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  Rivas, Rivas, Nicaragua
Friday, December 17, 2010

Michelle writes in normal text, Martin in italics.

For the record: I was really enthusiastic about going for a bike ride. Who wouldnīt jump at a route coasting downhill to a turnoff into a easy trail 10 minutes into the forest to the "eye of water" (a sapphire blue spring fed swimming hole in a clearing in dense green foliage). The bikes werenīt brand new, but I was up for a little challenge.

The cycle ride started off well. We were on our merry way circling the double volcano island and I was basking in the glory of such a dramatic backdrop. Even the mundane looks fabulous with a volcano perched behind it. We cycling on the only road on the island which performs a figure of eight winding between the plantain fields (they are exported from here to Honduras and Guatemala) and yards full of playful children, guard dogs and chickens. An idyllic setting.

I noticed my brakes were working their hardest to no effect at the bottom of a short steep run. Unfortunately it was also the top of a longer steeper run. I decided to try and ride it out by default because I was too paralyzed by fear to leap from the runaway bicycle when I had the chance. I probably would have made it if the front wheel hadnīt started wobbling on its axis. I was less than a stoneīs throw from the bottom (and at what would have been my top speed - close to 50km/hr we guess) when the wobbling wheel guided me into the gutter of the on-coming lane of traffic. The gutter brought my speed to zero in almost no time.

We climbed a very gradual hill and reached the crest to find an abrupt descent. At this stage I tested the brakes and decided they were not up to scratch. My initial thoughts were: If in doubt - bail. So I came to a skiddy halt but a halt nonetheless. Next thing I know Michelle comes screaming past me shouting: "What should I dooooooooooooooooo.....?". Before I could respond she was a long way down the hill. I stood there watching, hoping she would ride out the hill. Next second Michelle has comprehensively defined the phrase īto wipe outī. She managed to perform some form of inadvertent 360 degree karate move resulting in the bike flying 10m away and intimacy with the concrete road. Repressing a few curse words and egged on by some locals I hurtled down after her.   

I lay in the street afraid to open my eyes. From the chatter I knew there were enough neighbours standing in a circle staring at the broken gringo to keep me from being run over. The sound of Martinīs voice taking control over the situation was even more reassuring. When I heard his putting-my-foot-down tone saying "she cannot get on a motorbike" in his best Spanish I abondoned my plan to muster a brave face and decided to play just as dead as I felt. I wondered vaguely what alternatives to a motor bike the neighbours could offer as every neck and spine injury horror story I was ever told in lifeguard/first aid training replayed in my head.

Itīs hard to provide reassuring words to someone who is not moving has just injured themselves to an unknown extent. You can only say "everythings going to be fine" so many times. Instead I went for the reassuring pat, however, I soon discovered this wasnīt really possible anywhere without an associated "ouch, that REALLY hurts". After ushering the motorcyclists away, the crowd around us tried to call for a vehicle but this was fruitless. We needed a taxi or truck to take Michelle to Altagracia to the clinic. Hitchhiking was the only option and after a couple of failed trucks the Hotel Paraiso had enough space to put Michelle on the back seats and the bikes in the back. They kindly drove us to Altagracia īhospitalī where the nurse wrote a note in Spanish referring us to the hospital in Rivas. However, supplies were limited and I couldnīt even find a neck brace or stretcher.

The pain of being moved into the truck released all the feel-good/pass-out chemicals my body could produce. One of the first things I remember seeing when my eyes agreed to open was a nurse coming at my with a movie-prop sized (very large) needle saying a word that sounded like anasthetic. Donīt they tell you to stay awake for days if you suspect a concussion? I managed to yell "no,no,no,no" like I was my 5 year old self getting a booster shot until the nurse backed off rolling her eyes. I later learned she had said analgesiac (pain killers), and regretted having so forcefully rejected her offer. 

Off to Moyogalpa we went. Rivas hospital was back on the mainland, a 45 minute drive to the ferry port then an hour long ferry journey to San Jorge del Sur before an ambulance to the hospital. We took a 5 minute detour to the hotel where we were staying in Altagracia. It was enough time for me to pack all our belongings (thank goodness for the small-ish bags) to ensure we didnīt have to return. The drive to the ferry port was bumpy and long but we reached it in the nick of time to catch the ferry. The next challenge was moving Michelle from the truck to the ferry. They wanted her to walk and I wanted a stretcher....we decided on a compromise. We borrowed one of the doors from a construction site and loaded Michelle onto there. At least she had a hard supportive surface for her back and neck. Pillow under her head and a ferry seat cushion under her hips and it could have been first class.... Ironically we couldnīt get Michelle lying on a door through the ferry passenger deck doors so we had to leave her in the cargo area half underneath a lorry full of plantains and wedged up against a wall. Half the crew debated about taking her off the door as another lorry had to fit on the ferry but after a while the other half of the crew managed to squeeze the vehicle on no problems. I spent most of the journey explaining to the crew how the accident happened and then letting them show me all the various bicycle and motorcycle wounds and scars they had accumulated over the years.
 
