Wednesday, February 02, 2011

And Then He Fell



On the fifth day of what was supposed to be a week-long backpacking trip in Idaho’s Sawtooth Wilderness in August 2010, my partner Rich Romano and I woke up to rain, sleet, and snow. We tried to sleep in, but to no avail; early birds don’t lounge in bed easily. We made breakfast in the comfort of the tent and looked at our options.

The weather was too foul for our planned day hike to the ridge of the surrounding cirque, so I suggested we try something we’d never done before. "Let’s just stay in the tent,” I said. “We can play games and read out loud to each other. It’ll be fun.”

We lasted an hour. About four seconds after the last drop landed on our small two-person tent, we stormed out. The cloud cover was very low, the air was chilly. We packed with military efficiency and headed to the trail head. At the beginning of the trip we had decided that if the weather turned bad, we’d return to City of Rocks, where we’d started our vacation, for some more climbing. So that‘s what we did.

We drove south for a couple of hours and stopped at a hotel in Twin Falls for a nice hot shower. The next morning, we did some food shopping and found a fabulous gourmet shop. Foodies at heart, we were thrilled with the abundance of fresh veggies, imported cheeses, warm bread, and good California wine. We bought enough for every meal and snack until our departure.

We continued another couple of hours to City of Rocks arriving via dirt roads at its north entrance. Then we scouted some of the routes we wanted to do that day and the next.

Why didn't we discuss why that leader was bringing his second up on the climb that we planned to do first thing the next morning? On this short cliff of sport climbs, why weren’t they top roping and belaying from the ground?

With more than thirty-five years of bold ground-up first ascents, Rich is probably one of the most prolific Eastern climbers ever. He is definitely the Alpha climber in our relationship with almost three times as many years of climbing experience as I have and usually decides of what we climb when we’re together. With two teens and three jobs, I always happily surrender to this vacation from decision-making.

We made it to the campground and set up our tent on a spectacular spot with 360 degree views and the privacy of the end of a cul-de-sac. Satisfied, we then headed out to climb for a few hours, and between the perfect weather and the crisp rock, the end-of-the-day outing was absolutely exhilarating.

Once back at camp, we prepared our vegetable stir-fry with red onions, red peppers, hot green pepper, mushrooms, and tofu. We added some hot salsa and threw the mix over aromatic rice. While eating, we watched a pair of golden eagles and their young ride the updrafts above the spires; the sunset painted a backdrop of oranges and reds for their swooping play. As Venus set, the stars came to life one by one. By the time our meal was done, the Milky Way was almost at its zenith, shedding its glow on the valley below. The remoteness of our spot and the lack of humidity in the air meant that every constellation was distinct and clear.

Settled in the tent, we heard a lone wolf howl from the west, and a few minutes later, a chorus of coyotes responded from the east, as if to claim their territory. In bliss and slowly drifting into dreamland, we heard a great horned owl hoot from the other side of the valley.

It was a mere 40 degrees when we woke up, but the sun was shining and the sky was a stunning cobalt blue. We were both pumped to go. We cherished this cool weather, especially after suffering a horrendous heat wave for ten weeks straight where we live in the Gunks. After a hearty breakfast of cheese omelet burritos, we packed our climbing gear and made fun of all the other campers still in their sleeping bags missing out on this glorious day.

This was to be the last full day of a vacation that had been absolutely breathtaking. We got to the Super Hits – Bloody Fingers cliff, and decided to warm up on an easy face climb, Twist and Crawl. There wasn’t another soul around.

Richie led the climb and set the rope through the bolted anchor with the idea of setting it up as a top rope for me. "Are you ready to lower?" I called up. "I am ready," Rich responded. A few seconds later, I was looking for the mid-way point on the rope, and didn’t see it. "Is this the rope that doesn't have one?" I wondered. Why didn’t I ask this out loud? Somewhat complacent that our 60-meter rope would reach the ground, since we had done a dozen or more climbs thus far during the trip without it being an issue, we hadn’t ever discussed this potential hazard. I never tied into the system when climbing with his ropes, as per his request. He didn’t like that the rope, if it had kinks, was trapped at the other end with another knot.

