The Journey

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Episode 8: Rehab Week 2 to 6

2 Years on and I’m finally playing Magic in Rocklands again. Photo by Jethro Watson

This post, will be the last in the continuous timeline, my recent update briefly details how I’ll be writing after this post. The post recounts some of the events and feelings of the last 4 weeks of rehab. It was busy and challenging and I applied myself fully to the process of rehab. There was however a disconnect, as my body was healing and deriving meaning from that, my mind was consumed by grief and sadness. As a disclaimer, this is a dark post, if you’re not in a space to deal with that then read it later. It is what I felt at the time and although I know a part of me feels that same sentiment now, it is definitely not the wolf that I fed. I recall Jordan Peterson saying something like its not that the world is any less chaotic and terrible than you imagine, it may even be worse, its that you as an individual are strong enough to actually contend with that. We as humans are strong enough, and its important that we use that strength. Each and every one of our journeys matter.

Monday saw a return to the productive routine of rehab. I had an hour with the physio and an hour with the occupational therapist. It felt good to do some exercise again after the emotional weekend and I stayed in the gym after the guided sessions were over. I opted for a 30 min cardio session to try to work out some frustration. It helped whilst I was doing it but my energy ran out. When I stopped I was confronted by the view of Devil’s Peak out the window. Looming large and imposing near the rehab facility, it felt as if the mountain was mocking me, “Looks like you were enjoying life, well here’s some suffering for you”.

The rest of the second week in rehab continued much the same. I actually hopped with the walking frame from bed A to bed B. I stood in the parallel bars and took one hand off, one of the most terrifying things I’ve ever done. But overall and despite the enthusiasm of the first week, the week was tedious. The loss of the old me ever-present. When asked about the sense of loss I felt by the rehab counselor I was reminded of the loss I felt when my first relationship failed and when my good friend Schalk committed suicide. I was devastated but continued on. The lessons learnt from experiencing prior loss were useful but the loss remained. Cold, hard and final. The climber I once was, was dead. And like Tolkien’s elves would forever experience the the grief of their kinslaying, so would I carry that loss with me, always.

The wounds healing well underneath the Taylor Space Frame. Photo by Jethro Watson

On the more physical front, the left knee had started loosening up after being fixed straight for 8 weeks. I was becoming aware of the increasing movement and instability in the knee. It felt as if the knee was separating everytime I moved it and the lower leg was scarcely attached. It was also clicking and grinding, loud structural noises which the Physio was concerned about. Dr Laubser visited me and said that there was almost certainly further damage to the soft tissue (muscles, tendons, ligaments, etc) but that there was nothing we could do until the bone had healed. He made clear the importance of weight bearing on the broken bone. Without stimulus the bone would not heal. Once the bone was healed and the TSF removed, I could go for an MRI to assess the soft tissue damage.

The rehab professionals had now had enough time to assess my condition and held a family meeting to outline the process. I would be in rehab until the 4th of October, 6 weeks in total. To help prepare me for integration into the world beyond hospital they would send me ‘home’, first for a few hours, then a day and finally for a night before being fully discharged. That weekend I would be going to my parents house (since my home in the mountains was no more) and would see my dogs for the first time since the accident. My dogs were with me when it happened and Luthien sat right next to me until the paramedics arrived. How much they understood about the situation is debatable but they knew something terrible had happened. Judging by the reaction I’m certain that they thought me dead.

I cannot even begin to describe the feeling… Photo by Colleen Watson

Each week in rehab was harder than the previous. The relentless regime of exercise and learning how to function in the new world was taking its toll. By the end of each day, the inflammation and pain had reached its crescendo. The exercise, moving around and adjustments to the TSF pushed the pain beyond the reach of the drugs. The phantom pain which wasn’t being blocked by the opioid painkillers was also mounting and was at times the worst pain I experienced. Each day at around 5pm I would be back in bed holding on to my sanity as the pain consumed me. Adding to this was a sense of tiredness which I had never before experienced. The tiredness was a state of living death, at times I was sure I was on the ‘other side’ looking in at life.

There was however an event which saved me from full detachment. When my sister had bought me Magic cards from the Luckshack the Lady who helped her took an interest in my story. She and the community there arranged a visit to the rehab by three wizards, Jay, Dilyn and Daniel. For the afternoon we played Magic: The Gathering. It was so good to cast spells again and take my mind off the tedium, pain and loss. I cannot express how important that gathering was. It was perhaps the first glimmer of real hope that I may be able to overcome the suffering which was all too apparent.

Thanks Luckshack and the wizards, this really was hope unlooked for. Photo by Dilyn

I would be discharged for the full sunday and would eat my first proper meal outside hospital. My mother and I would also brave the world to go to a mall and buy a vinyl player to play the Tool LP which I had bought as a form of retail therapy. Overall It was a good weekend and the magic had been such a god-send, but as the flourescent lights of the hospital rehab welcomed me back I could not escape the pain and the loss. All I wanted was to go back through the looking glass, back to my tent in the Cederberg, back to the strong energetic climber cuddled up in his bed with his dogs, back to the life I had dared dream and tenaciously created. Some feelings cannot be expressed, they can only be felt, and it was too much. Not for the last time would I think that it would have been better to have died on that mountain, to check out before the suffering that followed.

Transferring from a wheelchair into a car for the first time. Photo by unknown

The last two weeks of rehab were a grind. Everyday doing as much exercise as my body could manage before the pain and tiredness hunted me down. The phantom pain in the amputated right leg was so severe that the doctor had put me onto a specific antidepressant that was known to have an effect on phantom pain. That combined with a higher dose of Lyrica, a drug originally for epilepsy but commonly used for nerve pain. The effect was roughly the same level of pain and a sense of lethargy and acute tiredness. The physical strength was increasing but I was drawn thin.

The end of the hospital stay had become my focus. No more 5am coffee, constant activity or fluorescent lights. An event horizon beyond which there was nothing perceivable. On the final weekend of rehab I would spend my first night out of hospital in weeks untold. Although the pain kept sleep patchy, it was still the best sleep Id had since the last night in my tent. It did nothing to alleviate the tiredness however. The next day I showered, it took almost 2 hours but I could actually achieve the task. I had been able to build enough strength and skill in 6 weeks of rehab to be able to exist outside of hospital.

Signing out of rehab on the last day. Liberating and terrifying. Photo by unknown

I would make it out of hospital in the end. Something that at one stage wasn’t necessarily clear. What world awaited me I did not know. Even the sun looked different out the windows of the car on the way to my parents house. I was broken, in pain and tired, so fucking tired. After 12 weeks in hospital I was spent, but I had made it. I knew that the journey must continue but for now I just hoped to rest.

It was a fool’s hope. The light at the end of the tunnel was the end of the hospital stay. Without that light, the world was dark. Sleep would elude me still that first night, afraid of the dark as I was. My legs buzzing and burning as I lay there, the cage of the external fixator amplifying any movement into pain. The grief and loss consuming my mind. Would it not have been better to have just died there, on that mountain, to not have all this suffering.

An Update From the Land of Rocks

2 Years on and I’m finally camping in Rocklands again. It’s a challenge, but also a dream that I’ve been creating post accident. Coming back to Rocklands for a longer stay has been drawing my curiosity and giving me an Aim to move towards. It’s beautiful here, Soul refreshing. But there is also a darkness here that I must engage with. There are Ghosts that I must placate. It is thus with the things that draw our curiosity. In a way this is the start of a greater quest, the rest of my life and what I will achieve with it after this cataclysm. I too am choosing to start this journey where the forest is darkest.

Walking in the mountains again at last. Photo by Fi Smit

Although difficult and challenging, I’ve found the time here peaceful and healing. The mountains are my home and rocks of ages past have not forsaken me. The energy of the climbers around me is inspiring, it’s good to connect to that and start to believe in it again. It has also been amazing to be able to walk in the mountain paths that are accessible to me. To watch the sun set in the mountains again has perhaps been more healing than I anticipated.

