PBP '99, A view from the ER

PBP '99, A view from the ER

1999 was to have been my "Fun" PBP. In some ways it wasn't.

As a bit of background, I completed PBP for the first time in 1995, Boston Montreal Boston in 1996, took 1997 off, and with only about 100 training miles together, attempted BMB in 1998 with a new tandem partner; my partner abandoning at about 950 km. After a slow start to this years brevet season, I comfortably completed the Toronto Randonneurs 1000k brevet three weeks before PBP. After this, I was looking forward to a pleasant PBP on my single, free of the pressures of doing it the first time, and with a lot more experience under my belt than I had in 1995. This year, I would be doing the ride with three other people: Mike Seager, my long time riding partner with whom I rode PBP '95, BMB '96 and a lot of brevets; Chris Leary, who Mike and I had met and ridden with at BMB '96; and lastly Cyndy Van Der Wiele, who Mike had met while riding brevets in North Carolina in 1999.

We all rode at similar speeds, and although we didn't plan on riding as a group, we expected to regroup here and there along the way. Coming along to tour the French countryside in a rented mini-van, and spend far to much time supporting and chasing us, where Marcia Swan, Mike's sister who had supported us in '95, and Charlene Leary, Chris's wife.

I spent most of Monday before PBP dozing and sleeping, getting ready for the 10 PM start. Up in the late afternoon, filling water bottles, rechecking the bike, off to dinner and then to the Gymnasium for the start. The first few hours where the usual very careful shuffle as my riding partners and I played dodge with all the other riders. Things settled down around the first checkpoint to the accustomed PBP grind up a roller, coast down the back and repeat. Sometime during Monday night, I separated from my riding partners on one of the climbs. This was no problem as we expected this to happen and planned on regrouping at the contrôles. Around dawn, I stopped for my first power nap on the side of the road. Due to an extreme sensitivity, I'm unable to use caffeine, so I substitute short, about 15 minute, naps here and there. While I was trying to nap, I discovered all the fine people who knew me, that where behind me, as every few minutes someone would slow down, shout my name and ask if I was "OK". On one hand, I greatly appreciated this show of concern; on the other hand, I gave up and headed out on the bike again. Through the night, I met people I've met at other rides in other places; half the reason to do these rides is the people you meet!

The checkpoints were beginning to pass with regularity. Mortagne au Perche, Villaines la Juhel, and Fougéres went past a little ahead of my 1995 times, and although a bit more tired than I expected, I was rolling along just fine. However, about 20kms before Tinténiac, at about 4:27 PM, I was riding along, estimating my time into Tinténiac and my long sleep break at Loudéac, when I found myself, with no particular surprise, on my back staring at the ceiling of an ambulance. Rolling down the road, with an oxygen mask on my face, and an ambulance attendant telling me, in accented English, not to worry, my bike was being taken care of by the ACP; we were going to the hospital in Rennes. Nothing to worry about. Right! Although, somewhat reassuring, the bike wasn't exactly at the top of my worry list. What transpired in between the ride on the bike and the ride in the ambulance is still a mystery to me, and if anybody knows, I'd love to hear it!

The next few hours were familiar to anyone that's crashed or taken a bad fall. Watching the ceiling go by from the gurney, my clothes were taken off with scissors, although I was given the choice of trying to take them off. Sure, no problem. A few X-rays, draw blood for lab tests, EKG, medical history, etc. The diagnosis came back as a dislocation of the left clavicle where it meets the scapula (commonly called a separated shoulder) severely bruised ribs, a hematoma on the thigh, road rash, a mild concussion, and a few other minor problems. After the first round of X-rays I was told I would require surgery either that night or first thing in the morning to put my shoulder back together. This meant there would be nothing to eat or drink till after the surgery. Hey, perfect after about 400km on the bike. About then, the one person who spoke English went off shift. Now most people don't understand much that's said in a hospital, but this was worse! Without my handy French phrase book, simple things, such as, "I need to go the bathroom," get complicated. Especially when you are confined to bed. And are having difficulty breathing. And can't move one arm because of the pain. And are afraid the arm might fall off. And have a concussion with short-term memory loss. And can't hardly remember your name, let alone what little French you do know!

Luckily, my rack pack had accompanied me to the ER. In it was a very valuable booklet. My PBP brevet book. Simply handing this to the ER staff let them know who I was, where I came from, what medications I was taking, what I was doing in France, my home address etc. Also in the book was a list of phone numbers for all the contrôles. Having this in hand, it was fairly simple, while the English speaker was still on duty, to have the staff call Tinténiac and Loudiac and have messages posted on the message boards for my riding companions and support crew. Luckily, they saw the messages and called the hospital back to let me know they knew what was happening.

