Why I was missing from IMWAN for a few weeks.

Fractured Fourth

I. Busted

I like to celebrate Independence Day, as one of the few mornings a year when I’m not obligated to be anywhere, by taking a long bicycle ride in the country. This Fourth I got out at the break of day and rode along back roads to a neighboring town about fifteen miles away. Holiday traffic was sparse, and the morning was beautiful.

My only real problem was the dogs. I’ve never seen anything remotely like the packs of hostile dogs I’ve been seeing nearly everywhere I ride this year. Near my destination I had to spray (with a harmless but somewhat noxious cleaning spray solution) two packs to ward them off.

In the middle stretch of the journey I had no trouble with dogs on the way out. This prompted me to put the awkward spray bottle away in my saddlebag for that leg of the return ride. Relaxing my vigilance proved a great mistake. I was completely blindsided by two or three dogs that ambushed me. I didn’t have time to react or take evasive action. My bike hit one of them, and I was thrown to the pavement at a speed of something like ten miles per hour.

Thankfully the dogs then fled and left me lying unmolested on the pavement. I found myself in the worst pain I’d ever experienced outside a kidney infection. I could hardly draw a breath. It took me a couple of minutes to pick myself up, mount my undamaged bike, and ride on. I was still eight or nine miles from home.

I had ridden perhaps a mile when a group of cyclists overtook me. This was an extraordinary event. Cyclists are very few on the ground in our county. In fourteen years of riding here I’ve seldom even seen others out and around. I had never before seen a whole group. They had just decided to turn down the isolated road where I was. Their coming was truly providential.

They saw immediately that I was in a bad way. They sat me down on the side of the road and called an ambulance. It soon arrived from the satellite fire station near the edge of town. I was surprised to see the first female ambulance crew I’d ever met. I live not too far from the main fire station in town, and had never before seen this team around there.

They had to cut off my T-shirt. I felt glad that I decided that morning to wear the shirt I cared least about. On the short ride to the hospital I declined anything for the pain. Soon after my arrival at the emergency room I reconsidered.

At the emergency room I got that shot, a tetanus booster, bandages for the “road rash” on my left shoulder and forearm, and X-rays. The attending physician informed me that the knot on my head seemed not to be anything serious, but that I had a broken collar bone. He put my arm in a sling, gave me a prescription for painkillers, and advised me to see the local orthopedic specialist.

In between these attentions I had borrowed a phone—I’d failed to take my cell phone with me that morning—and tried to see who I could get in touch with. Mom and Dad were close to home, where they had been staying since Mom broke her hip in exercise class shortly before Memorial Day. They were over two hours from where I lived.

Who did I know locally who might not be away for the holiday? The emergency room duty nurse recalled that an off-duty colleague went to my church. She kindly agreed to come in to take me home. By now Dad was on his way to pick me up at my house.

As they were wheeling me out for discharge, I saw another church member with whom I was better acquainted speaking to one of my rescuers. She had come to visit somebody else at the hospital, and had just learned that the city librarian had had an accident. It was just dawning on her that this was me when I came along in person—bandaged, in tatters, with a knot on my head and one arm in a sling. She was horrified. I tried to assure her that I was heading for home and would be in good hands.

My ride took me by to fill my prescription and dropped me off at my house. I spent the time until Dad’s arrival slowly and painfully packing. I’d already planned to go to Mom and Dad’s house later that day, and had rounded up what I needed the night before. Now I had to reconsider what I would be taking. Clearly I wouldn’t be needing, or even able to wear, some of what I’d already picked out.

Dad arrived and got me home without incident. I felt guilty. Weeks earlier I’d gone home to help him haul a bed downstairs for Mom to sleep on, and had helped Dad to bring her home. My plan had been to spend the holiday weekend helping to relieve Dad’s caregiver duties. Instead I had saddled him with the burden of a second invalid.

II. The Surgery That Wasn't

Fortunately my brother arrived from out of state the next day to spend a few planned days with us. He helped out a great deal—mowing, helping out around the house, fetching the ice packs that I needed to supplement the painkillers, and changing the dressings on my road rash each evening. He told me that he had last used his mandatory Army first aid training to help save the life of a man who had stepped on a land mine in Afghanistan. Doctoring me must have seemed pretty easy.

