I recently wrapped myself around a tree on the slopes of the Sierra Nevada mountains in Northern California. I am from the East Coast, where the mountains are gently rolling tree-covered slopes that are, occasionally, graced with snow. They are beautiful but they are old and well-worn; relentless Time has shaved down and rounded out their sharp edges and peaks. The Sierra Nevadas are the opposite. This is a range of sky-defying, God-affirming, snow-sheeted towers; raw, unhinged, un-harnassable monuments to the colossal energy released when Geology happens.
Mammoth Mountain sits in the heart of the Sierra chain, and it is here where I encountered what I believe was a western white pine, a spindly spear of pure evil, a stationary bark-armored hell-demon that cleaved my collarbone into thirds; and it is here where I got my first–and I sincerely hope final–meeting with three narcotics: dilaudid, fentanyl and percocet.
A while back I laid out a rubric for how I thought reviews should be done and I aim to tell this story in that style.
Okay. Like a ski run, let’s take this from the top.
Ch. 1: How to fail to fly
It’s easy to start skiing. You snap yourself into about four layers of clothes and gear, find a snowy slope, point yourself downhill and fall. I won’t waste time describing the lesson that I had because the lesson that I had, a half-day of instruction, had me starting and stopping on a dime, making broad S-shaped curves, carving patterns in lightly dipping practice runs–the lesson itself made perfect sense; explanations were clear, and I had demonstrated enough non-ineptitude for the instructor to say I was more than ready for the “green” or “beginner” slopes.
So this is exactly what I did.
My wife, Carrie, grew up skiing, and it’s wonderful watching her graceful slicing through snowy hills. She offered to go down a beginner slope with me and it was wonderful for about five minutes, as I weaved behind her, feeling a degree of freedom and unlimited possibility and complete abandon unlike any Earthly feeling I know. Skiing, I thought, felt like an exorcism from the daily anxiety-grind of thinking. It was Pure Motion, Pure Action–the only important thing being the Feeling of feet and legs and torso slipping across snow-slope; the only focus being on eyes-forward down-hill floating. Being with Carrie, doing one of her favorite things, moving through air as though air was not a thing at all–truly, I thought, God is real and magnificent and loves us.
And then I attempted to merge onto another green trail. The merge was a narrow path, steeper and more complex than I anticipated, and rather than navigating it successfully, I kept gathering downward, vertical speed–obviously, failing to “snowplow” successfully until I encountered a gully and then my collarbone made impact with the pine.
I came to quickly and the degree of pain I experienced cannot be adequately described. It was a combination of searing power-drill hell and frigid numbness. I immediately knew I was in a bad way. My arm itself was alright; my fingers and toes worked; that, I thought, was good. I wasn’t cloudy; I knew where I was. I also saw neither blood nor any other fluids pouring from holes in my head. Also promising, I thought.
It was just that my shoulder region no longer felt present.
I became aware of Carrie hollering at me and also for ski patrol. Now, at her workplace, she is a crisis management team leader. These skills–basic triage, but more importantly a focused and even-keeled temperament–proved useful here. She got down in the gully with me, on her hands and knees helping stabilize and reassure me. She is a saint, and I’ll hear no words otherwise.
Recalling that this was a beginner slope, ski instructors kept passing me by, asking if I needed help. I recall finding this line of inquiry uninspiring. My responses were along the lines of: MOTHERFUCKER, I’M WRAPPED AROUND A TREE.
Obviously the instructors who passed me by didn’t have any way of knowing what had happened and were doing an excellent job in making sure I was being attended to. My wife was far more civil and useful, and as I said, she is a saint.
Ski patrol showed up after a geologic epoch which I am told lasted a few minutes. I remained seated in snow, freezing, hyperventilating, trying to regain some control over my breathing. Ski Patrol Dude (“Ryan,” I believe was his name, bless him) ran me through a battery of concussion tests and back and neck tests, all of which, thank god, I passed. My head had connected with the lumber-demon, but it had not borne the brunt of the impact.

