2008-1-28, Lourdes, Midi-Pyrénées, France
“Seven years ago we treated Lance Armstrong at this hospital,” said the anesthesiologist as he felt for a nerve in my shoulder. “He fell during training, it was not… uh… grave… comme est-ce que on dit grave? he asked the nurse.
“Serious” I chimed in.
“Ah, yes. It was not serious.” He pointed to an exact spot just below my shoulder. “I will do the injection right here” he told the nurse, who then applied a wide circle of cold, orange disinfectant.
Next came a small jab.
“This is just for the skin.”
Four minutes later came the serious injection. Thoughtlessly I tilted my head to look.
“No! Don’t move. I am very close to the nerve. If I hit the nerve it will be very bad. Very, uh, serious.”
* * *
“Ne bougez pas!” Don’t move.
‘Don’t move’ was the first thing the two skiers said to me. They could see as clearly as me how my left arm was hanging just wrong, which is why, when I had come to my senses just moments before, I sat still, grabbed my left wrist tightly with my right hand so the arm wouldn’t just, well, hang there, and started shouting “Aidez moi! Aidez moi!”
The girl who told me not to move took off my helmet very, very gingerly, while her companion zoomed off to (bless his soul) alert ski patrol.
* * *
I’d woken up just before dawn to a view of cloudless dark purple skies and a good five inches of fresh new snow. Hell yes. I got suited up, had my petite dejuener alone in the little old hotel restaurant with it’s 60’s décor, and I hit the slopes. The resort of La Mongie is not huge in terms of vertical drop. The snowline and timberline are about the same here and that seems to constrain local resorts in that dimension. But the crowns of the mountains are rugged indeed, and the resort is spread widely across three bowls under masses of black rocky spires. A great deal of avalanche activity was apparent on the steep slopes above the resort boundary. No ducking under any ropes for me today, I resolved.
It was a big blue-skied fresh powder Tuesday, and the last day, I am confident, that there will ever be a president named George Bush; just kind kind of conditions under which it is profoundly easy to not consider one’s lack of medical insurance. With just a four-hour pass and a big resort to explore I thought it unlikely that I would do the same run twice. But, after a fun ride through the modest terrain park I saw a sweet route over some steep, untracked powder that happened to lead right back to the top of the terrain park. Seemed like good fun, so I was off again.
* * *
The layout the La Mongie terrain park is thus: there are two rails parallel to eachother, both about eight feet long. One is wide and flat on the top. The other is about four inches wide and rounded like a double handrail – which of course it would once have been if entrepreneurialism had not started making such structures specifically for snowboard parks. (High1 even had something shaped like a picnic table made smooth for jumping on and sliding across.) Rails, provided they are straight, are actually easier than they look, so long as you counter your natural instincts and go over them very fast. Angular momentum, you get the idea. Of course, start putting kinks and curves in your rails and the story changes, along with the likelihood of great bodily harm.
Anyway, La Mongie’s rails are straight and true, and were not to be the source of my impending injury.
After the rails are two tables and a quarter-pipe, in series. A quarter-pipe, just so you know, is perhaps better thought of as a half-half-pipe. This one was maybe 12 feet high and shaped like the positive side of an x=y2 parabola. As it’s effectively vertical at the top, the idea is to ride up until one stops – which may of course be in the middle of the air by that point, potentially show off by spinning around or grabbing one’s board, and then to come back down the same way you came up.
The quarter-pipe did not hurt me either.
So now to speak of tables, the source of my most recent and tragic of downfalls. Tables are essentially big piles of snow shaped to have a steep ramp up, a flat bit across the top (hence the name), and then another steep slope back down again. You may wonder why bother, since it is obviously possible to have a jump be just a simple ramp. If you’ve watched ski jumping in the winter Olympics, this is what you’ve seen. The key here is that the slope underneath that jump is really, really steep. After a big jump, one has a damned lot of downward momentum, and it’s pretty important to have ample time and space with which to translate that momentum into forward speed and to do so in a controlled manner. It is, however, impractical, if not impossible, to build an entire terrain park on a slope so steep. The way to build big jumps in a less steep terrain park is then to extend a flat “table” out horizontally after a jump’s ramp and then to drop the snow away at the point in a rider’s trajectory that should roughly be the intersection of air and snow. This subsequent slope for landing can thus be made much steeper than the main slope below.
