Beyond the Bear (12 page)

Back at the ICU, Dr. Kallman checked on me at least twice a day. He’d get up to speed on my status, silently reading through my chart at the nurses’ station directly across from my room. He’d slide the chart back into its spot, nod at the nurses, and head in.

“Hi, how are you doing?” he’d ask whichever members of the Dan-watch team were parked in my room. He’d then lean over me and meticulously clean, inspect, and re-dress the stitches holding my face together to a soundtrack of Steve Kimock tunes.

One night Kallman showed up while most of the city slept. With Sara and the girls visiting family in Philadelphia, he had no burning desire to go home to an empty house. He dealt with my wounds and checked my tracheotomy site, then pulled up a chair and sat quietly with me studying my face, fingertips forming a pyramid at his chin like a chess master pondering a move, thinking about how he was going to fix me. A nurse padded in to check my IVs, and padded out again. Muffled voices floated down the hall. At the nurses’ station, a phone beeped and a keyboard clacked. That time of night the unit was relatively quiet, a good time for Kallman to be alone with his thoughts. He leaned forward in the chair, thinking of the disarray beneath my skin and his role in the four-surgeon team it would take to put my skull back together. Having Sara and the girls away during on-call weeks was usually for the best. This time was different.

“I’m dealing with a really tough one,” he’d told his wife over the phone. “I really wish you were here.”

Seven days after I was mauled, with Brian and Jay on duty, one of my nurses was overseeing the routine lightening of my sedation. As Kimock riffs played behind my head, I’m told my feet started tapping to the beat. The nurse raised her eyebrows, caught Brian’s eye, and nodded toward the foot of my bed.

“Hey, Dan, your feet are really going there,” she said. “Are you dancing?”

They say I gave a weak smile and a slight nod of my head.

Brian and Jay locked eyes. They knew then that the wait-and-see period was over. They no longer had any doubt that I was going to make it.

“Well, you just keep on dancing, Dan,” Brian said. “Keep on dancing.”

CHAPTER 10

Opiate Dreams

The potent “milk of amnesia” drugs, along with morphine for
pain, helped keep me among the living but not in the same solar system as my body. The drugs put me into a psychotic orbit that now and then plunged me back to Earth just long enough to intercept reality, most likely when my sedation was reduced for those is-he-still-with-us neurological checks. While my feet were tapping in bed, my mind was stuck somewhere between semi-consciousness and Asteroid B-612.

Brian and I are at a Steve Kimock show in the Oak Savannah hill country of coastal California. People are dancing all around us. I’m dancing, too, but only from the ankles down. The rest of my body is lead. I concentrate on the music, and my mind drifts off like a runaway balloon. Higher and higher. A woman’s voice grabs the string and yanks, pulling me down, down, down toward the ground. Her words sound far away, like she’s standing on a chair, talking through an air vent. “Are . . . you . . . dancing?”

Am I dancing? Who wouldn’t be? I nod at her and smile.

I don’t know how or why I remember these episodes, but I do, and in Technicolor. The images and sensations that cluttered my subconscious alternated between ethereal bliss and cheesy horror-movie scenes, like evil nurses wielding needles the size of chopsticks and waiters carting trays heaped with food stepping over patients lying amid tangles of feeding tubes.

Although the drugs were for my own good, hearing certain things and feeling certain others while unable to move or speak was disturbing at times, terrifying at others. Latex hands poking and prodding. The picking, scraping, and packing of multiple claw and bite wounds. The suctioning of sludge from my tracheotomy tube that could rival water boarding.

I remember feeling a sting in my arm and looking down to see a fishhook embedded in my skin, then watching in horror as it multiplied like a fork-tongued amoeba and crawled upward until I had fishhooks embedded all over my face. I was frantic to get them off me, but my arms may as well have been stitched to my sides.

Helicopters were a recurring presence in my tripped-out state of mind, most likely due to the comings and goings at the hospital’s helipad. Now and then I’d detect that faint, familiar sound out my hospital-room window—womp-womp-womp—and off I’d go.

Medics tuck blankets around me, raise my gurney above their heads, and strap it to the top of the chopper just below the whirling rotor blades. If I try to sit up, they’ll take my head off, so I lie still and concentrate on breathing. The helicopter settles down in front of an office tower in a tornado of dust, its rotors nicking the side of the building with a sickening scrape that reverberates inside my skull. The pilot jumps out and climbs into the building through an open window. He returns with blankets and drugs. “Please don’t,” I beg. A needle punctures my skin. “Here,” a voice says. “This will help you forget.”