My eyes were glued to him while he was being lowered from above me, when suddenly I felt the rope slip through my right hand and heard it slither through my belay device – a sound I will never forget – and as I reached out to grab the end of the rope already out of reach above me, I knew too well what had just happened, I screamed.

And then he fell.

His face slammed into the rock first, and I saw his nose start to spew blood. His body went limp, his eyes closed: he had lost consciousness. He continued hurtling down, five feet, ten feet, hitting his head, shoulder, neck, head (again) and back. At each point of contact, I heard a thud. When he reached the last ten feet of the face he bounced down them, legs and arms jerking up and out, in every direction.

It all happened fast but everything appeared to be in slow motion. I made the conscious decision to memorize every point of impact as I watched him fall (Head! Neck! Shoulder! Knee!) so I could assess his potential injuries and report them to the first responders. But even as I ran to his side, my mind was busy denying what I’d seen. "This is not happening” I kept repeating. “I am hallucinating my worst nightmare. This is not happening!”

But it was happening. Blood streamed out of his nose, mouth, and ears. He was not breathing. I thought he was dead.

Pure terror coursed through my body, paralyzing me, poisoning every thought I had. Finally, he started breathing again, erratically at first, and then steadily. I knew I had to act quickly. I assessed the huge lacerations on his head and bent close to see if there was synovial liquid, a sign that would have meant a very serious brain injury. None that I could see.

He had landed on his back, but in the shade on the cold 50-degree rock. He was just wearing a t-shirt. I slowly repositioned his body to a better location a few feet below so he could catch some warmth from the sun on his legs and torso. Then, I put his feet a few inches up with the hope of preventing shock, all the while talking to him. "Richie wake up! Look at me, look at me!" His breathing stopped again. I yelled at him. He started wheezing and moaning. I yelled at him again, telling him to open his eyes. He did, but nobody was home.

There was no cell phone service, so I was going to have to drive to find help. "Don't you die on me now!” I ordered. “ I’m going to get some help and you better be alive when I come back! You can do it!"

I dashed to the car parked about 200 yards below, taking the shortest distance between the two points – a straight line – and avoiding the trail altogether, jumping over logs and bushes until I fell. I took a second to brush myself off and I then took a few more seconds to acknowledge that I needed to take care of myself if I wanted to be able to take care of him. It was a lesson that I would remind myself daily in the months to come.

Once in the car, shaking and crying, I took a few seconds to calm myself enough so I could at least drive the car without killing myself. Luckily, it was only a few minutes before I found a car parked with a couple standing next to it and they told me that there was a ranger less than a mile below. I screamed at Rich as I drove. "This is not how you are going to die! Not today! You are not going to die on me today Rich, do you hear me? Just hang in there dammit!” I yelled so loud I almost lost my voice. The pounding on the dashboard bruised my wrist.

I found the ranger and hollered, "We need help to get an injured climber out fast. There’s a head injury with blood everywhere. Fast!" And I headed back to the trail head, my whole body trembling in terror, an emotion I can honestly say I had never experienced until that day. Once I parked the car, I grabbed one of his jackets and bolted up to the cliff, my adrenaline, heart, leg muscles and lungs working in perfect harmony, getting me up to him in just a few seconds. I couldn't help but fear the worst. Over twenty minutes had gone by since I had left him alone.

I found him alive and moaning. Relieved, I put the jacket under his head. The bright red of his blood was vivid against the bright yellow of his jacket. I grabbed a roll of toilet paper from my pack and pressed it against his head, and started talking. "Help is on the way. Hang in there. Don't give up. Open your eyes. Stay with me.”

Ten minutes later, the rangers showed up. We had to wait another half an hour for the ambulance to arrive with a stretcher so Rich could be carried down the trail and driven to a field where a helicopter could pick him up. The rescuers were able and swift. In the ambulance, he was combative and had a seizure. They sedated him and put him on a respirator. Within two hours of the onset of the accident, Rich was being airlifted to the closest trauma center in Ogden, UT, three hours away by car.

