just as piercing and intolerable as a newborn baby crying. That well might have been the design intent of this alarm, just to make completely sure it would be impossible to ignore. And yet, astonishingly, the nurses—all four of them—were actually managing to ignore it. Where were these people? I pressed my call button. Eventually a nurse arrived, looking put-upon. “What is it?” she asked. “Well, are you ever going to do something about that alarm?” I asked. She looked startled, as if she simply hadn’t heard it until now. Unbelievable. (Why hadn’t the patient in that cubicle summoned her? I have no idea. Maybe he was dead, or maybe that cubicle was empty and it was just a malfunction.)

With the shrieking finally silenced all I had to contend with was the sound of people being shot, run over, and tortured to death. The TV movie didn’t bother with music or dialog or anything: just nonstop killing. My wife hadn’t called, and I was getting worried that the hour would come when I couldn’t take phone calls, or that my calls weren’t making it through. I had to tell my wife about the prospect of being released the next day, so she could find somebody to watch our kids while she picked me up. When a nurse happened by I asked her if I could please borrow her phone, just for a couple of minutes, to call my wife. (My own cell phone was with the police, along with my bike and other stuff gathered at the accident scene.) The nurse looked down at the cell phone clipped to her waist, as if it had betrayed her with its visibility. “Well, maybe a little later, when I come back,” she said. Translation: “No, and just to be sure, I’m never showing my face back here again.” (Obviously if she’d been willing to loan her phone to me, she’d have just said yes.)

Suddenly, an object came sailing at me from behind the curtain across the aisle. Amazingly, I managed to catch it. It was a cell phone. “Call your wife,” came a voice from behind the curtain. “Talk as long as you want.” I was filled with a sense of camaraderie with this unseen fellow inmate. I called Erin, made some quick arrangements for my Great Escape, and then asked the nurse very sweetly if she could possibly return the cell phone to its owner.

As I tried to fall asleep I start to feel really, really bad. My pain escalated and my heart was racing. I could hear my pulse pounding in my ears. Meanwhile, the wind was picking up outside and howling right through the leaky windows on my right, chilling me to the bone. I even started to feel delirious: I was having increasing difficulty convincing myself that the screams from the TV weren’t coming from actual people in the next cubicle, and that the wind through the window wasn’t going to spin me off into the night.

Somebody came by to take my vital signs. Every one of them was bad. I had a fever of 102; my blood pressure was crazy high; my pulse was 90 (compared to mid-40s normally). The person taking these readings looked a bit concerned and commented on my fever, but then left. She wasn’t one of the regular nurses. Another hour crept endlessly by, my pain continuing to increase. I was starting to feel frantic. I pressed my call button. A nurse came over. I explained that my pain was through the ceiling and all my vital signs were bad, and that I didn’t feel right. She said, “Well what do you want me to do?!” I said I wanted a doctor. She left.

I started to worry that I was actually going to die. Looking back, this wasn’t exactly rational, but then I was half out of my mind. I had a vision of a sensor moving through the room, beaming a red line that picked up everything and recorded it, and how quickly it would pass over me, how insignificant my form would be. It would register even less then the bed I was in. Moreover, my small existence was confined to the immediate present: the fact that I’ve walked the earth for forty-two years was immaterial, a flash in the pan, and the future was completely up for grabs. If I died right now, I thought, I would be erased so thoroughly I might as well have never existed. It was the closest I’ve ever come to believing in my own mortality.

I pushed my button again. A different nurse came. I repeated my complaints and again asked for a doctor. Instead I got the head nurse, but at least he was sympathetic. He also seemed as disgusted with the other nurses as I was. The first thing he did was give me more pain meds. “You’re allowed to ask for these,” he said. “The nurses have guidelines but they’re only guidelines. They act like they’re rules but they can always consult with the doctor and they know it.” Then he stripped off my bedding. It was all tangled and knotted up, doing me no good. Then he started pulling up and discarding the absorbent pads from beneath me. These pads are basically the same thing as what you get with store-bought chicken, that sit between the chicken and the Styrofoam tray, to absorb drippings. “Don’t let the nurses use these,” he said. “They’re disgusting and uncomfortable.” I couldn’t have agreed more. The guy put my bedding back in shape and gave me an extra blanket.

