#17 I Had No Ready Reply

Costa Rica - 2016, Part 2

I need medical attention, at minimum, an x-ray. As luck would have it, the only x-ray machine on the island belongs to the veterinarian.

(If you’re not sure why I need medical attention, you’ll want to read my previous post here.)

It’s another team effort to get me loaded in the back seat of the owner’s SUV, where one of the girls from the group pats my shoulder and picks twigs out of my hair. I hear the owner calling the vet’s office and, in what may be my only display of personal agency through this whole ordeal, I say: “I am not going to a veterinarian. I need a doctor. A people doctor."

Even though my face is buried in the upholstery of the back seat, I can tell the owner is planning to override my decision because she is still on the phone. She hangs up and says, “Well, the vet is already gone for the day, so we can’t go there anyway.”

We drive off and, I’m told later, the stray chases the SUV down the road as far as he can.

This is how I end up at the small medical clinic on the tiny Main Street (aka the only street) in Santa Teresa. A woman in blue scrubs opens the door and says, “Don’t worry. We’ll take care of you.” I start crying again. This time with relief. I’ve seen enough Grey’s Anatomy to know: scrubs = medical people! Medical people = pain killers. Hooray!

(Grey's Anatomy/ABC) They were so young!

After my examination, the doctor tells me that I don’t appear to be in any serious danger, but that the location of the injury and my pain level make her think I might have broken something. My legs seem fine, but maybe the tailbone or something else. On the plus side, she tells me, my blood pressure is great!

It’s true, there’s no X-ray machine, so I’ll have to go to a hospital. The best option is to go to the one in San Jose, the capital of Costa Rica. It’s a good hospital and it’s close to the airport where I’ll have to fly out to go back to NYC. The catch is that the only way to get me there is via MedEvac.

I’m sure she can see the mental calculations I’m already doing on the cost of a medical helicopter ride because she says, “Don’t worry. Your insurance will cover it. We’re checking with them now, but they always cover it.”

Always? How often are you calling in a chopper? “It’s Costa Rica,” she shrugs. “People do a lot of stupid stuff.”

Then she offers me morphine and a few pieces of candy saying, “you may hallucinate a little bit. It’s OK.” I don’t know if it’s the morphine or the power of her suggestion, but within a few minutes everything is awash in a deep purple and I’m at ease for the first time in hours.

The doctor then asks, “Why did they bring you in that car? Why didn’t they call an ambulance?” I tell her about the ranch, the intern, the bumpy ride slumped in the saddle. She’s horrified. “They should have called us! We would have come!”

I tell her what the intern said about the remote location. The doctor gives me a look that even in my purple haze I can see means, See? People do a lot of stupid stuff.

But she just says, “We’re used to retrieving people from remote places.”

Once the insurance company approves my transfer to the hospital it takes a couple of hours to coordinate it. I won’t be going back to the resort so my friend and yogi guide, Christine, agrees to come with me to the hospital while Misty packs my things and the group finishes their final night of the retreat.

What I could have been doing on the last night of the trip. Also, #IJLTP

When it’s time to leave, the doctor tells me that they will have to immobilize me fully for the flight. I try to relax as they strap me onto a board, my head fitted into a firm, but spongy brace. It’s really scary. For the first time, I start to think about what might actually be wrong with me. While I was still in the little clinic, I thought they might send me home with an ice pack and some pills, but what if I’m really hurt? What if the pain under the morphine never goes away?

I’m loaded into an ambulance for the short ride to a field where the helicopter is waiting. It’s my first helicopter ride, and despite the doctor’s early cavalier attitude, it seems like a big deal for the medical staff too because they’ve all escorted me there and are taking selfies with the helicopter in the background.

Photo credit: Kerry Girvin, a ninja who also sneaked me a chocolate croissant for the ride. I think the Medic ate it.

(It’s not lost on me that they might have been snapping my picture for inclusion on their local “People do a lot of stupid stuff” private FaceBook group.)