Dad confessed later that he was tempted to kidnap my brother and keep him at work. But no, he had to return to his home and job. This left Dad with the full load of getting meals and providing assistance for two loved ones who could hardly do anything for ourselves. Each night he had to wake up twice in the middle of the night, once to give me my medicine, and once to give Mom hers. It was a tough challenge for a seventy-five-year-old man.

Meanwhile I was trying to see a doctor for follow-up care. I scheduled an appointment with the orthopedic specialist on Monday, only to learn that morning that he could not, for insurance reasons, see me without a referral from my primary care physician. I had just had the second PCP in a row retire on me.

His much younger partner was the logical next in succession. I even knew this doctor. But he was not my physician of record, and it took two days of phone calls and paperwork to get a visit with him scheduled. During this time I ran completely out of pain medicine. For two days I had only ice packs and over-the-counter analgesics. They days seemed excruciatingly long. The nights, where I could sleep propped up in a sitting position for perhaps half an hour at a time, seemed endless.

The pain wasn’t just in my arm and shoulder. I felt severe pains in my upper left torso as well. There were times when I had trouble breathing with all the pain. It made me wonder whether I had some other injuries that had not been identified.

I finally got to see the doctor on Wednesday afternoon. He consulted the X-rays and agreed that I’d had a bad break on my clavicle (The technical term he used was “gnarly,” which shows that his recent family vacation to the beach had not been in vain). When I asked about the pain I felt elsewhere, he suggested that the collar bone break had put the trapezius muscle into a bind and was causing the other pain. That sounded plausible to me, based on my vague recollection of where the trapezius was supposed to run. I also received a welcome new painkiller prescription.

The next day—a full week after the accident—Dad and I made the long drive back to my town once again so that I could at last see the orthopedic specialist. I made a point of going early so that I could get by my job and make sure everything was going okay, and take care of a few essential payroll-related tasks. It was good to see everybody again. The hour or so I was there left me feeling drained.

The orthopedic specialist told me that the broken clavicle, even one so badly broken, would probably heal itself. However, I could heal more completely, and regain my full use of the arm more quickly, with outpatient surgery. We scheduled it for the following Tuesday. I would have to come in the day before for pre-operative tests and X-rays.

That Monday Dad loaded me, Mom, their dog, and a big pile of pillows for propping up on into their Hyundai and drove us to my town. We would spend the night at my house. Besides saving us another long round trip, and an extremely early start the next morning, it would give Mom a chance to be in a house that was all on one level. She had been improving at using her walker, and was able to have the run of the house.

My surgery was scheduled for noon on Tuesday. I had to be there for pre-op at eight. Mom and Dad naturally accompanied me to the pre-op room. We had a steady stream of visitors. There was my church’s pastor, our assistant pastor, and one of my best friends from the church.

Then there was the pastor’s younger daughter, who had been assigned to serve as my nurse. I had spent more time around her older sister before. This gave me a chance to get better acquainted. She had a wonderful bedside manner—though she did have to stick me twice to get my IV started. I tried to be nice about it.

Next the anesthetist came in and explained what he would be doing. They were just about to start the first medications when he got a call from the radiologist who had viewed my new X-rays the day before. It seems that the more thorough images showed that I had sustained broken ribs and a punctured lung, which had tried to collapse. Up to this point the understandable focus on that “gnarly” clavicle break had kept anybody from recognizing these internal injuries.

The anesthetist knew immediately that he could not put me under with a lung in that shape. He went off to consult the surgeon. This took some time, as the surgeon was in the midst of another operation and could not be distracted or rushed. I was left in an awkward position—literally, propped up on a gurney, with an IV in my arm, and getting cold. I was also in a good deal of pain, as my pre-operative fast had kept me from having any medication since the night before. The nurse did everything she could to make me more comfortable, shifting my position, bringing me some water, and wrapping me in a warmed blanket.

Once the surgeon had been apprised of my situation he and the anesthetist put in some quick calls to out-of-town colleagues and learned that I would not be fit for surgery for over a month. They came in and broke the news to me. The doctor told me in effect that I would simply have to get better on my own. He made an appointment for late in August and gave me a new pain prescription. We would check then and see whether everything had healed well, or whether I might still benefit from surgery.

