The Story - Tom's Perspective

Memory serves us best in remembering images, music, and multi-sensory experiences. I remember a lot of this experience primarily because of the images and multi-sensory experience (alas, there wasn't much in the way of music). Thank God I was not hiking alone. Even more luckily, I was hiking with a first year med student (Will), an E.R. Nurse (Jackie), and an editor (Leslie). We were hiking in the Shenandoah National Park in honor of my twenty-fourth birthday. We had planned a simple day-hike down into a creek and back out, including a bit of a picnic complete with frosted cake. It was about four miles in one way, and four miles back over the same trail.

After playing in the creek down at the bottom, we began to head back up. It had been raining intermittently, so we were in various states of drying off as we hiked. Conversing with Leslie at about 2pm, I spotted a vine off the left side of the trail, about ten yards away. It snaked down from high up in the tree, wrapped around a branch, and came all the way down to the forest floor. The branch it hung from must have been about sixty feet up. It looked like God had tied a rope swing to a ridiculously high branch. I began to climb, with Leslie looking on. When I noticed that I was closer to the branch than to the ground, I grew uncomfortable and began to climb down. About this time, Leslie shouted something to the effect of "look how high he is." Will and Jackie were further up the trail and could see that I was climbing fairly high. As I began to climb down, the vine snapped and down I came--fast. Too fast to think. There is nothing that I thought between the snapping and the ground. I heard two things: the snap of the vine and the crunch of my feet.

Immediate pain that defies description overwhelmed me and I began to scream "Ow" rather a lot. I thought it the best word for communicating what had happened, so I stuck with it for a long time. A good fifteen minutes or so, in fact. Will, Leslie, and Jackie immediately sprung into action. Jackie, standing over my left side, asked the most questions, which were answered solely with shouts (between the shouts of "Ow"). Will had a calm and collected look as he stood at my feet. Leslie looked worried, but steadily analyzed my eyes (when they were open, which was rarely). After a few pointed questions, we were all sure that there was no neck or back injury to speak of, so I could be moved. As we moved me on to the trail, we decided on a plan of action. Jackie would stay with me in order to bandage my ankles, staunch the blood-flow from my right ankle, and keep me from going into shock. Since I remembered the trail the best -- after all, I had picked the hike we were going to do -- I gave instructions to Will and Leslie as to how to get back to the trailhead. Will and Leslie raced off within twenty minutes of my fall.

This left Jackie and I with the keys to the car (a forgetful and hasty mistake), a backpack full of food (mostly upper middle class picnic food: classy cheeses, organic bread, etc.), and Will's coat. My shirt had already been sacrificed to stabilize my legs and stop the blood; sections of my jeans were now being used for the same purpose. I wrapped myself in Will's coat while Jackie and I prayed and tried to keep warm in the rain. The pain had subsided significantly and now only came in waves, which was something I could handle much better than the constant pain I had felt immediately after the fall.

Two hours after Will and Leslie had left, we heard some people coming up the trail. The noises came from the downhill part of the trail, and we knew we had sent Will and Leslie up the hill, so it wasn't them returning with help. A man and a woman rounded the bend a few yards from us. Looking him straight in the eyes, the very first thing I said was, "I just broke both my ankles, can you help?" I figured names and other niceties could be dealt with later. As it turns out, other niceties were dealt with quite well shortly afterwards. The man responded incredulously, "Why haven't you passed out?" knelt down by my ankles, and introduced himself as Saul, a practicing E.R. doctor in Brooklyn. He and Ani, his girlfriend, just happened to be on the first day of their long-term backpacking trip through the Shenandoah National Park.

They immediately provided relief of several kinds. Saul offered clothes that were actually dry and would keep me warm. Ani did the same for Jackie. Saul examined my ankles and reassured me that reconstructive surgery would be needed. With the infinite confidence of a doctor, he postulated that it looked like a trimalleolar fracture in my right ankle. I was intrigued to know what that meant, but didn't have the energy to ask at that point. I should remind the reader here that I had seen my left ankle, but both Jackie and Will had made me promise that I wouldn't look at my right ankle. I knew that it was a compound fracture, but I didn't know, and never will know, what it looked like. Jackie was worried that I might lose circulation – and thus my feet. Then, Saul and Ani set up a tent to get us out of the rain. Before he could move me, though, he wanted to wash my wound. Taking a little bit more from my jeans, he wadded it up and told me to bite it for the pain. He used purified water to clean out the gaping hole in my ankle.

