This series is for Mishima666, who has waited longer than I promised he would.
The tease: June 24, 2005 Day Planner entry, after the fact: "Hit deer - totaled bike - ended at Trauma Unit, UVA Hosp, Charlottsville, 2 1/2 days - bad scene all around.
What you may have missed:
Part One: http://open.salon.com/blog/monte_canfield/2010/02/19/motorcycling_memories_oh_deer_part_one
Part Two: http://open.salon.com/blog/monte_canfield/2010/02/20/motorcycle_memories_oh_deer_part_two
Part Three: http://open.salon.com/blog/monte_canfield/2010/02/21/motorcycle_memories_oh_deer_part_three
Part Four: http://open.salon.com/blog/monte_canfield/2010/02/22/motorcycling_memories_oh_deer_part_four
Part Five: http://open.salon.com/blog/monte_canfield/2010/02/23/motorcycling_memories_oh_deer_part_five_the_accident
There are "systems" everywhere. But most of us do not wish to be in the grip of a system wherein we have little to no control. But we often are. And one of the most invasive systems regarding control of our own lives is the medical system. We like to think that we are at least "partners" with our doctors, and that we have some real say in our treatment. And, often we can have that partnership if we insist on it and the physician isn't too arrogant. Usually such partnership cooperation is in non-emergency situations.
Emergency situations are different. Often your doctor is not even available, or defers to specialists. Still, a good medical team will usually keep you informed about what is going on with their treatment of you. They may actually ask you if you agree. Of course, by the time you are in the hospital they will have already had you sign an agreement to do what they have to do.
And the truth is that we are highly unlikely to disagree with their proposed course of action because they always hold the trump card: "He HAS to have this done now." The implication behind language like that is if you don't do it you may die or you may be seriously incapacitated.
From the moment the EMTs arrived I was in the hands of a competent, efficient medical system and, while I protested at first and even later, often and loud, in the end Sue and I always decided to go along with the big decisions. We violated their rules and procedures only when they were not looking. But, mostly, the system had me from start to finish.
Fortunately in my case this was a good system and the outcome was far better than had I been in some medical systems that are not so competent and not so caring. And there were angels in disguise even in this large system. But they were also ultimately making all the important decisions. I held no illusions about that.
I was alert as they wheeled me out from the Bath Hospital to the chopper and put me in it. That is to say that I thought I was alert. Later, at home, reflecting on the entire next 2 1/2 days I was not so sure that was even remotely true. The morphine did more than cause an allergic reaction, it was confusing my judgment even thought I did not know it. Of course it was also doing what it was primarily supposed to do: reduce my pain. I felt little actual pain on the flight to the UVA Medical center or during the tests.
[Pegasus Air Ambulance, close up. Stock photo.]
The chopper was left running while they were loading me in. There was little space in the chopper. Sue could not come with us. At first that upset me. But I was quickly starting to mellow out from the morphine and that worry slipped my mind. The pilot was already in the chopper. The Pegasus EMT got in and the local EMTs handed me in, strapped to the spine board and with the neck collar in place. I was placed head forward and the EMT was in a jump seat to the side of me.
The pilot and the EMT wore headphones so they could talk to each other and were in constant communication with the Emergency Trauma Center in Charlottesville. The EMT freed my right arm from the board and handed me earplugs. I could not get them in right and asked for some Kleenex. I stuffed those in my ears and that worked pretty well.
We took off and there was a window in the top of the chopper through which I could see out. I yelled a conversation with the EMT for a while. When we got to altitude the EMT told me that they could not fly directly over the mountains to the hospital because there were clouds too close to the tops and they needed more clearance. They said we would fly south to a place where there were fewer, lower, mountains, and then cut across there into the Shenandoah valley. They said it might add 15 minutes to the ride, for a total of about 40 minutes. I didn't care. My fear of flying was turned off. Mr. Morphine was hard at work.
When I next looked out the window in the top of the chopper I could see the mountains, the valleys, the houses, and roads, with cars moving on them. I watched us pass over small clouds now and then, and saw the sun break through. I saw everything. I saw the interstate, which I know was I-64.