He put me in a gauze sling, which at the time felt like the only thing holding my arm-shoulder module to the remainder of my person–and I got down the hill in a sled. I recall Ryan taking the shortest and fastest possible route, which meant I was taken down a steep hill, and as we made this journey together, I reflected on the possibility that I could wipe out again. I recall laughing quietly; I figured that, if I could mess up a beginner trail, surely, I could find a way to batter myself while being rescued, too.
I got to the bottom successfully.
I was sent to the ER–my wife and father-in-law got me there by folding me into the front passenger seat of our Jeep–and when I got there, I had to get several layers of clothes off me. They kept insisting that they didn’t want to cut me out of my ski-outfit. I hate admitting that I cursed at the doctors BUT I DIDN’T GIVE A FUCK ABOUT THE SHIRT, MY ARM ABSOLUTELY WILL NOT MOVE AN INCH FURTHER, CUT IT OFF, FUCK IT. Amazingly, I only lost one clothes-item, a thermal undershirt that cost me about $20. Until writing that very sentence, I’d given that lost clothing item no thought at all. Folks, if your limbs are wrecked, you will not miss the clothes that are cut off from your person. Trust me.
I am sure the doctors knew immediately what kind of special case I was, because my left shoulder was several inches shorter than the right one. I saw on the x-rays how this had come to pass; my collarbone had snapped into thirds, into a z-shape, and had basically collapsed. It was one of the more fascinating sets of pictures I’d ever seen, and the miracle that neither my head nor neck had been seriously affected was something I kept in mind throughout the process.
Anyway! I was laid into a bed, carted into the Serious Problems Ward, and here begins the next part of the story.
I would give my wife, my father-in-law, all of my in-laws, and my own family a bunch of extremely strong recommends. These are people you want to have in your life.
I would give the shattering of my collarbone an extremely hard pass. You don’t want to replicate this.
The tree itself, I would also give a hard pass. Fucking trees, man. I hope some beaver finds its way there and cuts you down, tree. I have half a mind to haul my ass back up there with a chainsaw or even an axe and chop you into something I actually want, like a guitar or firewood or lumber. Skiing I have more complicated feelings about, and will return to this in the end.
Ch. 2: Dope
I’ve largely lived a straight-edge kind of life, meaning that I have, almost entirely, avoided “drugs.” I used to never drink alcohol, either, but in my advancing age I discovered that there were people who could drink in an enjoyable, non-self-abusive way and I found that that beer, caffeine, wine all had aesthetics. They had principles and could be life-affirming. So I eventually came around to, “man, getting buzzed on good liquor is actually a blast.”
Point is that prior to this day of bone-annihilation, I’d had about one joint in my entire life, forget about opiates. I suppose I’m so fascinated with the painkillers because I’d never experimented with narcotics nor even wanted to, and here I found them not merely forced upon me, but close to essential for my well-being. I have since learned I was put on a cocktail of some of the heaviest hard drugs on earth–Fentanyl, Dilaudid and Percocet–and I would say they left me with “profound pharmacological impressions” which I have attempted to record here, in the style of, say, Alexander Shulgin.
Fentanyl was administered to me almost immediately after I was wheeled into another room, waiting to see one of two doctors. I felt the opioid kick in just short of immediately. I don’t know what my dose was but the nurse was not shy with the needle. I began to feel like I was swimming in a warm bath of liquid world. Everything turned to mush. I started laughing because what else was there to do when reality feels like a blender? Sounds, sights–everything got cylindrical–it felt like I was living and breathing inside a Univibe. My legs tickled. I was on a bed and couldn’t really move anywhere to begin with, but a blast of this shit made me want to move even less. It utterly annihilated the pain I was in, so for that, I am quite thankful.
I have since learned that fentanyl abuse, including the illegal “bootlegging” of fentanyl, is a key player in a crushing opiod addiction problem in North America. I hope that neither myself or anyone I know ever finds themselves in position to need this stuff. Extremely hard pass.
