Wednesday, January 2, 2002/lk
Marcia Page sees it only in a recurring nightmare, which goes like this: she's sitting down, her snowboard strapped to her feet, sliding over glare ice. She claws at the ice with her mittens, trying desperately to stop. She claws and claws, but she keeps sliding. Clawing and sliding. She can't stop. This is it, she thinks. This is how I will die.
Marcia sees it only in this nightmare because she doesn't remember what actually happened that sunny winter day last February. Nor does she remember anything from several weeks afterward as she battled back from death's door. She doesn't remember, but others do.
And it is from them that she has learned about the darkest day of her life, and about the days that came after as slowly, one by one, the lights came back on.
Monday, Feb. 12, 2001, was a sunny, warm day at Mt. Hood Meadows. So warm, in fact, that Marcia, snowboarding with friend Nick Holloway, took off her helmet and left it on the seat of her car for the last few runs of the day. She'd been wearing it all morning but it had no air vents and, in the mid-day sun, it felt stuffy and uncomfortable.
She and Holloway headed to the top of the mountain, where they traversed across Heather Canyon to Clark Canyon beyond. Once there, they took off their snowboards and hiked higher up the mountain so they could get a longer run.
Marcia, an experienced snowboarder, had ridden in the canyon many times before -- she'd even taken her daughter there. But she'd never been as high up as she was that day. The sun had turned the top layer of snow to a glaze and, as Marcia climbed carrying her snowboard, she concentrated on her feet as she stepped carefully, digging one foot-hold at a time into the steep slope. "I wasn't really looking around me," she recalled.
Finally, she and Holloway put their snowboards on and Marcia set off to lead the way down -- warning Holloway to watch out for cliffs off to one side. Ahead of her, Marcia saw what she thought were three "rollers" on the slope below. She began carving turns down the mountain and that's the last thing she remembers.
That's where the nightmare begins.
The third roller turned out instead to be a 65-foot cliff. From above, Holloway saw Marcia sitting and sliding down the slope, arms stretched back trying to stop. Then, in an eyeblink, she vanished.
After hurtling through the air Marcia landed on the hardpacked snow below the cliff, bouncing like a ragdoll and smashing her head and the right side of her body before coming to a halt.
Before Holloway could make it down to her, a woman on telemark skis came along. In a remarkable twist of fate the telemarker, Christy Vaughn, happened to be a trauma nurse from Oregon Health & Science University in Portland. She immediately activated the LifeFlight air transport system from her cell phone. At that point Marcia was still conscious, whispering coherent answers to questions Vaughn asked.
In another nod from fate, a LifeFlight helicopter was already in the air when Vaughn's call came. Its crew had been headed to the coast, but was returning to its base in Portland after that call was canceled mid-flight. When Vaughn's call came the crew flew straight to Mount Hood, arriving within half an hour of Marcia's accident.
Instead of following normal protocol and landing in the Meadows parking lot the flight crew headed up the canyon to stage the rescue from the mountainside, thereby saving about 40 minutes -- time that would turn out to be critical for Marcia's survival and recovery.
By the time Marcia arrived at OHSU in Portland -- less than two hours from the time she tumbled over the cliff -- she was in a deep coma and severely hypothermic. Along with the crushed right side of her body, a CT scan revealed "tremendous" brain damage, according to Marcia's husband, John Page.
"The entire right side of her skull was crushed down on her brain," he said, causing massive brain swelling as well as bleeding within and around Marcia's brain. Dr. Randall Chesnut, director of OHSU's neurotrauma program, put it bluntly. "Her heart was beating, that was about it," he said. "The likelihood of death was very, very high."
Marcia was rushed into surgery, where Chesnut removed several shattered pieces of bone from her temple. He also cut out the entire right side of her skull and removed it. This would allow Marcia's brain to swell more freely thus easing the pressure within her brain, and on the brain stem and its vital nerves.
One-hundred-and-fifty miles away, John Page was speeding west on I-84. An emergency room doctor, he'd been working a shift in Hermiston when he received the call about Marcia's accident. While Marcia was in emergency neurosurgery, OHSU doctors talked to John over his cell phone. The updates were not good.
