For such fractures, there were two treatments: fusing the bones in a surgical procedure or wearing a halo. From the beginning, Johan insisted on a halo. He had worked with patients with upper spine fusions. He had seen how limited their range of motion was. He considered it nothing less than a lifelong disability.
But a halo gave him hope. Fractures could heal, scar tissue could serve as cartilage and, in time, if it worked, he could be himself again. His orthopedist agreed. Fusion would be their fallback position.
Johan was happy when an orthopedics team brought in the shoulder harness, halo ring and supporting rods. They pulled the curtain around his bed, propped him up and started to set screws into his skull.
The pain was instantaneous. Johan gasped. They had forgotten to apply lidocaine, a numbing solution.
They backed out the screws and gave him four injections: two above the eyebrows and two behind the ears. Then they torqued the screws into his skull to 8 inch-pounds of pressure. The pain was far beyond the reach of the lidocaine. Johan thought he heard bones crack. It was a feeling he'd always remember. His head felt as if his skull would split like a walnut. Then came a raging headache, a feeling of claustrophobia and panic attacks.
The best he could do was count his birds. Back home, Johan bred exotics in aviaries outside his house. He imagined how he might pair them up. He considered genetic tables and color mutations, the more difficult and complicated the better, anything to get his mind out of the moment.
But the moment never ended.
LYING in bed, soothed by the Ativan, Johan watched the sweep of the second hand on a wall clock to his right, then the minutes and the hours. He became untethered and drifted and slept and dreamed, certain that the day had turned to night, and the night to day -- but only an hour would have passed, sometimes just 15 minutes. A day took a week, tomorrow forever.
As helpless as he felt, lying in bandages, unable to move, he knew that everything was happening for the best. Call it stoic optimism. It was something he'd learned growing up in Amsterdam, where the boys in the neighborhood teased him and the jokes turned to fights. He stood his ground and never let anyone know how much the punches hurt. The experience toughened him, taught him to be resourceful and adaptable, to focus on what he had and not what he lacked.
