By Ralph M. Gilbert
Traumatic pneumothorax: the presence of air or gas in the pleural cavity, which impairs ventilation and oxygenation, caused by a severe trauma to the chest or lung wall. Symptoms are often severe, and can contribute to fatal complications such as cardiac arrest, respiratory failure, and shock.
Every time I tried to lift my head the sky began to spin. Then I felt the nausea. I knew that I had to get up out of the snow but after a few attempts, I just lay back, exhausted. Suddenly, a spray of powder was kicked onto my face as a young ski patrolwoman executed a hurried skid stop. She bent down and put her cold face next to mine:
“Sir,” she said looking into my unfocused eyes. “Are you all right? Do you know where you are, sir? Where are you, sir?”
I realized that she wasn’t asking a particularly hard question, but I just couldn’t come up with an answer.
“I don’t know,” I replied.
She helped me to my feet.I looked around and saw the other skiers.
She radioed for help. The next thing I knew, I was being leaned back into a toboggan. Fighting the nausea and afraid that I would have to throw up, I asked to be tipped over momentarily before they restrained me to the sled for my ride down.
I regained consciousness in a strange hospital ER.
A young woman was standing over me. She asked: “Do you really think, sir, that a man of your age should be skiing alone in the glades?”
I hated that question. I found it particularly humiliating. As an intrepid, former U.S. Army trooper, I didn’t want to be talked to that way, especially by a woman who asked me the same questions my wife often asked.
Tests indicated a concussion. Upon release, I was told to buy a new helmet (each helmet can absorb only one crash), and not to ski for a week. I took only one day off, which I thought was plenty. I then purchased a new helmet and two days later I was back up on my skis again.
My next accident a few years later was to be worse, much worse.
Age denial? Not So Much
Before I tell you that story, I’d like to note that I’m not in total age denial. Now 79, I spend less and less of my après-ski time trading embellished ski stories with my buddies in smoky bars. These days, when we go on our annual ski trip, I can be found at night alone in my little room, carefully applying ice packs and winding compression bandages around my ill-treated joints.
I reject the idea, however, that I am suffering from any age-related diminution of muscle tone, balance or endurance. My ski dreams are still intact even if my body is not. I do realize that I should avoid the super steep double black diamond trails that I once traversed. But I just can’t resist.
Why? By story’s end, I’ll try to explain.
Each year, twelve of us, former army buddies at Fort Bliss, Texas go on a ski trip together. We had trained as Nike Missile crewmen back in 1958 during the Cold War. Our job was to join with others to protect the City of New York.Stationed in a darkened radar van, we were to monitor our radar screens for Russian bombers. Our Nike Missiles were buried in concrete shafts near us. Our vantage point was Spring Valley, New York, which otherwise is known for kosher chickens and Hassids. If we saw any Russians in the air we were to electronically challenge them, then shoot them down.
As a trained engineer, I was of the opinion that our system just couldn’t work; yet I am proud draw your attention to the fact that New York was never bombed.
Trying to regain that comradeship, we gather each year to place ourselves, once again, in harm’s way. For one wonderful winter week each February, we have traveled to France, Austria, Utah, and Colorado or wherever else we chose to drink beer and smoke that which is legal now in Colorado and recall our past glories:
“You remember the night that the MPs brought Uris back in handcuffs from across the border in Juarez? (Lewd laughter) He got drunk and tried to run away from an angry senorita when he realized he had run out of money. She chased after him.” (More Lewd laughter). We all had to chip in to get him out of jail.”
Our bonding would continue the next morning when we got up early to ski the slopes of Chamonix or Cortina d’Ampezzo or Vail or wherever else we were that year. We’ve been doing that many years now and our wives are wise enough to just let us go.
About ten years ago, when I was in my late sixties. I had just begun to be bothered by the altitude. I was short of breath and I also began to experience early fatigue. My hands were very cold. I paid $100 for insulated, elbow-length leather mittens.
