Photo of an Okinawan sunrise taken from Kouri Island. The burst of light hidden behind the clouds is a resemblance of the searing pain masked behind narcotic drugs.

Part 2: Narcotics

Continued from Part 1: The Car, The Knife, and The Boa

“Wake up buddy!”  The English-speaking paramedic pulled me back into the present.  “I need you to stay awake for me okay?”

The constant throb of pain returned as the butcher knife preyed for my next breath at the surface of my skin.  I breathe, it plunges, and the boa squeezes.  What if the pain never goes away?   I entertain a brief thought of the Greek Titan Prometheus.  How much would it suck to have an eagle eat the liver out of my body every day?  I could feel the ambulance slowing down.

“We’re at the hospital now, just another minute and we’ll get you in the ER.”  Either the paramedic lied, or “minute” was medical slang for “eventually”.  Half in, half out.  My breaths were a shallow pant.  Somehow, I had not suffocated as I had thought I would.  The oxygen mask kept me alive.  Through the course of the ambulance ride, the blood and lung-tapioca coming from my mouth had slowed down.  The ambulance finally came to a stop after what felt like 15 minutes of slow figure eights in the parking lot.

The driver and passenger doors opened and I imagined myself waiting in a half-crouch behind the back double doors holding an M4 at the ready.  In another second the ambulance doors are going to burst open as I jump out holding my rifle up to provide security while the paramedics scramble to find cover in the hospital.

A second later the double doors were ripped open and I laid completely motionless strapped to the spine board.

“It’s going to feel like you’re falling but it’s just a small drop,” assured the English-speaking paramedic.  I hear a count to three in Japanese and I slide out of the ambulance and begin rolling into the hospital.  Through my peripheral vision I notice my crew perform a “hand-off” with the hospital ER staff.

“Car vs bicycle collision, he was on the bicycle,” the English-speaking paramedic explains.  “Left leg possibly broken, right arm broken, collar bone broken, ribs probably broken, and he has a pulmonary contusion to the right lung with bleeding from the mouth and difficulty breathing.”

I knew he was full of shit!  So much for everything being just fine, he may as well have said I lost a game of chicken with a train!  I concentrate on breathing with my eyes fixed on the ceiling.  Every five meters I could catch a glimpse of myself in the steel reflection between ceiling tiles.  It looks like I did play chicken with a train…  My spine board convoy finally reaches its destination as I’m rolled into a room.  The staff maneuver my body onto their own spine board so the Okinawan paramedics can get theirs back.  There’s a discussion regarding ownership of the head and neck brace and that gets replaced as well.  A team of nurses replaces the paramedics.

“When does the pain go away?” I ask my new crew.

“Soon,” lied the first nurse, “we just need to do some quick checks first.”

“Okay.” I reply.

“We’re going to have to cut your clothes off is that alright?” the first nurse asks holding up a pair of trauma sheers.

“Do I get a choice?” I respond.

The first nurse laughs and begins cutting away my cycling jersey, “Sorry man.”  After countless field ops and deployments I consider myself to have a relatively high tolerance for “no-homo” encounters, however, I couldn’t help but feel a little awkward when nurse #1 started snipping away at  my bib shorts exposing my junk for everyone to witness.

“Those were my good shorts…” I offer, trying to distract myself with humor.  The second nurse chuckles and says something about being a cyclist himself and knowing my pain.  They finish exposing the rest of my body and place a light blue sheet over my torso restoring some of my decency.

One of them grabs my left hand.  “Can you move your fingers?”

“Yes.”  I respond wiggling the fingers.

“What about this hand?”  The other nurse grabs my right hand.  I wiggle the fingers and a jet of pain shoots through the arm.

“They move.”  I wince.  The first nurse takes a note while muttering something about a deformity.  “When does the pain go away?”  I ask with a thick hint of knowing it goes away when they make it go away.  They are going to poke every part of my body to make sure they didn’t miss anything before they administer any pain killers.  

“Soon,” the first nurse promises, “there’s medication on the way.”  The second nurse begins probing my chest with two fingers asking after every prod if it hurts.

“Here?” he asks.

“No,” I respond.

“Here?”  His fingers push another spot.

I reply, “Yes, a little.”

“Here?”  His fingers morph into the butcher knife and plunge into my chest.

“Hngh!”  I choke on the pain and the first nurse jots down another note.  This process continues until both nurses are satisfied everything has been checked.  “When does the pain go away?” I try again.

The first nurse reminds me, “Meds are on the way, don’t worry.”  After determining my head, neck, and spine were not injured I was slid from the rigid spine board onto the actual hospital bed.  The nurses reattach my IV line and hook up various electrodes across my body to monitor my respirations, heart rate, blood hypoxia, and whatever else that makes squiggly lines appear on the monitor.  The doors open and an old, friendly-looking doctor walks in.  Something told me this man had answers.

