Tripus Interruptus: A Tale of Four Bones

Having fallen into a somewhat reasonable schedule, I awoke with plenty of time to find a leisurely breakfast in Swakopmund and properly begin my day. Leisurely for me means avoiding packing the bike before heading out to food, as then I don’t have to keep an eagle-eye on my possessions while I eat. Extra points this morning went to a spot I’d found with proper coffee, a rare luxury.

After breakfast, I packed my things and checked out of my room. I was heading back from whence I’d came, to Windhoek, but along the alternate scenic route: a shorter dirt road through the mountains south of the main highway. Google estimated an easy 4.5 hours along C-28, with the first 45 minutes or so paved and hugging another of the ubiquitous pipelines. The road was flat and extremely straight, the road and adjacent pipeline making up nearly all the signs of human life. In all directions,  barren desert greeted the eye. Eventually, the pavement ended at a turnoff for one of the many uranium mines in the area, and my nearly 300km dirt adventure began, arcing up into the foothills and mountains.

Rocks, scrub-grass, and scraggly bushes replaced the endless blowing sand. Larger and larger crags supplanted the great brown plane. About an hour in, a perfect pile of rocks rose up on the side of the road, and I pulled to the side of the road. I gathered up my various snacks and water and scrabbled up to the top of the hill to enjoy my lunch with a view. It was perfectly still and silent, with only the occasional large bird coasting on a thermal to differentiate the scene from a postcard. It seemed I had it all to myself. I devoured my food in a state of blissful content.

Rock-top lunch spot

I repacked my things and continued down the road, winding through tighter turns and steeper grades. The road varied as usual between hardtack, loose sand, and loose strewn rocks. Cresting a mountain top, the road dipped into a decline and curved blindly right. I curved with it, but a little too fast, as the curve tightened as it went (a “decreasing radius turn” in the parlance of cyclists). Squeezing the brakes with time-worn skills, I attempted to slow, my rear wheel skidding through the thick loose earth. A few seconds into it, my conscious brain was fully aware of the rapidly-approaching reality: I wasn’t going to make it vertically through the turn.

My heart rate increased, my senses sharpened, but no panic came; I’d been through this before, and I wasn’t actually going all that fast (I’d estimate around 30mph). My mind quickly estimated some bruises and scrapes in my near future, but nothing more. I continued my skidding path towards the outside of the turn, eventually sliding onto the shoulder. Immediately, the tires sunk into the thick sand of the shoulder and the bike ceased all forward movement. The momentum translated into angular motion, with the bike swinging to the right. Hard.

The wind was knocked from my lungs. I was shocked by the feeling of pain coursing through my body. I began to sweat and curse. I turned the bike off, pulled myself out from under it, took my helmet, gloves, and jacket off, and sat on the edge of the road. Getting out of the jacket was particularly painful. I was breathing quickly, nearly hyperventilating. My side and shoulder hurt in a deep and sickening way. My mind immediately went to my clavicle, which I’d broken before. I ran my left hand across it and was happy to feel one continuous line. Then I raised my right arm and felt the bottom half of my clavicle separate. I sat down again and resumed cursing.

In that moment sitting on the side of the road, my head buzzed with thoughts and emotions. I felt like my trip was over. I felt like a failure. I felt sick with pain and buzzing with adrenaline. I felt alone and overcome.

But I had options. I could trigger the 911 setting of my SPOT communicator and be rescued, but my bike and the majority of my things would likely not come with me. I could wait and try to flag another vehicle down and ask for help. Or I could pick up the bike and ride the rest of the way to Windhoek and check myself into a hospital. Only the last option made sense. I would try my best.

To continue on, I had to right the bike. This was no easy task. I’d landed off the edge of the road, and in thick sandy dirt. It was hard to get a sure footing, and even harder to get under the bike (the usual protocol is to sit with your back to the bike as low as possible and more-or-less walk backwards while standing you and the bike up). I gave it a few tries as is and made no progress. I took off the backpack on the back seat to get a larger area to push. I sat on the ground and wrapped my arms under the handlebars and panniers. I began to push and lift. The pain in my chest was enormous. My field of vision narrowed. When the bike was halfway up, I nearly lost my strength, but adrenaline is a hell of a drug, and somehow I pushed through the pain with one last effort.

The bike nearly fell over the other way as I struggled in my daze to hold it steady while I got the kickstand down. I collapsed back on the side of the road, suddenly starving and dehydrated. I gulped down water in huge sips and devoured what was left of my biltong. Sweat beaded out all over my body as I looked over the bike from the shade-less roadside. My right mirror lens had been mildly shattered and its stalk loosened from its mooring, and my right highway peg was loose. I got up and gave it a once-over, but couldn’t see any other damage. I started it to make sure it still ran. It caught on the first turn. I turned it off and took out my phone.