At ten thousand feet where we skied Arapahoe Basin in Summit County, (the highest in the West), the FAA, coincidently, requires pilots to deploy oxygen masks, or so said Al who flew his own small plane. At my age I should have been skiing with a mask, but that would have made me look like a Florida pensioner. My hands were cold due to the low oxygen partial pressure and a slowed down, elderly metabolism and circulation system. Things were changing. My body was becoming more vulnerable to the cold.
Still, I considered myself to be in good health, notwithstanding my prostate cancer diagnosis, which I got just before I left. I chose to postpone the surgery until after the ski trip
“But Ralph, I don’t understand,” the surgeon had said reading my chart, “you’re postponing your cancer surgery to go skiing?” “Yes, doctor, I am.” I replied, “It’s only cancer but don’t you see, skiing is skiing.”
No Less A Man
The year of my accident, we skied Sundance, Utah.We’d been skiing all morning and I chose to sit out the next run after lunch to relax in the sun on the deck with Mike. He had a coffee and I had a beer. I looked up and found the swirl of black clouds above the rock towers intimidating.
“Looks like some flat light — perhaps I should wait,” I said trying not to sound as afraid and over-tired as I was at the time.
“Every time you chicken out, old buddy,” Mike answered, “You are a little less of a man.”
“So why don’t you go up there, Mickey-boy?” I asked. “You go. I’ll sit here. I’ll watch you be the man.”
“My knee. I’m going to rest.”
“Nice try,” I answered.
I got on the chairlift alone. It reached the top with a slight shudder. The visibility was worse. I sprung off. Around me was a brittle world of ice and snow. The silence suggested a vast sweep of wicked slopes unseen just below me. To my right, were two towering black rock formations, dripping with snowmelt, separated by a narrow passage.
The trail went between them. I could see the black birds, high above, as they rose in the thermal currents. I shivered as I skied between the rocks. A sign announced: Experts Only. I looked over the edge. A cornice overhung the slope. I would have to jump to reach it.
'I Was Flying'
I edged up. The snowfield was narrow; rocks stood out on either side. I stretched my back, rubbed my neck and took a deep breath. I calculated that an out-of-control fall would result in a fracture, or worse.
I could make out that the slope flattened out farther down, but in order to avoid the rocks, I would have to make my first turn cleanly and quickly. I counted backwards from ten and jumped. I made my first turn as clean and as easy as could be. I felt a rush as my skis carried the speed. They made a whoosh against the fresh powder and gave me a sense of weightlessness. My mind and body raced in unison. I felt a release of inner tension. I was flying.
Soon, the pitch of the slope reduced and I saw the boys down below ahead of me. I let my skis run. I was showing off. What I didn’t see, however, was a lone skier following too closely behind me. Where in hell did he come from? While I was executing a high speed sweeping turn he struck me from behind. He skied over the backs of my skis.
My body retained the speed I was carrying but my skis were momentarily slowed down. I fought to maintain my balance but slowly lost control and began my fall forward, accelerating as I fell.
I hit face first then my speed caused my lower body to rotate over my face and chest, which were momentarily planted into the snow. Then my skis flew over my head and hit the snow, which caused my lower body to spring up into the air and once again hit the snow. How many times I endured this pounding I cannot say but once at rest, on my hands and knees, head down, I couldn’t catch my breath. I felt like I was drowning. My body was numb. My vision was blurred.
While dazed, I marveled at the intense redness of my blood as it dripped from my face onto the snow. The number of red discs grew. Dick skied up.
“Ralph, Can you hear me? Stay calm.” he said. “ Can you speak?”
“I can’t breathe.” I managed to say. “I’m drowning.” I tasted blood and panic in my mouth.
“Hang on! Don’t pass out!” he shouted. Later, he confided that he thought I had lost an eye, but when the blood was cleared from my face it was my sunglasses that had cut my forehead. My eye was intact.
“That’s the worst ski accident I have ever seen,” the former EMT said. Dick surmised that during my high-speed head-over-skis fall, I had been holding my pistol-grip ski poles into my chest. Pistol grip handles are no longer sold. They’re too dangerous. The pounding impact on the snow of them and my clenched fist had fractured a rib. The sharp edge of the bone must have cut my lung, which collapsed.
