Pia’s perspective part 2 of 2.
I’m taken to see Kenneth. There’s one tube down his throat connected to a machine breathing for him. Another tube going down his nose, with green fluid running down into a bag. There are two pumps continually sending sedative drugs into his bloodstream. He’s in an induced coma, and I welcome that. It’s a relief that he doesn’t have to feel the pain that’s running through his body, to deal with the stress stirring within his bowels. The doctors words from last night have been on repeat in my head. “We opened him up and found his injuries were much greater than the CT showed. He was bleeding internally, and there is great damage to his intestines... he still needs surgery, so we’ll transport him to a bigger hospital tomorrow.” I lift the blanket covering his abdomen to see if my memory is correct, or my imagination is playing tricks on me. No. His belly is cut all the way from sternum to below his navel. A thin plastic is all that keeps his bowels in his stomach, and from both sides of the long wound there are drains collecting blood. The fourth and final bag connected to his body holds his urine; it’s far too dark, he needs more fluids, wait are his kidneys okay? Stop, I’m not at work, he’s not my patient, he’s probably in good hands.
Sit. I have to sit. Black dots cloud my field of vision. It’s gonna be okay. It’s gonna be okay. Maybe if I repeat it enough times it will ring true. The nurse says I can try to talk to him, but carefully. He shouldn’t be stressed, not woken up. I tell him I'm fond of him, I tell him to hang in there. We organize his things, put stickers with his name on his phone and GoPro camera. I hope they're not in vain, I hope he'll have use for them again. He's picked up by ambulance personnel, pulled over to a gurney, wheeled out of intensive care and taken by plane to Tromsø.
I'm left alone in Hammerfest, a town I've never been to, don't know anyone in and never intended to visit. I have more luggage than I can even begin to carry. A nurse comes to fetch me, I'm about to be released from intensive care and moved to a regular ward. My things are put in a shopping cart and wheeled behind me. What will I do with all our stuff? I need to get out of here, I need to make it to Tromsø to be with him when he wakes up. I need to get rid of this pain. I know I might be alone, but I also know there are good people who will help me if I just know where to turn. Rumors of our accident have reached our friends, and several people online have guessed that the couple mentioned in the newspaper is us. I reach out to a group of motorbikers who also enjoy to ride gravel roads and within the hour there's a plan for the luggage. Again I'm touched by the generosity and kindness of the motorcycle community.
Every so often the thought of Kenneth not making it slaps me in the face. I envision leaving the north of Norway without him, him arriving our home city in a coffin. Were those my last words to him? ”You don't look like a dead fish”? I don't need to close my eyes to be back to the scene of the accident, it’s playing continually in my mind. How could I not have seen this giant hole in the road? How could I have prevented this from happening? I wish we’d taken a different road, I wish I could have seen it coming, I wish there had been a warning, just a simple sign! I can’t sit still, I can’t bare these thoughts. I need to move. Look ahead. Okay. I have no pants. When the accident happened I was wearing netting wool underwear underneath the motorcycle pants. Let’s focus on pants. I can’t wear bright blue hospital pants on the plane to Tromsø. Catch a taxi to a cheap clothing store. Get some new memory cards for the GoPro cameras too. Try not to vomit while I pay. Will Kenneth wake up? Will he make it? Still no word on Kenneth’s condition. Pants. Now I have pants.
It's the day after and it's finally time for me to fly to Tromsø. My care nurse has helped me find a number to Kenneth's nurse so I can get some information. I'm scared to call because I don't want to bother them. I'm also scared to hear the news they might give me. Breathe. Still in an induced coma. One surgery down, need another surgery today. I know so many people who care so much about Kenneth and I care for them too much to let them find out through the news. I reach out to Grant, our friend who has helped Kenneth so much. If he makes it through this, he’s gonna need a lot more help in the time to come. In all the uncertainty and all the pain I’m happy to have people around me who also cares greatly about Kenneth. Somehow it makes the load easier for me to carry.