We turned east when we got to it and followed it for a while, then cut north in a valley, came over a low mountain and turned north again at I-81 for a few miles. We cut over a lower area of the Blue Ridge Parkway, swung east diagonally to Charlottesville, flew over the urban area for a short while and landed at the helipad at the Medical Center. It was a nice trip with only a few bumps as we caught up and down drafts crossing mountains.
It was a good ride and I enjoyed watching the ground from that height. The only odd thing about it is that I was on my back looking UP! And I knew it at some level but found it not strange at all, only interesting.
[The University of Virginia Medical Center at Charlottesville. A teaching hospital with schools of Medicine and Nursing and Level One Trauma Center. Stock photo.]
Oddly, I remember nothing about being carried out of the chopper and going down to the Emergency Trauma Unit. I do remembering talking to some doctors, one of whom said he was the Chief Resident. He said I would meet the Trauma Chief later. Meanwhile I was going to have some more tests.
He looked at the hematoma, which was now about 6" in diameter and had raised over my chest to over an inch high. He palpated it and I about went through the roof. The morphine was wearing off. He said that he would have the nurse give me something IV to take the edge off the pain. I said, "Good. The sooner the better." The nurse came in shortly and added another bag to my IV stand.
The resident came back, introduced me to a cardiologist who hooked up some leads to some round conductors that were already on my chest. I don't remember when they were put on, but it had to be at the Bath hospital. These leads connected to a monitor I carried with me, which in turn sent a signal to a monitoring station somewhere in the building.
Next a phlebotimist came in and took some blood and left. They would end up taking blood every two or three hours for the entire stay. An orderly came in and said that he was going to take me for some tests. What I did not know until I got the summary of my bill, was that they did all the same tests that were done at Bath, primarily CAT scans and Xrays, plus some ultrasounds. Test, test, and test again.
They first wheeled me down to get some CAT scans. I remember being apprehensive about doing that because I am claustrophobic. But one of the technicians said that this was not a narrow tube like an MRI, but was a "donut" that was less than 2' deep and he would run me through it and back out before he started so I could get a sense of how it worked. He did. And I realized, as I had with the chopper flight, that I was not actually afraid. The IV med the Chief Resident prescribed was workng.
The technicians had placed me up on the pad on the machine when someone came in and told them that there had been a really bad automobile accident and that this CAT scan machine and all of the others were needed for that. Apparently they had decided I was stable enough so they wheeled me into the hall. They said I would not have to wait very long.
That was cool to me and I said "OK." What I really wanted to do anyway was to try to figure out how they could work on me with me on the ceiling and them on the floor. And I wanted to know how they managed to get all that equipment nailed to the ceiling. Nor could I figure out what kept me from falling down on them.
Before I could work that out they wheeled me back in and did the scans and sent me to have my ultrasounds done and then the XRays. I was fascinated that the entire Trauma Center was set up the same way as the CAT scan area! The entire place was upside down. But I still could not figure out how they did it. I was having a great time pondering the design of the place and the amazing ability of these doctors and staff to do all they did while I was hanging from the ceiling! There must be some advantage to doing it that way but I couldn't think what that would be.
Eventually they hauled me back to a curtained off room in the trauma emergency area. Shortly thereafter Sue showed up. I was really glad to see her. She looked tired and worried. And I was starting to feel a lot of pain. I needed that nurse to put some more of that no pain juice in the IV.
Interestingly, when I realized I was in pain I also noticed that they had set up in this part of the Trauma Center normally. I was on the spine board, on a gurney, and I was on the floor, not the ceiling. So was Sue. I wondered why they did this part of the Center that way. But I never said anything to Sue about it. I was more interested to know where she had been.
I had told her back at the Bath County Hospital that I thought she ought to ride her bike down to Covington and rent a car, leaving the bike there. It turns out she did nothing of the sort. She, like me, can be a bit adventurous. In this case it also took a certain amount of courage.
She somehow packed up everything onto her bike and rode some 3 hours to the hospital. Now that was not easy. First there was a lot of stuff, which she managed to compress in a black plastic lawn bag she got from the hospital custodian. Then she used bungie cords to tie all of that over her luggage rack and the back seat. She got directions from the State Trooper, squeezed herself between the bundle of stuff and the handlebars and took off.