* * *
On my first run through the terrain park I hit the first table just right, only to land directly on top of some kid’s dropped ski pole. I turned to avoid said kid on his way to picking up said ski pole and shed too much speed. The second table looked quite big, and I felt I was going too slow to clear the flat part on top. I veered around the jump, hit the quarter pipe, and was on my way.
My second time through the park I made sure to have plenty of speed when hitting the second table. Turns out, the jump was somehow not so big as it looked. I flew and flew, while beneath me first the table top, then the whole landing just glided on by. I landed upright, but I’d missed the landing so the slope was too flat and, well, gravity is a real bitch. I caught en edge an thwack! all that force went straight into my left arm.
I flipped around instinctively, stopped, sat up, gathered my senses. My arm was wrong. It was too long and it was just, kind of, hanging there.
I grabbed my wrist firmly and Without any further thought: “Aidez moi! Aidez moi!”
* * *
“You still have the smile,” remarked, in English, the first ski patroller to show up after that skier had gone to alert them.
“What else should I do?” I am in fucking shock, dude.
There’s no point in freaking out after horrible things happen. Immediately before or during a catastrophe, maybe. But not after. We engaged in idle chitchat while waiting for the snowmobile. I kept opening and closing my left fist, afraid that I might soon not be able to do so.
Intriguingly, I’d been struggling to speak French the past few days, not having practiced the language in years. But sitting there, clutching the absurdity of my new disfigurement, the vocabulary was just flowing on out. My memory had been somehow jump-started. In fact, I don’t think I’ve ever spoken French so well. There was, though, the notable exception of the names of letters when they asked me to spell my name and address. Then again, I’m not sure I ever bothered learning those in French.
The second ski patroller took it upon herself to give me an emergency sling and to take a closer look. As she unzipped my jacket I looked away proclaiming that I did not wish to see. She enthusiastically agreed that I should not look.
“I think it’s not broken. Just dislocated,” she opined, “mais, je ne suis pas médecin!”
I wanted to believe her anyway, the way it was just hanging like that.
It was at least another five minutes until “le scooter” came. I do not imagine le scooter is how one really says snowmobile in French – but it was a common word and the word for now. It was not, however, the word of the day:
“Fuck.
“Fuck.
“Fuck.” I found myself mumbling repeatedly. “Aaaaauuurmmghh… fuck. Fuck. Fuck.”
Those were five very long minutes under that bright blue sky and inspiring crown of Pyrenean peaks. Skiers periodically rubber-necked by. Whatever wonderful chemicals the shock had flooded into my brain were rapidly wearing off.
“Aaaaauuurmmghh… fuck” it sure was
“fuck” starting to
“fuck!”
fucking hurt.
The first ski patroller chuckled. “Yes,” he said in English, “exactly. ‘Fuck’ is the word for today! Fucking sheet!”
* * *
The ride down the groomed ski runs on “le scooter” was not nearly so painful as the ride in “la ambulance” which, I was surprised to see, was actually just a black taxi with “AMBULANCE” decaled on the side. The meter was running.
The road back to Barrèges, which had seemed so short the day before, was suddenly much more curvy and unspeakably bumpier. I clutched my left wrist. The driver berated me for not having insurance. Fuck, lady, I get it. I politely agreed that I was an idiot.
Barrèges’s cabinet medical is a small office right next door to the old hotel with 60’s décor that I’d just spent the night in. There was a Dutch woman inside. She was holding a baguette, so I thought she was French. She took my snowboard inside for me after the “ambulance” driver left it outside and drove off without charging me. (Though that might be included in the bill sent to me by the ski resort, assuming that they did manage to get my name and address right and do bother to charge me.)
There was a sign on the wall, in Spanish, saying “This is a private medical clinic. You can pay immediately with VISA. You will be given an invoice for your insurance in Spain.” The doctor came in. She sat next to me right there in the waiting room and took off the emergency sling. Well practiced, she helped me take off my ski jacket in a way that did not hurt at all. Her eyes widened. She pointed at the bulge below my shoulder, now obvious under my shirt sleeve.
“Qu’est-ce que c’est ça?”
“That’s my arm.”
She gasped. “We need to make an x-ray. Now.”
Seconds later there it was, right on the screen: the bone in my arm was completely snapped in two. No wonder my arm was hanging wrong and strangely too long.
“You need surgery. I am calling the ambulance.” I was headed to the nearest hospital, in Lourdes, and this time it was the real deal. It went “weeeeeeee-ooooooooo-weeeeeeee-ooooooooo” like French ambulances should.