“Hey, how’ya doin’ bud?” He smiles.

“This sucks,” I reply, “I was told there are pain meds on the way?”

“Yes, you had a rough night, let me check on that.”  He steps out and a moment later returns with a female nurse carrying a handful of syringes.

“I’ve been expecting you,” I try to joke.

“I’m here, I’m here!”  She responds.  Clearly not having an easy night.  “Okay let me know when you feel this.”  I look down at my left arm and am surprised to see two additional IV catheters hanging out of my veins.  When did those get there?  She slips a Morphine syringe into one and pushes the plunger all the way down.  I could feel a cool sensation where it was entering my body, but no other effect.

“I don’t feel anything.”  The nurse grabs another syringe and pushes the Morphine into my veins.

“Just give it a second,” she says.  I wait about a minute and still feel no effect.

“Still nothing…”  I start to get a wretched feeling that I’m just doomed to live in agony.  The nurse pulls out a third syringe and slides it into the same catheter.  She slowly collapsed the plunger and once again I felt the icy Morphine trickle through my veins.  We both wait.  What the hell is going on?  Three doses and it’s like I’ve been injected with a saline solution…completely useless!  God, what else do I need to…

It was beautiful.  Warmth trickled through my body replacing pain with happiness.  “I think I…yes it’s working,” I tell the nurse and she disappears.  The warmth finished its work and a deep feeling of relaxation and euphoria washed over me.  I felt a heavy sleepiness take over, but was not exhausted like before.  It was like my body was telling me, “Hey if you want to take a nap we’re ready for you, but don’t sweat it!”  Here I am laying in the emergency room after almost dying, and I feel better than I have in years…  I couldn’t even try to give a fuck about anything.  I made it…finally.  The knife was gone.

“Looks like you have a visitor,” said the friendly old doctor looking towards the door.  Another man appeared next to my bed with the unmistakable mark of concern on his face.  It was the name I gave the paramedic in the ambulance.  “Are you his officer?” asked the doctor.

“…I…I don’t know this man,” I lied from my bed.

The friendly old doctor didn’t miss a beat, “He’s had serious trauma to the head,” he explained.  My lieutenant’s face went cold.  I like this doc!

“No, he’s my OIC,” I couldn’t push it any further, “Sir I’m fine…sorry I had to…couldn’t resist.”  A few people started laughing including my new favorite doctor and briefly my OIC before he made some comment about me being an asshole.

The next 18 hours became a blur as x-ray technicians came in and out of the room moving me around to take x-rays.  I slept the most peaceful sleep until someone would come in and wedge a board behind my back or broken arm to take more x-rays.  At one point I was moved into a room and placed into a device that had to have been a time machine.  I woke up in the ICU and every few hours I was given more Morphine, Percocet, or Toradol (all narcotic pain killers that have their own way of making your mind feel great when your body doesn’t).  I remember various visitors stopping by bringing books and magazines.  Someone had brought a stuffed Incredible Hulk and someone else a similar stuffed Spider Man.  Often times I would not remember falling asleep and would awake in an awkward position with my head hanging forward and drool connecting my face to the blankets or last magazine I had attempted to read.

The friendly old doctor came into my new room.  “How are ya feelin’?” He asks.

“I feel a lot better now, my chest is tighter though,” I respond, “It doesn’t hurt much but it’s harder to breathe.”

The doctor explained how the impact of the car had shattered my collar bone into four pieces, broke my right forearm, and crushed through my ribs collapsing my right lung causing a pneumothorax in both my lungs but primarily the right one.  I was familiar with this from numerous Combat Lifesaver classes and a live tissue course I had taken.  The pneumothorax is air leaking from a ruptured lung into the chest cavity where it pushes against the lung preventing it from inflating all the way.  The boa…  In combat you would fix this by sticking a 14-16 gauge needle  through the ribs into the pleural cavity releasing the pressure.

“Are you going to stick a needle between my ribs?”  I ask.

He was waiting for me to ask.  “Nope.”  He  pulls out a massive three foot surgical tube still in its sterile packaging.  “I’m going to cut an incision between your ribs and slide this into your chest.” His smile was genuine.  He loves this.

The doctor handed me the giant tube and informed me he was going to get his stuff ready and would be back shortly.  I glanced down at my new “gift” as the doctor left my room.  Did he really think I wanted to stare at this thing?  The monitor’s rhythmic beeps continued in the background reminding me that all my important parts were still working.  I really don’t want this inside of me…

One of my nurses on duty entered the room to do my hourly checks.  After going over my vitals and hooking up a new IV bag he asked if I needed anything.

“Yes,” I reply, “some Percocet please.”

Continued in Part 3: The First Surgery

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