Make it to Tromsø university hospital and finally get to see Kenneth. He’s out of his third surgery in 24 hours. They took his beard! I didn’t notice until now. With all the extra equipment on his body I failed to recognize that the bush that had previously hidden his face was gone. I see his naked face for the first time, he looks 15 years younger! The sedative drugs constantly pumping into his bloodstream have been lowered, they want him to be semi awake to put an epidural in, to relieve his pain. He’s awake with the tube down his throat. I’m impressed by his bravery and willingness to fight. That tube is excruciatingly uncomfortable, but he’s handling it so well. He can’t speak but he forms words with his mouth. He writes on a notebook, and what he writes makes sense. I hold back tears and tell him how fond I am of him. How happy I am that he’s still with us. I bend down and kiss the part of his lips that aren’t held up by the tube. There are no words I could offer that would alleviate his pain. I wish I could hold him, lie down in bed next to him, give him the familiar sense of my body soothing his. He smiles and gives me a thumbs up, until I let it slip that his beard is gone and his smile is replaced with shock.
The next morning I wake up in the patient hotel at the hospital, head down to the breakfast area for coffee. Because of covid, we are not to help ourselves at the buffet but ask staff to serve us. I ask for two cups of takeaway coffee and some fruit, but when the waitress turns around to fetch them I feel my lips go numb and the ground disappear beneath me, I’m holding onto a table looking for a chair. Sit down and have a glass of water and just breathe for a couple of minutes. Take my tray up to my room and have the coffee in bed. Is it the pain? The concussion? Low blood pressure? The entire situation? Most likely. Have a shower and another try at breakfast before heading to his room.
It takes me 3 attempts to eat.
He’s struggling. Upon arrival his nurse warns me they think he’s hallucinating. His pulse shoots up while he tries to tell me something, mouth some words. Time and time again I don’t understand and he rolls his eyes, just mouthing out words takes so much energy from him. I give him the notebook for him to write it out, but he can’t seem to focus his eyes well enough to see what he’s writing. The uneasiness of his face turns into panic when the nurse arrives. I explain what he’s doing and why, and how I would do the same if he was my patient. He drifts in and out of sleep and awakes with a jerk. “You’re dreaming. I’m here. We’ll get through this. We’re team Ride the Bean.” I send him my calmest smile and repeat these words while holding his hand.
The next morning there’s a missed call and a voicemail from his nurse. “Hello Pia, this is the nurse from intensive care. Don’t be afraid, everything is okay.” I take a mental note of what I should say if I call next of kin during my night shift in intensive care, and simultaneously freak out about what’s wrong. “We removed the tube from his throat and he’s asking for you.” When I get to his room he can force out a whisper. He’s no longer on a ventilator in the traditional sense. He’s breathing on his own now, with the help of OptiFlow, a noninvasive ventilation system. It’s not pushed down his throat, it’s sitting in his nostrils sending in lots of heated oxygen. The pain in his abdomen is still keeping him from drawing breath properly, and the doctors are trying to find a better solution for his pain management. The epidural isn’t working properly, they try another mix of drugs, they put in a new epidural. The amount of drugs he needs to keep the pain in check is affecting his breathing, slowing down his respiratory rate. When he falls asleep he forgets to breathe, and he’s awakened by an apnea alarm. “Don’t forget to breathe, Kenneth!” says his nurse, and naturally he’s terrified of falling asleep.
The oxygen levels of his blood are good because of the OptiFlow, but his lungs are unable to ventilate the CO2 and it’s building up. They try to remove the oxygen, but that lowers his oxygen levels from 98 to 88%, which is far too low for a healthy young man. He’s given a red and blue flute to breathe into, it looks like a plastic toy but is an important weapon to fight lung complications. So many patients who have been intubated get pneumonia as a complication, and Kenneth is struggling to cough properly because of abdominal pain, increasing the chances. The flute creates pressure in the lungs which opens them up. We start an intense fluting session to help mobilize the slime in his lungs. 10 repetitions, 5 minute break. Again and again. It’s hard work and Kenneth almost falls asleep between sets. We continue for an hour. After Kenneth’s intense efforts, the CO2 levels of his blood are close to normal. I feel happy, I feel relieved. The nurse says his CO2 levels are normal now, and he doesn’t need to be in intensive care anymore. I feel tricked. They’re moving him to ward? We’ve been working intensely together to ventilate him properly. I know life in the ward, I know resources are scarce. The nurse caring for him will have three other patients who also need help, I won’t be allowed to stay with him and there’s no way he will continue his flute by himself. There’s also his apnea. I wouldn’t feel comfortable as a nurse in the ward if Kenneth was my patient. The doctor walks in and tells me the great news about his CO2 levels. I explain how we got those results and that I won’t be nursing him that way anymore. He agrees the situation is not optimal and says he will not be transferred if he’s not breathing or ventilating properly.