After that I felt much better—just to have been paid attention to was greatly comforting—but the pain was still awful. So I tucked my blankets in all around myself, thinking of how I used to swaddle my daughters when they were babies. In my delirium my cubicle had seemed to grow and grow, to where it was the size of a handball court, then ever larger, like I was Alice in some Wonderland scenario. I decided to try using these illusory sensations to my own benefit, and imagined I was a little Asian doll, wrapped tightly in a paper dress that was like origami. I held absolutely still in my bed and soon began to feel I was rising up out of my paper-doll body, looking down at it, tiny but perfect in its symmetry. I rode this perception as long as I could and the next thing I knew, it was hours later and I’d actually managed to sleep. My head and body had that vacuumed-out, dried-out sensation and the pain was awful, but morning was that much closer, and it was finally time for more pain meds. I even managed a couple more hours of sleep before dawn, and by morning the TV channel had switched to something merely asinine, rather than ultraviolent.

Final Push

Late the next morning (November 30), the physical therapist returned for my “final exam.” She reiterated the plan: I would use the walker to leave the hospital room, go down a hallway, and stop at the stairs. Then I’d switch to crutches, go up a short flight and come back down, and then switch back to the walker and return to my bed. If I could do all this, I’d be a free man.

It took a great while, perhaps ten minutes, to make it to the stairs. Finally I got to the landing, but suddenly started to feel incredibly dizzy. I told this to the PT, who had me turn so my back faced the wall, and said to lean back a little bit to rest against the wall. She supported me at the waist. I felt dizzier and dizzier.

Suddenly I awoke. Holy shit, where was I? How long had I been out? Amazingly, I was still standing. My vision returned and I saw the PT looking up at me, her face a picture of great concern. There was also a nurse looking at me worriedly. The nurse had brought a chair. “Are you okay?” asked the PT. “Did you pass out?” Imagining another night in this hospital, I lied. “No, I didn’t pass out, I’m okay, just a bit dizzy,” I said. They sat me down in the chair and the nurse slapped a blood pressure cuff on my arm. “You are really pale,” she said. My blood pressure was extremely low. I was taken back to my bed in a wheelchair. Needless to say I’d totally flunked my final exam. But to my surprise and relief, the PT said she’d give me another chance later in the day.

Not long after she left, I got a phone call from an MD friend of mine. Hearing what had happened, he asked how long before my physical therapy I’d had pain meds. I said not long before. He advised that the pain meds can lower your blood pressure and lead to dizziness. Remarkably, another MD friend of mine called not long after, and gave the same advice. So I stopped asking for pain meds, and when the PT returned, a few hours later, I felt more confident. Hedging her own bet, she’d brought a wheelchair. “This time, I’m wheeling you to and from the stairs,” she announced. At the stairs, I got up on the crutches, and heeded the PT’s advice: “Up with the good, down with the bad.” That is, I planted my good foot on the higher step and brought the crutches and bad leg up to meet it, and then at the top turned around and came back down leading with my bad foot. It worked, and I passed.

From there, many hours passed in bureaucratic hassles. The nurse wasn’t allowed to give me pain meds within an hour of departure, and since my departure time got dragged out two hours, I was in great pain when it was finally time to leave. (I know: waah, waah, waah.) I was wheeled through the halls, into an elevator, down into the crowded lobby, and Erin went to get the car. She pulled up and I was wheeled out there. Getting into the car was really, really hard. I had to lower the parking brake handle and grab the steering wheel and slide myself almost into the driver’s seat to get my right leg—which wouldn’t bend—into the car. Erin got me all settled in and then, reflexively, gave me a little pat on the leg. I yelped in pain. Some homeless dude standing on the curb called out, “Man, you can pretend you’re embarrassed now, but when you get home you’re gonna want her to be pettin’ you!” This was amusing, but then the guy repeated his quip continuously while Erin loaded my walker and crutches in the car and we slowly rolled away. He wasn’t quite right, that guy.

Three friends had arranged to meet us at our house, mainly just for a visit but also to help moving me in from the car. It was tricky extricating myself, Erin carefully moving my leg like a piece of rotting lumber. It was like a contortionist’s act in reverse. It’s a good thing my friends were there, because I’d forgotten our street is on a slope that ran perpendicular to my trajectory with the walker. The walker is a spindly thing and surely would have buckled and collapsed like a crappy tin cheese grater had my friend not bolstered it from the side.

I made the ten or twelve feet to the porch steps in possibly less than two minutes. I switched to the crutches, and here I had intended to rest for a minute. But suddenly I felt really dizzy, just like during my ill-fated PT exercise, and I feared I would faint. So I pressed on, getting past the stairs and continuing, on my crutches, in a sort of slow-motion sprint to the door. Erin had it open already, and somehow I made the couch. I was so relieved. I had made it. I was actually home.