Walking out after sunset. Photo by Nicole Bosch

But by way of update since Im taking forever to write about this journey…

I’ve had my last surgery on the left knee to replace the Medial Collateral Ligament. The surgery went well, thankfully. Although it was the shortest acute recovery of all the surgeries it was possibly the most frustrating. Being back in a wheelchair for 3 weeks was hell. But we did that and now the knee feels more stable. Stable enough for me to be walking around in the campsite and some footpaths in the mountains.

Theoretically I still have 6 months of rehab to do. I can feel that I’m not yet close to recovering full strength and flexibility and have much to learn about the prosthetic. I’ll return to more formal rehab on my return to Cape Town. But the acute phase is over. And it was time for a change and a break from the grind.

Getting some decent training on the prosthetic. Photo by Nicole Bosch

The narrative section of this blog has also come to a pivotal milestone. So far I have detailed the accident, the period in ICU, the fitting of the Taylor Space Frame and the first week of Rehab. The next post on the narrative side will close out the hospital stay with the final weeks of rehab. I will continue to write narrative sections thereafter but the timeline won’t be as distinct. The density of new and relevant events lessened after the end of the hospital stay. As such I’ll be writing about specific events in isolation rather than keeping a more intact timeline.

Some of the events I have begun thinking about are:

  1. The Darkness of the last quarter of 2019
  2. The removal of the Taylor Space Frame
  3. The beginning of the prosthetic journey
  4. The First Knee surgery (probably in several parts)
  5. A sad but healing time at the end of 2020
  6. The second Knee surgery
  7. The camping trip to Rocklands

Thereafter the story is as yet unwritten.

Back in the mountains with my dogs. Photo by Nicole Bosch

The Concepts side of the blog will change too. I won’t be linking this last section of Narrative to the Concept I publish alongside it. Instead I will be writing about a list of ideas I call ‘Watsons’ Grimoire’. Its a list of Rules or Mantras or Affirmations or haikuish sentences that embody ideas which I have found helpful in life. If you’ve followed me thus far you’ll already know that these ideas have a degree of complexity behind them. I truly believe they could help you as they have helped me. It is in a way a summary of my philosophical view on life. The world we inhabit is a chaotic place so in attempt to keep myself orientated I read this list every day (ok its actually 71% of the time, statistically tracking your life is really interesting btw).

I continually update the list as my understanding of things changes or a better version of the phrase occurs or calls to me. I’m not claiming that the list exhausts all of the ideas needed to survive or thrive in this world but the process of keeping such a list and reading it almost every day has been a great benefit to me though this healing process. I strongly recommend that you consider doing it yourself. Robin Sharma once wrote that we should protect the garden of our mind, this process of maintaining and reading this list was for me like watering that garden so it can grow and flourish. I have updated the ‘Concepts’ page to reflect Watsons’ Grimoire. I have also linked the ideas to previous posts which have relevance to them.

I will be putting more effort into writing over the next few months now that the rehab schedule has changed. Hopefully Ill get a post out each week but lets see how that goes. I hope you stay with me on this crazy journey, till next time GL HF!

Watson

Photo by Jethro Watson

Concept 9: I am a Victim…

Nothing is Burning Photo by JM Watson

Why me? What did I do to deserve this torment? I am not a murderer of thief who got his comeuppance. I do not deserve this. I was peacefully going about my business and God or the world or someone came and fucked that up. I want my money back! The world has wronged me and now it owes me. It’s Its fault and I am the victim. Wronged and oppressed by Being itself, I have a right to be upset and a right to justice.

But How Does This Help Me?

I would be lying if I said that I didn’t understand this argument. Or even if i said that it wasn’t forefront in my psyche at times. It’s a powerful and alluring pathway of thought. Wouldn’t it be easier to blame someone else, perhaps Nick who lead me into the area where the accident happened? Or the whole climbing community for not educating me of the dangers? Or maybe even the government for not making sure nature was ‘safetyfied’? Why not go all the way to blaming God, if he exists, I mean surely its his fault right? Whilst it might be possible to mount compelling arguments in favour of such an outlook, I cant see thats it helpful.

So far as I can tell, if you pass the buck of blame to someone else, you pass the responsibility of remedying the situation as well. The two things are inseparable in my mind. This is a pretty brutal concept because it means that the reason my life is a fuck up, is me. I am a victim yes, but a victim of my own inability to assume enough responsibility for the shortcomings in my life. Could I argue that this is 100% the case, of course not. But it is how I have chosen to see it. I have chosen to believe that everything that befalls me is my fault. As such, I have the agency to do something about it. Not someone else. Not God or Being itself. Me.

Taking Extreme Ownership of Life

So here I want to unpack the various ideas that have lead me to this way of thinking. Again I ask you to suspend your own biases as I try to flesh out the thoughts in my head. Try to put yourself in my shoe bearing in mind my legs were crushed and my dreams destroyed.

There is a randomness at work

Id like you to think back to the very first time you realised you were conscious. You can remember that right? Just after you were born yes? Did you think ‘Shit, this isn’t what I asked for?’. Are the circumstances of your birth your fault? Not? well then whos fault are they? Is there a law which says thet it must be someone’s or somethings fault? Perhaps its just the way things are.

There is a randomness at work in life. Its brutal I know. Why are some born in Russia circa 1930 and some born in monasteries where life allows them to be perfectly content living peaceful and meaningful lives? When you look at life from a bigger perspective, there really isn’t a reason. Sure, we could say that its the Socialists fault that life was as horrid as it was. But why was it that a specific consciousness (yours or mine perhaps) is born into that place and time? When I try to answer that question I hit a solid wall. I do not believe there is a reason. Its just random.

Turns out there is a lot of randomness about life. Not only is the society that we are born into random but being born at all is random. To our knowledge there has never been a single repeat of a specific consciousness. There is also no reason to assume that there ever will be. That’s truly amazing, each life born on this planet (or another) has a unique conscious experience. If there is some stock or reserve of consciousnesses out there in the aether it must surely be infinite to sustain this continual production of unique conscious expressions. Perhaps there is not and another process is at play. But it’s still hard to fathom how any one specific consciousness, you or I say, came to be generated from this vast process. That’s about as random as it gets.

Oppression is the norm, not the exception

When I woke up this morning, I couldn’t walk. why? Well in short lets say gravity was the problem. Without two legs I was unable to overcome the pull of gravity in anything approaching the definition of walking. Gravity was oppressing me, holding me back for my true potential. My liberation was me putting on my prosthetic, once again having two legs I could now walk.

We recognise oppression by human means,race, creed, gender, ideology. These structures create limits to what we can do and achieve. But nature also creates these limits and we are often slow to realise that the entire world oppresses us. Unfortunately this is just the way it is. We could say that the reason we cant fly unassisted is Being’s fault. And perhaps its not wrong, but I doubt we would have learnt to build aeroplanes by complaining about how gravity oppresses us.

We have limits in life. We are always oppressed by something. As far as I can tell the correct approach to this isnt to blame the limits themselves, but rather to blame ourselves for our inability to overcome them.

Individual responsibility is key

I have often told people ‘don’t make my problems yours, you have enough as it is’. This is usually met with initial confusion and then utter acceptance. If I have a problem, regardless of who’s fault it is or what randomness created it, it’s my problem. To solve any given problem I am usually incapable or insufficient in some way, so I upskill. Sometimes taking on the necessary learning to find a solution or outsource to someone or something more capable. I still define the problem and specify the criteria for a solution, it’s still my problem.

Taking a high level of responsibility for the life one lives is as liberating as it is brutal. One must have a truthful open conversation with oneself. Seeking out the flaws, demons and inadequacies hiding in the shadows. There are parts of oneself which are difficult to face. But it allows for a much greater agency of action to improving oneself. If you’ve read my first concept you’ll understand why I think it important to make things better. The area in which one has the greatest agency to do that is with oneself.