I pulled up a map of Windhoek and looked up hospitals (thank goodness for Google Maps’ offline cache). There were a few options, the highest rated of which was the Rhino Park Private Hospital. Unfamiliar with Namibian health care, I was swayed by the word “private” and the high rating. I clicked navigate and steeled myself for what was to come.

I stared at the standing bike. Dual sport motorcycles like mine are high slung, and my first couple attempts at swinging my leg over the seat were met with sharp pain in my chest and guts. At one point, my foot caught on the far side of the seat, my other leg hopping for balance, and I nearly pulled the bike over sideways, the kickstand sinking deep into the loose earth, before extricating myself and stabilizing things again. I took a deep breath, stabilized my breathing, and tried to calm my nerves, old lessons from a round-footed Thai Chi instructor. I approached the bike, lowered my body slightly, and managed an incredibly awkward leaping high-kick that ended with my and the bike upright, my left hand clutching my side.

I restarted the bike, set my jaw, and set off. Controlling a motorcycle throttle involves twisting the right handlebar. This meant my right arm needed to stay more-or-less glued to the handlebar, forcing my clavicle to be in a constant state of painful stress. I continued slowly down the dirt road, every rock and bump a shooting pain starting deep in the pit of my stomach and rising through my arm. I navigated the winding road deliberately, extraordinarily aware that a miss-step now could have horrible consequences. Every turn flashed visions of tumbling down on my right side, and hideous images of the floating lower half of my clavicle punching through skin or lungs. Interspersed between these dark thoughts came the doubts about the rest of my travels, fear of the uncertainty of the state of Namibian health care, and the life-long impact of another broken clavicle (the left I broke in 2008 healed poorly and has effected my ability to lay on my left side ever since).

I continued steadily down the dirt road. The scenery was beautiful and desolate. Emotions welled in my head. After an hour, the sharp feeling of awareness and associated tolerance for pain associated with adrenaline began to ware off. The vibrations of the road took on new dimensions of pain. My breathing was shallow, as anything more triggered more unwelcome pain in my chest and side. An hour later, I had to switch the main fuel supply onto reserve. The beautiful desolation of the remote mountains continued.

Another hour passed. To the aches added soreness, but also relief as the dirt turned back to tarmac and the first signs of Windhoek loomed around the foothills of Windhoek. After a couple miles of smooth riding, the old familiar chugging of an empty fuel tank interrupted my internal homily. I pulled onto the shoulder and stood on the side of the road. I focused my willpower to jump off the bike and add my reserve fuel tank to the main one. While refueling, I realized my GoPro’s mount had broken and the camera had disappeared somewhere along the way (I know it was still present when I picked the bike up). I cursed to myself (I’d wanted the photos of the accident itself) but had other things to worry about. I repeated my graceless mounting and continued, tears welling in my eyes through the pain.

I pulled up to the Rhino Park Private Hospital, waves of relief and nausea pulsing in the back of my throat. I dismounted painfully and walked into the reception area. Through pitiful looks, the receptionist explained that this hospital had no ER, and kindly referred me to the Roman Catholic Hospital downtown, a few miles away. I held back my frustration, thanked her, and repeated the self-flagellation of mounting my motorcycle. I plotted a path to the Roman Catholic Hospital through increasing city traffic and arrived as the day was yielding to evening.

Park, dismount, snag my tank bag, and check-in. I was given a pile of paperwork to fill out and asked about my medical ID card. When I explained my situation, they asked for a credit card and placed a large deposit down for services. I thanked the universe for the miracles of credit cards and my high credit limits (yay privilege!) and was finally granted entry through the door to the ER. I begged the attending nurse to grab the large backpack on the back seat of my bike outside before it grew legs and was awash with thanks when he complied.

A hand-written ID bracelet was attached to my wrist. I was walked to a bed. Laying back in it brought forth a brutal reminder that any sort of abdominal effort had become excruciating. A nurse came forward to place an IV line into my arm. Never had I been so excited to see a needle destined for my flesh… which he proceeded to dig through for a solid 3 minutes as my teeth clenched searching for a vein. Eventually, another nurse overheard him repeatedly saying “don’t worry, we’ve got it,” came over, kicked him out, and started from scratch on my other arm. Next came my first taste of Namibian pain killers: basically liquid aspirin. Fuck it, it was better than nothing.