The pilot and a new medic get me on board and fit a headset over my ears so that we can communicate over the noise. Normally I’d be geeking out over this, but I’m fixated on my breath, which is now the only thing I can hear in the noise-canceling headphones. Christine is sitting next to me narrating what I’m missing: the medical staff waving as we take off, the views over Santa Teresa.

The medic takes my blood pressure and says, “wow! Your blood pressure is really good!” I wonder why everyone seems so surprised by this. But, he offers me more morphine and I forget to ask.

At the hospital in San Jose, we’re met on the roof by a team who rush out and help get Christine and me out of the helicopter. We meet the doctor who will see us through the next 15 hours - he’s a local from Costa Rica but spent many years in New York City, where he did his residency and spent the early part of this career. This is great because he is one of the only people who is comfortable speaking in English to us, so we’re able to communicate easily.

The good news is that upon initial review, the x-rays don’t appear to show any fractures or major issues. The pain is likely from soft tissue damage. And, my blood pressure is great!

The bad news is that I’ll need to stay overnight for hydration and observation. And the morphine drip is discontinued so they start me on a bunch of pills which I suspect are aspirin.

#fashun

Christine gamely stays the night with me on a rollaway cot, keeping me entertained with yoga gossip and anointing me with every essential oil she has at her disposal. She offers the oils to the doctor, who readily accepts her services, respectfully asking what are the medicinal benefits of sandalwood.

Every time they check on me, they ask my pain level from 1-10. Everything hurts, bad, so I say, “8” and the nurse gives me a look that barely hides an eye roll and says, “Really? 8? You’re sure?”

And then, I’m not sure. How does this scale even work? Maybe 8-10 is reserved for amputations? But, no. It hurts to breathe. I can’t get up to use the bathroom without two people helping me.

I double down. “9.”

In the morning, the doctor comes back in and tells us that the radiologist has reviewed my x-rays and there is some news. I have a fractured vertebrae - the L5- which is what’s causing all that pain. Still, the injury is “not clinically relevant” which I guess means I’m not about to die, so they release me with a huge envelope of x-rays and 3 prescriptions. We make it to the airport in time to make our originally scheduled flight back to NYC.*

When I get home, my friends and family fly into action, sitting vigil with me for the first few days while I make appointments to see my primary care physician and the spinal specialist she recommends.

The day of my specialist appointment, the pain is so bad that I break down crying in the lobby of my building. My doorman, the Uber driver, and my friend Barbara work together to get me into the car, even though it’s clear they are traumatized by my pain and tears.

Within a few hours, though, I’m already feeling more human. The specialist is kind and direct. He confirms the fracture diagnosis, and assures me that I was in no danger of permanent disability. But, I will need to stay home from work for 6-8 weeks while I healed. He gets ready to write the note.

I’m watching him write and slowly freaking out. How can I possibly miss 8 weeks of work? Is that even allowed? What will I do with myself? How will they survive without me at the office? I start to come up with excuses as to why I really need to go back to work sooner.

He looks at me like I have 5 heads.

“What kind of job do you have? Will they take it easy on you?”

I’m nodding, but even before I can spin that web of lies, Barbara interrupts. “No, they won’t. They won’t leave her alone for a second. Tell her she has to stay home.”

Five days earlier, on the beach in Costa Rica, I wished for time. More time to think and dream and plan. And now, I'm being given a pass to take 2 more months off of work. Why am I arguing?

I'm clearly distressed so the specialist says, “Well, if it makes you feel better, at least I can give you real medicine.” He gestures towards the pile of Costa Rican prescriptions. “These are all basically Advil, which will be good to use once the bone has healed. But for now, I’ll give you something for the pain.”

The reality starts to dawn on me. I’m not going back to work for 2 more months. And my life is about to change in ways I never dreamed possible.

The opioid epidemic is no laughing matter.

Cx

16/100

*Shout out to Misty Bailey for giving up her business class seat so I didn’t have to survive the 5 hour flight in coach!

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