Dilaudid was something I got after the first night post-surgery. What happened was a long and miserable story about failing to account for “what’ll happen when the local anesthetics used in surgery wear off.” In the end, I had to go back to the ER, reporting for duty with a combination of panic attacks and raw, chainsaw agony in my left shoulder module. So I was given this chemical.
The big difference between this and Fentanyl is that the intoxication lasts much, much longer. For me, the high was between six and eight hours in duration. I was driven home to Los Angeles after having this administered to me, and for the most part, I felt not like I was sleeping, but rather, that I was disappearing into the seat, evaporating into thin air; dematerializing; totally un-sensed to just about everything. One particularly unnerving element here, that I did not find true of Fentanyl, was that I could literally feel my heart–indeed, everything–moving at about 100th of normal speed. I had a semi-conscious dream-thought at one point, “ha ha ha ha what if my heart just stops entirely that would be hilarious eh I can’t feel anything anyway.”
Was I in actual danger? No, I was under the control of highly skilled professionals. Was my pain muted? You’re damn right it was. My consciousness was elevated into oblivion and beyond.
Apparently, I helped arrange luggage and move bags and pull out a change of clothes while under the influence. If I recall correctly, I ended up bringing my wife two shirts and leggings, but no pants. Go figure.
Extremely hard pass on this, too, unless you’re in a dire, mega-severe medical situation. Just because it’s not called heroin doesn’t mean that’s not what it is.
Percocet was the final ingredient in my painkilling suite and I have to say that I had the least unpleasant, most useful reaction to it. I was on two pills and then tapered down to one. Shortly after administration I felt dizzy and then more dizzy and then everything got funny and then I was just chill. As far as feeling like my heart was going to cease –none of that. I would not say this was a “mild” anything. I would say it was “least extreme.”
Hard pass. Oxycodone is no joke. It didn’t send me to the outer reaches of the Milky Way like the other two trips, but this hits hard and has all the (very bad) side effects of the other two. Stay away. Far, far away.
Ch 3. Surgery
The surgeon, Dr. David Hackley, reviewed the x-rays with me. These were some remarkable images, by the way. What I mean is that x-rays are often ambiguous and hard to read, and that in this case, mine were stark. The bone was clean-broken in a z-shaped figure. I was told that repairing it surgically, by inserting a roughly five-inch long stainless steel plate into my clavicle, was the best option. After some thought–after battling my own anxiety (“absolute terror”) about surgery and being put under–it was clear to me that operating immediately was the right call.
In retrospect, getting the process started then and there, with that medical staff, was completely correct. Especially because I was in an addled state, I give myself and my decision-making skills a strong recommend.
Dr. Hackley did a remarkable job, as far as I can tell, getting my body reattached to itself. I was able to play chords on my guitar less than a week after my skeleton got an unwanted stainless steel boost. I consider that a win. I am told that the anesthesiologist (one Dr. Davis) took special care with me and stayed with me long after I was out of surgery to make sure whatever post-surgery re-awakening complications that I had, were tended to.
I’ve been thinking a lot about bedside manner. Dr. Hackley, the anesthesiologist, really that of the entire staff at Mammoth Hospital. What I encountered, in general, was a confident but not arrogant disposition. People were genuinely concerned for me and my pain level and general well-being. I got vibes of serious, sure-handed, prepared professionals–nothing over-the-top, no bravado, which would have really turned me off. Their attitudes made a huge difference to my own mindset and my own positivity about the situation.
If you are at Mammoth and need medical attention, extremely strong recommend to the entire hospital.
Ch. 4: Thoughts & prayers
I have never really been part of the crowd that comments “yay get better” or whatever. I didn’t grasp what it would do, other than make me feel better for having said something. I guess I thought it amounted to a kind of well-meaning slacktivism.
I was sitting in the hospital, or at our condo in Mammoth, or in the car on the way home, and I began to spill out details of what happened to me, and I was absolutely floored that people–some of whom I only know through message boards and forums–would reach out and ask how I was doing, via direct message or Facebook comment or tweet or text or phone call. People said they were praying for me.