Now

It’s been a month since the crash. I can get around the house pretty adroitly with the walker and on crutches now; I generally use the crutches because I feel they present a slightly less pathetic sight for my family. Sleeping is really difficult—I’ve never been good at sleeping on my back, and my leg still hurts—but it’s so nice and quiet here. The only sounds are conversation, my daughters playing, the clatter of dishes, and my daughters practicing their instruments. Fortunately my job allows me to work from home, so I’ve been back at that. My right leg can bend almost ninety degrees if I dangle it from the edge of the bed and push on it with my other foot. I have lost fifteen pounds and get chilled easily. I have a long recovery ahead of me but I’m on my way.

Other chapters

2014 update: it occurred to me to add links to all the chapters of this tale now that they're available. Here you go:

The Femur Report - Part I (posted Dec 11, 2011)
The Femur Report - Part II (posted Dec 19, 2011)
Physical Therapy (posted March 11, 2012)
Bike vs. Car - How I Broke My Femur (posted Nov 27, 2013)

The Femur Report - Part II

NOTE: This post is rated R for mild strong language and disturbing images.

Introduction

This post continues the sad, alarming tale of my broken femur. If you’ve stumbled on this post without reading my last one, click here and catch up.

As I said in my last post, please note that though I’ve reported this episode as faithfully as I can, I cannot vouch for the accuracy of every detail. Especially where vast pain is involved, memory gets distorted. But I haven’t deliberately fictionalized anything and in fact have tried to be as straightforward as possible in the telling.

Waiting

On Sunday, the day of my crash, I had an overnight in the hospital waiting for the surgery. I don’t know if there was a reason not to operate right away, or if it simply took that long for the surgeons to be available.

My hospital room was the typical multiplex, with curtains separating the patients, so my world was constricted to a curtained cubicle with nothing in it but the adjustable bed and the rolling table alongside with its industrial accessories (e.g., drinking cup, kleenex caddy) the color of silly putty. The nurses were deathly afraid of me, donning rubber gloves for every interaction, even just filling my water. I was shown me the button to press to summon them, and in so many words told not to press it unless I really, really need something. (Kind of like “Go away, kid, ya bother me” except I couldn’t go anywhere.) My eyes were dry. I took out my contact lenses and ditched them on the side table where they writhed and dried up.

I slept okay at first because of the nerve block in my leg, but by the wee hours of Monday morning I was wide awake and suffering. The guy one curtain over was up too, watching some awful TV show. The TV, just beyond my curtain, was closer to me than to him. I could see a clock from my cubicle but couldn’t quite read the hands. I made it through dawn to a weakly lit early morning that seemed to take a whole day to get through. I had a phone in there but couldn’t dial out. My brother Bryan called, and managed to conference in our mom. She took the news pretty well, considering she’s a mom. Bryan and I joked that she should be the one to call our dad and tell him. (Those two haven’t spoken since 1984.)

Surgery

My wife arrived (taking care of our two daughters meant a certain amount of juggling) and in the late afternoon we got a reservation with the surgery department, and headed over there. It was a long trip because my gurney, with the traction apparatus sticking off the end, was too long for all but one of the elevators. Eventually we made it to a much larger curtained cubicle on another floor to await the operation.

It was quieter in there and for some reason—perhaps a more generous serving of pain meds—I felt a strange sense of calm. Maybe it was a forced calm, to protect myself from the unpleasantness of contemplating general anesthesia, or complications in the surgery. Prior to this accident, I’d never been checked into a hospital; had never had surgery (other than the screw in my tibia the previous day); had only broken one bone (tibia, age nine); and basically hadn’t put the medical industry through its paces. I was definitely having some dread; I drank in the sight of my wife, probably flat staring at her, as if saving up my memory of her for—for what? The afterlife? I babbled to her about this and that and everything else. On and on I babbled and she was kind enough not to ask me to shut up.

The surgery got pushed back and back until I was pretty much last on the docket. And then suddenly we were in motion again, down some hallways. We rolled past the nursing station and a convex mirror in which I glimpsed a horrific hollowed-out and jaundiced face, like a rock-video image expertly contrived to be as uncanny and creepy as possible. “Now there’s a sorry-looking bastard,” I thought to myself, just as the realization hit me—or had I known all along?—that the reflection was of me.

