When Going Gets Tough, Tough Get Going

I fell in the fire. I couldn’t get out.

Each winter the cherry trees were pruned, some a little, others a lot. The nipped branches fell to the orchard floor and were gathered into small piles. With over 8,000 trees, there were many piles. The big steel bucket in front of the 8030 Kubota tractor dropped down to ground level, traversed the tree rows and pushed the piles into heaps. It then turned 90 degrees, cross traversed the rows and pushed the heaps into the swale that runs through the orchard.

After a couple of years, the swale was spotted with cherry branch weirs along its edges. Entwined, compacted, dried during summers, the tractor could drive over them to extend the weirs into the thick vegetation in the swale. The swale's winter water passageway depth rose and narrowed each year. In October 2015, it was time to prune again. To reduce winter rain flooding, I decided to burn weirs which choked swale water flow.

The summer that year was long and hot. It was necessary to await rain to avoid a weir fire turning into a swale conflagration. It couldn’t be an Oregon, Willamette Valley drizzle. It had to be a soaking rain followed by a dry burn day. On October 24th, 2015, the orchard swale got its precipitation soaker and the next day was dry.

I started on the branch weir behind the house with a proven formula, half a gallon of diesel fuel poured over the branches, a topping splash of gasoline and a tossed flare igniter. The flare landed, the gasoline flashed, and the diesel fuel alighted down into the pruned branches. They crackled, dried out, caught fire and attempted to spread the fire to adjoining wet areas. Initially, it looked like a take but as I watched, the fire whimpered down to a burnt hole emitting white, damp smoke. The branches were too wet to sustain combustion.

To get continuous combustion, more of that magic fire ingredient, oxygen, was necessary. I loaded my formula ingredients in my truck and drove to the drive that crosses the swale. There, a compacted branch weir also traversed the swale. The open drive exposed it to a nice breeze. Reapplying the formula, the fire roared, sputtered, but before turning into white soggy smoke, breeze’s oxygen whispered it alert. Soon the temperature attained that needed to combust adjoining wet branches. I had my fire.

I opened a bottle of Jack Daniels, sat in the cab and enjoyed my creation. The breeze picked up. The fire grew into a blaze. It rapidly dried out wet areas and grew bigger. I watched nervously, but reasoned, wetness would keep the fire limited because swale vegetation was too green to burn. Things went as intended as I talked to Jack. The afternoon changed to dusk. The fire burned, at the edge of safety. As I listened to Jack’s clever analysis of what is and should be, a neighbor’s truck, suddenly pulled up behind mine. He got out agitated.

“Jim. What the hell are you doing!”

“Burning dead prunings.”

”Prunings, It looks like your setting the swale on fire. The fire’s getting big! It’s getting out of control!”

“No, it’ll just burn itself out once it runs out of fuel. This wooded branch weir is about 10 yards deep and half-burned out. I’ll call it a night once it burns down.”

“What about the fire behind your house?’

I disembarked from the comfort of the truck’s cab and looked down the swale. My first fire attempt had turned into success. I had 2 blazes going, both at the edge of safety, the point just prior to conflagration.

My neighbor jumped back in his truck and raced to my house, roused my wife and set her into alarm. He then drove back to his house, leaving us astir.

With 2 fires ablaze and a hysterical wife, I decided to put the fire behind the house out using a couple of garden hose extensions.

It was night by the time I had everything set up to play fireman. Alone, with wife and neighbor retreated to distant safety, I squirted water on my initial creation. The angry white smoke hissed up. The center of the blaze sputtered and then resurrected. The fire’s blazing core had moved well into the center of the swale. At the swale’s edge, it was hard to douse the hot spot ablaze. To get closer, I walked on unburned branches on the weir’s edge.

On about the 4th step, whoosh, the supposedly firm wooden branches fell under me. The fire had eaten from below. With only a T-shirt, Levi’s and rubber sandals, sans socks, I was standing in coals. My right leg was standing deep in coals. The unburned branches I’d fallen into were at shoulder height. My disturbance dropped lose debris to feed the coals below.