I remember, as several people helped me on/off a gurney, reading one nametag and seeing a title something like "intern". When I pointed at it and asked if he was a doctor in training, the laughing reply was, "No a nurse, with a (pointing at upper lip) moustache". Everyone was pleasant and helpful. I have no bad memories of the hospital staff, or my care.

So went the night. Sometime in the dark I started having great pain breathing, and with hand signs, grimaces, etc., I managed to convey my difficulty to the night staff. This prompted another trip to the X-ray department. In the bed next to me was an elderly French gentleman. Between calling "síl vous plaît" for a nurse, ignoring the call button on his bed, he kept up a running conversation with me. In French. I'm afraid I couldn't keep up my side of the conversation. But, I'll give him credit where it is due- he kept trying. And so went the night.

The next morning the surgeons came to visit. Luckily, they spoke excellent English. As you've probably guessed by now, my French is very limited, and even worse when I'm uncomfortable and barely awake. They explained the major injury, and gave me the choice of having them operate that morning, and spend several days in the hospital, or having it done at home. They assured me that a wait of two or three weeks would cause no problem, and in either case I would be an uncomfortable fellow. Now I was faced with a choice: I could let them operate and get it over with, but miss the rest of PBP That itself wasn't much of a problem as I'd already missed a couple contrôle closings. Or wait until I got home to have it tended to. Either way, I'd be an uncomfortable fellow with an arm in a sling. I choose to wait. I choose to wait for several reasons, and should you ever be in this situation you should consider some of these too. First there was the problem of being in a foreign hospital. They had taken great care of me so far, but you are in little enough control as it is when in the hospital. I really didn't care to have even less. Second, as soon as he gave me the choice, it was no longer a matter of emergency treatment. For my health insurer, we were now into that wonderful province of pre-approvals, second opinions, etc, etc. I really didn't care to get home and discover that they wouldn't cover the surgery or hospitalization! Last, I had a seat available in a mini-van that was following my riding companions and other friends around PBP. It was now Wednesday morning, and they still had a while to go. I had other things to do. I was ready to get out of there! As soon as I gave the doctors my decision, in a manner followed by doctors the world over, they left just before I thought of the 101 questions I had. Such as, "Is my arm about to fall off, or is it still solidly attached?"

After the decision to postpone surgery was made, I was given breakfast, the traditional French bowl of coffee, or in my case hot chocolate, and a baguette. Eventually a wash bowl appeared and I was able to clean myself up, including my road rash, which had not yet been tended to. In my rack pack I carry Neosporin, which I used on the road rash.

Later that morning, the hospital social worker stopped by to try and help me get back to Paris. Remember, at this point, except for cycling shoes, I didn't have any intact clothes to wear! Luckily, just as we were starting the discussion, Charlene called to check on me. A cordless phone was brought to the room, and we had a great discussion. They would bring my extra clothes and pick me up. Everybody was greatly relieved that somebody would be coming to take me away. The social worker and the hospital were free of a problem. Marcia and Charlene could tour the Rennes hospital district and I could stop worrying.

During the morning I was fitted with a sling to help ease the discomfort of my separated shoulder. The fitting actually took two attempts. The sling was provided by the local orthopedic supply company. On the first trip, two young ladies walked into the room with a size "Grande" sling. They looked at me, they looked at the sling, they laughed. This would have done fine to hold my little pinky. They said something that I imaginatively translated as, "No way is this going to work! We'll be back later". They returned about an hour later with something more appropriate.

In late afternoon, as the staff was starting to ask when I would be leaving, Marcia and Charlene magically appeared, bearing my back pack, stuffed with clothes, I could finally get dressed! Time to get out of there! It wasn't until months later that I discovered Charlene had been told to pick me up by two PM. Or they'd put me on a train for Paris. That would have been a sight! A few minutes with the usual hospital formalities, during which I was presented with a large envelope containing my X-rays, test results, and a long note detailing my treatment and the doctor's opinions. All, of course, in French. Actually, in medical French, which is even harder to have translated. Rather stumped a native Frenchman I know at home.

I spent the rest of PBP riding in the support van, urging on the people I knew and taking photographs. I remember walking down the street in Villaines la Juhel late Thursday night, returning from seeing my riding companions off at the contrôle, cycling jersey pulled over the hurt arm, cleats on my feet, and receiving a standing ovation from some of the spectators sitting in front of their home. Just some of the local enthusiasm that makes PBP such an enjoyable event!