* * *
I had to piss. The nurse came back with a weird plastic bottle that fit between the legs. It had a nice wide opening and a flat bottom and the shape was such that there was even no splashback. The nurse took the bottle and changed me into some kind of sterile surgical paper underwear. They were awfully tight. I reached down for a much needed readjustment. My hand bumped something. That’s odd! The nurse had left something on my stomach. I picked it up. It was surprisingly heavy, and warm, and, damn that feels like a human hand. I lifted the sheet. It was my hand. But that surely was not right! I could still feel my arm. The top, broken bit was still resting on a pillow and the lower part was still lying across my stomach. Both my eyes and my right hand, which was clearly holding my left arm up in the air, disagreed.
I tried to move my fingers. While my brain still imagined it could still feel a hand where a hand had been, it did not give any signals of that hand moving. This, at least, agreed with my other senses. It was kind of gross to hold my own, dead hand. I gently put it back and tried not to think about it.
The trauma surgeon came by and introduced himself. In good English he described our two choices: either open me up along the fracture and put me back together right there by attaching a metal plate, or, cut two little holes at my elbow and shove a couple rods up all the way up to hold the bits of bone in place so they might then fuse back together. The second, he said, was a much harder operation, but would be better in the long run. I told him I fully trusted his decision and to do as he pleased. He said I was lucky that they could schedule the operation for that same evening and wandered off.
Lying as I was, I could just see a piece of sky out the window. As that piece of sky started darkening, I considered that there was no TV in the room and that I would soon be missing the hope-and-changefest which would have been on at 6:oo p.m. here. Some nurses came by with a wheelchair, only to load it up with the pile of stuff that had been dumped in the corner of the room by the paramedics: my snowboard, my backpack, and the pile of snowboarding clothes that had earlier been stripped off me. They said they were taking it up to ‘my room.’
Time ticked by. I could do very little but imagine over and over again the act of cutting my arm open and shoving metal rods in it. Lying alone, staring at the sky and missing Obama’s inauguration, I wanted nothing more than to just get the damned thing over with. The worst thing is to have something frightening be about to happen, to know that it is inevitable, and to have enough time to turn it around and around in your head, exaggerating all the worst parts of it.
When a nurse finally came to check on me, I tried hard to explain this psychological phenomenon to her in French. She just gave me a compassionate look and said I’d better tell the anesthesiologist, he could give me something to make it go away.
I didn’t have to. They soon came and transfered me to a rolly-bed. It was time.
Lourdes has a relatively small hospital, but they somehow still found lots of corridors and double swinging doors to roll me through while a team of medical folks trotted along with me, talking hurriedly and in serious tones. After one last set of swinging doors we arrived in the operating room. I was hoisted onto another bed and green blankets were pulled up to my chest. People in blue suits with blue mouth covers and blue hats furiously adjusted a many armed monster of bright lights with diffusion covers on them, they were just like the light hanging over the chair at the dentist’s. Other people in other blue suits rushed in and out, pushing and pulling tables and trays of this and that.
There was a commotion to my left. To my surprise and amazement, I saw that someone had placed my left arm along a skinny metal table to the side, and various people were moving it a little this way, a little that way and doing the same with another metal arm hanging down from above, this time with an x-ray apparatus on the end. The surgeon came in with an assistant carrying a lead blanket. As this was laid over my mid-section it seems to me the surgeon said something about always using protection, but I wasn’t not sure if this was meant to be a joke. They made a test x-ray then moved something, either my arm or the x-ray apparatus, I couldn’t tell, and then ran another x-ray. Someone pronounced this satisfactory.
I did not like that strange arm. It lead away from my body in just the way that an arm would were it attached to me. But my arm was still lying across me, where it had always been! So that must not be my arm. This is really messed up. I closed my eyes and tried not to think about it.
Much to my delight, someone replaced my arm to the position in which my brain had still been sensing it to be all along. There was further scurrying and readying. Another arm-table was brought out, this time for my still-feeling right arm. A drip was put in and a great many sensors attached. The scurrying died down. The surgeon and three or four other people assembled on my left. I saw that my left arm was pulled back onto the other arm-table. I could not feel it, of course, so it only occurred to me after a few moments that I was lying cruciform.
I watched an assistant slathering that strange, dead arm in orange disinfectant. I did not like to watch this.
Scrape. Scrape. Scrape.
What is that sound? I had to look. From my angle of repose I could not see too well.
Scrape. Scrape. Scrape.