Neither she nor I had ever ridden the roads she was about to ride. She crossed three mountains, negotiated a long canyon, rode a long valley, bypassed a middle sized city, and entered Charlottesville on I-64. She didn't see the sign the Trooper said she would see saying "Trauma Center," and rode past the Medical Center exit. (It turned out that there was no sign saying "Trauma Center.") She got off at a hospital sign, and stopped at a gas station near another hospital on the east side of town.
They said there was no trauma center at that hospital and sent her back west on I-64 to another highway going north. She went back, found the northbound highway, but was still looking for a sign to the Trauma Center and went too far again. It was in the middle of rush hour, and traffic was backed up. So she got off at the next exit, crept along the shoulder hoping to see a stopped car where someone had their window down.
She saw a guy on a motorcycle and asked him where they would take someone in a helicopter who was in a motorcycle accident. He said that it was too complicated to give her directions from there, but that he lead her there. Yet another angel in disguise! She followed him through a bunch of back streets to the Trauma Center. She thanked him. He rode off and she came in to find me.
She found me in the Emergency patient area. My tests were over. She talked to me a while and then moved her bike to long term parking. A sign in the hospital long term parking garage said "No Motorcycles." She ignored the sign and parked there anyway. See what I mean?
She had spent at least an hour trying to negotiate Friday evening rush hour traffic in an urban area she had never been in before. And, she had done this without riding with me in the lead. That is a big deal. Just ask anyone who has ridden a bike. This was her first "solo" ride, and normally first solo rides are not like this one. As the good ole boys down here in the village say, "She done good."
After she came back, the Trauma Center Chief came in, introduced himself, and told us that I now seemed fairly stable and that I would be moved to a room in a unit where trauma patients could be monitored carefully. I asked him what all the tests were about and whether there was anything permanently bad they had found. He said that there were three main things they were concerned about.
First was whether I had any previously undiscovered trauma to my head. Second was whether there were problems with my spine from the crash. They found nothing to indicate either, but the Chief Radiologist had not yet read my results, and therefore, had not "cleared my spines." I should have asked him what that meant because it was a term I would come to hate.
And third, and the most problematic, was whether the hemotoma was not only on the outside of my chest but whether it was leaking blood inward beyond my ribs. That could be big trouble because it could put pressure on my heart and/or the blood vessels that ran from and to the heart. He said the tests did not indicate any damage beyond bruised ribs, heavily bruised muscle and significant crushing and tearing of the same.
He said that the hematoma had continued to grow while I was there, but in the last hour and a half had begun to stabilize. It appeared to them that the artery or arteries that had split open from the impact were sealing. He said that this was particularly good news because they did not have to do surgery to dig around for the sources of the bleeding.
He mentioned that it was the largest chest hematoma anyone there had seen. By that point it was over 8" wide by 7" long and stuck up 2" high on the normal surface of my chest, with more damage and bleeding done between the surface and the ribs. Well, when I do things I do them big time!
They wanted to monitor it constantly for "a while," maybe a couple of days, to be sure the bleeding had stopped and would stay stopped. I only wanted three things: some more IV pain killer and to get out of the neck brace and off the spine board. He sent the nurse for the pain killer; she came with a new IV bag, and I forgot about the spine board and the neck brace shortly after.
They wheeled me down a long, long hallway to an elevator. Sue was by my side. It felt really good that she was there. I was proud of her solo ride, and irritated that she did it because I don't want to think of the trouble she could have gotten into had she had an accident. But the meds were doing their thing and it was hard for me to concentrate enough to continue being irritated.
We went up an elevator to the 6th floor of one of the Medical Center buildings. That floor was dedicated to trauma patients and had all the high tech monitoring devices you can think of.
All I could think of was how they had managed to set up the Trauma Center so that the patients were on the ceiling and the doctors were on the floor. But it still didn't seem either odd or unusual.
They wheeled me into a room, picked me up on the spine board and laid it on the bed. I was just glad all the testing was over and never thought about them not taking me off of the board or removing the neck brace. That would come later.
END OF PART SEVEN
Next: Another catheter? Will I ever get off this spine board? Cheating the rules. What about getting out of here? Why all the continued rashes? Numb thighs? How will we get home? Going home. Post trauma problems. Local surgeon. Let's buy another bike. Fears. And, finally, finding a "new normal."
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