After I got into the tent, the waiting game became ten times easier. Our smiles had returned since we were warm and dry, and had met such amazing people on the trail. We continued to pray. Soon enough, about an hour after Saul and Ani had stumbled upon us, the first search and rescue person arrived with Will and Leslie: Stacey. She had the demeanor of an experienced medic and deftly executed her duties. With Saul's help, she had my ankles stabilized in a trice and chatted pleasantly about her background and other duties. Already, I was impressed at the quality of the people who were helping us.

Little by little, the forest seemed to come alive. I had only a small window through which to view it, but it felt as if the trees themselves had begun to crowd more thickly around my tent. More than thirteen volunteers from the US Forest Service and National Parks were going to ensure that I made it to the ambulance in the nearest parking lot. They were not going to take me back up to the parking lot where my car was parked. Rather wisely, they decided to order an ambulance to go to the closest parking lot on the downhill side of the Shenandoah National Park where they would take me on a stretcher. Not only was the entire way downhill or level, but it was a shorter trek--about three miles.

So they cut off all my wet clothes, gave me some more dry ones, zipped me up into a warm emergency sleeping bag that felt like a cocoon, and strapped me down on a stretcher. For the next three hours, the pain escalated as my feet and ankles felt like overfilled balloon animals. The pressure building up in my legs began to push against the braces that were stabilizing my ankles and the pain was intense and unmitigated. Jackie and Stacey occasionally checked my vitals, and I asked for morphine not too long after the evacuation began. Six volunteers at a time guided the stretcher down the mountain, calling out large rocks, trees, and water sheds so as to prevent as many shocks to my legs as possible. They also very kindly tried to keep my ankles raised. Most entertainingly, we managed to converse for most of the three hour trip. Though most of my responses were shouted, they asked about my major, my home state of California, why I went to college in Michigan, my favorite authors and sayings in Greek and Latin. I also managed to get a few questions out myself and learned how many were from that area, the reasons they enjoyed working in the Shenandoah, and some basic information about the trees in the region (since my view for three hours was the forest canopy, I had a few questions pretty quickly).

The Forest Service volunteers relieved one another frequently, and all thirteen of them helped at the river crossings. Those were probably the most comforting part for me. I saw how they had set up webbing from tree to tree across the river, and each person was posted shoulder to shoulder in the river so that they could hand me across without any danger of dropping me. That was also where my memory recalls most vividly the looks on their faces, the encouraging words, and ultimately even the beauty of the forest with the sunset filtered through the golden-green leaves of the trees and conjuring up the smell of the soil and the water.

And finally, we reached the ambulance. I barely had it together mentally to say goodbye to everyone, and my goodbye was probably a strange one. I do remember saying goodbye to Saul and Ani, and perhaps to Stacey, but my mind actually began to fog up around this time -if it hadn't already been foggy. I was no longer helping to make the plans; I was now just along for the ride, in the hands of good people whom I could trust. Leslie and Will were going to be dropped off at my car and drive it to whatever hospital I ended up going to (they were initially told that I would end up in Richmond). Thank God Leslie could drive stick shift, since no one else in the party could. Jackie jumped into the front seat of the ambulance and began to negotiate where exactly I would end up. We had been refused a helicopter (three times) that would have brought us much closer to the DC area for my initial recovery. Apparently helicopters don't fly in thunderstorms. So, Jackie asked the right questions and discovered a hospital that had both an ER and an Operating Room with an orthopedic surgeon on call: Winchester Medical Center in Winchester, VA. In the ambulance, I was hooked up to an IV of morphine, but it didn't seem to help the pain much. I had a great conversation with the nurse on my left, Bridget, and it helped make the fifty-five minute drive much more enjoyable.

Finally, close to midnight, I arrived at the ER. They put an IV in my right arm as well and hooked me up to several cool machines that I found fascinating. As it turned out, the first IV they put into me had a powerful pain killer called Dilaudid, so my mood improved rapidly upon entering the ER. Most of the nurses were probably just annoyed that I was awake, much less asking a ton of questions and looking around all the time. They gently stabilized me and sent me off to the Radiology to see exactly what was wrong with me. After scanning what seemed like my entire body with a stunning array of machinery, I was wheeled into pre-op waiting room, signed some paperwork, and was on the Operating Table before I could realize what they were doing to me. The last thing I remember seeing right next to my table was the eerie blue and white glow of the x-rays of my ankle hovering over me. They had blown them up to a larger than normal size, and notated all over them. And then I sunk into deep and undreaming sleep.

And, we must include the only picture from the whole adventure on this, the inaugural post. The green is the tent, the hand is Stacey's, and the foggy heads floating in the background are mine and Jackie's. Thanks to Will for having the presence of mind to at least snap one picture. Jackie and Leslie had prudently left their phones in the car, and mine was temporarily out of commission due to the fall, and the rain, and I think out of compassion and empathy for my suffering. Brave little iPhone.