Everything changed after I died. Three times. Tough day, that. The first two times they worked furiously to resuscitate me, restore a heartbeat, respiration, CPR, the basics… it was sausage factory emergency medicine at its finest, with unsung heroes stubbornly refusing to let death win. The third time, however, I was truly dead. Or so they say – all the best medical minds with all their monitors and other gadgets agreed that there was no way back, not from an alpha coma.
They were just waiting for my next of kin, my twin sister, to come in from Seattle to say goodbye and authorize them to unplug me. Technically speaking I wasn’t “dead” dead – I might have lingered on for a while even without life support, but the neurologists assure me that there was no chance of ever being “alive” again, not once I’d sunk into an alpha coma. A lingering vegetative state was the best I could have hoped for. Or the worst.
I’m not sure if dying just once would have had the same effect that dying three times did; there’s no way we’ll ever know because I died all three times in less than ninety minutes, not regaining consciousness until nearly two weeks later, against all odds. It must have all been thoroughly unpleasant, but I have little to no memory of any of it.
This part is what the doctors tell me, that I was clinically dead once where I fell, my friends performing CPR in an effort to keep my body and brain oxygenated enough to avoid irreversible damage, holding out for the ambulance to arrive so the EMTs could take control.
Then again in the ambulance, heart and respiration stopped as the EMTs worked furiously to hold on, bagging me, CPR, defibrillation, epi, the works. Alive only in the sense that they wouldn’t leave me alone and let me go, but apparently trying mightily to pack my bags and move on.
Then the third time, in the emergency room as the doctors tried to patch enough breaks, rips, and tears to make it worthwhile to continue transfusions, to continue to try. All that blood splashing out onto the floor – most of my own, plus the better part of fourteen units from the blood bank – seems like such a waste. Defib again, several times, more epinephrine, eventually put back together enough to be put on a ventilator and wheeled to the ICU, not expected to make it more than a few hours.
When they’d connected the EEG and gotten only alpha wave activity of uniform frequency and amplitude, zero variation, and nothing at all on either beta or theta waves even when they’d applied stimuli, they had assumed all their efforts were wasted. Too much time without oxygen, too much blood loss, too much damage; it wasn’t a surprise, they said, just a disappointment. Nobody likes to fail, especially people at the top of their profession.
But all of this was lost on me. I was “there”, of course, but not really there. I burned a little O2, generated a little body heat, required some changes of bandages, produced a bit of urine through the catheter, all of which they carefully monitored, but I was a lump of meat.
The medical team stayed in touch with my sister, Ella, and at the end of the first week, surrendering to the obvious had suggested that she might want to come and say goodbye – and, not coincidentally, sign the necessary forms.
It ended up being thirteen days that I existed in this state, lucky thirteen, a time about which my only hazy recollection is the scent of lilacs. Lilacs, my mother’s favorite flower, clumps of which she’d cut from her prized bushes during the short spring flowering season and put in vases around the house to share their sweet scent with us, a practice she’d continued until her own death seven years and three months before mine. Her death had proven more permanent than my own brief flirtation with the Reaper, cancer claiming her at sixty-eight. Odd, that I’d smelled her lilacs while I was dead.
Other than nothing – and lilacs – the next thing I was aware of was a crushing sense of loss, of sorrow and pain, of loneliness. It wasn’t coming from within, though, not my own sorrow or loss, but rather from an external source. There were waves of sorrow and sadness washing over me, crushing grief assaulting me with a strangely powerful force, unlike anything I’d ever experienced, forcing me to open my eyes as I struggled to understand what was happening.
As my vision slowly cleared I saw Ella sitting beside my bed, her head bowed over my right hand, which she clutched in both of hers. I heard her sobs and felt her hot tears fall on my hand and wrist. I watched her for a moment, puzzled. Had someone died? Why was she here? What didn’t I know?
It hurt to see the way she was suffering, to feel her pain; I wanted to say something, to comfort her, to find out what was wrong, but I couldn’t speak, not with a tube down my throat. I just knew that I had to make my dear sister, my only remaining family and someone I loved deeply, somehow feel better. Her heart was obviously broken, and I was unable to help. I saw her head jerk up slightly as I agonized over her grief, wishing I could help, almost as if she’d suddenly heard or felt something, and then I squeezed her hand.
Her head snapped up the remainder of the way and her beautiful hazel eyes met my matching pair. Her eyes widened in shock. “Jon? Jon, oh my god! Can you see me?”
Unable to speak, I raised my eyebrows and squeezed her hand again.
“Jon, god! Blink if you can see me!”
I blinked and was suddenly awash in sensations of joy and elation.