While in trouble, thinking of my stupidity, assuming I’d lift myself out with minor burn damage. I grabbed the edges around me. but the branches gave way when I put weight on them. Again, and again I fell back into the c They collapsed under my weight to become fuel for the coals below. Only the garden hose pointed down kept the added fuel from roaring alight and fire engulfing me. The center core of the blaze, the area I intended to extend the hose spry to, encouraged by fresh fuel below me edged closer.

With nothing to cling on to and lift myself out, no firm ground to stand on except coals, the blaze nearing, I switched to.

“I’m going to die. I’m going to be burned alive.”

Perhaps it was Jack Daniels speaking when I thought of Joan of Arc or being 71-years old was a long enough life but I was not as distressed as I needed to be. I was in death acceptance mode. It even occurred to me, being burned alive is not as bad as I thought it would be.

Then my high school football coach resurrected and spoke to me, Ollett or Popeye as we nicknamed him behind his back. He looked directly at me and reiterated his mantra from 53 years earlier.

“When going gets tough, tough get going!”

I had to get tough. I had to get going.

I tried to do a superman leap, failed, tried again, failed but as if elevated by will power alone, without leverage, I gained enough elevation on a 3rd leap to grope additional branches. Flaying arm to arm, grasping branches, twigs, and dirt, I arose from the fire hole I’d fallen into.

In the dark, I raced to the house, Levi’s smoldering, sandals burnt off. I left my right foot heel on a house stair step. Lower right leg skin peeled off as I broke free of charred Levi’s. In the shower, I washed what I could. Drying exposed flesh, a hospital trip was obvious.

Up until then, in fire shock, I felt pain but not severe pain. Out of the shower, real pain engulfed the burned areas.

The wife, in hyper hysterical mode, scrambled to drive me to the hospital. Painfully I put on pants and scrambled to her running car. She drove fast, as fast as she could, but not fast enough. I started screaming,

“Faster, faster, faster!” as the pain intensified.

Salem Hospital is a half-hour plus away from the farm, but that night it was 25 minutes or less.

In between screaming faster, my mind raced to health insurance. We had Kaiser Health Care. Salem Hospital was not part of Kaiser Health Care.

“It’s too far to drive to Kaiser Hospital. Am I going to be dunned for Salem Hospital care payments?”

At the hospital emergency entrance, however, right leg pain pushed out thoughts of economics. I’d taken sons to the Salem Hospital emergency room for their minor high school football injuries. I knew the routine, sit and wait. I wasn't going to sit and wait. I wanted a morphine injection, not in a half-hour, 15 minutes, 5 minutes, but NOW!

The emergency room staff rushed past me to save my hysterical wife, thinking it was her with the emergency. My shouts for attention diverted them back to me and they wheeled me into the emergency room. A crowd of sit and wait patients observed my gestations and screams for morphine.

Ahhhh! Oh God, that shot was wonderful. I went from pain lunatic to calm patient inquiring about whether Kaiser would cover me.

Like usual, for people in control, they didn’t answer. They informed me, I was being transferred to Legacy Hospital’s burn unit in Portland, the only burn unit in the state. I protested I just wanted my charred leg cleaned, bandaged and to be sent home.

Ignoring my suggestion, they wheelchaired me to an ambulance and bedded me down in back. The ride to Legacy was a letdown, my first ambulance ride didn’t have lights and sirens. I tried chit chatting on a morphine high but the ambulance personnel were interested in a sports game they were listening to.

The wife followed in her car. Like me, she had no idea where Legacy Hospital was.

At Legacy, the ambulance backed into the emergency loading dock and a little group rushed out and brought me into a new world. They removed the handiwork of Salem Hospital’s staff, studied my burns and whisked me to a patient room. I was pleased it was a private room but worried Kaiser wouldn’t cover private room cost. The vague answer about payment for my care was, as a geezer, Medicare would cover me, not a reassuring answer.

Stripped naked, I was wheelchaired into the shower room, an extension of my patient room. As they hosed the burned flesh, I made a decision which served me well.

