Category Archives: Philosophy

Grief and Gratitude

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As much as I wanted to engage in magical thinking I knew it was a healthier choice to come to terms with my new life, as painful as it might be. In an attempt to provide some sense of acceptance and closure, I visualized places and activities that in all likelihood I would never go back to again. Examples included local mountain trails, snowshoe hikes, and kayak trips, paddle boarding above sea turtles in Hawaii, swimming with sea lions, exploring a cloud forest in Nicaragua, touring caves and castles in Slovenia, walks along beaches and sand dunes, etc. After a rapidfire flashback of countless memories, I gave thanks for having had the chance to experience them, then bid them farewell.

Most of those fond memories were with Danielle and many wouldn’t have happened without her careful planning. Because she’s a social worker and I was a mail courier, we never had an abundance of non-discretionary funds. Thanks to her research and strategic use of our resources, we shared many experiences that would normally be beyond our price range.

Though I never doubted she would stay with me through the ordeal, I worried about what would become of her. Even with insurance and social security my condition was likely to drain our savings. She would sacrifice not only future vacations but possibly retirement and health savings as well. As my primary caregiver, the physical toll and added stress would inevitably affect her health and quality of life. Realizing that in all likelihood I would be condemning her to a life of drudgery, I experienced a different form of “survivor’s guilt”.

As an alternative, I envisioned a transition from unconsciousness to death on the street at the site of the crash had first responders taken a little longer to arrive. Even though my life would end sooner, it’d be a relatively quick and painless death. Danielle would be grief-stricken for a time but at least she’d have a chance to lead a normal life again. That was how I honestly felt, but since then there have been moments we shared which approached the happiness and normalcy of our lives before my injury. Though such moments aren’t always without pain and stress, the sense of possibility and hope they present make me realize my new life is a blessing as well as a curse.

Some might view my surviving the crash as a miracle, but what I feel is the true miracle is that I was fortunate enough to marry someone who would sacrifice so much and fight tirelessly for my well-being and a future together. Mostly because of her I continue to struggle to regain health and adapt.

Another Long Night

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As Danielle and Florence prepared to go back home for the evening, they made sure a mouth-activated nurse-call button was within reach in case of an emergency. They both gave a farewell hug which, while emotionally comforting, was physically painful not unlike putting pressure on a bruise.

Danielle also set up a small bluetooth speaker connected to my phone. At home I’d occasionally listen to music or a podcast through an earpiece to be able to sleep through the noise of my c-pap machine. Since my mind was still too foggy to follow a podcast I opted for music on a Spotify playlist.

I started creating the playlist around 2022 and envisioned it as a sampling of songs for an imaginary pirate radio station (inspired by early 90s Radio Free Hawaii). It gradually grew to many hours of music and is the same playlist as the one on the Spotify widget on the bottom-left corner of this site. I hoped it’d be a distraction from obsessive thoughts, but it backfired initially.

In my fragile state of mind I felt highly attuned to the emotions of others including the musicians’. Any song performed with a modicum of authenticity (especially involving themes of heartbreak or loss) was enough to trigger a steady flow of tears. This was surprising at first because I normally wouldn’t be so moved by music, but of course my circumstances weren’t normal and I struggled to hold back tears for the sake of my visitors throughout the day.

Another characteristic of some of the triggering songs was their association with specific memories. I was transported to happier times with Danielle such as driving to a campsite, attending concerts, dinner parties with friends, even cooking breakfast at home on a random weekend. These memories led to a different train of thought which was all of the activities I could no longer do and places I could no longer see in person.

At this point I was well aware I was spiraling into depression but gave myself permission to continue. I’ve always had a tendency to suppress my feelings but I felt if I continued that pattern it would make the trauma worse.

The First Day Continued

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When Danielle and Florence first visited me in the Neuro ICU, it felt like the first time I saw them since before the crash. On further reflection I recalled the hazy dream-like hospital room that was actually the Trauma ICU. My memories of it even at that time seemed faded and fragmented whether because of the heavy medication or a side-effect of physical and/or mental trauma.

