Written by Ernest W. Drew III during the Summer Writing Seminar 2021
Ernest W. Drew III
CAPT USNR (RET)
Vietnam 1965Is age 80 and resides in Providence RI. Enjoys traveling and photography. Wrote the story to chronicle the complexities of dealing with a severe fall far from home and the help that was extended during his recovery.
Six months ago, I was about to turn 80, or as my family likes to call this birthday a decade transition. My youngest sister, who hosted my mother’s 80th birthday celebration wanted to know what I was going to do about mine. My children wanted to know if there was anything I would like on my birthday. Normally, the family would have a party with all the brothers and sisters, children and grandchildren, and aunts and uncles with the number approaching 35 or 40 people. I am the oldest family member and the only person other than my wife who would be at a party who had one vaccination shot with the second one scheduled. COVID had changed a lot of family gatherings, and this would be no exception.
Just prior to the birthday I had an annual routine health exam. I have more than my fair share of ailments and aches and pains that require monitoring.
During my discussion with the doctor, she asked me for a short term and a long-term goal.
“My short-term goal is to get to age 80 in three weeks. My youngest brother has reminded me on a number of occasions that when I was born my life expectancy was 65 which he equates to me having exceeded my use by date.”
“That is a good short-term goal and maybe we should look beyond 80.”
The doctor who is the primary care doctor for both myself and my wife, Jane, has known us for at least 20 years and assumed that when it was safe to do so, my wife and I would want to start traveling again.
I was excited to say. “My long-term goal is to return to London with my wife and spend another week going to plays”
Each year the local theater company in Providence runs a London theater tour as a fundraising event. We have now been going for the last five years and what is usually a trip in September may become a trip next March. Included in the tour is transportation to and from Boston, airfare, coach transportation in London, a hotel in Mayfair and tickets to seven plays. The plays have ranged from musicals to dark Irish plays with small casts. One play I saw in London was The Inheritance, a play about the impact of aids on the gay community in New York City. One of the stars of this play is Andrew Burnap, a Rhode Islander, who came to visit us at our hotel. Each year Michael Billington, the theater critic for the Guardian, would come to lunch with us and talk about the plays we were about to see.
Almost all of the plays are in central London but each year we have ventured out into the countryside to see a play in a local small theater. Four years ago, we went to Bath, England to see the play “Height of the Storm” which was in previews and starred Eileen Atkins and Jonathan Pryce.
The doctor expressed that one of her goals is to go to London and see several plays. Her office has theater posters from New York City on the wall. She then injected into the conversation the following.
“I am concerned that your greatest risk is your tendency to fall.”
Five years ago, while on a transatlantic cruise, we stopped in Saint John’s, Newfoundland. While there, I climbed one of the hills to a lighthouse. The photographer in me was looking for a quintessential maritime photo opportunity. Coming down the hill, I lost my balance and tripped and fell, landing on my camera and hitting my head on the path resulting in a concussion. As I was going down, I tucked the camera into my chest to try and protect it. However, the impact damaged the zoom lens and the camera pressed into my rib cage. When I got back on the ship I immediately went to the medical office where they took an X-ray of my chest. The X-ray was sent as an email attachment to a radiologist in Pennsylvania. It indicated that I had cracked two ribs. The medical staff patched up the abrasion above my right eye. The next day I had the worst black eye of my life. Walking around the ship people would ask about the black eye and look at my wife who was wearing a small sign that said, “I didn’t do it.”
The second fall was on Memorial Day weekend two years ago. I was on my way to church to be an usher and caught my foot on the edge of a pothole while crossing the street and again landed on my head resulting in another concussion. I continued on to church not realizing that my head was bleeding. One of the parishioners suggested that she drive me home. When I got home I realized that two teeth were broken. The doctor continued.
“You need to remain vigilant and aware of your surroundings to minimize the risk of falling.”
I responded, “As much as you don’t want me to fall, I don’t want to fall again.”
She asked if I had my COVID vaccine and I assured her that my wife and I both were vaccinated and that we are now starting to think about leaving Rhode Island and visiting our daughter, son in law, and grandchildren in Virginia.
My birthday came and went with many more cards then expected from family members
but no party.