If you embody the ‘good’ you will improve the world around you in some way. If you embody the ‘bad’ things will get worse around you faster than you can imagine. Assume then that you yourself are the ‘bad’ and take responsibility for fixing that! No one else can. No one else will.

Responsibility and meaning

I have heard many people say of my accident that it happened for a reason, as if the event is tied into some grander meaning which we cannot fathom. I implore you, if you ever meet someone who has had a major disruptive change in their lives, do not say this. There are two problems with this. Firstly there is no intrinsic meaning with which we are imbued, meaning is something we construct. Secondly it alleviates the responsibility of the individual involved to create meaning. If the meaning already exists, why bother.

Is there a cosmic meaning to life? Could be. Who knows. But I think this is the wrong question. A better, more helpful question is: What meaning can I make of this life? If you ask that question, you simultaneously take responsibility for the fulfilment of its answer. Perhaps you decide that the best meaning for your life could be derived from saving lives. You then bear the responsibility to find the course of action that leads to that outcome. Becoming a doctor or perhaps an anti nuclear weapons activist. But it is you who must take responsibility for that and forge meaning, your own specific and unique manifestation of it.

In Physics scientists call the Higgs Boson the particle of mass. By analogy responsibility is the particle of meaning. Life is meaningful, but only if you take the on the responsibility of making it so.

Rehabilitation is My Responsibility

When I arrived in Rehab, I couldn’t walk. That, I decided, was my problem. The coincidences of a boulder falling from its slowly eroding perch just as I happened to be there was perhaps a random tragedy. But the fact that I couldn’t walk was decidedly my fault. I had not done the necessary healing. Nor the necessary hard work of rehab to build muscle and skill to be able to walk. I took ownership of that struggle and resolved to do something about it.

As shouldn’t surprise you now, I took motivation from a Tool song, 10 000 Days. In it Maynard sings of his mothers persisting faith being rewarded when she demands entry to the gates of heaven. I resolved to keep my faith in Being and take responsibility for my part in it. This is the list of Mantras I crafted from the lines of that song to motivate me in the rehab centre.

Give me my wings

  1. Its your time, do whatever you can without assistance
  2. Spread your wings, see how far you can push
  3. Tell them, speak your desires and your future into being
  4. You’re the only one, no more excuses
  5. Give me my wings, ask the question and deserve the answer

Episode 7: Rehab week 1 – To Arms and Order

Like a cairn marks the way in the mountains, moving to the rehab centre marked the way on the path back to the mountains. It was the first time since the accident that I would feel something akin to positivity after a long and exhausting fight through the gauntlet of surgeries. Photo by JM Watson

A Change Has Come

I transferred to the Life Rehab centre across the road from the Vincent Pallotti hospital for my post surgery rehabilitation. They just wheeled me across in the same hospital bed. It was the first time I had felt the sun on my skin for almost 7 weeks. Rehab was like a hospital in that we were in hospital beds in wards of 6 beds each. There were nurses and the same fluorescent lights. It was also unlike hospital, there was a canteen and a gym and patients were moving around freely, no longer confined to their beds. What a change.

On my arrival I met the physio, Madiga. She explained roughly how the setup works. I would sleep in the ward but would be doing guided gym sessions with her and an occupational therapist. They would get me into a wheelchair of my own. I would also be able to go to the canteen to eat meals. When she first saw me she asked why I was still in bed, I knew then that rehab had a different approach than that of the hospital. Instead of rest and recover, this was a place of action. Immediately I embraced that.

I didn’t have any physio that day, but I was able to use a kommode for the first time (basically a wheelchair with a hole in it to shit through). I cannot tell you how relieving it was to be able the sit on a toilet and shit again. The bed pan days were over, it felt as if the arduous journey through the Mines of Moria had finally ended.

On day two they brought me a wheelchair and I was able to eat in the canteen. It was novel to sit at a table and eat again. Lying in a hospital bed for weeks, my entire life had stopped, using a table again was a stark reminder of how much I had relied on other people to sustain me. That was changing.

I had my first physio session which was a challenge. No longer confined to the 15 min bed sessions with the physios in the hospital. Now I had an hour with Madiga in the gym. It was so good to exercise again and I felt some life returning. It wasn’t clear how long I would be in rehab but I would be able to do ‘home visits’ to assist in the transition back to the outside world. First for a day and then for a weekend.

A Week in Rehab

Routine established itself quickly. I would wake at the customary 5 am for coffee and wait for the rehab doctor to do his rounds. I asked him if it was possible to change the blood thinner injection to a pill form, which he agreed could be done. Long bone fractures and big wounds create a high risk of blood clots. Since day one I had been given a daily injection of Clexane into the fat of my belly. It was a painful daily experience. Wednesday marked the first day since the accident that I had not had a needle of some kind either permanently attached or stuck into me for some reason. Although I had the TSF through my leg, it was still a relief and a huge milestone for me.

After breakfast in the canteen each day I would head to the gym. I did two sessions each day, one with the physio and one with Nelia the occupational therapist. Both Madiga and Nelia were amazing, without them guiding me through the first phase of rehabilitation I doubt I would have made any progress at all. Whilst the exercise tired me out and the pain that it caused at the end of the day was incredible, I felt better for it. Finally I had some agency of my own on this journey instead of being a passive bystander as doctors cut and stitched me back together.

Standing using a walking frame in the physio sessions. Photo by Unknown

The freedom of movement and the canteen allowed for more visits from friends and family. Again it struck me how many awesome people I had met in my life and the support was invaluable. On Thursday I met the trauma counselor and discussed my feelings with her. She was far easier to talk to that the psychologist who had come to see me in ICU. My attitude continued to improve each day bolstered by the activity and conversations with friends, family and rehab professionals. The week had been exhausting. I was learning how to navigate the world with one fucked leg. As such it had taken every bit of me to stay with the flow of events in the first week of rehab.

A Time to Reflect

The first weekend in rehab I would stay there, not yet able to take on the rigours of a ‘home visit’. I would do one physio session on the saturday but otherwise rested. Sleep was better thanks to the exhaustion of the exercise and my mood had improved considerably. I had pizza with my mother and sister on the sunday, a welcome break from the hospital food. It was quite a social weekend for me seeing friends and family but the empty hours between the visits were still torturous.

Some form of normality after the bleakness of the hospital. Photo by Unknown

The pain was still considerable and the weight of the loss weighed heavy on me. I cried many times that weekend as the reality dawned afresh. Each new ability I gained (transferring into a wheelchair, using a toilet, brushing my teeth at a basin, eating at a table to name a few) came with a bittersweet feeling. Although I was elated to be making progress I was acutely aware of the ability I had lost. Every gym session or excursion outside stung with the memory of my previous life. Like a cold and final reminder that I would never live my dream of becoming an 8A climber.

I was, however determined. Tool had released a new album, Fear Inoculum. Once again I would turn to their music to help me on the journey. Pneuma reminded me to keep my eyes full of wonder and Descending would help to keep me on the path to order. I had trained myself both physically and mentally to lean into challenges and I resolved to do just that. I would remain true to my faith in Being and Like Marie, it was time for me to demand “…give me my, give me my wings”. Thank God for Tool.

It was raw and challenging but the journey into the unknown had begun and like the warrior in Invincible I would struggle to remain consequential.

Concept 8: At least there is still suffering

The Ouroboros, the snake that eats itself, a creature struggling to survive by eating itself and simultaneously creating its own suffering. Photo by JM Watson

I have been fascinated for some time by the ability of the human spirit to overcome suffering. People like Victor Frankl have suffered more than most of us ever will in our comfortable suburban ‘Hells’. He had the misfortune of being born on the wrong side of Aryan in Germany. The Nazi’s would force him to abort his child with his wife. He would also lose his wife, parents and brother to the concentration camps in Nazi Germany. Despite this he survived the camps and continued with his life’s work as a psychologist. Developing and applying what he called Logotherapy. A psychological treatment which posited meaning as its central theme. Perhaps it’s a naive opinion but when a man like this has something to say, I think we should listen.