Regardless, how could I not realize I was quadriplegic through that period which was at least a week? I tried hard to recall what people actually said to me but could only remember portions of my mother explaining how my family scrambled to get to Seattle and my brother Daryl explaining something about a computer.

Part of the missing information could be attributed to impaired hearing, since I noticed sounds coming through my left ear had a slightly distant or muffled quality. But I think the main factor was my fragile mental state compounded by heavy medication causing faulty memory. It could also be that “selective forgetting” was a way to protect myself from uncomfortable information my mind was incapable of accepting.

One example was at some point that day I felt the urge to urinate and thought I’d need to call the nurse for a bedpan. This alarmed my visitors because they witnessed the same scenario at the trauma ICU not long before. They explained for a second time that I had been catheterized shortly after being admitted to Harborview.

Perhaps suspecting there’s other important details I hadn’t retained, Danielle provided a detailed description of my injury. Though I had deduced what what was going on with my body, it didn’t hit home until she described it as the same injury suffered by Christopher Reeve. She then asked if I knew how I was injured and after I gestured “no” she recounted what she knew about the crash from police and first responder reports. Even though I had no prior memory of such details, it didn’t come as a complete surprise since a bike crash was always the most likely explanation. She described surgery scars along my neck and spine that resembled tattoos and puncture wounds on my head from having it bolted down to keep it from moving. I couldn’t feel them at the time but did later on.

Also new to me (though likely recounted before) was the timeline of my stay at Harborview. To me it felt like it could have been anywhere between a few days and a month. In actuality it had been about two weeks. Even more surprising was learning I had flatlined for a few seconds on at least two occasions. Danielle became teary-eyed as if reliving those moments and seemed almost as re-traumatized recounting repeated unsuccessful attempts to get information from my employer’s impenetrable HR department.

Although I retained a partial memory of it, my mother described how she, my father and older brother arrived at the hospital just two days after my crash. My dad and brother had to go back home after about a week but my mom planned to stay for three months. I was appreciative for their visit because my parents had been reluctant to travel by plane since the start of Covid in 2020.

Throughout the day we were frequently interrupted by nurses taking vitals and refilling the IV with saline, liquid food and medications, staff members changing my bed position and cleaning the room, and phlebotomists drawing blood samples. An odd side-effect of my lowered metabolism (or slowed-down state of mind) was that everyone’s movements seemed “sped-up”. The entire day seemed to go by rapidly as well and before long it was evening.

First Post-Crash Day Fully Conscious

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The first group I encountered on my first day of full consciousness post-crash was a team of various medical professionals. A nurse recorded my vital signs while a doctor assessed my cognitive health through a series of questions which I answered by nodding or shaking my head.

A couple of people from the surgical team focused on the extent of my spinal cord injuries, asking if I was able to feel or move various parts of my arms and legs. I was able to feel everywhere, though in a tingly and imprecise way, similar to how one’s arms or legs feel “asleep” from lack of circulation. I could definitely feel a sense of touch, but it seemed to emanate not from the surface of the skin but from a layer beneath. As expected, I couldn’t move anywhere below the shoulders while areas touched on my arms were felt on corresponding areas of phantom limbs above my chest.

Lastly, a specialist investigated my emotional state through another round of questions including if I felt depressed or had suicidal thoughts. This line of questioning seemed absurd at the time for how self-apparent the answers should be. It’s inconceivable that anyone newly quadriplegic would not be depressed. Likewise, any sane person who loses movement of all limbs as well as loss or impairment of numerous internal bodily functions would be lying if they denied having suicidal ideation even fleetingly.

That being said, I nodded in agreement about being depressed but shook my head to signal “no” to the question about suicide. I didn’t want or need suicide counseling and even if I were seriously suicidal, what could I do about it? But my main motive for lying was the possibility that my family would find out. I imagined how they may have experienced trauma from witnessing the trauma I went through, and how much they’d want me to survive. It would hurt them to know they wanted me alive more than I did at the time. There are moments when I still have such thoughts, particularly when my wife and I experience economic setbacks related to my injury, but the emotional impact suicide would have on loved ones is enough to keep the thoughts ephemeral and in the realm of speculation.

