RIGHT OUT OF LEFT FIELD

After having a sleepover the night before, we wore ourselves out by squirt gun fighting, diving onto the slip and slide, doing back flips, front flips and three hundred and sixty degree flips, as well as sideways flips off of the diving board into the pool during the morning. We roasted marshmallows, sautéd mushrooms and pan-fried shrimp, crab, oysters, and clams on the open bonfire throughout the afternoon hours, as well as finally soaking up the ninety-five degree weather while we lay on the trampoline feeling the refreshingly cool water from the sprinkler shooting up at us throughout the night before.

My sister, our buddies Jim and Crystal and I were lying down on the trampoline in our slopping sweat/water filled bathing suits. As the sun was rising above the evergreen trees surrounding our patio, the one hundred degree rays were tanning our stomachs, and our bodies were waking us up as they screamed for cooler conditioning.

Still pretty groggy from the night before and the exhausting heat, the ladies turned to face us guys on their left. Exuberantly tapping us on the shoulders and stomachs, one of them breathlessly suggested, "Good golly, it is going to be another mighty hot day. Do you guys want to go down to the swimming hole and soak in the cool water of the creek?"

Looking back at them, we answered, "Sounds fabulous to us. We can also catch some fish and fry them in lemon juice down there as well."

Heading inside the house, we guys grabbed our brightly-colored fishing backpacks and our ruby red and aqua blue fishing poles, solid sun yellow lures and turtle green bobbins. Then we headed back outside and hopped on to our bikes.

Seeing that we were exuberant about getting there, the ladies swiftly swept up their bikes as well and headed after us. Catching up to us as we got to the top of our street, the women called out, "Hey you guys! Why don't we just wait for grandma to get back home? Then she can drive us there and pick us up. That way, we don't freeze on the way back. Especially when we are going to be soaking wet!"

Stopping as we got to the top of the hill, we men looked at the red/black roses and fifty-seven foot cedar trees filled with squirrel and miraculously-decorated birds' nests, the elaborate shades of pink on the cherry blossoms and the cotton puffing mildly in the summer breeze. The whole time we were breathing in the revivifying smells, taking in huge whiffs of the natural oils, spicy cedar aromas and the pleasantly fresh cherries.

We turned our heads back to them and answered, "Well we could do that. But, do you girls really want to be on a set schedule? If we ride our bikes, we can have the whole day to swim and fish. We'll be swimming to cool off from the morning heat, then drying and warming back up in the afternoon while we fish. We can relax to the cooler rays when the sun starts to go behind the clouds. By the way, we are already soaking wet!"

The gals smiled and rode up to us. "That sounds real good" said Crystal. "But you forgot a few details. We will also be warming up to a huge fire and enjoying a fabulous fish lunch!"

Being a bunch of smartasses, we just looked at them with real stupid faces and called back "Well duh! That is if we cavemen can learn how to operate these here modern devices." Pulling the lighters out of our pockets, we "dorks" sarcastically ran our fingers over the flame. I yelled, "Yea, flame hot! Make for good roasting fish. That is, if we guys can remember not to cook selves. Got to remember, body parts need to keep away from flame. Even if flaming food tries jumping out of pan at you. Need to make sure food is dead today. No cooking it while alive!"

We got on our bikes and I excitedly sped ahead of everybody else. Getting a load of turbulence, I jumped onto my bike's back pegs, staring at the cloudless, clear blue sky, I popped a wheelie and coasted straight ahead. Seeing that I was coming upon a three-way intersection, I started to slow down. Right as I slowed down though, I got to a bad spot. A woman blew twenty miles over the speed limit into the bike lane and hit me.

The others saw me bounce off the windshield and fly into the ditch. They looked me at lying there and saw blood dripping out of a split in my head. Through the split they could see a pink, gray and brown lump of ripped brain. My right leg was bent round to the back of my head. Pink tendons and blue veins were ripped out and lying in a pile beside me. My back was torn open all the way, with white shards of broken bone and spine sticking out as well as pieces of my skin swaying lifelessly and flapping in the wind. Lastly, both my arms were bent backwards at the elbow, with shards of broken elbow in crumbles beside me.

My sister threw her bike down, ran up to the woman, who was getting out of her car, grabbed her by the shirt, yanked her down to her level, and started yelling, "What the fuck did you do? How the hell can you be so damn incompetent? You were too stupid to watch where the fuck you were going and you killed my brother! He's lying in the ditch like he was murdered in a horror film!"

The lady started sobbing, snot dripping from her nose. She stuck out her bottom lip and whimpered, "I'm so sorry honey! He just came out of nowhere."

The other two threw their bikes down. John hollered, "How the hell did he just pop out of nowhere? It's not like he rode out of in front of you! You incompetent boob! You drove into the wrong lane, the one that's supposed to be for bikers and crushed him!"

