Allan : January 15, 2006 - Tica Tica, Bolivia - Waiting for the ambulance
Diary entry posted Mon 11:11pm 15 May 2006
In a state somewhere between awake and sleep three hours had passed. The rain, thunder and lightning added dramatic effect to my sprawled body with my left leg in a cardboard box splint as I laid in the Tica Tica medical clinic. Still no ambulance. In a town with one telephone, one restaurant and no motel I wondered if I'd ever get out of Tica Tica. Doctor Sylvia and her assistant Jacoba checked in on me periodically while Jeremiah braved the rain, secured our bikes, and worked wonders getting my gear consolidated and ready to join me on the trip home.
Doctor Sylvia studied medicine in Sucre for six years. Now she was the only doctor for miles and tended to a primitive impoverished population base of more than 2,000 people. Many of them in villages accessible by only dirt trails. When I saw her running down the road to the muddy mess where my bike and I laid desperately, I wondered; why not drive? I guess she would have if she had a car -- or a motorcycle. Serving hundreds of patients with many too sick to get to the clinic, on foot Doctor Sylvia hikes hours, crosses rivers and braves inclement weather carrying her medical bag to treat sick people, deliver babies and bring medicine to villagers.
I learn later that her father and brother are miners working in the horrible conditions of the cooperative mines in Potosí. Her mother is dying of kidney failure. There's a transplant available, but they cannot afford it. Suddenly my broken leg and my sullen let down of an interrupted journey around the world on my motorcycle seems petty and miniscule in the scope of things. I'm happy I'm in her care and with Jeremiah's cool demeanor, professionalism and somewhat calm if not frantic at times handling of things. It's expected. I'm in good hands. And as long as I lie in this bed and don't move my leg, I feel no pain. No drugs either.
Four hours passed since the ambulance was called. Sylvia and Jeremiah grab my umbrella and brave the rain once more to hike to the only phone in town. When they return the concerned look on their faces distresses me -- slightly. The ambulance should be here. The rains have made the road very difficult and very slow. And it was getting dark. Did the ambulance get into an accident? Just as we were falling deeply into a fit of doom a Toyota Land Cruiser wagon pulls up to the clinic. Three young men hop out and cart a low slung wheeled stretcher into my room. Not quite a gurney, but with all hands they slide me onto the it and wheel me to the front of the building. As the group carries me my leg swings back and forth sending bolts of pain messages to my brain. Ouch. They don't have any straps to secure me to the stretcher. Nothing. Thinking fast I guide Jeremiah through my bags and direct him to my stash of tie-down straps. Working as best as he can, he straps and secures me and my leg to the stretcher hoping to prevent much movement as we make the four-hour ride in the pouring rain over rough dirt roads, through rivers, scaling switchbacks to Potosi -- where I had left just 12 hours earlier.
The true color of friendship shines under the worse circumstances. Unable to fend for myself Jeremiah took control of the situation and handled requests barked from me without hesitation. We are both on our separate journeys. Meeting in October in Creel, Mexico we rode together for a couple weeks before bidding farewell In Oaxaca. We reunited just over a week ago in Peru. Today he was putting his trip on hold while helping me. He asked if I wanted him to ride the ambulance with me. Sylvia offered to come too. I wanted the company and until MedJetAssist was fully commissioned, I wanted strength in numbers.
The ride from Tica Tica back to Potosí could have been a nightmare. With a bag of coca leaves sitting on the dash of the ambulance, my driver and his two buddies kept stuffing the natural stimulant into their mouths giving them the energy to make the four hour ride. They'd have to turn around once in Potosi and ride 6 or more hours back to Uyuni. With every rut, rock, bump and groove in the dirt road my leg bounced, rocked and pulled from side to side and end to end. Jeremiah, the legend, hunched over my leg with one hand above my knee and one hand below did his best to brace my leg and reduce the shock and jolt of the bumpy ride. He did this for the entire three hours of the journey. His back ached as he writhed and wiggled trying to remain somewhat comfortable. The ambulance rolled on as these boys made good time. They obviously made this trip before. With windshield wipers flapping and the suspension working overtime, we passed the gray walls of a canyon where I noticed the reflection of the emergency lights flashing. I didn't even notice that the ambulance actually had such gear. But no straps nor gurney. Hmmmm.
As the hours clicked by and the miles added up my foot became numb. Miah would rub and kneed it trying to stimulate circulation. The ambulance seemed to jump off a couple drop-offs sending my leg in the air and crashing down. I'd scream. "Ouch!" Jesus, that hurt! But Jeremiah like a statue, steadfast and secure just held onto my leg, minimizing its movement and my pain. Sylvia spoke of her clinic, background and patients. The driver and his buddies pulled another handful of coca leaves and stuffed them in their mouths. I finally pulled a couple vicadin from my pocket and sucked them down. This is one long ambulance ride. Bounce. Jolt. And shake.
When we finally pulled into the hospital at 10pm Sunday night the ambulance team wanted their stretcher, pillows and payment. And they wanted to get out of there. My things were unloaded and stashed in a hospital office while a crew of people rushed around looking for a bed they could move me to. I simply I laid on my stretcher in the middle of the lobby of the "emergency room" of the Daniel Bracamonte Hospital in Potosi, Bolivia -- the highest city in the world. That's when I noticed the short thin doctor with glasses, dark hair and dressed in a casual windbreaker carrying a messenger bag walk out the door of the emergency room. I thought he was leaving for the night. i was wrong. This was my doctor.