“I’m not going to look at my burned leg. Why ruin a morphine high?”

Soon the wife showed up. Somehow she managed to find the location of Legacy Hospital in Portland and navigated the maze of buildings and rooms to were I was tucked away.A wheeled fold away bed for her to sleep on was rolled in my room and she became Nurse Wife. Bathed, bandaged, tucked in bed, Nurse Wife in adjacent bed, another shot and some happy pills, it’d been a long day. I went to sleep with a happy pills interruption every 3 hours.

Awake at 5 AM I watched the news on the TV hanging from the wall with the remote clicker in hand to skip commercials by channel switching. At 6 AM, Nurse Wife brought a Danish pastry and coffee. At 8, bacon, eggs over easy, hash browns and sourdough toast were served. The only negative was the hash browns came sans onions. Things were looking up, wife nurse, private room with bath, TV, good food and happy pills!

“I can do this!”

Around 10 AM the doctors showed up, 3 of them. They huddled around my right leg, removed the bandages, moved it about, asked me to move the foot at the ankle, made unintelligible comments and got into a little disagreement.

One was a petite Asian woman, Doctor Lin, real petit like near 5 feet plus or minus an inch. She could be mistaken for a child. The other 2 were middle-aged males, non-committal, gruff types. With their examination complete, informed me, due to my conversation with Jack Daniels the evening before, they couldn’t do anything for a couple of days, an excuse to do nothing on Sunday, their day off and to hold a Mondy meeting of. How to proceed with my burns.

Nurses came periodically to check my monitor and give happy pills. Two of the pills were Tylenol but the white one, I knew not what it was. I did know, I liked it. Every 3 hours, about the time nerve signals, reminded me my right leg was charred, they gave me another. Then, I was willing to discuss philosophy or tell jokes.

Tuesday the doctors re-visited. The question they struggled with at their Monday meeting was, operate to save or amputate. Doctor Lin urged burn save surgery while the other 2 were for a quick whack. I’d given Doctor Lin due respect when she first examined me. I assumed she’d been insulted by many patients who dismissed her qualifications for her child-like appearance. I reasoned, she had to be qualified with her smock and stethoscope badges. It was good I did.

She returned in the afternoon and said she loved performing surgery and she was going to try and save my leg with 2 caveats.

“Jim, you’re an old man. Your heart might not withstand operations pain.

The 3rd-degree burns on your right leg resulted in ankle bones and tendons, the Achilles heel and the one the toes on the top of the foot. being exposed. We can’t graft skin on these. After your operations, if surrounding area skin does not grow to cover these, we will need to amputate.”

It was the first time I’d been openly told I was old. With happy pills fortitude, I replied.

“It’s okay if I don’t make it. Like you said, I’m old. I have a reptilian ancestors not too far removed, so, do the best you can.”

With my signing papers saying it was okay if Legacy and Doctor Lin killed me and assurance, Kaiser would cover surgery costs, I was scheduled for my first operation the next day.

Around 10 in the morning, thankfully after breakfast, assistants came to take me to the operating room. They stripped me naked, rolled me out of my comfortable bed and plopped me in a cold stainless-steel gurney with raised edges and a center drain.

As shivering meat, ready for the butcher, I was wheeled into a tiled room with lots of dangling things from above. My first thought was the movie “Babe”, where the pigs are fed by dangling tubes. Then I reminded myself, everyone who told me about their operation said, they didn’t remember anything other than going to sleep and waking up. As the anesthesiologist lowered his tube I thought.

“Here comes another experience, I'm either waking up to this world, another or not at all. Let's get the movie started.”

My last conscious thought as the anesthesia was placed on my face was.

”Babe either gets the shotgun or a feeding tube.

It was neither. My dreams are in CinemaScope. During the operation, it was a horror flick where I was held down by hospital staff, who even sat on me to keep me stationary, while doctors flayed my leg with their scalpels. I felt every cut and scrape but couldn’t move.

When the movie was over and I awoke, it was in my patient room. The nightmare pain was gone. I’d obviously been given another morphine shot. The doctors didn’t stop by, only a nurse practitioner, to check if I was alive.