Probably you’ve heard about general anesthesia and how they put the mask over your face and have you count backward from 10 to 1, and before you get to 1 you’re out. Well, it’s not really like that. If the patient is a child, they may put the mask over her teddy bear’s face first. Lacking a bear, I chatted with the doctors, all of them very casual and upbeat, and a mask was produced. It wasn’t put on my face right away—it was more like when somebody is handing around beers. Then they had it on my face but nobody was asking me to count anything.

Suddenly I found myself in the midst of something violent. I seemed to be tumbling, head over heels, like I’d been pushed over the edge of a terribly steep ravine. I was being smashed from every side. Here and there I caught a flash of orange—the color of my cycling clothes. I struggled to understand what was happening and ultimately came to realize that I was in a fight—not a fair one, either, I was badly outnumbered—and was getting the shit beaten out of me. It was futile to fight back—all I could do was try to cover my head. And then suddenly I was on my back, in a hospital bed, squinting in the light.

Recovery

There was a dude in there, in the recovery room, sitting on a stool staring blankly at me. He really didn’t look very friendly. I asked, “Where am I?” He stared at me with a look that said, “Don’t make me laugh.” I grasped that the surgery was over. But what was that violence all about? I was really shaken up. “Is the surgery over? Am I okay? Did it go okay?” The guy was still silent. “You’ll have to talk to the surgeon about that,” he said finally. I wondered if the anesthesia had worn off prematurely during the operation. Could I have put up a fight with these guys, I wondered? Had this guy been in the room? Had I perhaps taken a swing at him? Is he wary of me lashing out again?

Still nothing from the guy. If he had just put his hand on my shoulder and said, “You’re in the recovery room, the surgery is over, and everything is going to be fine,” I would have felt so much better. They could hire an actor to do that. What was this guy’s skill set? To cover his ass? To note in my file, “Disoriented,” and move on? Without another word he had me wheeled away to my hospital room.

I got to my room and my curtained cubicle. I was in pain and—my earlier instructions be damned—pressed my button for the nurse. A nurse I didn’t recognize—he looked to be about eighteen—showed up, and I asked for pain meds. He disappeared. Ten minutes later I pressed the button again. He came back, looking sheepish. He explained that I wasn’t in their system—there was no record for me, no file—so they couldn’t give me anything. Sorry. Had I been thinking straight I’d have shown him my wrist band, but of course I wasn’t thinking straight. Just then my phone rang. It was my wife, Erin. She asked how I was and I told her about the file and the problem getting meds. I didn’t have much else to tell her.

I lay back. My original I.V. site, the inside of my left elbow, had been abandoned. It’s just as well—it had become blood-crusty and gross, the needle slack and flopping around, before the surgery. And now I had a big bandage on my left wrist, which was peculiar because it seemed like one of the few places I hadn’t been injured from my crash. (I’m exaggerating, of course; my whole left side was unscathed except for road rash on my fingers.) My right thigh was swollen to the size of a belly, my leg all wrapped up in miles of Ace bandage. There was a tube coming out of my leg attached to a weird double-disk contraption, floating free in the bed. I had a new I.V. going into the back of my right hand. The TV blared next to me. I zombied out for a spell, but couldn’t sleep due to pain.

Eventually—I have no idea how long I waited—another nurse showed up and apologized for the mix-up with my file. I’d been brought back to my room just as the shift was changing for the nurses, hence the confusion. (Such great timing. I made a mental note to take the recovery room guy off my Christmas list.) Finally I got some pain meds. Maybe ten minutes later a third nurse came over, telling me my wife was on the phone but they couldn’t put the call through because it was after 10 p.m. (The TV can be on loud all night, but humans must be shushed.) The nurse said that my wife wanted to know if I’d finally gotten some pain meds.

Suddenly I realized how ungrateful I had been: when I’d talked to Erin about the pain med problem, I thought I was just griping. I didn’t realize that by telling her of my problem, I had launched her into action, that from that moment forward she’d be doing everything in her power to resolve the issue. She’d probably been all over that nursing station like a rash to get things cleared up. Of course she would: “sucks to be you” is not in her vocabulary. I told the nurse—who herself hadn’t been filled in on anything—to tell my wife things had been ironed out and I’d gotten my medicine.