Some Namibian hospital signage fails to inspire confidence

I managed to convince a kind staff member to type a stray conference room wifi network password into my phone so I could pass info about my whereabouts back home. One Dr. Karl Frielingsdorf came in and poked and prodded me painfully in the arms, shoulder, chest, and abdomen. Next I was thrown onto a wheelchair and I sent for a series of x-rays and my first CT scan to check for neck/spine damage. Again my credit card was ran (less than $50 for x-rays, obvious more for a CT scan), and had the pleasure of posing shirtless with my right arm raised painfully above my head. The CT scan was equally unpleasant, with an inexplicable watery feeling flushing through my chest as the contrast dye was pushed mechanically through my veins as expensive machinery hummer and spun around my head. Finally, I was wheeled into a private room with an en suite bathroom and TV. Unbelievably starving (it was well into the evening now), I flagged down the first nurse I could find and asked for food. I barely had time to look at what they brought me before it was gone. Sated, I finally had the opportunity to take a shower and change into clean clothes, amazed that my body appeared devoid of bruises.

I waited patiently for news. Eventually, the friendly doctor I’d met in the ER came in with a handful of x-rays. In an adorable accent and impressive bedside manner for someone who is clearly perpetually in a rush he broke the news (pun intended): I’d fractured my 2nd, 5th, and 6th ribs along with my clavicle. Because of my previous experience with a broken clavicle, I asked about having a plate put in to align my clavicle and ensure it healed where it belonged. The doctor said I didn’t need one, but that it was an option. In a rush to continue his rounds, he told me to get comfortable; I’d be there a few days recovering.

I think I could have a healthy career in bone modeling, no?

On another visit, we spoke more about the options. It turned out he was an orthopedic surgeon and would be the one to do the surgery if I went that way. Concerned in a distinctly American fashion about health care abroad, I pressed for details of the procedure to decide if my first real surgery (discounting wisdom teeth removal) would be in Namibia. He told me I’d be put under using the “Michael Jackson drug,” and be getting an “American made” titanium plate and screws from Acumed. I did my research. Dr. Frielingsdorf was a well respected surgeon, seemingly very well known in Windhoek, who graduated from Stellenbosch University, one of the top medical schools in Africa. Acumed is the first Google result for clavicle plates. Michael Jackson died of propofol, and he clearly had good taste in drugs. Namibian surgery it would be!

The next three nights dragged on in a manner familiar to anyone familiar with hospital convalescence. A string of disaffected nurses (sister in this Catholic hospital) paraded through my room at intervals, including in the middle of the night, taking vitals, swapping IV solution and shitty pain meds, and frowning. A friendly physiotherapist came by and subjected me to painful exercises including breathing in and out of a tube attached to a plastic box. Every morning, a bored and droning voice read scripture in an unemotional monotone over a pervasive intercom system. I watched TV. I read my books. I stared at the wall. I ate terrible food (though honestly far from the worst hospital food in the world). Every excursion in and out of bed was met with a horrible shooting pain from my broken ribs, always accompanied by a dull sickening feeling I associate with your body telling you you’ve hurt yourself in a significant way. One morning I discovered the unfortunate fact that hiccups with broken ribs is fucking excruciating, and simultaneously that significant pain is a pretty good cure for hiccups.

I hope you weren’t hungry…

I began to consider my options for recovery. Broken ribs suck. A lot. There was no way I was going to suffer the inherent effort and pain of international motorcycle adventuring with the added pain of my ribs, not to mention the additional risk of injury before my bones were healed. I also wasn’t ready to give up and go home. There was only one path that seemed to make sense: find a place to keep the bike for awhile and go back home to San Francisco to recover, and return and continue my adventure when I was whole again. The show would go on, but there would be a 6 week or so intermission.

After two nights, the doctor came by to tell me I’d be discharged the following morning with a sling and a box of Tylenol with codeine, not to mention my trusty plastic box with a tube I got to painfully breathe into a few times a day. We made an appointment for me to come to his office for a final consult prior to the surgery, which he said could be done in two or three days time depending on his schedule. Unwilling to suffer the social requirements of a hostel, I booked a room at the C’est la Vie guesthouse, which had good reviews especially for the breakfasts, near his office in the Eros neighborhood of Windhoek for the following night.

I was woken the next morning at 6am by the nurses on their rounds. I couldn’t get back to sleep, and waited until 9 when I was handed my discharge paperwork. I hadn’t exhausted my initial deposit, and was told I’d be refunded the balance. I was relieved to see my motorcycle hadn’t moved from its location in the parking garage, and I cringed with effort as I packed my things for my travels. I took off my sling and put on my motorcycle jacket. I stared at the bike ruefully with the anticipation of the upcoming tribulations, took a deep breath, and winced as I got on.