I won’t quote the entire book, ‘Man’s Search for Meaning’. But If you haven’t read it I suggest you do so, like now! Ill distill out three quotes which stood out for me whilst lying in a hospital bed broken both physically and psychologically.

“Life is not primarily a quest for pleasure, as Freud believed, or a quest for power, as Alfred Adler taught, but a quest for meaning.” Viktor Frankl

“There are three main avenues on which one arrives at meaning in life. The first is by creating a work or doing a deed. The second is by experiencing something or encountering someone; in other words, meaning can be found not only in work but also in love. Most important, however, is the third avenue to meaning in life: even the helpless victim of a hopeless situation, facing a fate he cannot change, may rise above himself, may grow beyond himself, and by so doing change himself.” Viktor Frankl

“There are situations in which one is cut off from the opportunity to do one’s work or enjoy one’s life; but what can never be ruled out is the unavoidability of suffering. In accepting this challenge to suffer bravely, life has a meaning up to the last moment, and it retains this meaning literally to the end.” Viktor Frankl

Life is about meaning. Without meaning we are lost. It is the thing that sustains us a humans, not value, not power, not hedonism, but meaning. There are three main channels to find meaning in our lives: Love, Work and Suffering. The last is the only constant in our lives and as such the most important. There will always be suffering to overcome.

A brief introduction to Logotherapy.

Suffering is the Substrate of Life

We say that the only certainties in life are death and taxes. I think this is a poor attempt to hide the truth. Suffering is the only certainty. If you are born (and that is far from a certainty) you will suffer, it is unavoidable. Even those born in full health and with wealth of resource to spare will fall ill and die. That’s not accounting for their peculiar hardships that they may suffer. To disregard this truth is what the core of religion describes as the path to Hell.

I am not well schooled in Buddhism but I think that the Four Noble Truths and the Eightfold Path are one of the best summaries of the fabric and meaning of life I have ever come across (believe me I’ve searched). The Four Noble Truths are:

  1. The Truth of Suffering
  2. The Truth of the Cause of Suffering
  3. The Truth of the End of Suffering
  4. The Truth of the Path That Leads to the End of Suffering

If we accept that: There is suffering. That it is essentially caused by Life or Being itself (to be specific, this differs from Buddhism a bit here but the idea is similar I think). That there is a way in which we can end that suffering without the cessation of Life or Being itself. Then the means by which we do so becomes the meaning in our lives.

Suffering is embedded in Life and transcending that suffering is the ultimate purpose of life. This is the fabric of Life, it is the substrate from which our conscious experience emerges.

Somewhat Simplistic but it covers the all the point succinctly.

The Last of my Freedoms

“The last of the human freedoms: to choose one’s attitude in any given set of circumstances, to choose one’s own way. And there were always choices to make. Every day, every hour, offered the opportunity to make a decision, a decision which determined whether you would or would not submit to those powers which threatened to rob you of your very self, your inner freedom; which determined whether or not you become the plaything to circumstance, renouncing freedom and dignity…” Viktor Frankl

Lying broken in a hospital bed unable to climb, walk in the mountains with my dogs, feed myself, or even move without pain, I still had the freedom to choose. My love of life had been stolen from me by suffering. My passionate work to improve myself in the realm of rock climbing had been destroyed by suffering. But at least I still had suffering. Whilst reading Frankl’s words, I listened. As I had in ICU, I again chose to embrace that suffering, to find meaning. Before transferring to the rehab facility I did know how the journey upwards would go, but I took the first step in Vincent Pallotti Hospital. I laid down a foundational phrase which would help me rebuild my life in the dark times ahead.

When faced with Unavoidable Suffering, Suffer Bravely

This wasn’t quite what I was thinking at the time, but it certainly illustrates the freedom of choice in the face of suffering

Episode 6: A New Hope – The Taylor Spatial Frame

This X-Ray was taken about two weeks after the surgery to install the Taylor Space Frame. It was a stark reminder of how my life had changed. Photo by JM Watson

The Last Days at Christian Barnard Hospital

The bottom is an ugly place, but that is not to say that it is not useful to reach it. When I awoke on Friday morning, frustrated, in extreme discomfort and emotionally depleted, I knew that I had indeed reached the bottom. I also knew that there was utility in that and I felt just slightly better for it. Although the day was no less grinding, I did meet with Dr Laubser who would install the Taylor Spatial Frame (TSF) around my leg. Finally it felt as if I was moving again, impossibly raising my head to breathe after drowning in chaos and despair.

He informed me that I would be able to bend my knee and weight bear post surgery. I would also not need to stay in hospital whilst the bones healed. Something which was not certain in my mind and a huge relief. I would be transferred to a rehab facility after about a week of observation and healing in the hospital. There they would help me to regain enough functionality to be released from hospital with the TSF. Exactly how long that would take or in what condition I would be was unclear. But at last there was hope and a foreseeable end to the hospital stay.

The next few days passed like decades. The same routine of early mornings, physio and doctors visits punctuated long hours of attempting to entertain myself by reading, watching YouTube and generally being an emotional mess. I wasn’t sleeping much better. I was, however, able to get a few patchy hours each night which helped. They transferred me to a private ward due to an infectious pathogen they had found in the tests they routinely did. The doctors said it wasn’t infecting my wounds but needed to isolate me from other patients.

The visits from my mother, sister, brother-in-law and friends sustained me, keeping my mind in check in the otherwise endless hours of neon lights and immobility.

The Taylor Spatial Frame Surgery

I transferred to Vincent Pallotti on Wednesday afternoon. Thursday Morning was an anxious time waiting for the surgery that afternoon. I knew I would be going back into a more painful state after the surgery. It meant more IV drugs and altered consciousness. The confused state precipitated by the drugs combined with the massive psychological trauma was not conducive to sanity. It took everything I had to hold on in those periods.

The Surgery was a long one and waking up in the recovery area was as confusing and unpleasant as I could possibly have imagined. I phased in and out several times before stabilising and I was in considerable pain. I could feel the same fractalization of reality between bouts of lucidity as I had when they gave me the Ketamine. Again I found the words of Dr Peterson useful: Shorten your timeframe. I tried to breathe and make it through each second. Not fully aware of where or at times even who I was.

My first view of the TSF, relieved to have the other ex-fix removed. Photo by JM Watson

My mother and sister were in the ward when I arrived, I was in considerable pain. The anesthetist had given me a PCA. It’s a large plastic syringe like pump that allowed me to self administer IV painkillers every seven minutes. This alleviated the pain somewhat but at the cost of lucidity. The pain would rise and I would push the plunger. Several seconds later I could feel my consciousness narrowing and be sucked back into the fractal world beyond. The struggle was real.

An X-Ray taken a few days later, the shattered bone and the screws holding it in place clearly visible. Photo by JM Watson

Hope, and Desperation Post Surgery

Surprisingly I slept quite well that night, but awoke feeling exhausted. Dr Laubser informed me that the surgery was a success in his eyes. A relief but it did nothing for the pain. The first physio session was unnerving to say the least. Bending the knee after almost 6 weeks of it being stationary was an uneasy feeling. It felt as though the whole knee was in a vice grip and it was more than i could bear to feel all the wires and pins inside me. I politely asked to end the session and subsequently broke down crying when the physio left. I felt stretched beyond what I could handle by the end of the day. Music helped to alleviate the burden of being until the sketchy sleep covered me.

The pain improved over the next few days but not by much. I was barely able to move around in the bed. Sunday was the next day with anything other than the routine of hospital life and visits from family and friends. The doctor cut away the protective bandage covering the TSF and I could see it for the first time. As always the sight seemed both shocking and intriguing at once. This thing before me, both biological and mechanical is what was left of the the leg that held a heel hook on Human Energy, a toe hook on Born into Struggle and hiked countless kilometers into mountains unknown. Now I could barely move it and not at all without pain.