I expressed a mild complaint. Hospital staff are gods and the doctors exalted gods. Gods prefer to hear patient hallelujahs and amens. They don’t like their benevolence questioned. I explained, my expectation of going to sleep, waking up and remembering nothing, versus the horror film experienced.

She summoned the anesthesiologist god. After listening to my nightmare, he explained anesthesia is fraught with danger, he liked to err on the side of safety and most important he'd kick it up a notch next time. For the remaining 3 operations there were no torture dreams.

In addition to not looking at my leg, I asked no questions about what Doctor Lin did or planned to do. A few days of moping around the burn unit on crutches were allotted to let Doctor Lin’s first meat carving adjust to her leg muscle re-configuration.

By the second week, I'd adapted to the burn unit world. I had a private room with shower and toilet, good food, a steady stream of happy pills, Nurse Wife in an adjacent roll away bed, wake up coffee with a Danish and a little library of books. Another pleasure was the TV and bedside remote. It provided 24-hour news and old movies sans commercials. Having been time rushed most of my life I wallowed in books and old movies.

The downers were seeing other burn patients and visitors. Sons, distraught at my condition came to offer support, the youngest flying up from Texas as if it was my last rites time. I admonished them, as an old man, I’d soon be dead and to save their sympathy for their widowed mother at my funeral.

The 2nd operation was uneventful without a torture dream. Again, I was stripped naked, rolled onto the stainless-steel gurney, waltzed down the corridor, pushed into the operating room, given anesthesia and zipped out of this world. My last recollection was looking at cracks in the room's tile.

Next, I awoke in my patient room bed and returned to happy pills, morning coffee, Danish pastry, 3 square meals, TV and books. Things were good.

Nurse Wife finally got an affirmative written response from Kaiser Health Care. I was in the right place and was covered by Kaiser and Medicare. That night, about 3 AM, I awoke happy. My financial liability fears were gone, Kaiser and Medicare covered me.

I’d paid into Social Security 55 years, 40 of them at the maximum, and was still shoveling money into Medicare by working. Since qualifying for Medicare, I’d only seen a doctor for flu shots. Due to income restrictions, I paid the maximum for Medicare option coverages.

My Medicare summary thinking was.

“I’m getting screwed!”

Musing in the wee hours that night, it dawned on me.

“I'm getting my money back! I'm no longer getting screwed by Medicare!”

I laughed aloud, almost a hysterical laugh. Soon a nurse rushed in and inquired about my mirth. I explained I was no longer being screwed by Medicare.

She missed the humor of it and gave me a shot. I didn’t awake until 9 AM, past coffee, Danish and breakfast. The physiatrist was bedside. She wanted to know what was troubling me in the night hours. I explained my good fortune but she too lacked humor’s insight.

No matter how I explained I wasn't nuts; she didn’t care, she was going to save my mind. As a young physiatrist, fresh out of university, she was either the one nuts or was trying to get billable hours. Nurse Wife contacted Kaiser and her billing was denied allowing my brain to wander unfettered in the burn unit.

I have a relatively high tolerance to pain and once even requested a tooth cavity filling without mouth-numbing Novocain, a procedure never repeated. In the 3rd operation, Doctor Lin skinned the upper leg to obtain graft material for the lower leg. She warned it would be "uncomfortable". I didn’t experience an operation sleep nightmare. The nightmare was when I awoke in the recovery room.

The pain was unlike during the rush to the hospital. It was another, deeper level of excruciating. I wasn’t laughing about Medicare recapture, I was broken, physically and mentally. I couldn't scream, only whimper. I'd never been to this place, a place where one simply blubbers. If it was an inquisition, I’d confess to anything provided they'd kill me expeditiously. Nurse Wife was standing next to me. I whimpered how beautiful she looked on her wedding day.

The nurse with the magic needle was busy with another matter. Nurse Wife left to demand the needle. I got my magic injection. The pain eased but afterward, I knew there is a dark place, a place where I break. I never want to return there.