In that we did not use any of our timeshares in 2020 and had carryover points, we used some of the points to get two units at Greensprings Vacation Club in Williamsburg, VA. Jane I wanted to be with family, but we did not want to be with a lot of other people to minimize any potential pandemic risk. Our arrangements were to stay in the Williamsburg area for a week in April. The next set of concerns was how to get to Williamsburg. We decided on driving. In that the drive was about 12 hours, we decided to stop at one of the hotels near the Baltimore airport for a night’s rest. This came after a year plus of sleeping in our own bedroom and not venturing out of the house. As we approached the hotel there was a little hesitancy. Everything appeared to be very clean and there were restrictions as to the number of guests in an elevator at any one time. The hotel industry was obviously taking COVID seriously. The next morning while getting a takeaway breakfast at the front desk, I entered into a discussion with another hotel customer.
“Are you flying out of BWI?” I asked.
“No, my wife and I have come to the hotel for a weekend to get away from the madness of Washington DC.”
He had his two small boys with him, and they were about to go to the pool. I mentioned to him that we were on our way to see the grandchildren. He volunteered the information that it had been a stressful year for both himself and his wife.
He said. “My wife became a per diem COVID ICU nurse and has been away from home three weeks at a time for more than a year
I thought this was probably the toughest job that anybody could do during a pandemic. He then told me that his job was also very stressful. He was a Capitol Police Officer. I told him that I hoped that he and his wife could take advantage of the short downtime they had during the weekend.
We left the hotel in the morning and drove from Baltimore to Williamsburg. My daughter and her family arrived later that afternoon. After a year of not being around family there was a flood of emotions. The daughter we were visiting is the youngest of four children. In those initial moments Jane and I realized the importance of being able to hug someone you hadn’t seen, other than through FaceTime, for more than a year. The grandchildren, Ryder age six and Olive age four, were excited to see us. I had forgotten they’re like small individual tornadoes, they were loud and always moving. Each one would fight for your attention in their own way. We had small gifts for the children, but the biggest hit was, what has become known as grampy’s cookies, Golden Oreos. For the rest of the week a consistent request was for a grampy cookie.
We planned out the week and had decided to go into colonial Williamsburg where we found few people and a lot of outdoor activity. The environment was such that we felt safe and could stay together as a small group without having to interact with many people. Williamsburg had many docents, dressed in colonial costumes, to explain the trades of the colonial times, the types and purpose of the various gardens, and the purpose of each of the colonial buildings. One of the docents was an extremely tall man and looked a little bit out of character when standing next to the women at the garden exhibit. A specialized group of docents cooked using the methods and equipment of the colonial times and had their breads and meat on display for us to observe. The grandchildren wanted to do more than look at food. They wanted to sample it. I could see my grandson’s arm start to lift and he rested his hand on the table close to the breads. Just as quickly has he positioned himself to take a sample his mother swiftly moved his arm back to his side.
On my last vacation day, I set out with my son-in-law to go to Richmond to the Virginia War Museum and to also see the remaining civil war monuments that had become a flashpoint in the Black Lives Matter rallies. The museum had exhibits of Virginia’s participation in military actions going back to the revolution. One of the exhibits was to commemorate the Medal of Honor winners from Virginia. This exhibit was on a lower level. I started to descend a set of black marble stairs towards the exhibit space. While stepping from the bottom step to the marble floor, I fell and ended up on the floor. I was not able to get up on my own. I realized that I couldn’t will the lower part of my left leg to move. The museum staff wanted to call an ambulance, but I convinced them that it was not necessary.
I was unable to support myself on my left leg. There was enough strength in my right leg for me to stay upright. My son-in-law and the museum staff were able to get me in a wheelchair and out to my car. On drive out of Richmond we went by the Robert E Lee monument. It was surrounded by a fence and had been covered in graffiti. Even with the pain in my leg becoming more severe I was able to take a photograph of the monument through the windshield of the car. As my son-in-law was driving back towards Williamsburg, I was checking my phone to find a clinic or emergency room that could look at my leg.
My son in law said. “Should we call the wives and let them know what happened?” I told him that we could wait until after we saw the medical personnel. Neither of us knew the severity of the situation.
We found a hospital close to the timeshares and made the decision to go there directly. That determination of the address of the hospital was the full extent of my medical due diligence. By the time we reached the emergency room, the dull ache in my leg was becoming a sharp pain in my knee. It was determined using an MRI that my injury was the result of a catastrophic failure of the quadricep tendon of my left leg and would require surgery. This injury requires intervention sooner than later. The quadricep muscle can retract and be difficult to reattach. I discussed with Jane the implications and contacted some medical people back in Rhode Island and we all agreed that the surgery should take place in Williamsburg.