Womp-womp-womp-womp-womp.

I’m hovering above Pebble Beach, the gated golf community near my parents’ home in Carmel. The chopper lands in front of a mansion perched atop rocky cliffs with Pacific Ocean breakers below. Gulls, pelicans, and egrets fill the sky. A blanket of fog hovers offshore. The pilot waves like a beauty queen and vanishes. I stagger inside, blankets draped over my shoulders, my face in tatters. What kind of hospital is this? Chandeliers. Upholstered, wing-backed chairs. Carpet the color of blood. Wait! That IS blood, my blood! I’m bleeding all over the carpet! Where is everybody? I’m so tired, so woozy. Must rest.

“Sir, you can’t sleep here,” says a man in a gold-brocade vest.

A nurse taps me on the shoulder and pulls me to my feet. She leads me into a side room, one with a front wall made entirely of glass. She’s gentle and concerned. Thank you, kind woman. Maybe now someone will help me. What’s this? In the back of the room is a display case, and now I’m staring down at a diorama of the Russian River, with The Sanctuary, the parking lot, the stairs, and the spot where the bear dragged me off the trail. Is this so the doctors will better understand how to help me? I don’t want to see it! I turn my head to the left. A huge, stuffed and mounted grizzly stands on its hind legs, paws the size of dinner plates, claws like railroad spikes, eyes on fire. I scream, but my lips don’t move and no sound comes out.

“It’s okay, Daniel. It’s okay, it’s Mom. You’re safe here. I love you. We all love you.”

Escapes from the hospital were another ongoing theme—floating down a river in a gurney, flying away on a couch, tumbling backward out of a window into the snow, hitching a ride behind a ski-trail groomer.

The dreams weren’t always disturbing. I dreamed my father, Steve, showed up, that he was standing outside looking into my hospital room, holding my hand through the window. And I loved all the Kimock shows, especially the one I traveled to on a gurney powered by orderlies on bicycles. The Buddhist monk session was one I never wanted to end. Thirteen of them in saffron robes sat lotus-style in three circles, each on a different tier of a three-tiered floor. With prayer beads in their hands, they began to chant.
Oooooohhhhmmmm
. I could feel the vibration in my solar plexus, and couldn’t have felt more at peace. When a nurse appeared with another dose of drugs,
in my dream, maybe in real time for all I know, I tried to fight her off. I wanted to stay in that spiritual place inhabited by monks. I was powerless to stop her. Paralysis and unconsciousness
crawled through my veins. The monks faded into the crawl space of my brain as I drifted higher and higher until I was a speck in the sky. Going, going, gone.

Once I was able, I starting writing these dream sequences down, and found I couldn’t stop. I have filled pages and pages with memories just as weird and even weirder. For a while it was almost an obsession. Maybe someday I’ll gather them all up and feed them to a bonfire on winter solstice, a good day for casting darkness out of one’s life.

As miraculous as surviving the attack in the first place, I made it through that first week without any major complications. The swelling subsided enough that reconstructive surgery was a go.

It would take the collective expertise of a four-surgeon team to put me back together. It would take an assortment of building materials, manmade and biological, and a whole pile of hardware: screws, miniplates, microplates, titanium mesh, bars, wires, stitches, staples, and tissue and fat harvested from various parts of my body.

As my medical records tell it, top priority was constructing a watertight barrier between my brain and nose by repairing the tear in the dura mater, the membrane that protects the brain and keeps cerebrospinal fluid where it belongs. Dr. Kallman assisted neurosurgeon Dr. Louis Kralick by harvesting patching materials—fat from my abdomen and fat and fascia from my thigh. Once these were stockpiled and ready to go, Kralick used existing lacerations to access my forehead, snipping through the stitches, folding the skin back like an open book and holding it in place with stainless steel clips.

With my forehead skin out of the way, Kralick peeled down the pericranium, the thin membrane that covers the outside of the skull, as a single sheet from my upper forehead down to the brow.
Much of the rubble of my facial bones was now exposed. Kralick picked out the fragments and chunks, passing them to Kallman, who reassembled those big enough to salvage with tiny plates and screws. Kralick
then used a surgical saw to cut an oval of bone the size of a goose egg from the intact middle of my forehead. He carefully removed it, exposing the dura directly beneath, and passed it to Kallman. He lifted the frontal lobes of my brain with a retractor to access the large, crescent-shaped tear. Kralick used fat and fascia to patch it, then tucked the folded-down sheet of pericranium underneath the lobes to reestablish a watertight seal and provide blood flow needed for healing. This he tacked into place with tiny sutures.