With my pain relieved, I was able to sleep for spells at a time. There was a device like a blood pressure cuff on my left calf that periodically inflated, then gradually deflated. Its purpose was to increase circulation, so as to prevent blood clots. The way it rumbled on my leg was like a cat purring, and a dozen times that night I awoke from a light sleep with the pleasant awareness of my cat Misha purring and stretching against my leg. Then I would remember where I was and the actual source of the vibration. At one point a nurse was attending to me, helping get me comfortable, soothing me with words, and checking on the device, and she had the patience to listen to me talk about my cat. “Mmm-hmm,” she said, sincerely, and said something nice about cats. She was a really sweet and caring nurse—as good as they come.

Purgatory

I needed to log thirty-six hours of hospital time, enough for a course of I.V. antibiotics to get into my system, before I could go home. I managed to sleep through the night until early, early the next morning (Tuesday). The TV behind the curtain could not be stopped. Information was coming in, drip by drip, of a big shooting in Oakland. The newscaster repeated every few minutes that one of the victims was a year-old baby. He wanted to be very sure nobody missed this point. He brought it up again and again, like a bully on the schoolyard rubbing it in. Across the hours of this coverage—one tiny new fact every half hour or so—there were the ads, depressing ones. A vocational college to try to re-employ you. A reverse-mortgage to get you “the money you deserve” (translation: “here, let us finish you off and completely destroy your financial picture once and for all, you stupid wretched bastard”).

My unit had been equipped with a urinary catheter. I have to tell you, these devices are overrated. When I had discovered the thing the night before, I was of two minds about it. First, I felt it was totally unnecessary, as I’d told the surgeons right before the operation that I’d just finished completely emptying my bladder. I guess that wasn’t good enough for them. At the same time, I looked on the bright side and thought, “Well, for once in my life I won’t have to get up in the night and pee. That’ll be nice.” But catheters aren’t like that. They never actually drain your bladder. In fact, the pee just sloshes back and forth between your bladder and whatever is at the other end of that tube. It’s really unpleasant because you always feel like you have to pee. Now I lay in bed and wondered who had thought this thing up. I pictured two surgeons who had just had their operating table soiled by their patient, and one surgeon says to the other, “Why couldn’t we just shove a tube right up the patient’s dick to drain off his piss? Make things a lot easier.”

Because my surgery had been pushed out so late, I had worried about getting dinner afterward, so Erin had gone out to the grocery store and outfitted my room with enough food for an army, or a bike club. I’d been too out of it to eat after the surgery, but now I managed to eat half a sub sandwich. I hadn’t eaten since Saturday evening (this was Tuesday morning) but after that half-sub I couldn’t eat another bite. My breakfast arrived and I couldn’t look at it, other than the milk. My neighbor was complaining—“Why do you keep bringing me this? I can’t eat this!”—and later I heard him barfing. No prima donna he; whatever they were serving him was literally making him ill. He would alternate between heaving and cussing.

On the plus side, my phone started to ring. My wife had gotten word out to my bike club about the crash; there had been much speculation because a cyclist from another club saw me being loaded into the ambulance and thought he’d recognized me. So calls began to trickle in from friends. I was so grateful for those calls. They reminded me that there was a world outside my curtained cubicle, and a world outside the gangland shootings and daytime TV, a world that I still belonged to, whose inhabitants still remembered me and wished me well. And then Erin arrived, bringing all kinds of goodies: an MP3 player, a book of existentialist philosophy, and my glasses (so I could finally read that clock).

During Erin’s visit, the physical therapist came around to get me on my feet and using a walker. This seemed absurd, of course, but she assured me it was possible. She had more info than I did about the surgery: because of the titanium rod, my leg was technically capable of supporting my full weight. She carefully lowered my leg to the floor. Somehow I got upright. I supported myself on the handles of the walker the way lazy people do the Stairmaster at the gym. My right (bad) leg was basically dangling, and that alone hurt. I pushed the walker forward six inches. I didn’t dare put weight on my right leg, and thus didn’t dare raise my left foot from the floor. So I used a squirming motion to slowly advance my left foot six inches. My right food would do nothing. It was about as responsive as a phantom limb; it could have been a counterweight strapped to my hip. I reached down with my right hand and pushed my foot forward. Amazingly, it complied, sliding forward six inches until it was level with its strapping, heroic, uninjured mate. I repeated this process and made a grand tour of about six feet out and six feet back, which took about five minutes. The physical therapist promised to return for another session later that day.

After my wife’s visit—she had to compromise between attending to me and giving our kids as normal an experience as possible—I put in headphones and listened to some music to drown on the TV. I chose the lightest, easiest tunes possible (e.g., Sade, Beck) and focused my entire brain on it. The music had never seemed so complex and multilayered, and for days afterward every track I’d heard would come back and invade my head. I almost always have some tune in my head, using about 2% of my brain power, but these came back strong, taking like half my brain. The tracks I listened to in there are ruined for me forever, so strong is the negative association with those hospital days.