The woman who was now sobbing uncontrollably, whined, "I know, sorry. The least I can do for you is let you call an ambulance and we can try to get him to safety." Shaking now, she handed my sister her phone.

My sister grabbed the phone, her entire body trembling. She dialed nine-one-one. She stuttered and cried as she spoke to the dispatcher. "My brother was hit by a car. I don't know if he is breathing. I think he might be dead! We are on the northern side of Central highway, right by Sunset Pond. Hurry, hurry, hurry, I do not want my brother to die!"

The dispatcher responded, "I am so sorry darling! Don't worry, I will get someone on their way ASAP! Don't start worrying, I will not let your brother die!"

It took the ambulance about five minutes to get from the hospital to where we were. When they got there, they immediately put me on a stretcher. Because I was not breathing they attached an Ambu-bag to my face to force air into my lungs.

When we finally arrived at the hospital, I was immediately sent to the emergency room and they put a new tracheotomy in me. They did this by:

1. Finding the bulge in my neck where my Adam's apple was.

2. Having one doctor move his finger about one inch down my neck until he felt another lump, the cricoid cartilage.

3. Now that they were right between my cricothyroid glands, they were ready to make the incision.

4. The doctor then grabbed a razor blade and made a one inch horizontal incision. The incision was about half an inch deep into my trachea.

5. He then pinched the incision open and slid his finger into it, making sure it was the right size.

6. Now that the hole was made, he put a trach tube inside of it. This was about one inch in depth.

7. Finally, he attached me to a ventilator, a mechanical breathing machine. Watching my chest rise, he was satisfied with his part.

"Now that we got the man breathing, we will get him healing!" he said to the nurse. She grabbed one of the IV poles in the back of the room, wheeled it swiftly over to me and stuck an IV needle in my left arm. The doctor placed a bag of blood on the hook in the top center of the pole.

Once she was done attaching the IV, the nurse went over to my sister, who was crying. She was trying to look at me through her tears, and just praying and hoping I was going to be alright. Wrapping her arms around her, the sweet nurse explained to my sister what was going to happen.

When a bone breaks, the tissue severs the blood vessels running down the length of it. Blood leaks out of these veins and quickly forms a clot called a fracture hematoma. This helps to stabilize the bone and keep both pieces lined up for mending. The clot also cuts off the flow of blood to the jagged pieces of broken bone and their edges. Without fresh blood, these bone cells quickly die. Swelling and inflammation follow due to the work of cells removing dead and damaged tissue. Tiny blood vessels then start growing into the fracture hematoma to feed the heeling processes.

After several days, the fracture hematoma develops tougher tissue, transforming it into a cushiony callus. Cells called fibroblasts begin producing fibers of collagen, the major protein in bone and connection tissue. Chondroblasts then begin to produce a kind of cartilage known as fibrocartilage. This transforms the callus into a fibrocartilaginous callus, which bridges the gap between the two pieces of bone. This callus will usually last about four weeks.

Next, osteoblasts move in and produce bone cells, transforming the callus into a bon's e callus. This hard shell lasts on average three to four months, and it provides the needed protection and stability for the bone to enter the final stage of its recovery process.

Various complications can occur with fractures depending on the bone, the severity of the break, and the person's age. Children are susceptible to additional forms of fractures, but their bones tend to heal faster and more completely than most adults. Infection does present a problem to any compound fracture, as the break in the skin can allow germs to enter. Broken ribs can possibly pierce inner organs, and the healing process itself can inadvertently harm other organs and tissues. In compartment syndrome, a fracture's injured muscle swells so tightly that air and oxygen will not be able to enter the high-pressure tissue. Without sufficient oxygen, the tissue of the muscle will proceed to swell until injury and muscle death ensue. Pulmonary embolisms can happen if a fracture's blood clotting breaks loose and cuts off blood flow to lung arteries. This condition is especially common in hip and pelvic fractures, accounting for an estimated one third of hip fracture deaths.

The first step involves the doctor determining whether or not a fracture occurred and if so, to what level of severity. The following steps of treatment depend on the physician knowing exactly what they are dealing with. They generally will accomplish this by, (doing what they are doing now,) examining your brother and inspecting his x-rays they just took.

Just as the body does its job in lining up broken bones and limiting mobility, the doctor must ensure this alignment. They will further immobilize the affected area by putting it in a, splint, cast, brace, or whatever they might think to keep in place the healing pieces.

Simple immobilization may not always be enough to ensure correct bone healing. In this case of more complex fractures, a system of weights, ropes and pulleys are inserted to constantly pull on the fracture to maintain alignment. Like now, doctors may have to perform surgery to remove foreign material or bone fragments and stabilize the bones, tendons, and every other thing. The number one way to stabilize certain fractures is to go in and align the bones with metal rods, screws, and pins. Some fractures, such as those in the hip and joints require artificial replacement.