My physiatrist texted me and said she was sorry that I had fallen but was glad that I had not hit my head.
The next day my leg was operated on, and I woke up after the surgery with a dull ache in my leg. I looked at my leg to see what the surgeons had done and found that it was in an immobilizing brace. I was told that it would be locked straight for the next 8 weeks.
Later in the day while recuperating, I was feeling out of sorts. My youngest daughter, who was giving Jane a quick break, observed that I was holding my chest and complaining of chest pains. She notified the nurse who then notified a doctor who then ordered an electrocardiogram. The electrocardiogram was irregular but inconclusive. Then they ran a blood test to check for the enzyme which is present when one is having a heart attack. When I first came into the emergency room the blood test for heart attack was part of my initial screening and the result was well within normal limits however this new blood test showed the enzyme at 10 times normal. Two cardiologists came in to talk with me.
One of the cardiologists said, “You have had a heart attack.”
I immediately responded that I had not had a heart attack. It seemed absurd to me to think that I couldn’t detect such a severe medical event happening in my own body. Sure enough, it was true.
I had given the Hospitalist enough information after he ordered the electrocardiogram that the cardiology team were able to look at my records in Rhode Island and talk with my cardiologist. The cardiology team was recommending I be transferred to a cardiac care hospital because the hospital I was in was not equipped to do open heart surgery. I called my son in Rhode Island and expressed my concerns and asked him to get in touch with my cardiologist. The hospital had a catheterization lab and it was determined that they would do a catheterization at this hospital. I was fortunate in that there was no permanent damage done to my heart and it did not impact my rehab from the leg surgery. I spent the next four days in the post-surgical unit and started doing some rehabilitation for my leg injury. Jane was part of the process from the beginning, spending many hours in my room each day. The initial goal was to have enough faith in my good leg to be able to transition from being in bed to a wheelchair.
I was 555 miles from home and not able to get in and out of a car. There was a need for a longer-term solution for rehabilitation. Fortunately, as I was reaching the time for discharge, a room opened in the intensive rehabilitation unit at the hospital, and I was transferred only from one corridor to the next. With the brace being locked, I was not able to bend my left knee or easily get up. The unit’s initial assessment, I think because of my age, was that I would require a wheelchair and not be able to get up and down stairs at home. Therefore, I would have to think about a ramp being built in order to get from the ground level to the first floor and consider expanding a small guest bathroom on the first floor into a full bathroom in order to have shower capability.
I was scheduled each day for 1 1/2 hours of physical therapy (PT). I started initially transferring from the bed to a wheelchair and using the wheelchair to go to the therapy room. Over 17 days, I was able with the PT’s help, walk straight-legged around the unit to the rehabilitation room. Initially I would walk 10 or 15 steps which was extended to over 100 at the end of the 17 days. In the rehabilitation room I would do exercises to strengthen my leg and to help me regain some flexibility. They also got me to walk up and down stairs, one stair at a time, and climb in and out of an automobile. Jane would bring my car to the hospital and work with the PTs to get me in and out of the car. During the second week of physical therapy there was another patient in the rehabilitation room working with a different therapist. The therapist he was working with that day was a young woman who was short in stature. The patient was at least 6-foot 7 inches tall. In the discussion he was having with the therapist, he mentioned that his retirement job was working as a docent in colonial Williamsburg. I recognized him but he did not recognize me.
The occupational therapists also worked with me for 1 1/2 hours each day. They gave me a set of tools, a long shoehorn, a piece of gutter with ropes on it to help me put my socks on, and a long, reinforced loop to help me lift my leg. For the first 5 days or so I had very little balance. The OTs would help me get from the bed to the bathroom in order to sit on the toilet and then sit on a shower chair and take a sponge bath. With my leg in the long brace, it was very difficult to bend and reach for a washcloth or soap or shampoo. Jane observed all of this training and became my OT when we got home.