Top view of the STF. Photo by JM Watson
The marks drawn on my knee helped the doctors align the TSF. Photo by JM Watson

The nurses also changed the bandages on the wounds still healing between the Meccano set and replaced the sponges around the pin sites (something I would later do each week on my own). Later that day the physio would help me move the leg over the edge of the bed and slowly lower the foot to the floor. The pain and discomfort was real. I was only able to sustain that for several seconds. I had touched the floor for the first time since the accident, a momentous milestone.

Dressing change. Photo by JM Watson

Dr Laubser also started the adjustment of the TSF, a process which would continue for 5 days. The support struts of the TSF which join the two rings together have a locking screw mechanism that allows them to be lengthened or shortened. A computer program determines the correct sequence of adjustments needed to correctly position the rings to align the bone shards. The movement is spread out over 5 days to lessen the pain and allow the body some time to adapt before the next adjustment. Whilst the adjustment wasn’t painful, it did precipitate more inflammation. I felt more pain at the end of the day after the adjustments.

The next few days passed much the same. The pain did begin to lessen and I moved away from the trippy drugs, thankfully. I did my first stand heavily assisted by the physio and with all my weight through my arms on a walking frame. I was only able to do one stand the first day. Progressively adding two more the next day and three the day after that. The journey back to the mountains seemed impossible. I was still in a dour mood for the week after the surgery, despite the progress and the hope it had brought.

My first touch of the floor for about 6 weeks. Photo by Lyal (Thank God for that guy)

The Last days at Vincent Pallotti Hospital

By the weekend I had recovered a bit more, I was in a lighter mood when My birthday came. I ate burgers with my mother and sister and although I was still distraught, I was eager for the transfer to the Rehab facility.

Love had been lost and purpose had been expunged from my life, all that was left now was suffering. Thankfully I had asked for a copy of Mans Search for Meaning by Viktor Frankl, which I had intended to read whilst in Rocklands. His words brought some dignity back to my mind and remembered in me some of the thoughts which I had cultivated over the few years prior.

” When faced with unavoidable suffering, suffer bravely” Viktor Frankl

Damn how I tried, through the tears and the pain. Looking back on that period I understand that I succeeded in rekindling hope. At the time, however, I could not see the forest for the trees. The forest had apparently seen me and was preparing the reveal itself. After spending a week and two days in hospital post surgery, I would transfer to rehab on Monday the 26th of August.

Concept 7: What do you want to achieve with your life?

Climbing: The star that guided me to be better

I have been struggling to articulate my thoughts on this next concept for three weeks now. So instead of trying to express myself in a more detailed and articulate form, I’m going to get real fuzzy here. I’m going to describe to you how i feel about the idea of having an Aim for your life. When I actually faced up to it, because it is terrifying, I decided that my Aim in life was to be the best climber I could be. That Aim improved my life beyond what I had conceived possible. Now the terror is fully realised, I have failed, I will no longer be able to posit that Aim for my life. Perhaps the reason I have been unable to fully engage with this topic is because the loss of that unifier is still apparent and may actually never be resolved (more on this in a future post sometime).

We talk a great deal about having goals, but not so much about having Aims. I think that’s a function of our modern world moving away from what might be loosely defined as the spiritual, but that’s a discussion for another post. Whilst ‘Goals’ and ‘Aims’ can be interchanged in use, for the purpose of this post I’d like to define them more precisely. I understand that goals are important and that there is a collection of literature surrounding goals I don’t think, however, that they are as important as Aims.

So to distinguish them, think of the following comparisons. Where goals are specific and measurable (SMART for those who like acronyms), Aims are a more loosely defined collection of ideas which guide us over time. Unlike goals, our Aims are never realized. They are unending motifs that define our lives, allowing us to forge meaning. When you are hungry, the goal may be to eat, but the Aim might be something like feeding yourself consistently and in the best way possible. Where goals are more fixed, Aims move and change. As a climber you might have a certain problem or grade as a goal, but the aim might be to be the best climber you could be and it could morph into being the best boulderer you could be. Where setting goals is a more logic driven function, requiring some definition and structure, Aims are more rooted in emotion and an elusive quality of interest or curiosity. As an investigative journalist you may have a goal to write a book, but the Aim would be to investigate themes and questions that consume your thoughts.

Whilst I refer to having a single Aim in life, it is infact a complex idea, for some there may be several Aims closely linked, for some perhaps just one. However you cut the cake, I believe it is important to have an Aim for your life. I mean the alternative is quite literally to be Aimless. To be so diffuse, like a spinning compass, that you are both everything and nothing simultaneously. Potential lacking the specificity to be anything at all. Having an Aim informs you, orientating your brain, emotions and the very core of your being towards something. It unifies you and guides your thoughts and actions where otherwise there would be pure hedonism, animalistic desire in response to stimulus. It is what they refer to in the Bible when they say ‘straight is the way and narrow is the gate’. Our Aims don’t just keep us on the path, they create the path. They create the meaning in our lives and a life devoid of meaning is truly Hell, I’ve been there, I know.

So how do we go about discovering what our aim in life should be? The best sense I have been able to make of this question is to combine your limitations to with what you find interesting or what your curiosity pulls you towards. This idea of curiosity or interest is elusive, but it does operate within us. We have all heard the adage that we regret what we don’t do more than what we do. As difficult as it is to define, we know what it feels like to be disappointed that we never chased an opportunity or investigated a desire. It cuts at us and only we, as the individual, can truly understand just how much. On the contrary, doing ‘what we love’ seems to imbue our actions with a kind of magic that is mysteriously lacking in that which we do not find interesting. But we must follow our hearts within the limits we find ourselves constrained by. You may not have the means to become an astronaut, or reinvent yourself as a Doctor at 50 or 60 years old. There are truths about existence which cannot be overlooked. Part of having an Aim is to transcend those limitations, but we also need to be reasonable and not attempt the impossible. Finding that balance can be difficult but as Yuval Noah Harari said ‘Life is hard, deal with it’.

I wont delve too deeply into how I came to posit Climbing as my Aim in life but to sketch a brief scenario. I was disillusioned with life when climbing offered me a release, and hope, if somewhat unconsciously. The progression that climbing offered and sense of alignment found in the flow state which climbing requires was contrary to the Nihilistic view on life that I had been infected by. Suddenly there was an emotional (ie feeling based and not articulated knowledge based) improvement in my life. Something i didn’t think was possible. I had been on this emotional journey of meaning for a few years when I was introduced to the ideas of Dr Jordan Peterson who allowed me to see that having an Aim was important and that I should do it consciously. He also said something along the lines of: Ok so you don’t know what to do, then pick something, you’re gonna get it wrong anyways but it beats Aimlessness. And so I chose climbing, because I had the resources to follow that Aim and it called to me with increasing curiosity and interest. It may not have been a conventional Aim or even worthwhile in the eyes of society (I mean if you’re not fighting for the rights of some disadvantaged group or making money what are you doing?), but it was my Aim and that was important to me.

As it turns out Peterson was right, almost immediately I began seeing the world differently. I improved my nutrition, work life, even how I viewed and interacted with people. Moving away from the cynical ‘everyone is a cunt’ model I became more and more accepting of people, if for nothing else so I could get more climbing partners to climb with. I discovered fasting which improved my energy and helped shed fat I could never get rid of before. I started working from home and increased my discipline, producing work of a better standard and faster so I could take Fridays off to go on longer climbing weekends. My training increased to include running and pilates to boost my strength and overall fitness. The pursuit of climbing became the pursuit of the unknown, looking for more challenging routes, problems and even climbing areas that were remote and difficult to get to. Climbing became the inspiration for change and growth in my life, allowing me to rediscover the awe and majesty that life has to offer. In short, it saved me.