On top of the grafted skin peeled from my upper leg and set atop the exposed flesh of my lower leg, they put a layer of cadaver skin to give the grafted skin cover while it adhered. This eventually crusts up, turns horrid black, stinks and peels off. I thanked the corpse it came from and signed my body over for spare parts on death which will probably be rejected because of long use and abuse.

Once the cadaver skin peeled off Doctor Lin did an uneventful clean-up operation and then it was waiting for a yea or nay recovery. Daily, they checked Doctor Lin’s handiwork’s recovery, observed how much my foot could move and reminded me, graft on exposed ankle bones or exposed tendons was not possible. They also reminded me there was the danger of infection, a reminder there was still a plan B. My recovery was up to my reptilian abilities to grow skin over exposed bone and tendon.

The days flipped by. A month passed with Thanksgiving turkey on a Legacy Hospital bed tray. Each day I observed the tree outside my window shed its autumn leaves. I learned who were dedicated staff, who were paycheck staff and a little about their outside lives including providing advice, even to a newlywed nurse on her kitchen remodel. Nurse Wife and I gave them nicknames.

Dragon Lady was a middle-aged female nurse who had new tattoos of dragons on her arms. I asked if it was okay to ask a personal question.

“It depends on your question.”

“It’s about your dragons.”

“Okay, what do you want to know.”

“They’re new. Most get tattoos when young, not that you’re old, but you’re not just out of nursing school.”

“And, what’s the question?”

“Why did you get them now?”

"When I decided to transfer to the burn unit, I knew I had to be strong. Dragons are strong. When I quaver in the burn unit, I look at my dragons to remind myself to be strong."

“Thank you, that’s a wonderful reason.”

Even if it was untrue, it was beautifully said. With time, the size of my happy pills shrunk. I still got one plus 2 Tylenol every 3 hours. They were always signed out for by the nurse providing them and carefully accounted for. Once, a nurse dropped it before handing it to me and tore apart the patient room looking for it until it was found in the wastebasket, an incredible Olympic pill bounce leap from the portable bed tray.

I finally asked what the happy pill was. They blurted out a name but I needed it written down to know what it was. They wrote OxyContin which is Oxycodone. I had no idea what that was.

As I waited for my reptilian abilities to kick in, the hospital environment bored. The simple pleasures no longer were sufficient to compensate for confinement. I wanted out but they wouldn’t let me out. The PT staff, (physical therapists), took control. Instead of my corridor crutch strolling, their daily exercise was a walker stroll. I stood on the left leg, hopped the walker forward, then hopped left leg to match and ambled around. It was more difficult than expected. I concluded it was to justify their lack of doctor status billing. I humored them and sat in an enclosed outdoor patio they’d designed and were proud of.

The devil still in me, I asked if it was okay to smoke there even though I no longer smoked and knew it wasn’t permitted. A smoker, whose hands were caught in a hot glue press making plywood, was in an adjacent patient room. After his happy pills, with bands bandaged mittens, he walked across the street from the hospital for his nicotine fix. I switched from falling leaf observation to watching his attempts to get a cigarette out of the pack, flick his lighter, lite the cigarette, and smoke. He held the cigarette between the 2 mittens carefully so as not to set them afire.

After 5 weeks Doctor Lin came to inform, Nurse Wife, and I she was leaving Legacy Hospital to work at Salem Hospital. She tossed medical protocol aside and shocked. She didn’t shake hands or pat on shoulders but hugged, hard hugs with a quiver to her voice and moist eyes, first with Nurse Wife and then me. My hug was a tad less and while she admonished, Nurse Wife, to “Make sure Jim behaves himself.” Hugged by a doctor, a meat carving surgeon, I loved it!

The hospital still wouldn’t release me despite 35 days of occupation. Desperate, I pleaded with the replacement doctor, one who wanted to amputate. He shrugged and said my ankle bones and tendons were still open. I pestered the nurses; even told the psychiatrist I was going nuts. Why couldn’t I recuperate at home while lizard skin grew?