III. On the Mend

There were more visitors, including the chief of the hospital and two of his leading administrative assistants. I knew all of them. The head of the hospital was both my neighbor and one of my bosses on the library’s Board of Trustees. This time they told me I was the boss.

When the chief took over management of the hospital some years earlier, he had implemented various review and patient feedback policies to improve the hospital’s culture and service. I now saw this system in action. While the insurance company snafus and the failure to determine the full extent of my injuries earlier had been regrettable, the system had caught the problem before it had potentially disastrous consequences. The fail-safes had worked. I had no complaints.

My nurse got off for lunch about the same time I was discharged. She and her father, the pastor, took my family out to eat. As I had not actually been worked on, and had now had some pain relief, I was glad to have a good lunch. We had a nice time together.

Then we went to the library to let my staff know my status. We found that they too had provided for us. We now had roast chicken and other goodies for supper. Even the dog—who had spent half a day shut up in my bathroom—benefited from that!

The next day we drove back to Mom and Dad’s house. In the meantime heavy storms moving in from the Gulf had inundated our home town. There had been minor flash flooding. The house had not been touched, but Mom and Dad’s storage unit had flooded. Dad said that we had probably lost their Christmas tree. We had to detour some miles around a damaged bridge. The familiar river bottoms we passed through had the highest and roughest waters we’d ever seen there.

The days kept on passing. Back when Dad and I had set things up to bring Mom home from the hospital, we had moved out their recliner to make room downstairs for the bed. Since it was impractical to haul it upstairs, I had been having to try to sleep on a bed upstairs. Now Dad managed to make room for the recliner in the “mud room” beside the kitchen. It wasn’t a great place to sleep—but in that recliner I now COULD sleep, more or less.

Better sleep seemed to accelerate the healing process. By the following week I was able to walk an hour one way into town—I couldn’t drive, and couldn’t have Dad at my beck and call when he had so much else to do—and visit the public library. I also walked by a church where our family had once gone when I was a kid, and found myself invited to sit in on a women’s Bible study. Another day I walked by the church and had a long and helpful talk with the pastor.

By the middle of the week I had completely stopped my pain medication. I was still constantly sore, but it was a manageable soreness. I could now take proper baths—no more painful, and inadequate, washcloth baths. I no longer needed Dad to wash my hair for me.

Mom was also making great progress. She had been to see a physical therapist, and was now able to replace her walking frame with a cane. We could both now do much more for ourselves. We were even able, slowly and carefully, to set the table at mealtimes. Dad was finally getting some much needed time to rest and take care of other business.

This past Sunday showed just how much we had improved. Mom was able to get from the car and into the church almost unaided, and could use the foot pedals when she played the piano. She celebrated by doing some serious playing. I now had enough breath to sing out loud during worship. And Dad, who had been almost in tears while delivering the message the previous week, was now bright and cheerful.

I convinced Mom and Dad on Sunday that it was time for me to come home. On Monday they drove me to my house. Dad and I went recliner shopping. Then we all got some lunch. Dad also gave me a test to see whether I could drive my manual-transmission car to his satisfaction. After the new recliner had been delivered and settled in, we said our goodbyes.

Four weeks after the accident, I’m still on the mend. I’m still sore a lot, still have to be careful how I reach and pick up, and still unable to sleep more than an hour or two at a stretch at night. I still don’t have the energy to work full days, so I have yet to get started on truly catching up with a month’s lost work. My yard work is going undone, and it will be a long time before I go bicycle riding again. I probably won’t ride far out of town from now on, for fear of dogs.

Much as I wish I had never encountered those stupid, vicious dogs, it has all worked out. I’ve experienced wonderful kindness and concern from many different people. I understand far better now what people with serious injuries have to go through. And I’ve been reminded of the many gifts from a gracious God that I have reason to be grateful for.

You're a lovely person...but those dogs could menace others. It concerns me because once they form a pack like that dogs can be become dangerous, as you've experienced, unfortunately.

I'm glad you're healing up.