It was my right lung, a pneumothorax.
In the emergency room in Provo, a young doctor greeted me. His face betrayed his concern. I could see his cowboy hat hanging on a peg on the wall behind him. He said:
“There is only one thing I can do, Ralph, that is, with your permission, I’ll put a probe into your chest, apply a slight negative pressure to your lung cavity and hope to re-inflate your lung. Unfortunately, I can’t give you any anesthesia. You’ll have to tough it out.” He paused and turned his face away. He looked like he needed a drink himself.
‘So what’s the good news?” I asked.
“You can hold the nurses hand, if you wish,” he said.
“I’m afraid so.”
She was pretty and blond in a sort of a polished apple way. Was I being unfaithful to Paula, my wife? She smiled at me.
“Hey, I’m Sally.”
I took her hand. It was warm and comforting. I felt calm and realized why it might be a comfort to not to have to die alone.
The doctor swabbed a spot on my chest and pushed an 8-inch probe through the skin. He pushed it in deep. I squeezed Sally’s hand. The probe reached the dark of my lung cavity. We watched its progress on the fluoroscope screen. The tube was then hooked up to a low-pressure mechanical source. The lung slowly re-inflated.
Wow! I could breathe! It felt so good!
I was transferred to the recovery room with the tube still connected to the slowly pumping low-pressure device. Sally waved goodbye.
“It should heal on it’s own,” the doctor said.
The Long Ride Home
As far as I was concerned I was ready to go home as soon as the lung had healed and the tube was disconnected. I had a pressing appointment back in Boston (the cancer surgery) and I wanted to fly home with my buddies just as soon as the doctor disconnected the tube.
“Not so fast. You fly, you die,” another doctor told me. “You need to stay a few weeks here with us and let it heal, maybe a month. A sudden change of air pressure on the plane could collapse your lung again.”
The boys left for home the next day, but my son, Keith, arrived from Las Vegas intending to take me home. He spoke to the doctor. The thought of being stuck in Provo for almost a month with his dad just wasn’t ‘in the cards.’ He wanted to leave, soon. He negotiated with the doctor. Could we drive, or take a train?
“Okay,” the doctor agreed, if I wore an oxygen mask the whole way home. Even though the Eisenhower Pass takes us up to 10,000 feet, we approach it gradually on the train and not precipitously as we would in an airplane.
The trip across the country was magnificent. Keith insisted on a sleeping compartment with a porter and with proper white tablecloth service and three meals a day. Unfortunately the British fighter pilot oxygen mask and small oxygen canister had their limitations. I started to run out of oxygen in the mountains and moved the partial pressure gauge backwards hoping to extend its life and mine. By the time we got to Chicago and sea level the canisters were empty.
Keith shipped them back to Provo and we made it back to Boston in time for my surgery appointment. It was determined that my lung had healed sufficiently for my prostate cancer surgery to proceed.
I was now free of the cancer and the collapsed lung had healed. I was ready to ski again.
A Great Story, Another Ski Season
I took the probe home with me as a souvenir. It’s in my desk drawer. I can show it to you, if you wish. After a few drinks, it all makes for a great story.
And I continue to ski. Next year at eighty, God willing, I ski free in New Hampshire where we have a ski house.
So why do I do it? Why do I put myself at risk? I acknowledge that some men, who grow up with an overprotective mother like the one I had, will eventually mature, reach manhood and will no longer need to constantly prove themselves. Others, like me, never do.
This year is planned for Taos, New Mexico. I intend to watch out for lone skiers, following too closely behind me. But, I am not afraid, not at all, a thing like that really couldn’t happen again. Could it?
Ralph M. Gilbert, now a writer, was an engineer, soldier, architect and successful businessman. He currently serves on the Board of the American Society for Technion (Haifa, Israel) and the New Hampshire Music Festival. He was president of Temple Emanuel in Newton, MA.