The Vacation that Went Awry

by Amy L. Sebes

We decided to visit a friend of ours in New Delhi and return to Korea via Thailand. Seeing Bangkok was a must, but we also were attracted to the sandy beaches and clear blue waters of Phuket Island, which we decided would make an ideal spot to spend my thirtieth birthday. It was a fateful decision.

The vacation lived up to our expectations and, with the exception of a day-long bout of "Delhi Belly" in India, was a thoroughly enjoyable expedition—until our last day, at least. The night before our return flight to Seoul, we booked a cab and requested a hotel wake-up call.

The next morning we awoke, glanced at the clock, and realized with dismay that we had never received our wake-up call. We hurriedly jumped out of bed, got ready, and after some grumbling at the hotel main counter, boarded our taxi at about 7:30 a.m. Realizing that we might miss our flight to Seoul but that there was nothing we could do, we relaxed in the back seat and watched the tropical Phuket scenery pass by. That is the last clear recollection I have of that day and the several days that followed until I woke up in an intensive care unit, completely disoriented, in a strange hospital with nurses surrounding me speaking a strange language. What follows is a description of the car accident that my husband and I were involved in and of the next few days, based on my husband's recollections and accounts of others who were involved in our rescue.

During our taxi ride on the two-lane highway leading to the Phuket airport, another taxi (with no passengers) careened head-on into ours while apparently rounding a curve, probably much too fast. As is typical in many Asian countries, there were no seatbelts in the taxi and, as a result, my husband and I were thrown violently head-first into the seat in front of us, then tossed around the back of the car. My husband remembers seeing the driver slumped over what remained of the steering column and remembers somehow pulling me out of the car, despite his own severe injuries. He has a vague recollection of the two of us lying side by side on the side of the road surrounded by a group of locals telling him in English, "You OK. You OK." I seem to remember my husband holding my hand.

We don't know how long we remained there, but my husband says I asked him repeatedly, "Where are we?" (answer: "In Thailand") followed by, "What happened?" (answer: "We've had a car accident.") Like a macabre version of Waiting for Godot, this dialogue was re-enacted approximately every five minutes until we were somehow loaded into the back of a pick-up truck along with an angelic passerby who, with unbelievable foresight, held my husband's head stationary between his/her hands during the ride to the hospital.

My husband and I were driven to a local government-run hospital where no one on the premises spoke English and where the people at the front desk would only proceed with our check-in when they were somewhat reassured that we had money or health insurance. My husband and I were then separated: I was put into the women's wing of the hospital on the first floor, in what my husband describes as a large, dirty, concrete-slab room filled with row after row of beds and no doctor or nurse in sight. My husband was put in the men's wing on the fourth floor, where conditions were the same.

Fortunately, my husband was able to shrug off his disorientation and painfully make his way through the hospital to find me. It wasn't until months later that we realized how dangerous his attempts at walking actually were. He has told me that I was able to speak to him—though I made no sense—and it became clear to him that neither of us was receiving any type of medical attention. At this point, he attempted to return to the main desk to make a telephone call and realized that he would only be able to use a pay telephone outside the hospital. Faced with a tremendous language barrier, he then tried to persuade a nurse to wheel him first to the women's wing (where the money pouch was still wrapped around my waist), then to a kiosk near the hospital (where the nurse helped him buy a phone card), and finally to the pay phone (where the nurse, after much confusion and a lengthy delay, obtained the phone number from local information of the U.S. Embassy in Bangkok). After several attempts he was finally successful in getting connected and spoke to the Embassy's nurse practitioner. That phone call probably saved my life, since the medical staff at the Embassy soon arranged for our transfer by ambulance to a more modern, privately-run hospital elsewhere on the island.

By the time we reached the Phuket International Hospital (roughly eight hours after the accident), we were no longer bleeding externally, and our wounds were stitched and bandaged. We were examined and treated by clearly competent, English-speaking doctors, and subjected to a battery of x-rays and cat-scans. At the time, my husband was diagnosed as having severe whiplash, a broken nose, and a fractured jaw. I was diagnosed as having two broken ribs, a fractured tibia (shinbone), a broken alveolar plate (the bone in the mouth upon which the lower teeth are attached) and massive dislocations of the lower front teeth. We both had severe lacerations and hematomas on various parts of our bodies. An orthopedic surgeon visited me later in the day and scheduled a surgery for the next morning to set and pin the bone in my leg. My husband faced the prospect of facial surgery.