The doctors were now sewing my gory and bloody tendons, and they looked over in deep amazement as my sister finished explaining. Overhearing the conversation, one of the doctors smiled and looked over to her. Showing her a ten-inch metal rod, he added, "Don't worry, your brother does not need any plastic or metal limbs. He needs just a small rod inside his right leg. This will reconnect some tissue that he tore. No need to fret though, we will get him jumping and running with you like he did before this pesky little slowdown!"

The nurse explained, "The same type of immobilization that keeps stress off the healing bone also leaves the surrounding muscles with little to do. This leads to the loss of muscle mass, strength and flexibility. Special exercise regimes allow people to slowly rehabilitate their newly-mended limbs without risking re-injury. This, darling, is why the doctors are doing what they're doing. Baby girl, we will definitely not stop helping your brother until we get him back to normal. There is no need to cry, your brother will definitely be alright!"

My sister and my friends were now more cheerful and upbeat. "We'll just keep praying and believing he will" said Crystal.

The last set of bones they repaired were the bones of my spinal column. They accomplished this by putting a rod into my spinal cord. This was so that the bones and tendons would grow back in the right places, stopping my spine from becoming crooked and crushing my lungs. They also fused my neck to my spine. This was to give me more control of my head after my neck finally recovered from being broken.

Before the operation, the doctor carried out a complete physical examination to figure out my leg lengths, muscle length, lung function and any postural abnormalities. He then turned to the nurses and asked, "Now that I know how we will be doing this, shall we get started?" As they were getting me turned onto my left side, he happily added, "Let's get his back intact!"

This procedure meant:

1. Taking a blade and slicing flaps in my upper vertebrae.

2. Removing the bony outgrowths along my vertebrae that allowed my spine to twist and bend.

3. Laying matchstick-sized bone grafts vertically across the surfaces of my exposed vertebrae, positioned so that they touched each adjoining vertebrae.

4. Folding the flaps back to their original positions and covering the bone grafts. These grafts would regenerate, grow into the bone, and help to fuse my vertebrae together.

5. To support the fusion of my vertebrae, the surgeon used a steel rod, extending from the bottom to the top of the curve that was induced when I landed in the ditch.

6. The doctor attached the rod by fastening it to hooks suspended from pegs inserted into the bone of my upper back.

7. Like changing a tire, the steel rod was jacked up and then locked into place to support my spine securely.

Coming up behind them now was the gastroenterologist. Looking at my flat belly he said, "Well, this guy sure looks hungry. Let's get him eating." Grabbing an endoscope with a camera and light on the end of it from his front pocket, he slid it into my mouth and down my throat. Flipping on an x-ray TV in front of my bed, he wiggled the endoscope into my esophagus and stomach. Finding a patch of great-looking skin in my upper left abdomen, the gastroenterologist pulled out a tiny drill. Moving to my left side, he felt around my abdomen and found where the endoscope was. Drilling into my abdomen, he made a little hole as he pulled the endoscope out of my mouth. Getting the full hole made, he set the drill down and started to insert the PEG tube. This was simply done by sliding the long plastic tubing into me and filling the balloon with 10cc of sterile water. When he was done he wiped the blood and stomach acid off me.

For the final procedure of the night, the urologist walked over to my waist on the left side. Grabbing a last long plastic tube from a cabinet to the lower left of my bed, he unwrapped the tubing and attached the urine bag to it. Moving up to my waist, he grabbed my penis, gently rubbed around the pee hole to open my urethra and not tear any of the skin inside. Then finally he slid the plastic catheter through my urethra into my bladder. Then he turned his head to my sister, who was on his front right. As she was cringing as she watched him moving the catheter into me he politely and encouragingly said to her, "I know this probably doesn't look too soothing, but this catheter will help to prevent your brother from having to be repositioned and moved a ton to get cleaned up. This way, he can freely pee without hurting any healing parts of his body."

Smiling and trying to sound uplifting too, she responded, "Yeah, he needs his time to rest and heal. It just does not look very comfortable right now."

The urologist smiled back. "Yeah, having a bunch of tubes in him probably doesn't seem like it would be too comfy. But they will be slowly removed as he heals. For now though, they will allow him to rest peacefully and start his healing processes." Giving my sister a hug, he left the room.

Once these issues were all worked out my father entered the room. He hugged my sister and they both walked over to the top of my bed. Staring into my face, he said, "Please, please, please John, do not die on us right now! God got us out of the drugs, the abuse, and the other bad parts of our lives. He will get us out of this as well."

Coming into the room behind them was the rehab doctor. Putting his head between my relatives he told them, "The x-rays of his brain show that he has suffered a tremendously severe amount of brain damage. People with the kinds of bruises he has on his brain come out of their coma with severe anger, chronic depression and mental retardation, as well as being unable to do anything but sit in a wheelchair and drool the rest of their lives. I do not know what you think would be the best idea, but I know I would not want my child to be trapped this way the rest of their lives."