Marcia and Charlene had already checked and found that the ACP had my bike at the Tinténiac contrôle. We managed to stop by after it had closed for the returning riders. All the people manning it were looking tired, and relaxing. I found that the gentleman running the contrôle had my bike secured at his home. He insisted on driving me there so I could see it, and pick up what small things hadn't accompanied me to the hospital. Like the pieces of my helmet. I was glad to see my old friends and both sad and happy to see, that unlike me, the bike was virtually untouched by the incident, bearing no evidence to explain the crash. And my trusty Bell helmet, veteran of two BMBs and all the brevets in between, had given it's life to soften the blow to my thick skull. The ACP offered to transport the bike back to the start, and, if needed offered to have it packed and shipped back home. I gladly accepted them shipping it to the start, but declined the offer to ship it home. If I hadn't had friends with me to help, I probably would have accepted their offer. When we finally picked it up in St. Quentin, it was missing the frame number. With luck, it will return with the final results.

Finally, at one of the contrôles I had a few minutes to myself, with a pay phone in site. It was time for one of the more painful parts of the experience--calling home and telling my wife. The call started with the traditional "I'm out of the hospital...." and went on from there. Sandy immediately started the chain of contacting our physician, getting the required insurance referrals, and finding an orthopedic surgeon who would be able to see me immediately upon my return home, since the dislocation needed repair as soon as possible. She was successful and the day after I returned home I stood in the examining room of a surgeon. More X-rays, look at the ones from France, the usual poking prodding, "does this hurt?" dialog, and the diagnosis. I felt like I was dealing with a TV evangelist, as he told me: "You don't need the sling anymore, and you don't need surgery immediately, if ever. We don't normally surgically repair that injury; physical therapy alone gives just as good a result. Start cycling again anytime you feel up to it; just, please don't fall." After what the surgeons in France had told me, it rather sounded like "Be Healed! Get up and walk!" Well, sort of, it was actually: use the sling only for comfort, your arm won't fall off, and become good buddies with the physical therapist. What followed was a round of twice a week, weekly, biweekly, monthly and finally bimonthly visits to the physical therapist, and a set of exercises to stretch and strengthen the muscles.

Epilog

As long as this account is, it's really only scratched the surface of my PBP '99 adventure. There was a side trip to the National Police Station in Fougéres, where we joined the police in a brandy toast, and I haven't mentioned the trip home, with all the kind help people gave me along the way. Especially Marcia and Mike who helped care for me and "inserted" my luggage and I onto the airplane for the trip home.

It's now about five months since the crash. The only bill that has arrived was for the sling. This was paid with an international money order. At least I think it's been paid. The money order takes six to eight weeks to arrive. All the notices are in French, and I'm not positive if the final one I received says, "payment received", or "judgement entered". I've just had my final visit with the orthopedic surgeon. I now have full range of motion and most of my strength recovered. The few muscles that haven't recovered fully, are still improving. I'm still in "tight" with the physical therapist for another couple of months. I still have a bump on my shoulder, which you can watch slide about as I move the shoulder. No one has taken a scalpel to me, yet, although it is still an option should the aches and pains, or cosmetic defect, I've picked up bother me too much. By the way, there's no penalty for waiting another year or two, over having it repaired immediately after the injury, although the down side is it would take about eight weeks in a sling and then another round of physical therapy to recover from the surgery. For now I'm putting that off as long as possible! I've put a few miles on the bike, which after a check by the builder, recovered nicely. The only lingering question, and doubt, at this time is "what happened?" Amnesia of the accident itself is not unusual, the bike gave no evidence, and none of the witnesses left a statement. I don't know what I did, or how to avoid a painful repeat performance. I suppose the moral of the story is to always get that second opinion and at least at PBP, if something bad happens to you, the good people are there to help.

If you have access, and are interested I've posted pictures from PBP '99 and BMB '96 at http://geocities.com/pdusel. Information on shoulder separations, a not uncommon cycling injury, can be found at http://www.hughston.com/hha/a.shosep.htm.

As far as PBP 2003 or another round of BMB are concerned, much as I love both events, and would like to complete them on a tandem, well, I'm already an Ancien of both, and the Toronto 1000k completed my R5000 requirements. 2000 was always planned as a year to spend more time with my family and sailing. 2001 and 2003 are a long way off yet, so, we'll see.