We were given a room together. When the orthopedic surgeon came to check up on me that evening, my husband says I was still complaining of abdominal pain. Feeling that caution was a good rule of thumb, the doctor decided to delay the surgery and check on my in the morning. Again, it was a fateful decision.

Late that night, another surgeon visited our room to check my condition, perhaps because the orthopedic surgeon had reported my continued abdominal pain. When he learned of my symptoms, he arranged for an immediate ultrasound, which revealed significant internal bleeding. My husband, who was in the room with the doctor, was informed that I would need to be rushed immediately into surgery to stop the bleeding, the source of which would later prove to be a lacerated liver. Unfortunately, the hospital did not have a supply of my blood-type, O-negative, which would be necessary to replenish what I had lost. The operation could not wait, however, and I was wheeled into emergency surgery, with no known blood supply source. I have a vague memory of being in a very dark operating room, of feeling frightened, and of asking the surgeon, in halted, labored breaths, "Can - I - hold - someone's - hand?" He translated to an invisible person on my right, and a nurse's hand came into vision and held mine as I succumbed to the anesthesia.

During the surgery, hospital staff made frantic calls to other hospitals, searching for O-negative blood. Since blood type is often ethnically-linked, and since Thais rarely have Rh-negative blood, no supply was found. The staff then placed announcements on local radio stations and began calling hotels, hoping that a Western staff member or guest could be found with the right blood type. By this point, I had lost roughly a third of my blood supply, and the nurse practitioner in Bangkok, whom my husband was keeping abreast of our situation, began to make plans to search for an appropriate donor from among the Embassy community there and to fly down the needed blood. However, this plan proved unnecessary as a Swiss man who worked at one of the hotels on Phuket arrived at about 1:00 a.m. and donated a pint of O-negative, which was immediately used as a transfusion, helping to stabilize my condition.

When I finally regained my senses in the intensive care unit a few days later, my husband was allowed to come see me and explain our situation. It was then that I first remember looking at my husband and seeing his face, swollen and bruised almost beyond recognition.

After several days I was deemed sufficiently recovered to be released from the ICU and was taken by stretcher to the same room where my husband was being treated. I hadn't been in the room for even an hour when the nurses came in and rolled my husband away. Shocked and dismayed, I waited patiently until an English-speaking hospital administrator came in about an hour later and informed me that my husband was undergoing surgery to try to repair his broken nose and jaw. He had delayed his surgery until I was delivered from the Intensive Care Unit, since he needed to be able to talk (or, more accurately, to mumble) to our doctors, the Embassy staff in Bangkok, and our family back in the U.S.

During our vacation and throughout this entire ordeal, we found the Thais to be wonderful and gracious people. The nurses and doctors in this hospital were among the most gentle, caring and kind people I have ever encountered. Despite the language and cultural barriers, they did all within their power to help us. My miming skills had vastly improved after a year and a half in Korea, but I soon discovered that I was too weak even to act out what I needed. All I could do was to attract the attention of a nurse and repeatedly focus on one carefully chosen word. The nurse would then summon other nurses, who would stand in a ring around my bed listening to me repeating, for example, the word "water." Usually they would then engage in a brief conference, come to a consensus, and then dispatch the least senior nurse, who would scamper quickly out of the room and return with, in many cases, a pillow.

After an indeterminate amount of time had passed, a surgeon and a nurse wheeled my husband back into the room. His face and head were completely bandaged and he was hooked up by a series of tubes to a large steel machine. His jaw had been set and wired shut and would remain so for the following six months, preventing the intake of any solid food. The surgeon picked up a long, thin plastic tube and proceeded to insert it into my husband's left nostril and push it well into his nasal passage. The tube immediately filled with blood. Both the doctor and the nurse drained the blood several times, then both left the room.