That last bit frightened me.
As a quasi-atheist, as a doubter, what right did I have to receive anyone’s prayers? Perhaps it felt fraudulent to me, to accept overtly non-secular wishes of well-being. One thing I can say, with certainty, is that, whatever was offered up by my friends and family and acquaintances, it bolstered me in a gut-level, inarticulate way. Just to know that people wanted to know my status; just to hear concern and love–I cannot say that it had any direct physical effect on me, but it absolutely had a mental and emotional one, which in turn, I am sure, has helped my physical recovery.
Would I “pray” for someone else? I have to give an extremely strong recommend to the simple acts of reaching-out and offering words of encouragement in any form. If those things are what constitute a prayer, then I absolutely would.
Will I ever ski again?
Had I been asked this T+24, 48, 72, 96 hours form the event, I would’ve said, and indeed I did say, not a goddamn chance. Life’s too short; I have too many other interests; it’s expensive; why would you throw yourself off a mountain, you idiot, things like that. But I have, in classic Alex fashion, changed my mind.
I refuse to let that tree shake my faith that skiing is beautiful and liberating from Earthly constraints. I refuse to let that collision be my lasting memory of the act of mountain-sliding. I don’t know when I’ll get back up there, but back up there I will get. Is it dangerous? Sure. So is driving a car and many other things. My assessment, “life is too short” isn’t wrong. Life is short–so short, in fact, that it ought not be wasted by hiding at home, afraid of the “what could happen” boogeyman.
Mammoth Mountain, you got me this time, but you haven’t seen the last of me.
I give it an EXTREMELY STRONG RECOMMEND. Let me clarify, when I say “it” I mean this/ your/Alex’s story. Reading it is like being carried on a poetic, post-humorous dark and crazy, neck bending adventure. As I was reading it and it captured me, I realized this story is a beautiful metaphor of a hero’s journey. Every one knows heroic journeys always lead through dark valleys and difficult confrontations with stationary bark-armored hell demons on the Sierra Nevada mountain range. Right? And like a good hero’s journey this story shows us the overwhelming power of, no, ha ha, not narcs man, (but that too); rather it shows us the kind of power that resides in all of us — the transformative power of human love and kindness. And while we all know this at our core, sometimes we need a writer just like Alex, to tell the story of him snapping his neck, to remind you, me, all of us, especially now more than ever, that the potentiality of loving-kindness is so magnifienct it can give meaning to even the worst fucking — fuck fuck fuck fuck fuck fuck fuuuuuuuuuck, that must have hurt sooooooo muuuuuuuch — run of our lives. nice one Alex, and nice one Kerry!
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D’oh, nice one *Carrie (not Kerry) … just showing, kids, no narcotics are needed to have your head occasionally in the clouds. 😉
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One of the best things I ever saw on TV was Jessie Pinkman trying heroin for the first time on Breaking Bad. You matched that with your terrific take on the effects of the elements of your drug cocktail. What a good piece of writing Alex. Btw, we have met a few times. I’m Joanna’s aunt!
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Hi Alex-
I am one of your mom’s old LBS students- it has been a long time since we have seen each other!
WOW, great read- sorry for your pain…so well written I felt I was along on your journey…
I broke my leg snowboarding in Germany on a family vacation some years ago- I was trying to avoid barbwire between slopes (only in Europe) …we both have hardware in common- I have a screw in my ankle- I spent the rest of my vacation in the hospital. One consolation was the beer and cake they served my while I was in the hospital (also only would happen in Europe).
My youngest son – Calvin 10 years old is in a cast right now. His first ever break. He is worried about his sports career I told him if his mom could complete her first marathon ( age 33) after her break he could still work towards any physical goal…
I sure hope your next ski experience is a better one…I still love to get out there despite my injury…no pain no gain! Cheers!
Joan
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beer & cake in the hospital? that sounds fantastic
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also, best of luck to Calvin–at 10 yrs old he has plenty of good athletic years ahead of him!! XD XD
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