But lying there in that hospital bed in the new ward it was apparent that that Aim was lost. the very thing that had rekindled in me the love of life had been smashed. I was forced to painfully and inescapably experience the disintegration of my psyche when the centre pin was removed. Whilst I understand that it wasn’t climbing that actually changed my life, it was having an Aim, climbing was the mechanism by which I came to understand that. It was that which was lost. It was like knowing that it is not air that sustained me but breathing. I was unable to breathe albeit that there was air a plenty. As I write this now, I am still Aimless. I do not know if I will ever find another Aim that calls to me as climbing did, although I am acting in a way that allows me the greatest chance at following such a calling if I happen to identify it. Its like wading through a foggy swamp, there is no visible end, no motivation, but I must continue to wade. Into the Unknown, with no heading, no destination and quite possibly no reward.

Story Time: The Giant’s Castle in The Land of Dragons

I’ve been struggling to articulate my thoughts on the next concept following the Wards of Sadness. It revolves around having an aim in life and how my aim of climbing changed mine. So to fill the space whilst i’m chewing on that I thought Id try something different and recount one of my past adventures. Something I would like to begin doing for future adventures as well.

Once upon an Easter in 2017, a group of four of us embarked on a four day hike around the Giants Castle in the Drakensberg. A stunning feast of pure awe awaited us.

This was roughly our route.

The Giants Castle is a section of rock that juts out from the more distinct line of the escarpment forming a small peak on a spine whose tail is a prominent feature in the valleys below. The area to the north of this point forms a bowl of large cliffs and converging valleys. The aim of this hike was to summit the giants castle point and the hike back along the edge of the escarment over a large ridge called Mt Durnford and come down Langalibalele Pass. It would give us views of the point and of the bowl of valleys below from two different sides.

We camped in a campsite close to the hotel from which we would start our first day. We were all quite fit and covered the hilly sections of the lower escarpment quickly.

It’s in these early slopes below the towering edges of the plateau where the Drakensberg really starts to come alive. The rolling green grass and magical slopes of the barrier of a thousand spear as it is known in its local Language name. The Giants Castle itself was veiled in cloud that first day but the views were no less impressive.

As we came closer to the mountains the clouds lifted briefly showing the cliffs of the Castle in their full splendor as we hiked passed them on the way to Giants Pass.

The pass was grueling and I was apparently the slowest of our group at ascents. But slow persistence paid off and the views from close to the cave where we would sleep our first night were worth the effort.

In the morning the clouds had closed in thicker, covering the valleys below. We were in our own mountain world now. We had breakfast in the cold and with the mountain air filling our lungs we were ready to explore this dream like world.

Further up the pass we saw just how cold the night had been with these impressive plant freezes a common sight.

We crossed over the bulk of the Giants Castle which was a longer hike than anticipated. The back side of the Castle slopes away from the valleys and we were walking in the pathless and more barren terrain of the plateaux. When we came up the last slope up to the point it seemed that we suddenly stepped out of an elevator and onto a viewing platform.

To our left were the cliffs we had walked passed the day before and the bowl of valleys covered in a magnificent white blanket.

To our right was the rock spine which stretched out into the ocean of cloud which mesmerised us as it rose and fell. Sometimes covering the spine and sometimes revealing it.

Lourens had brought with him the remainder of our friend Schalk’s ashes and we made a cairn of rocks to place them in. A fitting resting place for a dearly loved friend and adventurer. Despite him taking his own life, I will love him until I die. I miss you Bro.

We hiked back off the point and got some good distance in before rounding a ridge which ran along the edge of the plateaux. We camped on its slopes facing the escarpment eager to be shielded from the eyes of the local herders. We had had an encounter that day which left us feeling less than comfortable with their interactions

On day three we would conquer this ridge, Mt Durnford. It was a much bigger slog than I thought it would be. I was constantly lagging behind and need more than a couple of breaks. There was a specific spot we had to crest the ridge at so that we could find the only gap in the mini cliff on the other side. The path down was treacherous but we got right spot in the end.

Whilst crossing through the various valleys of the plateaux that day we had another encounter with the local herders which was tense to say the least, they are pertty pushy and just say ‘give give’ the whole time. All the while covered in ponchos which gave me the impression they were armed and hiding it.

We had planned to camp at Bannerman Cave above Langalibalele Pass but were put off buy the increased density of local herders in this part of the plateaux. We decided instead to push on and come down the pass a bit to camp. For views this was a fantastic decision. The lower slopes of the Drakensberg are truly magical and we all sat and watched them talking of the hike as the shadows lengthened and called us to a deserved sleep.

We had only a small distance to cover back to the hotel and we took our time walking slowly on our tired legs. Savouring the clearer view of the Castle and the escarpment we had hiked through.

There are few times in my life when I’ve felt more connected to the mountains than the hikes in the Drakensberg. They are epic arduous adventures but each time I went I was reminded anew of the awe that I feel when hiking through them. I wish one day to experience that awe again, for I cannot recall the feeling and there are not the words to describe it. I recount this adventure here to remind myself of what I seek. To light a flame of hope in the amidst the chaos. Hope that I may one day be able to do these things again, however daunting the dragons may be.

Thank you for indulging me and I hope that you too experience this awe one day, in whichever form it calls to you in.

Episode 5: The Wards of Sadness

In a previous life, chasing my dreams on Panic Room 7A+ which I sent just weeks before the accident Photo by Dan Bates

At the end of the first two weeks in ICU I wasn’t exactly out of the woods yet, but the canopy was starting to thin. The doctor was confident that they wouldn’t need to amputate the left leg as well, the major life and leg saving surgeries were done. My body could now focus on healing, to close the envelope before moving onto fixing the bones. The Monday and Tuesday passed with no new drama, the same unpleasant ben pans, semi-sleep and pain. My temperature was still spiking up into the 38’s at times although my blood markers of infection had apparently begun to drop. I went for what I was told would be the last dressing change in theatre, whilst there was more pain after coming out it wasn’t nearly as bad as the actual operations. I was also starting to wean off the IV drugs in preparation for the ward transfer. The lower level of care would mean that I would need to come off the more dangerous IV stuff and onto Targinact, a powerful oral Opioid. By Thursday my temperature had stabilized and the infection markers in the blood test still continued to fall. A good sign that the infection had been slain.

On Friday I transferred to a normal ward where my wounds would heal. The doctor would monitor them and call for transfer to the next hospital where the orthopaedic surgeons (Bone Doctors) would work on fixing the gap in my tibia.

The epic Journey through the narrow gates of ICU had ended and without the hardcore cocktails of IV drugs and constant surgeries my consciousness stabilized. For the first time my consciousness was exposed, fully and unveiled, to the full devastation the Nothing had left in its path. Choose what ever definition you wish, Self, Identity, Core, what it is to be whoever I was, it was so apparently destroyed that it doesn’t matter. What had once been a focused, spinning, moving, cohesive whole had hit some kind of phenomenological obstacle in its timeline and was shattered into fragments much like the rocks floating in the void when Fantasia was destroyed. My Ego jumped desperately between the larger fragments, frantically seeking the Ivory tower as remnants of who I was crashed unrestricted and unbidden into other parts of me.

Only the Auryn didn’t guide me to the ivory tower, that would remain hidden for many days to come

The day outside looked warm, the softer light of the late winter afternoon bathed Signal Hill in a beautiful light, above its slopes paragliders lived out their dreams, chasing life and thermal alike. It was a Friday and the conditions looked good. The climbers in Cape Town would be scrambling to get to their projects before the light fades, I was no longer one of them. I had endured psychological pain before, I had been humbled and forced to change who I was, that was dark, but I had persisted. I though perhaps, fortified as i was, I could weather this, I was wrong. My leg was buzzing sharply from the movement from transferring wards. Without the IV drugs my whole body was tingling, aware of every touch, my body ached from the immobility, pain from moving and pain from remaining still. But all that seemed to fade as I looked out that window. Did I need this? Had I not been humbled enough? To what end was all this suffering? As the sun set softly, warmly, invitingly like some kind of sick cosmic joke, I cracked. Memories, dreams, fragments of me came crashing into my consciousness, each time exposing the damage anew. The shockwaves of psychological pain slammed into me, forcing shudders as I cried. I broke that night, there in the artificial darkness of the hospital. I had been forced through the bottom, beyond the meta-structure of life, to a place so chaotic that only raw emotion could exist. A kind of fatal, existential sadness was all I could feel. A sadness that was connected to all things through death. The Sadness of the complete destruction of future, of dreams and of Love. The Sadness that called to the End.