The OTs would work with me in the rehabilitation room with exercises designed to increase flexibility and reach. It was very difficult early on to use any core body strength to get up to a standing position while doing a transfer from bed to a wheelchair, from a wheelchair to a reclining chair and any of the above to a walker. They all required arm strength that I normally did not have. Part of each therapy session I was doing arm exercises on a device that looked like bicycle pedals or the ‘coffee grinders’ used to raise and lower sails on large sailboats. I asked the therapist if she was trying to get me in shape for the America’s Cup. The other thing that the occupational therapists did was help me learn how to shower safely, which put them in close proximity to me. My sense of modesty was challenged.
The recreational therapists worked with me about 30 minutes a day. We did things like putting puzzles together while standing at a table, building endurance, playing Scrabble while standing and on two occasions played corn hole while holding on to the walker. All of these activities helped with my balance.
The last 17 days of the 24 days I spent in the hospital had been in intensive rehabilitation. The family decision was that the best way for me to get home to Rhode Island would be in an ambulance. I had hired a long-haul ambulance company that came with drivers and medical personnel. I was placed on a gurney and Jane had to sit on a mattress and lean against the side of the ambulance. The EMT on the trip was wearing USMC Vietnam veteran hat. I asked him about his Marine Corps service, and he wanted to know if I had been in Vietnam. I answered in the affirmative. We immediately connected on the combat veteran level and although my wife was in the ambulance with us, he started sharing his Vietnam experience to include incidents that he had never talked to his wife about. He, like many others, had not spoken of disturbing experiences that he had while in Vietnam.
The EMT was concerned that politicians that send young people off to war do not have the experiential base to understand the impact of that decision. He said that anyone who is going to run for president of the United States should have combat experience.
We had a long discussion about moral injury. He confided with me that he was still coming to grips with the impact of moral injury. The EMT told me that he was taught to kill prior to going to Vietnam, and that he became very good at it. He did not understand justifications for the rules of engagement that determined who was an enemy and what was hostile intent. Some actions he took based on ROE, decisions that he and superiors made, still haunted him.
When he left Vietnam, he came home and eventually ended up getting a college degree and becoming an emergency room technician and an EMT. I found it interesting that he had spent a lot of effort and time in order to be able to help other people. The EMT told me that he had given up on the VA and its ability to help him. He had a strong work ethic and didn’t want to be declared disabled or be given a label. He told me the best advice he was given while in Vietnam was from a gunny sergeant who told him to go home and suck it up. In the 50 years since he had returned from Vietnam, he had definitely done more than suck it up. It was a pleasure for me to have met him and for our meaningful conversation, instead of the vanilla conversations that I have had with veterans in the past.
I see by your hat that you were in Vietnam …yes
When were you there….in the 70s
I was there in the 60s
Where were you ….near the Cambodian border
I was off the coast
Nice to have met you
The 11-and-a-half-hour ride back to Rhode Island was not as I imagined it would be. Suddenly, the EMT said we were pulling up to my house. The EMT and the driver pulled the gurney, with me still on it, out of the ambulance and positioned it so that I could get off and stand up using the skills that I had learned from my therapists. After climbing one flight of stairs to the back deck and through the backdoor, I was home.
The requirements for my rehabilitation at home changed from the initial assessment. My older children have set up the first floor as a modified rehabilitation suite. The house is an old Victorian and has a double parlor, dining room, kitchen, butler’s pantry and guest bathroom on the first floor. The dining room table has been moved into the right-hand side of the parlor and is now directly in front of the fireplace. In the dining room there is now a rented hospital bed as well as a leather reclining chair that my son got from his mother. My wife and I have our bedroom on the second floor along with the shower. It was another 11 weeks after returning to Rhode Island before I could again use the rooms on the second floor. I was not able to get to the second floor for a shower, so my son had hooked up the handheld shower to the deep sink on the deck that my wife uses for her gardening projects. The sink had both running hot and cold water. Each day I would either shower or do a sponge bath while standing in my all together at the kitchen sink. Those mornings that the temperature was above 68 degrees I would go onto the deck in my bathing suit, wrap my leg and brace in a contractor’s plastic bag and take my shower outdoors. One day, a neighbor saw water running off the deck and came running up to see what was leaking. You can imagine how surprised he was to see someone in the middle of the city taking a shower on their deck.