As if conjured by thoughts and memories, my wife Danielle and mother Florence arrived soon after, looking just as worried as I expected.

Assessing the Damage

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In hindsight, what obsessed my thoughts upon regaining full consciousness at the neuro ICU was described by Elisabeth Kübler-Ross’ five stages of grief: Denial, Anger, Bargaining, Depression, Acceptance. I certainly experienced all of them, though in varying order and levels of intensity and repetition, for my mind kept looping back to different stages and emotions.

Denial was one of the earliest stages, which I felt as soon as I realized I couldn’t fully move. Anger was less dominant and would be directed at what I felt to be an unjust god or universe, myself, or anyone else who may have been involved (I had no idea since I had no memory of what happened). I also experienced my own form of bargaining, imagining what I’d sacrifice or do differently were I to have a chance to regain my former body and way of life. Depression permeated my mental state at the time, and though I knew I needed to accept the reality of my situation, it was and still is a struggle to retain acceptance and resist the temptation of magical thinking.

To distract from thoughts related to grief and loss, I focused instead on physical sensations. Though I couldn’t see intentional movement below my shoulders, when I attempted to move arms or legs I detected certain muscles firing. The signals were fairly weak but were hopeful signs nevertheless. Occasionally I’d feel a sudden random leg twitch which made me think of rigor mortis. With each twitch, as well as whenever I moved parts of my shoulders still capable of movement, I felt a surge of tingling similar to how it feels when one’s leg or arm is asleep.

My sense of touch below the shoulders was altered in other ways as well. The cloth touching my body felt odd and unnatural while parts of my arm that were exposed seemed extra sensitive to even the slightest breeze such as the one emitted from an overhead AC vent. I felt the sensation of a metal bar over my chest just below my neck which was actually the separation line between the paralyzed and non-paralyzed parts of my body. Overall, my body felt numb, which I was later informed was a result of widespread inflammation due to trauma. This was a small blessing since as inflammation reduced over time, muscle tightness and spasms increased and continue to plague me to this day.

My phantom limbs were in the same position over my chest while actual arms were still alongside my torso. I’ve always thought phantom limb syndrome only occurred when one loses limbs, but apparently it also happens when the brain has faulty connections to limbs. I’ll never get over how strange it is to feel my limbs at the wrong locations.

The main source of physical pain I felt at the time came from the breathing tube near my throat and an additional tube taped to my nose which I later learned was a medication feed tube. The pain was heightened every time I swallowed. I also detected a few chipped teeth with my tongue. The only other notably altered sensation was a feeling of tiny sparks on the skin of my forehead. This turned out to be the new way I experienced sweating.

Having spent what felt like sufficient time alone, I looked forward to the staff and visitors that I expected would soon show up.

Surrendering to Reality

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When I woke up with the full realization that I was paralyzed, my mind was deluged with questions, speculations, fears and regrets. Judging from the faint light though window blinds, it was still early dawn. I was relieved no one else was in the room because I needed time alone to think.

One of the earliest and most reoccurring thoughts was simply why? I felt the more literal and simplistic answers such as bad luck or bad choices the least satisfying and hardest to accept, and turned my attention towards religion. I wasn’t a deeply religious person before the crash but did hold some hope for the existence of karma. But it’s easier to understand in the abstract how one’s circumstances could be the result of actions in a past life or how current actions affect future incarnations. When one suddenly becomes quadriplegic, such knowledge is of little comfort though it did provide an explanation.

Were I Christian I’d probably want to believe god works in mysterious ways or that my catastrophic injury was part of a master plan. Conversely, I could imagine becoming so disillusioned that I rejected my faith and now characterized god as cruel or indifferent. But if by some miracle I was completely healed, then god would once again be loving and merciful. Recognizing the futility of such magical thinking, I found it comforting nevertheless. I visualized being back home as if my life had never been disrupted. Perhaps that was my reality in an alternate timeline or parallel universe? As much as I wanted to escape into fantasy, I knew I had to focus on the present.