The day is coming to an end and the evening shift nurse, Rita, comes on. I listen to report being given, I listen to her laugh and be social with her colleagues. I’m glad to hear that, and even more glad when she asks a critical question. After report she says goodbye to the day shift, does the routine double checks and start talking with Kenneth. The way she connects with him is brilliant, and I feel we are in good hands. Later, the nurse in charge comes in and asks when it’s time for Kenneth to move to ward. Rita leaves the room for a couple of minutes while I watch Kenneth, and comes back with heat in her cheeks. “You’re staying here tonight, Kenneth! And so am I”. She took on a double shift to make sure he had room there, on an evening with heavy helicopter traffic. She gets the anesthesiologist to come and change his epidural that isn’t working properly. She takes his hallucinations seriously and convinces the doctor to get a CT scan of his head to make sure there are no complications. She gives me a blanket and a comfy chair and I can tell that she genuinely cares about the both of us.
The new day brings with it a more stable Kenneth, who breathes better and is not so terrified. His night was awful but his body is doing better. He’s transferred to ward and the nurses we meet there are fantastic. They have solutions to help relieve his nausea, they motivate him, they take him seriously. As the night comes his anxiety increases and he calls for me to please come. To help him relax they offer me the bed next to Kenneth. The nurses need to come into his room several times at night to give him antibiotics, check the epidural, give fluids and nausea medication. I lay down so that he can always see me. I’m happy to be close with him, sensing that my mere presence seems to calm him down. Whenever a nurse tells him something he looks at me and asks my opinion of the matter. He’s scared and I’m his sense of security. It pains me to see that he’s so afraid, and I’m more than happy to stay there with him.
There’s a knock on the door, a new man walks in and asks if he can draw some blood samples. He comes in, draws equipment from his pocket, put a tourniquet around his arm and gets ready to poke. I ask if he would please desinfect his hands first. “I did before I came in the room”, he explains. “But since then you’ve touched the door handle, reached into your pocket and now you’re about to do an aseptic task”, I explain and immediately regret it, I don’t want to be harsh, difficult, demanding. I don’t want people to dread coming in to our room, but I also want staff to uphold a proper routine of hand hygiene. Especially in a pandemic. I feel torn, he says “of course”, cleans his hands, and draws the blood.
We stay for the weekend and as it progresses Kenneth has several breakthroughs. First shower, first walk, first yogurt eaten. He doesn't need the antibiotics anymore, he isn't nauseous to the same extent. Our local hospital is called and prepared to take over, and transport arranged. We are picked up by ambulance workers, who all look like surfers. Driven to the airport directly to an ambulance plane. Kenneth lies on a gurney, under the duvet wrapped up in seatbelts while a woman in red directs his move onto the plane. She's an absolute darling, makes sure his pain and nausea are adequately relieved and makes me feel very welcome. Every now and then she connects a suction to the tube coming out of Kenneth´s nose, and sucks out the contents of his stomach. We are in capable, comforting hands.
As we land, we are met on our local airport by local ambulance workers. This is absolutely not how we imagined our homecoming. Two of them are in the front seat, while a third sits in the back with Kenneth. Kenneth has been dreading the journey for days, but now we´re almost there. The road is bumpy and Kenneth is both nauseous and in pain. The trip feels short though, because Kenneth is engaged in conversation the entire journey. We have quite a lot in common with the ambulance worker in the back, and hope to meet her in better circumstances later. For a coffee, in nature. We arrive in in our home hospital, the very same I work in. In the slightest sense of the word, we are home. But in another, far from it. Our home was on the road, our home was in a tent. Now 1500 kilometers separate ourselves from the motorbikes carrying our homes. We do not know the state of our Teneres or luggage, but we do know the state of our bodies. And they´re not fit for living on the motorbikes for quite some time. But we're not giving up anytime soon. We're Team Ride the Bean.