Tears still stained her face, but it had otherwise transformed to a look that was a mix of joy and sheer disbelief. “Can you hear me, can you understand what I’m saying?”
I blinked again, and with a shriek of joy she released my hand and ran into the hallway, calling for the nurse, a doctor, anyone. The powerful sensation of joy that I’d felt faded as she released my hand, but I had no time to think about that as my room was quickly flooded with medical staff.
I soon had stethoscopes on my chest, lights shined into my eyes and ears, blood pressure cuff attached, pulse and O2 sats taken, and was generally poked, prodded, and violated. It was decided to test whether I could breathe on my own and the respirator was turned off and detached. When I did okay, they quickly removed the tube from my throat, a very unpleasant experience that I recommended strongly against.
I still had sensors on my scalp for the EEG, and the leads were quickly reattached; I had all the waves now, some of them going crazy as various people worked around me, which seemed to utterly blow the mind of the neurologist. He instructed everyone to go hands-off and stand back so that he could get a reading with less interference from other bodies, grunting in surprise as I quickly settled into more-or-less normal rhythms.
He was muttering to himself as he disconnected me. “Jon, I’m going to want to check you more thoroughly later, when things settle down and it’s quiet. There are still a few minor anomalies, but you’re mostly normal. It’s the damnedest thing I ever saw, simply unheard of. It just doesn’t happen; you should be dead, young man. You’re either a very lucky or a very unusual man.”
With those gentle words of encouragement, he wandered off, muttering to himself in confusion and leaving me to the care of the doctors that were more concerned with the massive injuries to my body than what might (or might not) be happening in my head. They continued to poke and prod and run every test they could think of as Ella stood beside me, tightly gripping my hand and refusing to be budged.
I was bombarded by sensations and emotions as various people touched me; shock, disbelief, concern, awe, confusion, compassion, Ella’s unbridled joy, on and on to the point of being overwhelmed. I didn’t understand it; I felt battered and bruised mentally to go along with the aches and pains that I was gradually becoming aware of throughout my body, but when I tried to ask the doctor about it all I could do was make a low squeak, and he quickly shushed me.
“Shhh, Jon, don’t try to talk. You’ve had that tube in your throat for almost two weeks, so it may take your larynx a couple days to recover. I’m Dr. Arthur, your internal medicine specialist. I’ll ask you a series of yes and no questions; nod or shake your head if that doesn’t hurt you, otherwise blink once for yes and twice for no, got it?
I nodded. It hurt. I decided to use the alternative plan as he began since my eyelids were the one part of my body that didn’t seem to hurt.
“Do you know your name?”
One blink.
“Do you know where you are?”
Two blinks.
“You’re at St. Mark’s Medical Center; you’ve been with us almost two weeks, since the day after your accident. You were moved here when it became apparent how much damage you’d sustained. Do you remember what happened to you?”
Two blinks.
He smiled. “You got the double-whammy. Dr. Feldman is right, you should be dead. You were hit by lightning, but apparently, you’re the dramatic type and that wasn’t enough for you, so you also fell about forty-five or fifty feet out of the tree you were taking down. Actually, your friends say the lightning blew you out of the tree, so you didn’t just fall.”
I felt like I almost remembered it, that I could just about recall being up in a tall, dead oak that we’d been removing for the homeowner, cutting and then lowering the upper limbs on ropes. But then I’m an arborist, the foreman of a tree removal crew. I make my living taking down sick, dead, or unwanted trees, so I’ve been up a lot of trees. Maybe I was recalling an entirely different day – and besides, the day I was vaguely remembering we’d been under clear, blue skies, I think. I was frowning as I tried to sort it out and he seemed to read my mind.
He went on, “It was a freak thing, no way could you have known. Ever hear of clear sky lightning?”
One blink. Yes, I’d heard the term.
“The storm was almost thirty miles away, but the lightning went sideways across the sky, a powerful bolt by all reports. It hit the top of the tree you were in, the highest thing anywhere around, but when it went down the trunk it found you, a much better electrical conductor than old, dry wood.”
I had a hazy recollection of being on only my climbing belt and spurs, no harness or safety line affixed because I was moving around too much as I removed limbs. It was careless, but quicker, a costly shortcut. I blinked once to acknowledge his words and encourage him to continue.
“The charge jumped to you, entering at your shoulder – you have a burn there - and traversed your body, exiting at your ankle. Apparently, you wear some kind of metal spikes for climbing?”
My climbing spurs, yes, of course. I blinked once. He continued, “It jumped back into the tree through the right ankle spike, where you have a second burn, and finished its trip to earth down the tree trunk, all in a split second. Your friends say you virtually exploded off the tree in a flash of light and debris, that your safety belt totally failed, and that you struck several branches on the way down.”