I was in serious pain. The hospital ran out of the drip version of the pain medication and they started giving it to me orally. That didn’t work nearly so well. The pain began to take over, especially in the long dull sections of the day when I wasn’t on the phone. Soon it was all I could do to try to find a position where the pain was manageable. No other thought was possible; the idea of, say, reading seemed absurd. Using my hands I would adjust the position of the leg, causing it to shoot out rays of pain in every direction, and then hold very still and wait to see how far that pain would recede. If it went right back to the baseline (i.e., unacceptable) pain level, I’d try again. And on and on.

To be continued…

It’s late and time to think about something else for awhile so I can sleep. So I guess this is about as good a place as any to cut my tale off for now. I reckon there will be one more installment of my unpleasant story. There’s still a bit more to tell.

Other chapters

2014 update: it occurred to me to add links to all the chapters of this tale now that they're available. Here you go:

The Femur Report - Part I (posted Dec 11, 2011)
The Femur Report - Part III (posted Dec 28, 2011)
Physical Therapy (posted March 11, 2012)
Bike vs. Car - How I Broke My Femur (posted Nov 27, 2013)

The Femur Report - Part I

NOTE: This post is rated R for mild strong language and disturbing images.

Introduction

I had a bad bike wreck on Nov 27. Writing about its aftermath isn’t the most cheerful way I could spend my time, and I wouldn’t expect reading about it to be uplifting. Still, it’s been an extraordinary experience and it would seem a shame not to record it.

Note that though I’ve reported this episode as faithfully as I can, I cannot vouch for the accuracy of every detail. Especially where vast pain is involved, memory gets distorted. But I haven’t deliberately fictionalized anything and in fact have tried to be as plain and simple as possible in the telling.

I’m not going to get into how the wreck happened. That’s a whole other story that makes me angry to think about. So I’ll start with when I hit the ground.

The ground

I’m on the ground. A second earlier I was upright, on my bike, enjoying a mellow, unrushed descent at the end of my ride. I’m astonished at how quickly I was dropped to the ground, like a duck shot right out of the sky. I’ve been cycling competitively for thirty years and this is not how a crash usually unfolds. I’ve written at length at how in a crash situation time seems to slow down and I can easily perceive what is happening and what action to take. Not so today. BAM—like that, I was down. I heard my helmet sliding on the ground but only for a second. I didn’t slide much, but rather ground to a stop.

Every experienced cyclist knows that after you crash the first order of business is getting out of the road. This isn’t a sports field where you have a moment for self pity or mustering your resolve—it’s a road and you could get run over. So you scramble to get up as fast as you can. In the past I’ve started this scramble even before I stopped sliding along the road. But today I cannot begin to get up. Mainly this is because I cannot stop screaming, and the screaming is taking all my energy, all my will. I am screaming louder than I thought possible.

I’m screaming in pain, which is remarkable. Crashing on a bicycle doesn’t usually involve that much pain, at least not up front. Initially our bodies give us a surge of adrenaline and endorphins and the pain is masked almost completely. We can snatch up our bikes, run off the side of the road, check things over, and (if it’s a race) can often straighten out our handlebars, climb back on, and start chasing back to the group. The pain doesn’t arrive until later, when you’re cleaning out your road rash. But today? This was at least twice as much pain as I’d ever felt before in my life.

I can see my bike in the road. The impact has knocked the chain off the front chainwheels, which vexes me inordinately. The water bottle has been knocked out of its cage. Closer to me, I see blood dripping on the ground but I’m not sure what part of me it’s coming from. And the ground, this road—it’s a medieval surface of smooth pebbles imbedded in asphalt. I can start to see why such a relatively low-speed crash has hurt so badly—it’s an incredibly hard surface (pebbles being far harder than asphalt) and doesn’t allow you to slide. Whoever chose this surface material should be tried for a war crime.

Help

With astonishing quickness several people swarm around me. They’re local residents who have heard my screams. “I’ve got to get out of the road,” I tell one. He is crouching next to me. “Don’t worry, we’re stopping traffic,” he said. For a moment I think of asking him to get the Advil out of my toolkit but of course I see the absurdity. “I’m in so much pain,” I tell him, and scream some more. I’ve found what for some reason seems the least painful position: my right leg is straight forward—its hip is the center of the pain—and my left leg is bent double so I’m in a half-squat, leaning forward, supporting as much weight as possible on my left hand. My left arm shakes with the effort. “Who has a signal?” someone asks. “I do, I’m calling,” someone answers. I tell them, “I don’t think I need an ambulance,” but immediately I realize this is wishful thinking. “Actually I do.”

