Llama through the looking glass: fugues in M major and small acts of kindness, 10/11/14 – 01/12/14

Following the events in my previous post, I was airlifted to Newcastle Royal Victoria Infirmary. Memories of my sojourn in hospital are fragmented at best. I must confess myself an unreliable reporter and events may not have occurred in the order in which they’re described. Indeed, some of them may not have occurred at all. I’m happy to confirm, though, that I received superb care from both of the hospitals in which I stayed.

There is torchlight and a shimmer of bright nylon overhead. Somebody says “I’m going to give you a lot of morphine but I’ll also have to fit a catheter.” Very well, Sir, we’ve only just met but provided you promise not mention it to a soul outside this helicopter, I agree to your terms! Later I am told that in fact he fitted a cannula. Another (or possibly the same) voice tells me that they’ve ordered a helicopter and that it will be half an hour. Where on Earth is it coming from? Scotland, as it happens. A notion of being in the wind again, a strap coming tight over my torso, so much light and so much noise, a voice warns me I’m going to be winched.

Someone very gently takes my contact lenses out. I will not see clearly for two weeks.

I spend two days in surgery, of which I have very little memory. I do remember an MRI scan, very close, very loud. In my fear and utter disorientation, I am crying and begging them to stop. Eventually they sedate me as I am moving too much for a clear image. From my discharge notes:

  • 11/11/24 Insertion of intra-medullary nail, rotational flap and split skin graft to the right tibia.
  • 12/11/24 Thoracic 4-8 posterior spinal stabilisation
  • Whilst at RVI Mr Marquis became acutely confused and underwent an MRI which demonstrated fat embolus syndrome. He has since made an excellent recovery and has no ongoing problems from this.

So I have a titanium rod running from just below my right knee to just above my right ankle. Five of my vertebrae are connected with Mecanno and I had multiple, small ‘clots’ of fat tissue in my bloodstream.

Image of author's fractured leg

That’s what an intra-medullary nail looks like. X-ray from Leeds Teaching Hospitals.

I am in shock, tight in the grip of the big M, very confused and I can’t see properly. In and out of consciousness and constantly medicated, I become convinced that I’m the victim of a conspiracy to gas me and I effect a standoff with the surgical staff until they can prove their bona-fides. They are colossally patient with me.

Fugue #1: I’m producing a TV show called “My S**t $400 Bruce Willis Pilot”. I’m sure you can guess the premise. In fact, if I can get BW interested then I think it’s got legs but he seems to take himself a little seriously at the moment. I digress. In this pilot, John McClane has been sent back from the future to save Sarah Connor from the Terminator – so it’s pretty much like Terminator but with more quipping and less footwear. Bruce Willis dares me to manually remove my catheter. (It definitely is a catheter this time and not a cannula). I can only confirm that it was painful, fruitless and that you should never take a dare from Bruce Willis.

Nights move very slowly on the High Dependency Unit. I sleep propped on my side because it hurts to sleep on my back – the weight of all of me on top of muscle that that was caught between my ribs and the rest of the planet. The nurses turn me to the opposite side every four hours. Across from me, someone is connected to a machine that regularly whirrs to viscous life to drain the fluid from his lungs with a noise I can only describe as Cthulhu meets medicine. At least I can work my own lungs.

My scalp is crusted with blood at which I compulsively pick so that the nails of my right hand are Walking Dead grim. My parents are coming to visit me tonight and I ask a nurse if she can help clean me up. She is South Shields born and bred and yet has a New England accent. This does not seem strange to me. She finds a way to shampoo my hair while I lie flat on the bed and then spends half an hour with a nailbrush and some kind of plastic stylus freeing my nails of the gore. Even now, I am blinking tears at her kindness and care for my dignity.

Fugue #2: It is cold. There is a bare rectangle of muscle on my thigh to which corrugated cardboard has been stuck with masking tape. I have to peel off the tape and cardboard without hurting myself. I think this is my brain trying to explain to my body the process of taking skin from my thigh to graft to my calf. Unfortunately, my brain has no information so it just makes things up.

The hospital moves above me in a scrolling mosaic of ceiling tiles as I am wheeled from the HDU to a trauma ward. New faces, new names to mishear, half-learn and forget in my stupor. I am suddenly confronted by the intimacy, the sheer languor of my slow-dance with death and I cry uncontrollably for what seems like two hours. I explain my situation and ask for some medication to take me out of the world for the night.

Fugue #3: The nurses, the other patients and I are in an ill-lit cross between a Cold War bunker and the set of Alien. We freeze, motionless, for long periods to conceal ourselves from some nameless and terrifying presence.

Each night I find some peace in listening to one of the other patients chat to his mother in a musical, silvery language that turns out to be Gujarati.

X-ray of author's vertebrae

I am Titanium Man! Well, small parts of me are. And actually, I don’t know if this bit is. X-ray from Leeds Teaching Hospitals.

Two friends drive up from Bradford to visit me. In my mind’s eye, the visit takes place in a corridor next to a fire escape. In reality, it was on the ward. To try to nail something of the world down, as they are leaving I ask one of them if they are really real and if the visit really happened. She takes my hand and assures me of both.