“What... happens... now... to... the... other... victim?” I heard myself say, in between sobs, as the chopper left. The park staff helped me retrieve the climbing gear and pack the camping equipment, then gave me directions to the hospital.

During the three hour drive, I would call someone back East whenever there was phone coverage and in tears, explain what had just happened. Every now and then I would retrieve messages left on my voice mail from the social worker at the hospital explaining every transition. “Rich just arrived in the ER.” “They are sending him for a brain CAT scan and X-rays.” “They are going to do sutures on his scalp.” “He will be transferred to ICU.” By the time I got to the hospital, I knew everything they had done so far.

When I arrived at the ICU, I was welcomed by the social worker who took the time to ask about my support system back home and what I had done to try to reach them. He made sure I had my basic needs met (“Did you eat anything today? Where are you staying tonight?”) and when the consultation was over, almost two hours later, he asked one more time, “What can I do to help?” I looked down at my hands and replied “I need to remove his blood from under my fingernails.”

When Rich finally arrived in ICU after all of his tests and procedures, he was in a medically-induced coma: the pain would have been unbearable otherwise. Unresponsive, intubated, and on a ventilator to help him breathe, he was in essence a vegetable. I was told it would take hours before they ease back the sedation and so I went back to the car, where everything had been thrown pell mell, and started sorting things out. I knew I would want to be next to him the instant that he became responsive, and the only thing I could muster the energy to do in this out-of-control situation was pack our gear to be ready to fly back home when he would. It took two hours. Passersby stared at the sobbing woman and her mounds of gear strewn across the parking lot, not sure what to think.

Hours later, Rich woke up slowly, having no idea what had happened. I gave him the best account that I could. He just shook his head and replied, "Sucker-punched." As a hard-core trad climber, with no injuries in almost 40 years of climbing, it was ironic that he would suffer such a tragedy while being lowered on bolts.

He asked me to list his injuries and I did: 26 cm of scalp lacerations glued back together by over 40 staples, a torn MCL, a fractured nose, acromion process, and third rib. He had had a seizure in the ambulance. The spineous process of the sixth cervical vertebrae was sheared off. He was lucky to be walking. 
THE AFTERMATH

Once back home, the reality sank in. This event had forever altered our lives and our relationship, and now defined our future. From now on, there would be “before the accident” and “after the accident.”

The sudden tragedy united me with others who had stories of horror and trauma, stories that resonated within me. We now shared a common bond: from my hair cutter who found his three-year old daughter face-down in a pool (she lived), to the mother whose son was victim of a drunk-driving accident (he did not).

In the weeks following the accident, I would relive the fall while running, driving, trying to fall asleep, taking a shower. I would see Rich descending through space, hitting his head, again and again. I had met horror and horror was not leaving me. I recoiled at the sight of blood on my plate while eating steak. I jumped at the slightest unusual sound. I was unable to witness any type of violence, either implicit or explicit, while watching movies or the news. During this time, to my dismay, we used up what was left of Richie's meager lifetime allowance for romantic comedy movie-watching.

About five weeks after the accident, I was told by three different people that I might be suffering from post-traumatic stress disorder, given the nightmares and sudden flashbacks that plagued me. I pulled out the DMS-IV from the bookshelf, collected during the days when I was studying abnormal psychology, and looked up the symptoms of PTSD. Sure enough, despite my best stress-management efforts, I had all the prerequisite indications and then some.

I found a therapist specializing in Neuro-Linguistic Programming, a modality I knew to be an effective and successful treatment method for PTSD. Two sessions later, the flashbacks and nightmares had stopped, and the emotional turmoil of distress had toned down to a relatively manageable intensity.

The lingering guilt and shame, however, were eating me up. Unlike grief or anger, there is no true outlet for shame or guilt. It didn’t help that I had a dozen daily reminders of Rich’s condition, and seeing my beloved suffer became my own personal form of hell. I felt as if my breath was being cut off by a deep knot pressing into my lungs.