He shook his head. “Amazingly, that was a good thing; hitting the branches beat the crap out of you, but it also probably saved your life. A straight, uninterrupted fall from that height would almost certainly have been fatal; until about an hour ago, we thought you were gone anyway.”
I couldn’t help but think of the old saying about how ugly one person could be; that they fell out of the ugly tree and hit every branch on the way down. I figured I probably fit the metaphor pretty well at that point.
When I offered no response, he asked, “Would you like a list of your injuries? It’s quite impressive.”
I figured if he was impressed, what the hell, I might enjoy hearing it too, so I gave him the affirmative single blink. Ella continued to sit and hold my hand, and I continued to sense gladness, relief, and joy from my twin, although it was heavily tinged with worry. I still didn’t understand the sensations, but I’d become alert enough to realize that they were my sister’s emotions, not my own.
I forgot about it for the moment as Dr. Arthur began his litany. “The most significant was the lightning strike, of course, because it stopped your heart and precipitated the fall that led to all of your other injuries. You were lucky that your friends knew CPR; they kept at it until the paramedics arrived and took over, and they bagged you, zapped you – defib - several times before they got a heartbeat but still had to rely mostly on CPR all the way in. They said they lost you once more on the way, but dragged you back.
“You had some internal injuries and bleeding to go along with all of your external injuries; we had to do some repairs on your liver, which entailed removing a small piece that was too badly damaged. We thought you might lose a kidney, and almost had to remove your spleen to stop the blood loss, but those injuries began to improve while you were in your coma still. There was a lot of bruising and shock to other organs, but nothing lasting.
“Beyond that, your right leg is a mess. In addition to the lightning burn where the charge exited your body, you have a broken femur, which was a compound, or open fracture; the bone was sticking out several inches through your skin, and there was significant bleeding due to torn muscles and blood vessels… not your femoral artery, fortunately, or we wouldn’t be having this conversation. You also fractured both your tibia and your fibula, tore your ACL and MCL, and dislocated your patella. Now that you’re apparently going to live that leg will need more work, probably including steel rods and pins. Still, you will likely always walk with a limp.
“Somehow your left leg got off easy; you managed to break just your fibula, which takes some doing without breaking the other bones, although you also dislocated your ankle and hip. Sounds bad, but it’s about your least damaged part. You with me so far?”
I blinked an affirmative answer, wondering about the “so far” portion of the query; how much longer did my tale of woe go on? I was about to find out.
“Your next major injury included another stroke of good luck; you apparently hit something jagged on the way down and tore through the skin and all the muscles of your abdomen. You’ve got a row of staples from the top of your pubic bone up to your left lower ribcage, but you lucked out and somehow your peritoneum didn’t rupture. If it had, it would have been spaghetti city and it probably would have been a bridge too far for you to return from, given all your other injuries. To put it bluntly, you didn’t spill your guts, which is a very good thing.
“You’re in good physical shape, so your muscle tone helped, and your head is apparently made of stone because you had only a fairly minor concussion and no cranial bleeding. Your helmet stayed on, by some miracle, and you didn’t land on your head or that helmet would have been wearing you.”
I smiled, appreciating both his gallows humor and his blunt, no-nonsense approach.
He went on; “Right arm, you broke the humerus, did some shoulder damage besides the lightning entry point burn, and broke your clavicle, which is why your right upper arm is in a cast and sling; you also dislocated your thumb. On the left side, you broke both radius and ulna in your forearm and crunched up a few of the carpal and metacarpal bones in your wrist and hand, which is why that’s also cast. I don’t think either of those will require additional surgery, although your left wrist might if there’s ligament damage. Obviously, since you were almost certainly going to die, all of this was put on hold.
“Let’s see, what else… hairline fracture of your pelvis, two slightly fractured lumbar vertebrae, the bruised spleen I mentioned, broken nose and a couple of loose teeth, and three cracked ribs, although we have no way of knowing if the ribs happened in the fall or during the CPR. Other than basically dying on us three times, I think that’s about it. Probably hurts when you breathe, doesn’t it?”
Everything hurt, but I blinked once, slowly, and he chuckled. “Must be tough to sort that from all the other aches and pains, huh?”
I blinked again, and he patted my shoulder – the left one, fortunately. “We’ll get you some better painkillers, maybe a morphine drip you can self-administer as needed.”
Ella had been sitting silently, taking it all in, but now she had questions, most of which I wanted to ask; we’ve always been pretty simpatico that way, perhaps because we shared both a womb and our early lives so closely. “You said they might have broken his ribs doing CPR?”
Dr. Arthur shrugged. “It’s not uncommon, but if they hadn’t done it he would have certainly died, so small price.”
“What other surgeries will my brother...