"They told me they weren't optimistic about her survival chances," he said. "They said, `Try to get here as soon as you can, but . . . .'" Despite the grim news, John was strangely calm as he sped down the freeway.
"I really had faith that there were no better physicians anywhere to be taking care of her," he said of Chesnut and the OHSU neurotrauma team. "These are the physicians I refer my most dire cases to."
He also was comforted by his faith. "My personal faith in God allowed me to say, well, she's made it this far and whether or not she survives is not in my hands. I was certainly prepared for the idea that Marcia might not survive, and I was okay with that."
John finally arrived at the hospital, joining Marcia's parents, who live in Portland. At one point, doctors wheeled Marcia past them on a gurney and they didn't even recognize her.
"She was within two feet of us," John recalled. "With the facial swelling and the incredible amounts of head trauma, she was unrecognizable to me and her parents." Marcia spent five days in a "profound" coma. She'd lost so much blood that she had to be given more than 12 units, along with fresh-frozen plasma to restore clotting capabilities that had been lost in her massive hemorrhaging, then she was hooked to a dialysis machine to warm it all.
She was paralyzed on the left side of her body due to the trauma on the right side of her brain. She had also suffered 24 fractures, including a broken jaw, clavicle, shoulder blade, pelvis and leg. She had broken both hips and dislocated one. All the ribs on her right side were broken and some were separated, and she had sustained a compression fracture to her back.
After 10 days Marcia began to slowly emerge from her coma. She wriggled her toes. To everyone's relief, she responded to touch on her left side -- the paralysis had been temporary.
She blinked at people through a haze of brain trauma and drugs. She was tangled in breathing tubes, IVs and a cord attached to her head which monitored brain activity, but she began to respond to familiar faces -- particularly John and their three children, Jenny, 17, Lisa, 14, and Jeremy, 11, who drove to Portland nearly every day.
"All of the memories from that time are just kind of nightmarish impressions," Marcia said. "If someone told me I'd been at home in bed the whole time, I would believe them. I thought I was having a bad dream."
Marcia couldn't speak due to the tracheotomy tube in her throat so doctors didn't know the extent of her brain damage. Marcia had survived, but no one knew if she would be the same Marcia she was before Feb. 12.
As she faded in and out, Marcia frequently became agitated and kept trying to pull out the various tubes keeping her alive. She had to be constantly watched. It was during this time that the Pages got their first taste of what would be a constant outpouring of compassion over the next months from the Hood River community.
A tireless stream of friends began driving to OHSU not only to visit Marcia, but to spend "shifts" watching over her -- to relieve family members or when John had to go to work. "I was so amazed that people were driving all the way down there," Marcia recalled. "Someone would show up and I thought, well, where will they sleep? They'd say, `We're not here to sleep. We're here to watch you!'"
The same thing was happening in Hood River, too, as people stepped in to take care of John and the kids -- cooking meals for them, shuttling the kids to and from activities and making sure nothing slipped through the cracks.
"It was almost an embarrassing amount of kindness," John said. "It was overwhelming."
Meanwhile, Marcia continued to show signs of improvement. One day her brother arrived at OHSU for a visit. Marcia recognized him and wrote for the nurses on her dry-erase board, `This is my brother, Dale. He's the one trying to pull out my tubes.'
"That's when my parents said, `Okay, it's still Marcia'," she said, laughing. "That's when they knew I wasn't a vegetable. Here we are in our 40s, and I'm still trying to get my brother in trouble."
After four weeks Marcia was released from OHSU and sent to the Rehabilitation Institute of Oregon (RIO), located at Legacy Good Samaritan Hospital in Portland. Up till then she'd still been confused about things, but at RIO she started to become aware of what had happened.
"She got fairly depressed," John said. Marcia went straight into a regimen of intensive -- and agonizing -- physical therapy. Not only did she have to rehabilitate much of her body, she had to battle nerve damage that had impaired her ability to swallow.
She even had to learn how to walk again. "My vestibular system had been damaged," she said. "I had no balance so I would just tip over." During her first week in rehab, Marcia remembers pulling John down next to her after a particularly excruciating therapy session.