Because of his brain and neck injury, Rich couldn’t drive or work for ten weeks, and he almost lost his job. The financial stress caused by a sub-par health insurance plan from GHI (a bottom feeder, as they are known in the health insurance industry), which did not cover any post-ER physical therapy or other doctors' visits, made the ordeal even more frustrating and difficult.

Over time, the physical ailments that originated from the accident were healing slowly but steadily. The side effects of the severe concussion, however, were taking much longer to improve. In most aspects, a traumatic brain injury (TBI) is very different from other physical issues. A broken limb, for instance, limits the use of a specific part of the body. When the body heals, the limb regains its previous function.

But brain injuries do not heal like other physical traumas. No two brain injuries are alike, and the consequences of two similar injuries can be very different. Symptoms may appear right away or they may not be present for days or weeks after an injury. They can take months or even years to heal. And because our brains define who we are, the consequences of a brain injury can affect all aspects of a life, particularly one’s personality.

Rich experienced some long- and short-term memory loss and developed sleep disturbances, fatigue, loss of balance, and difficulty concentrating. One day, he broke down completely because things he could normally do with his eyes closed, he could no longer remember how to do. Another day, on the way to the orthopedist, he couldn’t make sense of where we were going, even though we were driving a route he'd driven a thousand times before on the way to work. Every time he struggled with his recovery, it would bring back my guilt, shame, and grief. It was intolerable.

The insomnia and memory issues were the biggest challenges for Rich. Four months after the accident, he started bio-feedback, which apparently has a high success rate for TBI injuries. He had a couple of good nights sleep after just a few sessions, making him feel hopeful and almost normal again for a few days. But then the insomnia came back and after many sessions, it was decided that this modality wasn’t working. He also tried regular sleep aid medication, cranial-sacral therapy, homeopathy, and acupuncture. Seven months after the accident, he was only able to sleep a few hours a night.

My shame and guilt were so deep that there were few people I shared it with fully. Hence, I went about my jobs and my day-to-day responsibilities as if nothing had happened, expertly compartmentalizing. Eventually, the insidious agony from the guilt and its accomplice, shame, were nothing compared to the oppressing bottomless grief. In pain, it is easy to feel alone, despite the unbelievable support we received from our friends, family, and the climbing community, near and far.

As if dealing with guilt, shame, and grief were not enough, then came the anger. We are well aware that there are inherent risks in rock climbing. But we were angry that someone, somewhere had put a route up not thinking that someone, somewhere, might not be using a 70-meter rope. Did the last three meters really make a difference in the route? No. Then why not place the bolts so a customary 60-meter rope would reach the ground? How many people will have to be injured before safe bolt anchor practices become standard? And why didn’t the guidebook mention this potential hazard for this route, whereas it did for other climbs?

Of course, we should have tied a knot at the end of the rope. We should have clearly marked the middle of all the ropes to avoid confusion. We should have discussed this potential hazard aloud since we were new to the area. Rich should have worn a helmet. And I – I should have kept a keen eye at all times on the rope being fed while lowering him. Yet despite our fifty-plus years of combined rock climbing experience, we failed to do any of these things. But as our great friend, Richard Goldstone, aptly wrote in a climbing forum, “We can, of course, take pride in doing things that other people do not when it is the other people who pay a steep price. But anyone who thinks they are immune from a momentary lapse that has tragic results is living in a fantasy which I sincerely hope is never intruded on by reality.”

Ours is a reality we hope nobody else has to encounter. Ever.


City of Rocks is becoming notorious for this sort of accident - as stated here:


A YEAR LATER

September 1, 2011

The one year anniversary, which I began to dread weeks prior, is finally behind us. This was, by far, the worst year of our lives. Back in June, I realized that I will never recover from this event. I will always carry deep grief, guilt, shame, and anger, but that it was okay. I was trying really hard to work on these emotions in the hope that it would free me of their weight. It wasn't working. Ironically, once I surrendered to the fact that I would never recover and will always carry this pain, I felt instantly better, relieved in some way. I embraced them, made them part of who I am and will be. 