The week after that night felt like eternity, busy with the tasks of living, bedpans, eating, physio (which basically involved me waving my arms around and sit-ups). The days stretched, blank and meaningless, as nothing of the path forward revealed itself. There was progress of a sort in healing and movement with physio and I learnt midweek that the orthopedic surgeon would come to see me on the Friday (an event that would eventually reveal some of the path forward). There were however some moments that broke the tedium during this week in the underworld.

Dressing change on the stump Photo by Dr Carlien Wassermann

The Doctors changed the dressing whilst I was awake for the first time on Saturday. The anticipation of the potential pain to come was in fact worse than the event itself. Horrified as I was, I confronted every new sight. Seeing the shape and devastation of flesh for the first time was macabre to say the least. The poles of the external fix which held my lower leg in place could be seen extending deep within the muscle to the bone as they penetrated openings in the skin. Once they were powerful machines carrying me into the future, now one was gone and what was left of the other was shattered into pieces, desperately clinging to life.

Dressing change of the shattered left leg Photo by Dr Carlien Wassermann

Tuesday was a day with many people, I saw friends and family and Drs including the trauma surgeon and orthopedic surgeon who screwed my knee back together. In as much as seeing friends and family saved me, the doctors vague answers plagued me. There was talk of possibly a year for the bones to heal. I had no real idea what this meant but the answers weren’t forthcoming. A year in hospital? A year of lying in a bed? Could I do that? I didn’t think so. The doctors assured me that the answers were coming and that there was a path, but lost as I was I could not see it. What was once a life defined by passion and drive was suddenly an empty meaningless vessel with no direction. Frustration infused itself in to the sadness as the nights tormented me. Lying broken in a hospital bed I was forced to witness, again and again, the death of what was.

The dressing change on Thursday was easier and coming off antibiotics after a full 28 days since they were first administered the day I arrived was progress indeed. I also transferred into a wheelchair for the first time, progress for sure. I had been quarantined in the ward as I had been contaminated by some wound colonizing bacteria from the hospital, it was apparently not infecting my wounds however (I don’t understand it either). Confined as I was, despite being in a wheelchair, I could not go further than another spot next to the window in the same room. The same view of signal hill with its paragliders chasing their fucking dreams. I mean thanks God, thanks for this Grief. What was once enthusiasm and a love of life was now replaced by bitterness. Where before I would wake in the morning and say ‘Hell yeah’, I now awoke each morning longing for the Hell to end. By the end of the day I was overwhelmed but also exhausted, I hadn’t slept at all the previous night and the emotions had defeated me. The doctor gave me a different combination of sleeping drugs, thankfully it worked and I found myself pulled by sleeps embrace.

What I was had died, I was no longer the active, climbing, purposeful person I had worked to create, that was clear at least. Who I was I had no idea, pieces scattered in the sand in shadow. I doubted I would be able to reassemble what was left, definitely not something that I’d recognise. Death is never an easy thing to witness and it had taken all of me to pass through that gate. The damage was complete. And I could not bear it.

Finally I slept, I could cry no more and the world disappeared. There was no telling what trials the morning would bring, or who would face them.

Episode 4: ICU Week Two

My home in ICU with the machines continually feeding me drugs Id rather not take. Photo by Dr Carlien Wassermann

By way of a disclaimer, this post contains graphic images which some may find grotesque. I would encourage you to view them however, they are part of what life is and facing these things will only make you stronger. The same is true of the contents, these next few posts expose a side of life which isn’t easy to face but again you would be diminished for not doing so.

Monday 22/07/19

After some rest over the weekend, rest being a relative term, it was back to theatre on Monday evening to have the dressings changed. At this point my left leg was basically held on by my calf muscles and the ex-fix. It would have been too painful and too much risk of infection to open the leg in the ICU so all dressing changes would be done in theatre. Although I came out of theatre feeling drained, it was at least a small compensation that it wasn’t as bad as the last weeks oppereations. Dr Bischof had also cautiously mentioned that they were more confident that they could save the left leg, something which was by no means certain at this stage.

Tuesday 23/07/19

Tuesday brought more emotions, I can’t tell you why it hit me so hard that day but it did. There were so many things that seemed to happen during the day as well. The Anesthetist came to place a new epidural catheter, they need to change them every few days for risk of infection. The placement of the epidural is unpleasant to say the least, a large hollow needle is inserted between the vertebrae and into the area surrounding the spinal column and the catheter is then fed into that space, to find to exact spot the doctor needs to move the needle around a bit and it feels like someone is literally scraping your spine from the inside. the process was further complicated by me not being able to sit forward, usually epidurals are used for child birth and are inserted in a seated position. I needed to roll over and stay in that position for some time, a painful situation for me which was again accompanied by an increase in drugs to compensate. The dull high of the morphine and the reality separating feeling of the Ketamine is a combination I would never get used to. Its as if you fade away from reality, reality becomes dull and feels like its breaking into whatever smaller parts it consists of. It felt to me as if I was being pulled by death’s scythe out of reality and it was out of my control if I came back or not.

The discomfort in my bowels had been growing for days now and with laxatives I finally passed movement again. I had to use the bedpan twice that day and both episodes were amongst the worst experiences of my time in hospital. Not only was turning, lifting and positioning painful, but the actual act of shitting was as well, follow that with the inability to clean oneself and having to have the nurses roll me off the pan and clean up the mess. Each episode left me broken and drained.

I did see Nick and it was comforting to chat to him. I also got new Magic cards which helped to take my mind off what was a very emotional day. The ever elusive fits of sleep with their strange and very real Precedex dreams would flit bout me like ghost of healing, as ethereal as they were important.

Wednesday 24/07/19

Although I had gotten through the emotional rollercoaster of the day before, today would see me in theatre again, looking back on this week I can liken it to going round after round with the devil in an MMA cage. Monday, theater; Tuesday, rest; Wednesday, theater; Thursday rest; Friday Theatre; and Saturday was like judgement day and judged I would be. The operation today was by the orthopaedic surgeon to reconstruct the Tibia head which had broken into three sections. He would open the knee up on the side and manually rearrange the pieces before fixing them together with two castellated screws which would go right through the Tibia head from side to side. The surgeon was encouraging post-op, he said that there was more bone contact than he expected, exactly what that means I can’t tell you, but he seemed to think that the operation went well. My family came to visit again and I spent a long time talking to them and then to the anesthetist, Dr Carlien Wassermann, who had kept me alive in the first operation. Despite the operation, the day passed quicker than the day before and it felt that there might be a bit more light ahead. The day merged with the night in that same way, without ceremony or sunset, in the ICU the only thing that really changes is the hue of the light. It’s just as bright at night and it’s just as busy.

Thursday 25/07/19

At least I got a bit more rest in today between surgeries, by all accounts tomorrows surgery would be a big one and as events would later transpire, I really needed all the rest I could get. I had another bowel movement which was painful, the rolling and the lifting to get on and off the pan were quickly becoming some of my worst memories of my hospital stay. But beyond that the day was more peaceful, it felt for the first time that there was a bit of space for me to think. I thought of the future, the distant and now unknown future, the chances of saving the leg were growing with each day the doctors had told me. But what did that mean, what kind of functionality would I be able to get out of the leg, would I be able to walk again, or climb again? My entire life had been changed to centre around climbing and it would seem that that was no longer an option. Although these thoughts were heavy and the chaos thick, I did at least have time to think them and the anxiety they provoked only seemed to strengthen my resolve further. Although i didn’t know what the future held, I knew what must be done to engage with it. Having opened some new Magic cards the day before and my continued fascination with stories of mythology, I was perhaps not hopeful but certainly had a better understanding of what may be necessary to move forward: Pick up your Spear and go conquer the dragon that assailed you. The Dragon was life and the only spear I had left was my mind. It may prove a futile journey in the end but that’s irrelevant, the only honorable course of action was to fight. I didn’t know how valuable this day of introspection would be as things took a more dire turn during the night. During the afternoon I received more blood ahead of tomorrow’s surgery. Unbeknownst to me, tests had been returned that showed my infection markers had begun to rise.