After much discussion between the two surgeons, Kralick repaired the hole in the anterior base of my skull by spanning the gap with titanium mesh.
Kallman had pushed for this extra support to ensure my brain would not sag into my nose down the road.
Afterward, if you were to look up my nose, you would have seen titanium, but that would change over time. Titanium is unique among metals in that tissue will eventually grow over it. Kralick then lowered the retractors, setting my brain back into place. He scrubbed out while Kallman replaced the oval of bone and secured it with additional plates and screws.

Oral surgeon Ray Holloway stepped in next to lock down my jaw with an arch bar and wires to assure that when my split palate healed, my upper and lower teeth would line up straight. Also, since my mandible had come through the mauling intact, locking my teeth together would serve as a template for putting my mid-face back together.

Once Holloway finished, Kallman teamed up with oculoplastic surgeon Dr. Carl Rosen to tackle the disaster area around my eyes. “One of the most severe multiple injuries I have seen,” is how Rosen would later describe it.

Working together, they rebuilt my cheekbones first, anchoring them with miniplates to nearby bone that was either intact or had been pieced back together. Next Rosen opened up the sutures holding my eyelids closed to examine my dead and dying eyes. What he saw took him aback. The optic nerves seemed almost surgically severed, as though the bear had studied human anatomy and knew exactly how to blind me with precision. The right eye was cleanly sliced off the optic nerve and all but a thread of muscle, and was shriveled like a prune. That one he took out. The left eye, the cornea partially cloudy, had a long piece of severed optical nerve still attached and just enough remaining muscle and blood flow to possibly survive. This one he kept, despite there being no hope for vision.
He left it not only to keep the new socket he’d be building from contracting, but for cosmetic reasons since, if it did somehow survive, it would move in a more natural way than a prosthetic. He also felt strongly that it wouldn’t be right to remove both eyes without involving me in the decision. Once he’d taken it out, it wasn’t like he could put it back. To take it without me understanding why it was necessary could have left me with lingering doubts.

Some of the bones making up my eye sockets were big enough to be reassembled with plates, but the sides toward the center of my face and the bones of my nose were too fragmented, some even pulverized, to hold even the tiniest of screws. So Rosen and Kallman patched the sockets and fashioned a bridge for my nose out of titanium mesh and harvested fat and tissue. Rosen then placed an orbital implant, a ball made of unpronounceable plastic—polymethylmethacrylate—deep into the right socket, and secured as much viable tissue and muscle as he could on top. The remaining eye went into the left socket topped by a conformer, like a giant contact lens, to help maintain the shape. He then stitched both eyelids shut.

Their work done for now, Kallman unclamped the skin of my forehead, laid it back down, and stitched it in place. The medical marathon had lasted fourteen hours.

My family, Chris, Jay, and others in the loop had spent those long, anxious hours running piled-up errands, checking in, researching eye injuries at the library, checking in, getting something other than hospital food to eat, checking in, going for long walks on nearby trails, checking in, pacing up and down the hallways, checking in, cat-napping in the waiting room.

After scrubbing out, Kallman and Rosen met my family members in the ICU conference room to let them know the surgery had gone well. Rosen told them he’d removed one eye and that hope for the other being viable had faded. Then he choked up.

“I’m sorry. I can’t tell you how much I wish there was some way to restore Dan’s vision, but the bear made that impossible.”

As hard as it was telling my family, the part Rosen dreaded most lay ahead—telling me. As Alaska’s only orbital and oculoplastic surgeon, he had seen people lose vision in countless ways, from macular degeneration, to flying lawnmower debris, to war. You’d think he would have been used to it. Not that it’s ever easy to tell a person he’ll never see again, but I didn’t lose my eyes in a bar fight, or in a drug deal gone bad, or driving drunk into a tree. I was just a guy out doing what he loved who unwittingly stumbled onto the mother lode of bad luck. Experience had taught him that it’s best to deliver such news in small bites rather than serving up the whole elephant. Even so, telling me I’d never see again—meaning I’d never again see my family and friends, or a breaching whale, or a falling star, or a mountain cast in alpenglow, or a beautiful woman, or words on the page of a book—was almost too much.

“This one’s really getting to me,” he told his wife
at home that night after the kids had gone to bed. “Sometime in the next week, this twenty-five-year-old guy is going to regain consciousness, realize how lucky he is to be alive, and then I’m going to have to tell him he’s blind. I’m trained to fix things, and when I can’t, I feel so inadequate. This is one of those cases that makes me wish I was in some other profession, any other profession. I am so not looking forward to this.”