Rich is making good strides too. His sleeping pattern, albeit erratic, allows him to have quite a few good nights of sleep in a row now. He's feeling more confident about his physical abilities, and is back to climbing. The few cognitive impediments that still linger are less prevalent, as time passes. Just recently, I've heard him say, "I'm back."

The incredible emotional and financial support he received by friends, family, and the climbing community through this ordeal was absolutely instrumental in his recovery. We thank everyone who has helped, from close to afar. You have made a difference.

Link to a truly interesting New York Times article about the effects of TBI on relationships.

© 2011-2012 myrbou.blogspot.com

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6 Comments:

Blogger pm said...

Miriam and Rich,
Thank you for your articulation of your experience. It is truly helpful to those of us who have gone through analogous events and continue..and continue... to be survivors, dealing with PTSD, the guilt, the anger...You are a wonderful writer. love to both of you.
Patty M.

6:33 AM  
Anonymous Anonymous said...

Hi Myriam,
That must have been very difficult, but very cathartic, to write. You did all the right things, and kept your head together, although maybe we've been taught that tears are a sign of weakness. Uh, nope, no way. Through the course of your text, it became clear the number of levels you went through in dealing with all varieties of pain -- and in the end you came out stronger, as did Rich. And what a butt-load of medical know-how you mastered! Apparently traumatic injuries to loved ones bring out the doctor in all of us. Rich is lucky to have a smart doctor by his side, who can also provide a bona-fide fluffy French-Canadian omelette in the morning.

We're looking forward to seeing the two of you out on the rock again soon! Let us know if you need anything, even just a happy-foodie-party, for which we're always game.

Avec nos meilleurs voeux pour une rehabilitation rapide...
Derin and Pete

1:35 AM  
Blogger theresa said...

Myriam, in a blink of an eye the unthinkable happens to the most prepared. It is a miracle that Rich is home and healing....
The play by play you have shared is astounding to say the least and the more the story is shared it will raise awareness to how close the edge really is. We all can learn from your harrowing experience and ask more questions... responsibility of route setters to keep others safe? for one.
70 meter rope the sport standard?!?!
Your rescue was courageous! The response team...dream team!
Feel free to fall apart at regular intervals...you're entitled!
Hugs to Both T

7:10 AM  
Blogger LP said...

Myriam,

Your story hits very close to home for me and my friend. I fell July 31,2010 at Devils Kitchen in the Catskills. I was air lifted out and spend three weeks in the hospital. Like you, my friend remembers my whole fall.You both went through a tough time and the healing process will take time. You did an great job dealing with a very tough situation. I am glad Rich is healing. Lets talk some time. larryny7@gmail.com

Larry

11:42 AM  
Anonymous Anonymous said...

Myriam
As a physical therapist working with TBI and other neurologic diagnoses, know that Rich is very lucky to have your support and encouragement through this rehabilitation process. It is so tough for others to understand that even the most simple strategies no longer work for everyday skills following TBI. The deficits resulting from TBI are subtle and invisible to many. Rich will recover more every week, and perhaps will surprize everyone in his recovery, however far it goes. Patient advocacy and support groups can really help move things forward . I am so sorry this tragedy happened; best wishes for continued recovery for you both!
Donna Lannan , Concord NH

4:45 PM  
Anonymous Anonymous said...

Thanks for sharing. I caught my partner (and significant other) on a 30ft whipper last summer. Until that day, I never tied in to belay though he is considerably heavier. Someone else had "left" a cam, irretrievably stuck at the base. We wondered "why?" and "how?" I joked, "Here's why!" and clipped in. Then stayed that way. That cam is likely the only reason he didn't deck. I flew 15 or so feet in the air, stopped only when that cam caught and held me. We were nearly face to face. It's been affecting my ability to climb and to belay ever since. Until I read you story of flashbacks, guilt, fear, and PTSD I thought--and no few of our climbing companions agreed--that I was loosing it just a bit. Thank you. Now I know how real this is for the "other" victim. All the best to you both in your recovery. No matter what form your experience takes from here, climb on.

9:10 PM  

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