It was still early in the morning, and my guesthouse didn’t have check-in until 2pm, but I headed there anyways in the hopes of parking the bike, unloading, and resting. I painfully rode through Windhoek’s streets and pulled up to the gate around 10am. There was no answer. I waited outside for awhile, feeling sore and exhausted. Eventually I went to the closest gas station to fill up since my bike was running on fumes. Dismount, wince, fill up, remount, wince, dismount, wince. This time a woman greeted me at the gate and let me in. Despite my motorcycle jacket and before I’d carried anything, she asked me if there was something wrong with my arm. My explanation was met with sympathy, and thankfully a place to unload while my room was cleaned for check-in.

I took in my surroundings as I waited. C’est la Vie was a gated plot of land with a large house in the front. In back was a large patio attached to the house, a yard with a pool (drained for the season, as well as the ongoing drought), and a building with three guest rooms. Wandering around were three dogs, three cats, and a tame rooster. As soon as I sat down, two of the cats approached and competed for my attention with an insatiable desire for affection. A tiny half-blind-and-epileptic dog named Sushi waddled up constantly licking its muzzle. Even the rooster came up, said hi, and let me pet it. It was just the animal therapy I needed.

When the room became available, I went in for a much-needed nap. The orange cat, appropriately named Garfield, followed me in. I got ready to collapse into a painful heap, the cat following me around my room like a pack animal. When I was ready for bed, I tried to herd the cat out so I could shut the door, but his resolve exceeded my own. I left the door open and climbed into bed, groaning as I lowered myself prostrate. The cat hopped onto the bed and climbed up onto my chest. I guided him into a position away from my broken pieces and passed out cradling him, contented far from the smells of sickness and bleach, interrupting nurses, and walls of medical equipment.

I woke up several hours later still pleasantly attached to fur and found a place for dinner. My body rejoiced the light exercise of the ten minute walk, and what appetite I could muster was well-rewarded by a steak dinner at a massive tourist-trap restaurant. Better still, a beer and a Coca Cola! Civilization, I’d missed thee!

The healing body has an incredible appetite for sleep, and who am I not to indulge it. The next morning, I walked out of my room and onto the patio for a huge and delicious breakfast spread prepared by Sam, the owner of the guesthouse and mother the trio of kids that lived here with the trios of dogs, cats, and other animal odds and ends (two rats, a parrot, and a wild bird with a broken leg she was nursing to health). Included in breakfast was a french press full of actual coffee, the first I’d had in ages in this land of the powdered shit so much of the world suffers. Ahhh, there’s my privilege again!

In the afternoon, I walked over to another hospital near my doctor’s office for more x-rays. I was reminded that a medical imaging waiting room is a sorry sight, but my wait was pleasantly short, and upon entering I was greeted by the same technician I’d seen on my first night of convalescence, who seemed genuinely excited to see me. More painful body contortions and I was off to the surgeon, large floppy x-ray film in hand. Amusingly, half the folks from the medical imaging waiting room awaited me in Dr. Frielingsdorf’s equivalent. Presently, I was ushered into his office, filled with diplomas and impressive-looking awards. I continued to be impressed by his charisma as he looked at my new x-rays and tried in vain to talk me out of the surgery. We then settled into specifics, which included my surgery date: the next evening. I was then handed off to an assistant who gave me paperwork on prices for the anesthesiologist, hospital, and Dr. Frielingsdorf himself, the last of which needed payment before the procedure in cash by the next morning! I’ll say, Namibian health care prices are pretty goddamn reasonable, but it still took 5 rounds through ATM’s at maximum withdrawal to assemble the required cash for the surgeon’s portion of the procedure, and between the hovering guards present at each ATM in Windhoek, and my previous experiences here, I was understandably nervous taking out and carrying that amount of cash…

Surgery cash-money!

I treated myself to a final nice meal before my requisite surgical fasting, and subsequent hospital fare, and then another good night’s rest at my guesthouse. In the morning, I was sad to leave without another of the fantastic breakfasts. Full of paranoia, I carried my backpack full of (the good kind of) blood money to the doctor’s office. The compassionate owner of the guesthouse agreed to let me leave my things, including my bike, as she’d drive me to the hospital! The joy of avoiding riding my motorcycle to the hospital, especially enduring the process of getting on and off, helped put off the small but undeniable existential fear of going under the knife for the first time.