Moments later, my husband began making muffled, desperate-sounding grunts. It was obvious that something was seriously wrong and I was completely incapable of doing anything to help him. I gathered up what little strength I had to utter, "Help, help, help," but it just didn't seem loud enough for anyone to hear.

Once again, providence was on our side. Whether somebody heard my feeble attempts at yelling or heard his grunting, or was just passing by, we will never know, but shortly thereafter a group of nurses came running into the room, began speaking animatedly, and immediately wheeled my husband out. I was told sometime later that he was now in the ICU. It wasn't until many days later that my husband was able to communicate why he had been making those strange, muffled sounds: due to the blood blocking his nasal passages, he had been unable to breathe.

By this point, the Bangkok Embassy had notified the Embassy in Seoul of our situation, and wheels were in motion. A hat was passed around the consular section, and numerous colleagues and FSNs generously contributed money to help send a friend and fellow consular officer, Mike Hoff, from Seoul to Phuket to help arrange our medevac to the U.S. He also helped us to determine the ultimate fate of the two taxi drivers: it is unlikely that either one of them survived the collision.

I was still unable to sit up at this point, and still connected to a urinary catheter. After another surgery to set the bone in my mouth and reposition the teeth, and as soon as my husband no longer needed the nasal drainage tubes, a medevac flight was scheduled, and we were off. I traveled on a stretcher on the plane, accompanied by a Thai nurse from the Embassy in Bangkok.

Once we landed in the U.S. we both assumed that we were on the road to recovery, but after several weeks of recuperation in Phoenix at the home of my in-laws, my husband's neck pain did not relent. More thorough x-rays determined that two of the cervical vertebrae were fractured. What was misdiagnosed in Thailand as severe whiplash was actually a broken neck.

To make matters worse, the ligaments surrounding my husband's spine were torn, exposing the spinal chord to serious potential damage. Not only were the vertebrae damaged beyond the possibility of normal healing, they were also unstable and sliding around, causing severe pain and raising the potential of partial or full paralysis. What might have happened had my husband tripped and fallen, or been handled too roughly at any period in the previous month, is not a line of thinking we care to follow.

The following week, my husband underwent a spinal fusion, a procedure in which bone from his hip was extracted, put into the injured vertebral region, and connected with steel plates and screws. As anyone who has been involved in the recuperation from spinal surgery knows, my husband suffered unspeakably in the aftermath of the surgery.

A word about the role of the State Department in this whole ordeal: we feel tremendously grateful for all the assistance provided us by both Embassy Bangkok and Embassy Seoul. Special thanks goes to Supani Saison and Sandra Moore, Embassy nurses in Bangkok; Dr. Thomas Lucas, Regional Medical Officer; Agnes Hebler, a retired teacher and an unpaid American "warden" on Phuket Island; and all the people at Embassy Seoul who contributed finances, care, and concern on our behalf. We owe our thanks also to the people in Seoul who generously donated their annual leave to the leave donation program. (It would have taken my husband over two years to earn back the leave he lost). Our families in particular appreciated the frequent calls from State Department officials updating them on our situation.

Five surgeries (including four root canals) and lengthy period of physical therapy behind us, I now have a fully functioning liver and a thick eight-inch scar running vertically across the entire length of my torso of which I am very proud. My husband, however, now has a mouthful of braces and will soon be fitted with orthodontic headgear to help bring back the proper functioning of his jaw. He is back at work, although his neck mobility is quite limited, and his ability to participate in sports and other physical activities which he previously enjoyed will be significantly curtailed for the rest of his life.

One of the greatest ironies of the story is that, international dateline excluded, the accident occurred on my thirtieth birthday. Expecting a minor mid-life crisis of sorts, I instead entered an era of profound appreciation for the day-to-day enormity of existence.

A message from the gods? A completely random occurrence? An irrevocable mixture of both? Ten months later I still don't know for sure; life remains as elusive and mysterious as ever. However, I do know that this incident will color the rest of my life and be a yardstick by which all other events will be measured. Whether the extraordinary experience of being alive is a celestial gift or a result of the most random of chances, I feel profoundly fortunate to be moving through it, and on my way to a new decade of life.

©1997 Amy L. Sebes. All Rights Reserved.