Before I was moved from the lobby I had to pay for my x-ray and my hospital bed. Coughing up the equivalent of about $8 in Bolivian currency I was then wheeled through the dark and quiet hospital corridors toward radiology while Jeremiah and Sylvia dealt with my things and the coca leaf-chewing ambulance crew. As I was ushered into the x-ray room an intern who had the demeanor and look of a janitor and the x-ray technician started pulling and tugging me onto the x-ray table. I screamed as they tried to lift my 155lb mass up six inches from the bed onto the table. Any slight move of my leg sent zings of pain through my leg. They ignored my screaming and please in Spanish to stop and wait for more help. Someone HAD to hold my leg stable and level. My vicadin was wearing off. Actually, I'm not sure if it ever did any good. Just as they were flopping my limbs onto the table Jeremiah showed up and provided better late than never help.
My be-speckled and windbreaker donning Doctor -- Doctor. Rosando -- had a good command of the english language. He reviewed the x-ray. So efficient and fiscally prudent was the radiologist, he got two views of my tibia and fibula on one piece of film. The doctor confirmed what I already knew. "Your leg is broken." Then he added the new information. "In three places." We looked at the x-ray. Sure enough the tibia and fibula were both broken close to the knee with a third break in the tibula halfway between my knee and ankle. Damn heavy motorcycle. Would have stronger boots prevented the fractures? The what ifs didn't matter. My leg was broken, my trip interrupted and I needed to get back to the States for proper medical care. Meanwhile the rest of my clothing is cut from my body. My BMW ComforTemp long underwear and my Patagonia capilene underwear. All victims to my fateful muddy bike dump.
Fortunately my cell phone had service in Bolivia. I was on the phone to MedJetAssist as they wheeled me into a room with three other patients. I sent text messages to my girlfriend in California. Jeremiah got clearance from the hospital to sleep there. But he couldn't have a bed. I directed him to my sleeping bag and mattress in my things and he set up camp on the floor in the hall just outside my room. It was getting close to midnight. My Doctor Rolando wanted to set me up with an IV and pain medicine. But first they needed to be purchased from the hospital pharmacy. Apparently nobody gets credit at the pharmacy. I stuffed a handful of Bolivianos into Doc Roladno's hand and he served as my medicine messenger and trucked over to the pharmacy. I wanted to know more about the pain medicine and was worried about syringes and needles in my arm. Dutifully questioning every move, I'm sure they thought I was the biggest pain in the ass. But it's my life. My leg. And I'm in a place that is arguably the poorest city in the poorest country in South America. I'd better watch out. Meanwhile Miah drifted about the hospital and when he returned to my side he said "this place is scary," and offered other words of encouragement regarding the patients and conditions he witnessed. But it was all I had. I was simply turning back -- and this was a momentary pit stop.
MedJetAssist quickly took the information necessary to start the research and process of evacuating me out of Bolivia and getting me to a hospital in the United States. I put my girlfriend Angie in touch with them so together they could communicate and coordinate. MedJet connected me with a doctor in the States who informed me the pain medicine Dr. Rolando had purchased was a high-grade of ibuprofen (Motrin/Advil). I asked if they had something stronger like morphine. "Oh no. We don't have anything like that. It's controlled by the government." Great. The third largest cocaine producing country in the world and I'm getting Advil for a leg broken in three places. I sucked down another Vicadin under the orders of the MedJetAssist doctor while the janitor looking intern gracefully and in one easy step found a vein in my left arm and started the IV. My doctor said that a trauma doctor would be in the hospital in the morning and he would look to further stabilize my leg, reduce the fracture and prepare it for the long journey back to the United States. Until then, I'd try to get some sleep and ignore the pain.
The lights went out in my room at just after 1am. It's been a long day and the peaceful serenity of the solitude of riding the wide expanse of the Bolivian altiplano seemed so distant. Yet here I lay with my leg inside a cardboard box, wrapped in gauze and an ace bandage. I slowly closed my eyes.
As the clock ticked on my foot grew numb and hot. I couldn't move my leg. I started to moan. First silently to myself. Then more vocally. Soon i was unleashing at regular intervals strings of profanity. "Shit!" The list goes on. After a while one of my roommates starts repeating and mimicking my English words. It makes me laugh hearing the swear words with his Spanish accent and I wonder if he knows what he's saying. I'm sorry I'm keeping them awake with my groans and moans. But the pain just got stronger and stronger. My foot felt like it was on fire. But the pain wasn't coming from the broken bones. Or at least I thought so. Perhaps my makeshift splint was too tight. Circulation felt cut off. I finally can't handle it and I raise my voice trying to awake Jeremiah from his resting place in the hallway outside my room. One of my roommates reaches for his buzzer to call the nurse.
Jeremiah inspects my leg and sure enough there are problems down there. Seems the cardboard box had slowly slid down my leg and now was digging into the top of my foot which by now was beet red as the edge of the cardboard had dug a canyon sized gouge in it. Soon the intern and an assistant nurse are in the room wiping the sleep from their eyes. Jeremiah quickly gets them scrambling for a pair of scissors pointing to my circulation deprived foot. A small pair shows up but can't get through the cardboard. The intern says he's going to get some local anaesthesia to help reduce the pain. Finally a sturdy pair of scissors cuts through the cardboard and in seconds I feel relief. Wow. It was that easy. The doctor still injects a dose of local anaesthesia which comforts me as he assures me that I can now get some sleep.
Thankfully within minutes I'm in dreamland. And my roommates get their well deserved sleep.
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