A friend rents me one of the television/radio/telephone consoles. I make my blurry way through Pacific Rim, Skyfall, The Lone Ranger, The Dark Knight Rises and, bizarrely, a lot of James Martin cookery shows. Pacific Rim is quite baffling – I am not sure it would be any less so without the morphine. It is also very Japanese and incredibly gloomy. Apparently the future will allow us to fight inter-dimensional squid with giant robot avatars but it has no internal lighting. For The Dark Knight Rises, I have to skip all the bits where he has his back broken and miraculously heals it in an underground prison. Just for the record though: no way – my ribs still hurt and it’s three months since the accident. I have no clear memory of the The Lone Ranger. Again, I do not feel the big M is to blame. And speaking of the big M, James Martin is strangely relaxing if you’ve broken your back, leg, collar bone, seven ribs, can’t use your left arm and can barely see.

Fugue #4: I awake to find the ward lit as though for a German Expressionist film. Oh brilliant – tonight’s going to be a paranoid detective drama directed by F W Murnau, that’s just what I need. I know that it is a hallucination and yet I cannot wake from it; I must ride it out until a nurse arrives with toast at 6 a.m.

I discuss the morphine end of my medication spectrum with the doctor on the morning ward round and we agree to scale it back. I ask also about how I am being affected by my brush with death and clinical a psychologist comes to see me several times to talk it through. Apparently my hallucinations are the most detailed she’s ever heard.

For each trip to the toilet, even to transfer to the chair next to my bed, I must be hoisted in an electric winch. I come to find comfort in its strange sense of weightlessness, its freedom from the push and pull of skeleton versus muscle. Eventually, three physiotherapists get me to my feet and onto a walking frame. It’s been over a week since my head was 5’9” from the floor and I am dizzy in 15 seconds.

During my transfer to Leeds General Infirmary, I fall asleep in the ambulance on the A1 and awake in Yorkshire. The trauma ward in Leeds is a far quieter place; only one other bed in my bay and no television or radio, no Geordies screaming about heroin in the middle of the night (I didn’t dream that – I doubled-checked with someone on my ward).

It’s now almost two weeks since I’ve had a cup of coffee. Those that know me will understand what an absence this is. It’s odd what you can do without when it comes right down to it.

The man opposite me has an oxygen mask, one of those exoskeletal frames on his leg and multi-packs of crisps strewn round his bed. When the curtains are drawn on that night, I hear him take his mask off so that he can eat crisps. The next morning, his lung collapses and a surgical team push a tube through his ribcage to drain the fluid. I’m definitely not saying post hoc ergo propter hoc here. It’s just odd the choices we make, given our circumstances. No that I have room to talk – look how I got here.

The physiotherapists here have me moving from bed to chair on a banana board, which makes excursions to the bathroom a bit more self-reliant. Then I’m on a walking frame and then on crutches. I take my first more-or-less-solo shower for weeks. I need help to wash my back and my calves but apart from that, the nurse affords me as much dignity as she can without compromising my safety.

(Possibly) Fugue #5 I am woken in the middle of the night by a plastic surgeon. He rattles through the usual questions and has me do some little tests on my brachial plexus. Then he tells me not to sleep on my left side and not to eat or drink anything. I ask if I’m going into surgery and he ducks the question and leaves. I can’t work out whether I’ve imagined it or not. I call the night nurse, apologise that I’m not sure if I’m hallucinating but has she had any notes from a plastic surgeon? She hasn’t. In the morning I explain again to the consultant. “So you were woken in the middle of the night, given a barrage of questions and the notes weren’t completed. It does sound like a plastic surgeon.” I don’t return to surgery and receive no further nocturnal visits.

To avoid deep-vein thrombosis, I am injected in the abdomen with tinazaparin each night. The nurse shows me how to do it for myself as, regardless of left-handed-incompetence, I will have to manage it when I am discharged. I make a bish of it the first night but he is very patient with me and I get it right thereafter.

I am visited by a succession of friends who all bring me coffee from my favourite local indie. Some measure of normality comes back to my life.

Detail from author's cognitive test

“Describe in single words only the good things that come into your mind about your mother.” That’s a Bladerunner quote – I’m not having a go at my mum.

An occupational therapist takes me though Addenbrooke’s Cognitive Examination to test my…um…cognition. One of the questions asks me to write at least two sentences about my last holiday. How I laughed. Note that in the picture (left) I picked up the bonus point for spelling and grammar. Another exercise has me naming the subjects of various drawings. “Well, that could be an alligator or a crocodile. The illustration doesn’t have sufficient detail about dentition for me to make that distinction.” I score smartarse out of twelve.

Finally, the physiotherapists teach me to take stairs on crutches and this means I can be discharged. It swirls up far more quickly than I expect and within three hours I’m strapped in an ambulance wandering if I’m ready to leave hospital. There’s no pleasing some people.

Further detail from author's cognitive test

Cognition, you say? Let’s discuss comparative dentition in order Crocodilia.

My family and many of my friends came to visit me in Newcastle and in Leeds. I’m not naming you in case I hallucinated it. You know who you were. Thank you. I hope you know that I would do as much for you (though I really hope it’s never necessary).

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4 thoughts on “Llama through the looking glass: fugues in M major and small acts of kindness, 10/11/14 – 01/12/14

  1. Pingback: Return of the llama, 12/11/15 | not really a llama

  2. Pingback: An accretion of brutality, 12/05/17 | not really a llama

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