2.4: The Inside

What followed the accident is a complex story with many threads. In coming posts I’ll pick up some of those threads individually, and follow them in more detail. But first I want to give a big picture of what happened.

I sustained bad internal injuries in the fall. In a first surgery, doctors removed my spleen. In a second surgery, they removed half my pancreas. My left kidney had lost its blood supply; it was dead. I had damaged my intestines a bit, which caused a bacterial infection in my abdomen. Over the next few days, that infection got worse. I needed several blood transfusions. Climbers came to save me yet again, this time in a van arranged by the owners of the hostel. I also received donations from kind strangers, via the nonprofit blooders.org.

My hands and feet were swollen with edema.

Meghan arrived on the second day. My dad, my sister, and Kristin’s partner arrived soon after. They spent many hours making arrangements with insurance companies, doctors, and hospital representatives, often negotiating language barriers between Spanish and English. Zari, a friend and colleague of ours back in Virginia, spent hours helping us over the phone in both languages.

Because of the other issues, it was a few days before they could repair my broken femur. They drilled out the core of the two biggest fragments and hammered a made-to-measure titanium nail down the center of the bone to hold it together.

The leg surgery went well, but soon after, my blood oxygen dropped badly. I was diagosed with ARDS, a condition in which your lungs fill with fluid, now famous as one of the more serious effects of SARS-CoV-2. I was intubated and put on a ventilator. I could communicate only by writing, but writing was hard.

I don’t write well at the best of times.

I spent a lot of this time unconscious and sedated. I remember only snippets. Waking up to Kristin sitting awake by my bed in the middle of the night. Watching the sonogram as they threaded a port-a-cath into my heart. Hospital representatives coming to my room to collect payments. Trying to explain to the nurses how hungry I was. I would lose 20 pounds in the hospital. 

The hospital in Monterrey had state-of-the-art equipment, but was pretty small. Labs had to be mailed out to be processed elsewhere, slowing things down. After 10 days, with my condition stable but not improving, I was put on a plane to a much bigger hospital in Washington DC.

In DC, I had another surgery, an attempt to clean out my infected abdomen. The remainder of my pancreas was leaking digestive enzymes into my belly, a very difficult condition that is slow to heal. I had multiple endoscopies to place stents to control this, and had three tubes implanted into my abdomen to drain the fluids. Despite this, the fluid still leaked out of the surgical incision in my abdomen, where the doctors now connected a vacuum.

Because the bacteria that infected my abdomen were antibiotic resistant, I was placed on ‘contact protocol’, and kept in an isolated room. Anybody entering had to put on a disposable gown, gloves, and mask, and throw them in the trash when leaving.

Still intubated, but off the ventilator for transport. I got to pump my own air.

I went through a period of psychosis, where I experienced vivid hallucinations, paranoia, and delusion lasting several days. I’ll write more about this; it was one of the most bizarre, fascinating, and scary things that has ever happened to me. I was given many, many medicines. At all times I was connected to pumps and monitors, the ventilator, the vacuum, and IV drips. Everything made noise. Sleep was hard.

Slowly, my lungs improved. The fever that had lasted more than 2 weeks became easier to control. I was taken off the ventilator on February 3rd, and switched to high-flow oxygen. Things that might seem trivial brought me immense joy. The taste of cranberry cocktail. The crunch of ice between my teeth. I tear up remembering how happy it made me. I still couldn’t talk- it would take months for my vocal chords to heal – but I spent hours writing/talking about all kinds of topics with Meghan, Kristin, and my family, who took weeks away from their own lives to help me. I worked on some puzzles. A nurse brought me food.

First solid meal. Hunger is the best sauce.

Soon, I moved from the ICU to a regular hospital room – ‘the floor’. Now I could glimpse the outside world from my bed. The cherries were blooming. Over time I re-learned how to sit upright, then to stand, then to stumble from my bed to the bathroom. I brushed my teeth for the first time in weeks. My sister shaved an ironic mustache out of my overgrown stubble.

I spent almost three weeks in that floor room, slowly building up strength, waiting for my leaking pancreas to stop digesting my insides. Even though I was getting stronger, this period was punctuated by some of the hardest moments for me, physically and psychologically. Up to this point, I hadn’t felt much pain, either right after the accident or at any point in the hospital. Now, I had torturous gastrointestinal pain. I was constantly hungry, but eating caused more pain and nausea. I had to eat tiny meals, constantly, but procedures would often keep me NPO – ‘nihil per os’ – for 18 hours at a time, making everything worse. My hematocrit dropped dangerously low, for reasons unknown, and I needed several more blood transfusions.

All in all, I spent 5 weeks on the inside. When they released me, it felt sudden. They disconnected my IVs, switched me to a portable vacuum system for abdomen, and handed Meghan a stack of documents: prescriptions and directions for followup. Then they told us I could go. I hobbled through the halls with Meghan as fast as I could, humming the tune from ‘The Great Escape”.

Escape from the hospital

I came home to a world that was very different than the one I had left back in January, and still is. It was February 23rd, 2020. SARS-CoV-2 was on the rise.

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