Why didn't you let me die on the snow? she demanded.
"Poor John," Marcia said. "After all he'd been through, for me to say that. But I was just wanting to escape the pain. I thought, if this is as good as I'm going to feel I don't know if I can handle it." Marcia -- already a slender woman -- had lost 10 percent of her body weight and was not eating. Her doctors finally threatened to surgically implant a feeding tube.
"I didn't want that," she said. So she began to work harder at getting food down, studying food graphs and charts and struggling to maintain minimum daily calorie counts. Then, during her second week at rehab, Marcia made a breakthrough. An accomplished concert pianist who began playing when she was 8 years old, Marcia had been eying the piano in one of the therapy rooms. But she hadn't had the courage even to sit down on its bench. She was afraid of what would -- or would not -- happen.
"I didn't know if I could play, and I was scared to find out," Marcia said. Finally one day curiosity -- and a little urging from her therapist -- got the better of her. "I sat down and just started playing," she recalled. "I played my 8th grade recital piece. My fingers just knew what to do." According to John, it was like "flipping a switch."
"It was a moment in time that turned the depression around," he said, and Marcia agreed. "From then on, I said `If I can't do anything else, I can at least play the piano'."
Marcia Page came home to Hood River eight weeks after her fall on Mount Hood. She wore a helmet to protect her head; the portion of skull that had been removed would not be replaced for another month.
"The irony of, either you wear a helmet snowboarding or you wear one all the time was not lost on me," Marcia said. She continued physical therapy. Her right eyelid, which had been closed from nerve damage, began to open wider as time passed. Her balance improved.
In May, Marcia went back to OHSU for surgery to replace the portion of her skull. Holding it in place permanently are 10 titanium screws. She also has two screws in her temple and two in her jaw. She invites anyone who asks to feel the small knobs of the screws -- as well as the soft, fleshy spot the size of a 50-cent piece on her temple where the skull was so crushed it couldn't be replaced.
"I think that's why I don't get tension headaches anymore," she said with characteristic good humor as she rubbed her temple. "It all just gets let out that soft spot."
In July, Marcia went windsurfing and mountain biking. In August, she got her driver's license back. She suffers from double vision -- although even with that she was lucky: when she looks straight ahead her vision is fine. Only when she looks up or down or to the side does it blur.
"I just tilt my head to adjust," Marcia said. "Since I'm not a mechanic it doesn't matter."
Dr. Chesnut calls Marcia's recovery "remarkable." He considers her the "poster child" for head trauma recovery -- as well as for helmet use. The fall she took would have left her seriously injured even if she had been wearing a helmet, he said, but she probably would have avoided the neurological damage and the permanent hardware in her head.
Marcia and John chalk it all up to a miracle -- albeit one that had a lot of help from the Hood River community.
"I feel that, during all of this, our family has been the recipient of the very best that a small town has to offer," Marcia said. "I cannot imagine having had this good a recovery without the support of family and friends in this community. It still amazes me how (people) just poured into us when we needed it. It made all the difference, I'm convinced." After a pause she added, "This is an amazing community."
John agreed. "It really was something," he said. "When you're in the medical system, you have even a more acute appreciation for what that entails."
Despite her traumatic fall and long recovery, Marcia refused to even think about giving up one of her passions: helping to coach Hood River's Summit Snowboard Team. But that meant she would have to face her demons and get on a snowboard again.
Early in November, John took Marcia up to Timberline on Mount Hood. She was a little nervous -- especially when she saw patches of shiny glare ice.
"That's what my nightmares are made of," she said. "But I just love to snowboard. I just wanted to feel that feeling again." It was a bright, sunny day -- just like that fateful day last February. When she got to the top of the Palmer Snowfield she strapped on her snowboard and made sure her helmet was secure.
Then she took off down the mountain.
"On Feb. 12, it was a beautiful day," she said. "When I went back, it was another beautiful day. I felt like I got to complete the awesome run that I never got to finish on that day. It was a sense of closure for me and it felt wonderful."