At the hospital, a friendly and familiar face from the x-ray and surgeon’s waiting rooms greeted me and we chatted. He was a local who’d been assaulted with a board by muggers when taking out his trash before work. They’d shattered his elbow and he was scheduled to have it re-assembled after my own surgery. In a twisted way, seeing his injury made me feel better about my own simpler one.

I got checked in and brought to a room a few doors down from my previous one. I was handed a gown and some paper underwear and told to change. They were some sweet duds.

Ready for some Michael Jackson drugs!

Restless with anticipation, I awaited my call to the theater. Eventually I was put on a gurney, wheeled to a preparation area, and left next to another surgery patient for my turn. The minutes dragged on, then were suddenly interrupted by a cacophony of activity as a be-gowned Dr. Frielingsdorf, two nurses, and an anesthesiologist burst into the area. My futile attempts at conversation, most of which were focused on repeatedly re-affirming they knew which side to cut, were quickly interrupted by an injection. Seconds later, my limbs grew heavy, my mind cloudy, and I was back in my room. Jesus, MJ! You were hardcore!

My mind struggled with the disjointed memories, and my hand went to my shoulder. Instead of flesh, I felt a bandage with my fingers, but my shoulder registered no touch. I poked and prodded the extent of the numbness. My mind went to warnings the doctor had given of nerve damage. My mind wandered to the implications of the potential loss of feeling. It also registered the relative lack of discomfort, and the ease at which my arm moved, and rejoiced. I ran my hand along the curve of my clavicle, marveling at the continuity and shuddering at the perceptible notches of the stitches below the bandage.

Sleep came easy with the exhaustion and post-surgical haze. The next morning I was sent a third time for x-rays to check on my results. They wheeld me back after with them in my lap, and I marveled at my own insides. Later, my surgeon came to check on me. I attempted a joke about how easy and routine my surgery must have been, but it stumbled as he replied with gravely that no surgery is routine. Then he smiled with pride at the x-rays, in which the fracture line is nearly imperceptible, then scurried off saying he’d see me later. What desire I’ve ever had to be a surgeon went with him — I have no desire for that degree of time management.

Save your metal detector comments, titanium is non-ferrous

The day passed slowly, and I mentally cursed the nurse who’d connected my  IV line, as there was no quick disconnect to provide me freedom from the wheeled IV holder. It meant I couldn’t even put a shirt on, or go for a walk without dragging the chrome IV tree with me like my best friend. In the afternoon, the surgeon came back and told me I’d be staying another night, leaving in the morning once again. I finally had a timeline, so I found the cheapest one-way flight back to SF from Windhoek and booked it, leaving four days later.

I hadn’t known how long I’d be hospitalized, so I hadn’t booked accommodations for after. I called the C’est la Vie guesthouse, but they were booked solid for the next night, but I went ahead and booked the last two nights before my flight there. In the meantime, I had one night in a cheap Chinese guesthouse down the street. Once accommodations were settled, I relaxed and waited for what I hope will be my last night in a hospital for a very very long time.

In the morning, I got a pile of medications (blood thinners, more pain killers, antibiotics, and anti-inflammatories), and an even bigger pile of paperwork to ultimately submit to my travel insurance. I snagged a cab to my Chinese guesthouse for the night, dropped off my bags, and accepted my continual new painful and sedentary existence. The time passed uneventfully, and the next morning, one of the guesthouse owners was kind enough to drive me over to C’est la Vie and reunite with my things, and the friendly folks and animals there.

Long surgery bill is long

In my last two days in Windhoek, I made dozens of calls trying to find safe storage for my motorcycle, was forced to go to the Ethiopian Airlines office to “verify” my credit card, and eventually had all my needs straightened out by Sam from my guesthouse: she’d allow me to store my motorcycle in her garage for a good price, and arranged a ride for me to the airport. On my last night in Africa, while whiling my time away alone in bed, there was a knock on my door. Sam’s oldest daughter and her boyfriend were outside, and invited me to come over to the patio and hang out. It was a wonderful sendoff for a hard few weeks, as they plied me with wine and we chatted long into the night.

The next morning, I headed to the airport for my 35 hours of painful air travel excited to have such a wonderful place to come back to when I returned. To be continued…

3 Replies to “Tripus Interruptus: A Tale of Four Bones”

  1. One hell of a journey! Glad you powered through everything thrown your way in strange new places 🙂

  2. Inspiring doesn’t quite fulfill the feeling here. This is moving. Moving to get up and go. Sit down to write. And then share the experience.
    And yes, you definitely have a healthy future as a bone model.
    Light it up buddy!

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