The plywood mill worker had just been released with boxing glove bandaged paws, proof there was a way out before full recovery. A few nurses had become confidents. One took sympathy and clued me in.

“Jim, nurses have no power on who gets released and the doctors are always super safety conscious.”

“Yeah, well with open wounds, a hospital’s an infection playground, how do I get out?”

“Jim, it’s PT you got to impress.”

“Physical therapists? Aren’t they way down the pecking order?”

"Not on release. If they're convinced you can take care of yourself outside the hospital, they can put in the freedom card at a staff-patient review conference."

I had to impress the PT police.

I don’t know if walker speed or distance records are kept at Legacy’s burn unit, but I know, while it may be unofficial, I hold those 2 records.

With my walker runs, promises I’d wash and bath open areas daily, with Nurse Wife my tutor, I was given release card.

In hindsight, I don’t know if it was the PT staff that gave the final okay. Medicare reimbursement is based on, “DRG”, (Diagnostic Related Care). It’s a formula where the hospital is paid a flat fee for a defined treatment. If they perform the care at less cost, they pocket the difference, if they over-run, they're out the extra cost.

Perhaps it was the DRG reimbursement Legacy would get and an accountant who set me free, not PT. Suddenly my open wounds could heal at home with Kaiser Hospital plan oversight. After 38 days, I was wheeled out in a rented wheelchair by Nurse Wife, freed with a big bottle of OxyContin pills. Kaiser sent a physical therapist to check out the home environment, signed off on it and they scheduled my coming in for weekly look and see visits.

During those 38 days and nights at Legacy's burn unit, I met interesting people and learned a lot, a lot I wished I didn’t learn. The worst was the burned children, one was a girl, stunned at her sudden burn predicament, a bewilderment look on her face. Never leave a handle of a pot containing hot things hanging over the stove’s edge. The result can be one of those children, the remorseful parents, after the handle is pulled down by a child trying to help mom.

Back at the farm, I was pleased to note, the weir fires had burned the branches then sputtered out as intended. The neighbor warning me of setting a conflagration stopped by with his wife to give me a get-well card without apology. Another came with a cheap bottle of wine sniffing out if the farm was up for sale. It wasn’t.

I got a cripple parking pass good until January 1, 2022. Over 2 years after leaving Legacy Hospital, I transposed from wheelchair to crutches, to cane to slight limp which I exaggerate when used at Costco or Portland Airport handicap parking spaces. Doctor Lin warned me not to drive until I could do so with my right foot because the brain has difficulty switching feet on the gas and brake pedals. I disobeyed, of course, and drove slow and careful on the road. By summer harvest season I was running the forklift to load cherries on 18-wheeler truck trailers and scooting about the farm in a Huskavarna mule. To prove Doctor Lin correct I slammed on the gas pedal instead of the brake pedal driving up to an 18-wheeler trailer stuffing the mule under the trailer up to the mule’s windshield. It had to be extracted by a tractor and took a lot of fiberglass to put it back together.

By the burn’s first anniversary, lizard skin had crept over exposed ankle bones and the tendon on the top of the foot but the Achilles Tendon continued to fester. Kaiser after a year tried a vacuum graft technique with another patch of skin from my hide. It took. The doctors predicted a need for special shoes with my right foot unable to make the full pedal movement for walking due to signed tendons but they were never needed.

Freed from burn wounds and cripple paraphernalia, I prune trees, drive the tractor to push the branches into the swale to burn.

Every morning, while putting on socks and shoes, I thank Doctor Lin. On every July 3rd, I go to Salem Hospital and drop off a special collection of premium cherries for her.

Years later the OxyContin still sits in the medicine cabinet. Untouched. When taken, not just pain went away, the world also was okay. I know it’s not okay, it’s screwed up. I talk to Jack instead, a friend I know, well who understand the world’s not okay and has ideas to fix it.

At the hospital, during convalescing and subsequently, I write. It’s a saga, “It’s Better To Be Lucky Than Smart.”

It tells what Jack has taught me.

Author Notes: Tonight the 4th anniversary of my getting burned.

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