Martin kept me awake by asking me what hurt while he wrote it in Spanish from our phrasebook and described the beautiful scenery he could see (I could see the underside of a very grimy banana truck and the bug eyes of banana truck drivers staring at the pitiful site that was me). My heart melted with gratitude when a gang of other passengers told the boat guys they would simply have to wait ītil tomorrow to get their door back and told the cab driver someone had called for me that he would have to find another fare, they were calling an ambulance. 

Around six of us carried Michelle and the door off the ferry and into the tourist information booth where we sat waiting for the ambulance for only about 20 minutes. We were greeted by a small van/car that had enough room to squeeze a stretcher in. They had a neck brace and a plank of wood stretcher (not much difference from the door but lighter and easier to carry). We drove to Rivas which was only a short distance away but by this time of night seemed like forever. The driver was mixing speed with comfort but in Central America the roads make the latter all but impossible to achieve.

As they moved me onto the spinal board all I could think was "I better not have a spinal injury, because the quality of that transfer would have failed my lifeguard exams". The high speed of the ambulance set me sliding from side to side of the plywood board crashing into the rails of the bed and the paramedic/first aider failed to find my blood pressure because he didnīt seem to know how to use the arm band. It was a relief to be wheeled into the hospital.

Conversely I was dreading arriving at the hospital as I didnīt know what to expect in respect of facilities, cleanliness and expertise. However, we had been referred to Rivas for a reason. Entering ER (A&E) the Spanish note from the nurse and my basic Spanish sentences (My hip hurts, my head hurts etc) managed to get the message across and they almost immediately wheeled Michelle into the X-ray room. Despite there being four nurses (and my commenting on that they looked pretty strong - to their amusement) we had to recruit some men to lift Michelle onto the X-ray table. This was fine and they imaged her hips and hand whilst I chatted to one of the men about how to stop an out of control bike - "just put your foot on the tyre" - thanks, tips. I was brought back into the room (I wasnīt sure why) and the nurse pointed to a seat. Rather tired and bemused at this point I took a seat and had a few deep breaths. Suddenly everyone was laughing at me and I looked around to see they needed to get Michelle into the seat I was sitting in to image her neck and spine. I made a joke about it but still was perplexed as to how we would get her into a chair!! Needless to say we managed it and with X-rays complete we moved back to ER. A couple of specialists appeared and they generally just poked Michelle in her wounds and offered little help. One was particularly chuffed with himself that he could say "bottom" in English.

I was too relieved to learn my skeleton was totally intact to be concerned that their treatment of my flesh wounds consisted of mixing something antibiotic with water from the dripping rusty faucet in the corner and smearing it on top the film of gravel and travel grime already coating the wounds.  They left me to dry, I thought, but after an hour or so I realized theyīd left me altogether. Like a good ER nurse anywhere theyīd moved on to more dire straights, all promises of painkillers forgotten in the downgrade to "surface injury". I sent Martin to ask if it was ok for me to get up and go to the bathroom and the answer came back that it was ok to get up and go home. I was prescribed 2 ibuprofens (advil) a day and an antibiotic a day for a week. Martin took our bags to a hotel while I mentally prepared to get vertical when he came back for me. 

I felt a mix of gratitude, respect and guilt when we were told the only charge would be $10 for the ambulance. 5 x-rays, 2 prescriptions and hours of ER time were all compliments of the socialist state of Nicaragua, whether my luxurious foriegn travel insurance would have covered it or not.   

I was still acutely aware of how lucky and priviledged I am as Martin unpacked our first aid kit (containing everything they presribed and more) in our hotel room (cleaner and more comfortable than the hospital) to wash, treat and dress my wounds before bed.

By the end of the very long day I was well enough to regain my sense of humour, joking that it was a good thing it was me and not Martin as I didnīt think his lean physique could have taken the beating so well. If your new yearīs resolution is to lose "that last 10 pounds" might I suggest you find another; those 10 pounds might just save your neck one day.

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