Friday 26/07/19

The night was terrible, I managed to drift off to sleep early after a quieter day but awoke shortly after midnight with increasing pain the the right leg stump and left knee. It began by feeling sensitive and I could feel more pain with the tiny movements i would do, by morning it had built to an intense pain in the right hand side of the knee. I could also feel I had a temperature, which was confirmed at first light when the nurses did the rounds. Somewhere infection had taken root and Dr Bischof was visibly concerned. She ordered blood to be taken and cultured to try to isolate what type of infection it was. I was put on further antibiotics, these ones they apparently use to treat Tuberculosis but they used them because they have a good bone penetrating effect. The antibiotics were delivered intravenously and the drip bag was kept in a thick silver liner to prevent exposure to light, it was unnerving to say the least. The trauma doctor brought in an orthopaedic surgeon to assess the knee clinically and they decided that if the went through with the surgery, they would literally cut the knee open on the side and go in and manually clean it out to try to stop the infection from eating away at the cartilage in the knee. In the end the doctors decide to proceed with the surgery despite the infection and at 15h30 I went under again, this time for 5 hours. The orthopaedic surgeon opened and cleaned the knee whilst Dr Bischof and her supporting team performed what is called a gastronomicus flap and grafted skin taken from my thigh onto the gaping hole in my flesh.

During the final surgery to close the hole. Photo by Dr Carlien Wassermann

The gastronomicus flap involves cutting a part of the calf muscle out but leaving it attached at one end, then rotating that flap of muscle around to the front of the leg and suturing it in place. This bulk of flesh serves to close the hole in my leg where the rock had gouged out tissue and further tissue had later been removed as it died off. This large hole left the bone exposed. The bone would not regenerate if not covered by flesh and skin to provide an infection free area with good blood flow.

The muscle flap from my calf clearly visible. Photo by Dr Carlien Wassermann

I would be missing a large chunk of my calf muscle but at least the bone would have a chance of healing. After 5 hours under anesthetic with my body already taking shots, I awoke feeling broken once again. Not for the last time did I have this feeling of being a conscious passenger without agency traveling through this Hell which seemed never ending and tomorrow would prove no different as the source of the infection was brought to light.

Post surgery but before dressing, the skin graft held in place by staples to avoid over tensioning the skin. Photo by Dr Carlien Wassermann

Saturday 27/07/19

Yesterday’s operation had tired me out completely and I actually got some sleep, it was patchy but it helped. I felt a bit recovered when I awoke in the morning but today would prove to be one of the hardest and lowest moments of my stay in hospital. I later looked back at this period and thought about the ebb and flow of a kind of vital life energy during this ICU period, it was as if each operation took all the energy I had and I was barely able to recoup enough energy to be able to make it through the next operation. It was brutal, knowing each time that Id come out feeling broken again but still having to just hold on as the rollercoaster rose and fell, with my consciousness on board, a passive bystander.

The anesthetist came to change the epidural around midday and was surprised to find the epidural site infected. She decided to avoid placing a new line for fear of further infection. She and Dr Bischof were concerned, an infection penetrating into my spine was a dangerous and unneeded complication. I was given a stronger flow of the IV drugs before rolling onto my side so the doctors could cut open the area and disinfect it. Reality once again cracked and distorted, blurring around the edges as the morphine, ketamine and precedex dimmed the flame of consciousness in a most unholy way. I could still feel the cutsa and scraping as the doctors worked but at least there was minimal pain.

Without the epidural controlling the pain sent up my spinal cord and only the IV drugs to dull me, I was far more aware of the sensations in my legs, I would have to ride out the rest of the ICU stay with more pain, and there was heaps of it to come. The anesthetist did inject local anesthetic around my femoral nerve in both legs although i can’t say this helped much.

Dr Bischof wanted to assess the extent of the infection and whether it had moved into the spinal cavity itself. She arranged an MRI scan to determine this. Without the epidural movement was much more painful and I would soon be wheeled into the MRI room and transferred first to a stretcher type bed which could be wheeled into the NRI room (there can be no metal in the MRI room so the normal hospital beds aren’t allowed inside) and then onto the MRI table itself. Both painful transfers after an already pain filled day. To add a further complication, the machines which regulated the flow of drugs into my body were also made of metal in places and I was detached from these stemming the drugs which deferred the pain.

Inside the MRI was tight, hot and claustrophobic with a hard thin board to lie on, add to this the loud alien sounding noise that the MRI makes as it spins and moves and the resultant experience was truly nightmarish. I lay corpse still, alone with the sound, heat and terror of infection. The pain increased as the drugs faded. In total there were three scans done, each lasting an eternity as I waited to be pulled out of the MRI between each. The nurse attending to me administered a dose of drugs buy hand when I was pulled out. Each time she did the pain reduced but so did reality, slipping away into that strange escher drawing like state typified by the ketamine high. It was all I could do to keep my mind from splitting apart as the nightmarish cycle of pain, desperation and mind altering drug trip coalesced. All the while the over loud alien whooshing sound of the MRI threatened to fully derail my sanity. Again I was transferred to the stretcher bed before being transferred back into my hospital bed, this time there were fewer drugs in my system and the pain lanced through me and consumed my conscious field, there was nothing but pain in those few minutes.

When I returned to the ICU I was finished, my head spun and my breathing was erratic. I am certain that the MRI ordeal was as much as I could take. there was no escape and reality was truly too much for me to take. but alas there was more coming, the constipation caused by the drugs was ever present and the discomfort was again growing, my abdomen distending from the pressure within, despite the activity of the day I would find sleep almost impossible due to the discomfort

The only salvation that day was when the head nurse came to offer me some comfort and told me that they had found no evidence that the infection had spread from the surface deeper into the spinal cavity. It is uncertain to me that I would have had the will to fight that too.

Sunday 28/07/19

I did manage to get a few hours of sleep in the morning before Dr Bischof made her rounds. she reassured me that the infection had not spread and it seemed that my infection markers were dropping in the blood test results. The anesthetist came to change the Main Line from the vein in my right shoulder to my left. They change these IV points frequently to avoid infection, in my case though my body seemed to reject the intrusions faster than most and the site would become clogged or inflamed and would have to be moved. Each day I would have at least one change or blood sample taken, I looked and felt like a pincushion for the storage of doctors needles. The intrusions into my body were a norm but I would never grow used to them.

I did manage to have a bowel movement again, as uncomfortable and distressing as that was, it did bring some relief to the discomfort. However, a new problem emerged when they removed the catheter for the first time since I arrived. The drugs mess with one’s ability to control bowel and bladder functions and the muscles had also not been used for two weeks, despite the build up of pressure, I could not urinate at all. Most of the night was spent trying to re-learn how to pee. Initially my efforts were useless, a terrifying feeling as one as can imagine. Later, I succeeded in passing small amounts of urine which relieved the pressure just enough to be able to find some light sleep. Only to wake minutes later and begin the ordeal again. Moving to place a pee bottle between my legs was painful each time, again and again I fought the muscles needed. After a full twelve hours of effort and distress I managed to urinate and although I would still have difficulty with this in the future, the battle had been won.

The first sequence of surgeries were over and the left leg had been saved, so it was time to start preparing me for transfer to a lower care ward where the wounds could heal before the next phase of the journey began. These first two weeks had taken me beyond what I believed i could bear, but even with the emotions and the drug trips, the journey was mostly rooted in physical experience. Something which would change drastically as I was moved out of ICU. The next battle would be one of sadness and loss. Like Atreyu in the Swamps of Sadness I would know what it was like to lose my Artax.