Inle Lake Myanmar Boats Sunset

The Accident

Bagan, Myanmar. February 1, 2017

The Backstory

I struggle to type this due to the limited mobility of my left arm. Hopefully this contributes brevity to the piece.

This trip is about getting out my comfort zone, which I’ve done successfully in both large and small ways. Riding a bicycle for the first time in 17 years, meeting and hanging out with strangers (without booze sometimes!), hiking a gorgeous island mountain, and kayaking with a new friend are just a handful of my latest adventures.

But riding a motorbike was not on the list! It seemed too dangerous, especially for someone just getting reacquainted with regular bicycle riding.  However, if you want to see pagodas in Bagan, it’s really the only way to get around because the roads are too hilly and sandy for basic multi-gear bicycles.  Tour groups go to the most crowded pagodas for sunrise and sunset and are scheduled down to the hour for the remainder of the day.  Basically boring af, let’s be honest. Horse carriages are available but are incomprehensibly slow and cruel to the animals.

I spent an anxiety-filled lunch deliberating the pros and cons. Then I picked up my very much alive and present fear and we hopped on the e-bike.  I teetered around the driveway of the Ruby True for a couple of minutes feeling rather unsteady, but consoling myself with the idea that I’d get the hang of things after riding for a few minutes.

In Myanmar, e-bikes are battery powered scooters, with max speeds of 60 km/hr (~37mph). I was ridic tense while riding but overall felt like I was in control of the situation. I hovered around 20-30 km/hr the whole time, which felt slow and safe.

Bagan, Myanmar, e-bike, accident
Wheeee . . . . (minutes before I crashed)

 

We (I had a travel buddy for this leg of my trip) were just a few km from the chosen pagoda, when the paved road went right and my bike spun a hard, uncontrolled left on a gravelly/sandy patch.

Maybe I accidentally sped up while trying to brake? My bike jumped the curb, abruptly stopping and slamming the left side of my body into the pavement.

I got out from under the bike and slowly stood up. Immediately, I felt woozy and sat back down. In a matter of seconds, the pain in my left shoulder became excruciating and I couldn’t move it. My left forehead got ‘heavy’ as blood started to drip down into my eyes.

Anyone who knows me knows that I hate hospitals. If I’m outside of work, someone has to literally be dying for me to go to one. However, my shoulder hurt so fucking bad I knew it needed medical attention, and not the kind that I could give to myself.  

I stayed calm because panicking never does anything except, you know, gets your bike to slam you into the pavement.  But what absolutely could not happen was a loss of consciousness.  A post-traumatic LOC can indicate a severe head injury (a skull fracture and underlying epidural hematoma, if you are curious).  And I knew that whatever hospital we were heading to in Podunktown, Myanmar definitely would not have a CT scanner.

A calvarial fracture and epidural or large subdural hematoma would be a death sentence as there probably wouldn’t be a helicopter available to fly me to Mandalay (closest major city) in time for the necessary surgical evacuation. If I remained conscious though, I wouldn’t suspect anything too severe as the impact has to be pretty strong to cause a skull fracture and the underlying hemorrhage. Plus, I have a thick skull. Seriously.

A kind stranger took my scarf from around my neck and fashioned a sling for my shoulder. It was so nice of her, I wish I had asked her name.

The Hospital

A taxi appeared from nowhere to take us to the hospital. The reception area was colored a sun-faded blue or green or beige. Turns out this unimpressive room wasn’t the reception but was the entire ER. Sigh.

A balding, chubby man, clearly a resident, asked me some questions in good enough English while scrawling my answers in a small notebook, which turned out to be my medical chart! Fortunately, medical terminology translates well.  E-bike injuries are also really common although I lied about mechanism of injury for insurance purposes.

I left a healthy patch of my beautiful brown skin on the pavement. The doctor examined my gnarly, bleeding shoulder, then the nurses, (dressed in traditional British-style uniforms complete with hats and skirts) removed bits of gravel from it before dousing it in Betadine and dressing it with gauze.

The pain from cleaning my wound would have killed if it wasn’t overshadowed by the throbbing of my shoulder joint. A fracture seemed likely.  Archaic xray technology revealed a type 3 acromioclavicular joint dislocation with probable distal clavicular fracture. Yes, guys I had to read the xray myself. There was no radiologist in the hospital.

The ER doc informed me that locals with my injury are treated with an ORIF, K-wire fixation. Surgery in a 3rd world country was not the type of adventure I had in mind! Fortunately, I knew this kind of injury is treated conservatively in the US, except with professional athletes. What would have happened if I hadn’t been a doc and hadn’t known that?

I got an IM shot of Diclofenac, an NSAID, plus a tetanus shot, and instructions to return in the morning to consult with the orthopedic surgeon.

hospital, ward, nurse, myanmar
The orthopedic ward. Nyaung-Shwe, Myanmar

The Lesson

For the first time in awhile, I felt lucky to be a doctor, because it made navigating the whole process easy and way less scary than it would have been for almost anyone else.

I suppose I was lucky to have a pal with me but I felt compelled to make jokes to keep him from freaking out.  This task also kept me from getting too deep into my own shock and from obsessing over the concern of losing consciousness.  But overall, I think that even being solo, I still would have handled the situation like the boss bitch I am.

I was also super lucky that I didn’t sustain a serious head injury as I def should have been wearing a helmet and fully know better as someone who has read thousands of head CTs of motorcycle accidents. Why didn’t I? The anxiety of riding the e-bike made me forget to ask for a helmet from the hotel. It wouldn’t have spared my clavicle from fracture-dislocation or prevented my shoulder wound but I could do without these forehead lacs and black eye that I’m currently rocking.

injury, Bagan, Myanmar, black eye, gauze, accident
1 day post accident. It doesn’t look THAT bad, right?

I was fucking scared as hell on that bike but like I used to tell one of my friends, sometimes you just gotta grab life by the balls. Even if there had been other reasonable options besides the e-bike, I’m glad I tried it. Just 2 years ago and certainly 5 years ago, my fear would have been insurmountable.

My wounds will heal and my scars will fade (hopefully). But I will be a little less hesitant to try the next terrifying opportunity that arises.

That doesn’t mean that I’m going to bungee jump next month (zero interest) or not wear a helmet on a bike. But when you are taking a chance on yourself, when you are living at the edge between what makes you comfortable and what scares you, you have to take risks.

There is always the chance that life will slam my hopes and dreams shoulder first into Burmese pavement but there is also the (much higher) chance that I will make it to the pagoda for the beautiful sunset intact. But there can’t be a beautiful sunset without first trying to get there.

So, like everything else on this trip so far, the accident was just another metaphor for life.

I have struggled this past year (2016) to give myself proper credit for personal accomplishments. I’m pretty proud of myself for acting in spite of my fear in this circumstance. There was a good chance it could have turned out okay, but it just didn’t happen this time.

I’m proud of myself for even being able to have this outlook after having spent so many years focusing on the worst in situations, in other people, and in my choices and myself.  Next time, I’ll be better prepared with motorbike lessons and a helmet. But, there will definitely be a next time.

beach, quote, adventure, find yourself

TL;DR?–Don’t let fear stop you from taking a chance on yourself.

Existential or medical questions are always welcome!

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