A guy on my left says, “I’m a doctor. You’ve got a broken femur. We called an ambulance.” There’s a cyclist on the scene and he has taken my bike out of the road and leaned it up against something. I can see he’s put the chain back on and I take strange comfort from this. Someone asks me for my home phone number and in a moment I’m talking to my wife. This is the worst call to have to make. I give her the news—my head is fine, but something is broken—and hope that I sound merely miserable, not scared.

A fire truck arrives from a station that is very close by. I beg for pain meds. They work quickly but it could never be quick enough. I get 5 mg of morphine intravenously but it doesn’t do anything. They’re cutting off my clothing. The EMT gets to my right shoe and I ask him to let me undo the rotary buckles and take it off, sparing its life.

Here a massive wave of gratitude washes over me. This is the moment when I go from being in charge of my situation—which is to say, being helpless—to when I turn my situation over to those with special training who know exactly what to do. Imagine if I were on a battlefield, or a remote road alone, or on a mountain where my survival meant crawling for miles through my pain and injury. Then I’d really be screwed. I am relieved to be passively placed in good hands, where all I have to do is answer questions.

They get my helmet off. Now the medics are preparing a long scary-looking metal apparatus next to my right leg. The man who earlier identified himself as a doctor tells me, “They’re going to have to put you in traction. This will pull your right leg straight. You’ll have to lie back. It’s going to hurt like hell.” It does. I can’t stop screaming. It seems like nothing they could possibly do to my leg could hurt more than this. The traction device is basically an iron maiden for the leg. I get 5 mg more morphine and that’s all they’re allowed to give me. It’s still not enough, not even close. An ambulance has arrived somewhere along the line and I’m scooped onto a stretcher and into the back of it (more screaming). I’m begging for more pain relief.

(I’m going to pause my story for a moment now to make an observation: I can now speak from experience about the stupidity of torture. To be freed from this pain, I’d have told anybody anything. The fact that I have no secrets simply means that I’d contrive something, anything I thought would satisfy a questioner. If the medics had asked, “Are you part of The Institute?” I’d have said yes. If they’d asked if I knew who masterminded Operation X, I’d have said yes. I’d have begged for a list of suspected operatives and randomly circled names, if it meant being freed from this pain. That is how desperate pain can make you.)

At some point I am given some other drug, perhaps to treat anxiety, and I start to suffer less. But every bump in the road—and there seem to be endless bumps—makes me cry out. The ambulance’s suspension seems to be shot.

Hospital

We arrive at the hospital. I am whisked from place to place, hallways and curtains, and end up in the X-ray department. It’s all huge and industrial and Orwellian and when somebody says, “We have to move you onto the X-ray table” there’s an unmistakable note of apology in his voice. Four of them lift up the whole sheet and move me. It is impossible to set somebody down lightly when he has a broken femur and the table is hard as glass. More bloodcurdling screams. I have a flashback to 1984, when I was fifteen, in a hospital in Wyoming after a car wreck with my mom and two of my brothers, and I suddenly heard my brother screaming his head off from all the way down the hall. The shock of recognition—that’s my brother screaming!—was not so different from the shock I feel now: that’s me screaming!

The X-ray table is my worst enemy for what seems an endless period of one X-ray after another, many with my body arranged in torturous positions. They know my femur is broken but are trying to figure out if my pelvis is broken. Finally another excruciating transition to the gurney, and I’m taken back to a curtained-off row.

They get some more pain meds in me and I’m starting to get some real relief. Presently my wife arrives. Of course I’m glad to see her but also full of remorse at putting her through this. If she were some fiery hot-blooded type who slapped me across the face first thing, I’d probably have felt better. Of course it’s preferable that she’s stable, calm, and strong. She knows she doesn’t have the luxury of getting upset and making this her problem—it’s mine and she’s my support. A team of doctors arrive. “We’re going to drill a hole through your tibia and insert a long screw, so we can get a good purchase on your leg for traction,” one of them explains. I love the idea—if it means getting this barbaric clamp off my leg. “You’ll take the old traction thing off as soon as that’s done, right?” I ask. They assure me they will—soothingly, as if we’re in agreement that the old traction device is the center of all my pain.