No matter how I felt about my situation, the reality is that it happened and there might not be a satisfying explanation. I could relate to existentialists who, after confronting the incomprehensible nature of existence, sought to create their own meaning. I was also more inclined to believe in the Gnostic concept of a malicious demiurge as creator of a corrupted material world. As hard as it might be to accept, the universe is chaotic and owes us nothing.

From Dream to Nightmare

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Upon waking up at the Neuro ICU, I rested for some time with my eyes closed. I noticed an odd sensation of movement despite not hearing or feeling wind and vibrations which would indicate movement. What I did feel was my arms hugging my chest tightly as if in a straight jacket, though the material felt more like a rubbery mesh than cloth. Meanwhile a nearby machine produced a steady hiss similar to an air pump roughly synchronized with my breathing patterns.

Disturbed by everything I was sensing, I reluctantly opened my eyes to a dark room bathed in a dim green and purple glow from various monitoring devices. As my vision adjusted, I craned my neck and realized my arms were both flat on each side of my torso and I was wearing a standard hospital gown. I also glimpsed various tubes all over my body. An IV in my right arm, some type of nose tube, and a breathing tube connected to a ventilator.

My first instinct was to attempt to go back to sleep, hoping what I was experiencing was sleep paralysis or a false awakening within a nightmare. This proved to be futile, as my mind struggled to reconcile the disconnect with my body. One likely factor was medication, as the initial feeling of movement while awakening was similar to the feeling of heavy drunkenness. As for the illusory straight jacket, the only theory I could come up with was that it was some form of phantom limb syndrome. I struggled to move phantom limbs and “actual” limbs to no avail. At that moment I wasn’t experiencing phantom leg limbs but nevertheless could not move my legs or any part of my body below the shoulders nor could I talk.

With that realization I felt like crying but was perhaps too much in shock to do so. I also may have held out hope that I was still in a bad dream. I was definitely in a nightmare, but not the type one can wake up from, though I did grant myself a brief respite by eventually falling back to sleep.

Half-Awake In the Dream

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After losing consciousness during transport, my memories became increasingly fragmented and “impressionistic”, most likely a side effect of strong medication. This roughly coincided with my stay in the Harborview Trauma ICU which was about a week after being admitted to ER, though subjectively it felt more like a month.

Since talking to my wife about my hospitalization, I realize there were times when I was conscious enough to answer questions, yet had no recollection despite remembering things earlier in the chronology. Odder still, some of what I did recall was in a liminal state between dream and waking life.

As if my mind was attempting to reset to the morning of the crash, it placed me in an “alternate reality” version in which I arrived at work like usual and promptly started the daily routine at my workspace. Suddenly I was back on the gurney and being wheeled out of the work area and through a sub-basement corridor I had never seen before. Through dream logic architecture I ended up at the UW Medical Center ER. I recognized one of the nurses as a former co-worker and realized even within the dream that it made no sense since she was a senior lab tech at the UWMC clinical lab. I speculated that one of the “actual” nurses had a voice similar to my co-worker’s, causing my mind to actually see her as that person.

I was next transported to the Harborview Trauma ICU (partly via light rail!), which I must have realized was where I “actually” was either consciously or subconsciously. At that point my experience took a paranoid turn as I began to suspect nurses and assistants were skimming my medications for personal use. Within the dream state I passed out and reawakened in a fantastical ICU bathed in a hazy white glow. I somehow got the notion this was at a sprawling new hospital connecting the Northgate light rail station to the nearby library.

It was at this imaginary location where I realized I was being visited by my wife as well as parents and brother from Hawaii. Somehow I knew this aspect of the pseudo-dream was “real” and not in the spirit realm and was glad they were alive and well, though I could tell they were shaken to see the state I was in. It seemed I wasn’t conscious for long, and had several other interactions with family before waking in a more lucid state at Harborview’s Neuro ICU.