Most of my time at home is spent in the dining room. Jane made sure that all my needs for the next day before she went upstairs for the evening. In the house all the floors are wooden. I felt safe walking around on level surfaces in a very familiar environment. I approach climbing the stairs to the second floor as though I am training to climb a mountain. Initially I have been on the second floor about once a day. Climbing the stairs is supposed to be a supervised activity which Jane would do but in less than a week I had the confidence to go up on my own and surprise her by being on the second floor. This feat is accomplished by stepping up one step at a time with the good leg and literally pulling the bad leg up and placing it on the stair. This is done with death grip on the railing. Since my fall, my limited mobility and the advice of my medical team is preventing me from leaving the house and walking in the neighborhood on my own.
This is a typical day for me. I’m tired of sitting around the house. The doorbell rings. My son, Ian, who has agreed to take me for a walk, is at the door. I step out of my house with cane in hand about to reacquaint myself with the neighborhood. The first challenge is to get from my deck to driveway. At the end of the driveway Ian and I turn left to start a journey of unknown length. Immediately, I’ve become aware that the sidewalks can be treacherous, full of trip hazards and inviting everyone who crosses them to fall. The first obstacle that we encounter is the root of a tree pushing up two panels on the sidewalk to form an inverted V. Unless you’re a skateboarder, the utility of the sidewalk at that point is next to nothing. I continue east on that sidewalk. There are more trees pushing up more sidewalk and cars are parked so that the front of the car is over what would be a front lawn and the back of the car is jutting out and across the sidewalk, making it impossible to pass without going on to the grass strip or into the street. Ian and I are now 200 steps from the house on my great adventure. The sidewalk smooths out for a short distance and Ian is walking faster then I want or need to. We are now agreeing on a pace and continue the journey.
We are approaching an intersection as a young woman with two small boys are approaching at the same time. She tells them that they must be careful as they walk by because I have the cane and the brace. The boys are in a hurry and want to run ahead of her as they go on their way.
The next obstacle that I encounter is trying to cross a street at a red light. This is not an ordinary intersection; it has five vehicle exits as well as all the crosswalks to help people get across safely. Ian tells me that I will not cross as quickly as I used to and that I need to slow down. Fortunately, there is no traffic coming and although I’m not going to make it across as the light is counting down, I will get to the other side of the street. I am at the next corner.
I turn right and realize that I am only halfway back to where I started. I look at the health app on my phone and see that I have already walked 1200 steps. I look up, and coming towards us, is a man walking his small dog on a leash. I have a fear of being tripped by a dog but survive this encounter unscathed.
My concentration is hyper-focused on placing my next step. I am being warned by Ian that someone is passing me and I should be aware of those around me. A car pulls into the driveway in front of us and the woman immediately opens her trunk to get to her groceries. I am waiting for her to remove some of her groceries and start to take them inside so that I can get by the opened trunk of her car and continue on my way.
I am now less than a block from my house and looking toward the corner. I see the young woman with two boys that we met on the other street as they were running by me. As I get closer to them, I can see what their mission was and why they were in a hurry. They are all holding a Del’s lemonade a lemon flavored icy slush. The boys are now walking slowly because they do not want to spill any of their lemonade. The young woman is walking a little quicker than they want to be going. She explains to them that her boyfriend is much taller than her and she has gotten used to walking quickly. However, one of the young boys says to her “slow down you move too fast.” In the last four months I have been told to slow down at least 100 times by doctors, therapists, children, and my wife.
I have tried to be an independent person for all my adult life. However, this period of recuperation has forced me to be more reliant on people than I normally would. Starting on the day of the accident my wife had to arrange for an extended stay at the timeshare. She was with me every day I was in the hospital and worked with the therapists so she could help in my recovery. Once we returned home, she did all the cooking and cleaning in addition to attending to my therapeutic needs. My wife has had to go with me to all my appointments. She has become the duty driver. In addition to doctor appointments two times a week, I go to PT on an outpatient basis to work on leg strength and range of motion. Without the PT, I would be confined to home for a much longer period. Without Jane’s ongoing support my recovery would be much longer and not as successful.
The doctor has now given me permission to drive. On one occasion prior to being given permission I snuck out of the house and drove the car around the block. I needed to know that I was able to do it.
In my own mind I don’t make progress as quickly as I would like. But those around me say that I am making great progress. It is obviously a matter of perception.
The day I fell, I had a conversation with my son-in-law that still haunts me. Just before the descending the black marble staircase, I said to him
“My doctor would probably want me to be holding on to the railings.” Next time, I will make sure I actually follow her advice.