The drill

My wife asks why this operation wouldn’t be done in an operating room. “Oh, we don’t need a room for it,” they assure her. “It’s not like a big surgery or anything, it’s just a procedure. And we have to do it right now.” And they’re not joking, there’s no leaving and coming back, no apparent bureaucracy, they’re already preparing. They put on these Plexiglas face shields like a SWAT team would wear. Now, maybe it’s just the pain meds, but suddenly I’m struck by how improbably good-looking they all are. It looks like the cast of an TV show, an eye-candy hospital drama that isn’t even trying to be realistic.

They describe the local anesthesia they’ll be using: Novocain and something else. I warn them that I historically metabolize Novocain very quickly, so it usually starts to wear off by the time the doctor thinks it should be kicking in. The doctors offer a blandly reassuring response. They’re putting the bit into the drill. I swear the bit must be a foot long. I crane to see what kind of drill it is. I’m hoping for Mikita or Skil. If it’s Black and Decker, I’m out of here. It turns out to be Craftsman, which is just barely satisfactory. I relate to them a story from my dad about a fleck of chrome from a Craftsman tool that befouled a photocell in a satellite and sent it way off-course. (At that time I may have thought I was only thinking about this anecdote, but Erin assures me I actually told it.) Now they’re ready to start.

“Erin, you may want to make yourself scarce for this,” I tell my wife, but she’s sticking around. I suppose she feels a duty to stand by me, but it also wouldn’t surprise me if she had feelings similar to my own: as horrible as this is, it’s fascinating. How often do you get a chance to watch something like this?

A resident will be doing the drilling. She lines up the drill. Her eye and her hands are as steady as a pool shark’s as he lines up a shot. She looks to be about twenty years old. The others are giving her advice and encouragement. The bit goes in. My head flops back on the gurney and I scream. Of course the pain is bloody murder but with it comes a strange feeling of vindication. Sure, this hurts like hell, but of course it hurts like hell—it should hurt like hell, I’m having a drill go through my leg! The pain in the bone is only part of it, though—the vibration along my whole leg is just as bad. As for the local anesthetic, it’s not quite up to snuff: I can feel the drill well enough to recognize when its direction changes and it’s being drawn back out of my leg. I get a huge sense of relief from this, knowing the procedure is almost over.

Then the drill is out and the resident is getting a pat on the back. I ask her, “Is this the first time you’ve done this?” She replies, “No, it’s my second. The first one was a disaster. Halfway in the drill died, and everybody had to run around looking for another drill before we could get the bit out!” Now I’m even more impressed with the calm she had beforehand. You know the saying: “Learn one, do one, teach one.”

Relief

To the screw in my tibia they attach, on either side, cables that run through little pulleys on an apparatus attached to the foot of the gurney. From these cables they hang water-filled plastic weights. With the cables pulling the tibia screw forward and thus pulling my leg straight, they no longer need the original traction device, and finally remove it. What a relief. Somebody notices that one of the weights is leaking and sends for a replacement.

Now they set about giving me a nerve block. This is kind of like the epidural that pregnant women get. I don’t know the exact science but it involves injection of drugs right into or near to nerves. To pinpoint where to administer this, they use ultrasound. One watches the monitor while the other administers the drug. “Okay, you’re right in position, drop some right there. Good. Go a little deeper here. Drop some more.” The guy has the depths of my leg mapped like some high-tech mining operation. “Okay, a little deeper, little more, okay—right there—drop the rest.” The sense of competence of this team thrills me, and then when the nerve block takes effect, the pain in my leg quiets down some more.

(Note: having read this, Erin wonders about the sequence of tibia screw vs. nerve block. She doesn’t remember which came first, but thinks it more logical that they’d have started with the nerve block. I distinctly remember the screw being first based on the pain, and based on my understanding that the screw was essential whereas the nerve block was just a nice-to-have. But as I said earlier, memory can be distorted.)

They move me to a hospital room and say “No food until after surgery tomorrow.” Not a problem. For once in my life I have no appetite.

To be continued...

That’s about all I care to write for now. If you feel like this was something worth reading, stay tuned because of course there’s more to tell.

Other chapters

2014 update:  it occurred to me to add links to all the chapters of this tale now that they're available.  Here you go:

The Femur Report - Part II (posted Dec 19, 2011)

The Femur Report - Part III (posted Dec 28, 2011)

Physical Therapy (posted March 11, 2012)

Bike vs. Car - How I Broke My Femur (posted Nov 27, 2013)