Someone was dragging something along it. They’re shaving me, I realized. She could even cut me, and I wouldn’t know!
Oh, right. That’s the point. Again I closed my eyes and tried not to think about it. A sheet was thrown over my head. Soon thereafter I could not particularly breathe. An older male voice pointed this out, a younger female voice apologized very quickly and the sheet was lifted a few inches away from my face.
It’s starting, and they aren’t going to let me watch! An instant later I decided that had been a very stupid thought. I did not want to watch at all. I did not much want to listen either, and I thought it would not have been a bad idea for them to give me earplugs as well.
I don’t recall hearing the initial incisions, but the sound of a drill working its way through bone was quite clear. I can’t say I understood too much of the specialized surgical French being spoken, but a few things were pretty obvious:
“OK. Push… slowly. Slowly…”
“To the left. Non! I said to the LEFT!…”
“Merde! Merde! Take it out. Try again…”
Thankfully, such statements were interspersed with the occasional:
“Voila! C’est parfait…”
Or at least:
“C’est bien, that’ll work.”
I learned some new words too, like the word for hammer in French (marteau). It’s close enough to Spanish that I figured it out right away when I heard the surgeon asking for one. My inference was quickly confirmed by a loud, unmistakable tapping sound.
I had nothing to look at but a bed sheet a few inches from my face and no way to ignore what I was hearing. I started reciting Lewis Carrol poetry in my head, desperate for a distraction. An assistant checked on me, “vous êtes bien monsieur?”
“Yeah,” I told her, “but I wish I didn’t have to listen!”
The surgeon replied, in English “I’m sorry but this the more difficult operation. It is very technical, but it’s best.”
This I interpretted as ‘I know. So shut back up, we can’t have you squirming!’ so I just said “no, no! I understand. Take your time, I trust you!” And I shut back up.
Worryingly, after some time, and I have no idea how long – hours, it seemed – I began regaining a bit of feeling around my shoulder. I was soon aware of a lot of pushing and tugging. By then my ghost arm no longer felt like it was still lying across my stomach, but rather like it was floating up from my body. It felt as if I was submerged and had just relaxed the arm completely. Rationally I knew it was not so, but I really could feel my left arm, and it really was floating in midair.
I resolved not to say anything about regaining some feeling in my shoulder unless it really started to hurt, which it actually did at one point when the surgeon started shaking my arm violently, or so it seemed. I said, in French, “I felt that. It hurt!”
One of the assistants freaked out, peered under the sheet a bit, “What? It hurt? Where? Tell me!”
But the surgeon interjected, in English, “when did it hurt.”
“Just now, when you were shaking my arm.”
He translated this into French for the assistant.
“You can relax, Mr. Skory. The game is over. We are done.”
I understood that he’d been giving it one final test to see how well the rods would hold.
All I managed to say was “Oh. Good. Thank you.”
They took the sheet off my head. My arm looked about the same and there was hardly any blood. I was cleaned me up, the incisions bandaged, and an immobility harness was strapped on me – the same one I am wearing right now. They tore off the various sensors that had been stuck to my chest and my right arm, and then put in a catheter to drip anesthesia into the nerves controlling my arm. This kept me from feeling much of anything in there for the next couple days.
I was transfered to a rolly-bed, rolled back through swinging double doors and corridors, put in an elevator, and brought to a big room that already had my stuff in it. I was thirsty as hell. I was not well hydrated while snowboarding, and they wouldn’t let me drink anything before the surgery. Eventually I was brought water, and dinner too.
French hospital food turned out to be pretty tasty, except that they kept giving me the exact same soup.
* * *
I ended up spending two days in the hospital. They wanted to keep me another day, saying I was not ready for the pain if they took the catheter out of my arm. Somehow I convinced them that I really would prefer to dull the pain with pills in a hotel room rather than pay for another day of hospitalization. As it turned out, I do not have to pay for the operation, but there is a flat rate for the hospitalization of about €700 per day. About US$2000 for this kind of surgery is a bargain, really. But if I can avoid paying another €700 I think I can damn well deal with the pain!
Being that I was alone, broken, and somewhat helpless, a social worker found a hotel room for me near the hospital, and a nurse to visit me every couple days to change my bandages (and help me wash my back). Tomorrow morning will be a week since they released me, and I have an appointment with the doctor for some x-rays and an evaluation of my progress.
He might even let me leave Lourdes, though I’m not so sure if I can afford to risk trying to heal without the spirit of St. Bernadette so near.