Getting Thru

Getting Thru

I have never felt a greater sense of community and belonging than I did on my solo thru-hike of the Appalachian Trail. I spent most of my time alone, but whenever I encountered another thru-hiker there was an immediate spark of recognition and a connection. A recognition that whatever we were or did before, we were now thru-hikers. We’d trudged through the rain, scrambled over rocks, dodged rattlesnakes, sworn at mice, seen amazing views, met incredible people, and accepted both food and kindness from complete strangers.  We’d been hot, we’d been hungry, we’d been thirsty, we’d hurt, and through it all, we’d persevered, because we were thru-hikers. It didn’t matter if we’d known each other for 30 seconds or 6 months, we were a community and we looked out for each other.

There are some people on the trail that youJES_AT_2013-59 connect to so strongly that they become more than just your community and your friends, they become your crew, your trail family. For most of my hike I was a loner. I rarely saw the same people more than once. I was part of the community, but didn’t have a trail family. Somewhere in Maine I realized that that had changed, I was part of a crew and had been adopted into a trail family. I still hiked by myself, but my crew, my new trail family, was never far away and would often materialize in the evening to cook, camp, and carouse.

On October 4, 2013, I reached the summit of Mount Katahdin and was immediately greeted by the eight people that had become my crew, my trail family. We were on top of the world! We knew who and what we were. We were thru-hikers! We were confident, we were respected, we were strong, and, as long as we were on the trail, we felt a certain sense of invincibility and solidarity. At that point civilization meant luxury. It meant hot food and grocery stores and soft beds and the family and friends that we’d left behind.

We returned to the world we’d left behind and realized and that there was a price to pay for all of the luxuries that we’d been dreaming about. Even though we’d changed, the rest of the world really hadn’t, and most of the uncertainty, chaos, and problems that we’d left behind were still sitting there waiting for us. We thought that we’d have lots of time on the trail to deal with whatever baggage we were dragging behind us, to figure out how we fit into the world, and what we wanted to do with our lives, but it didn’t seem to work out that way (at least for me). We’d been warned about post hike depression, that leaving the trail would be hard, and that we’d have trouble adjusting to civilization. We thought we understood what that meant and that we were prepared for it, but we weren’t. We had been a part of something that was bigger than ourselves and we had changed.

We had disconnected ourselves from jobs, our homes, our lives, and the people we loved so that we could follow a dream, hike the trail, and go on an incredible journey. Our new world on the trail had became our everything, and now that it was gone. We were lost at the very moment that we’d expected to be found. We went home but were strangers there because we had changed. The people that were close to us and understood us when we left didn’t understand us anymore because we had changed. Our trail families, the people that understood us now, were far away and having their own struggles as they tried to figure out how to connect to the worlds that they were returning to. It takes time or trauma or both to disconnect from the world as completely as we had, and we hadn’t truly understood how hard it would be and how much time it would take  to reconnect to world.

It is three months later and it seems like most of us are either still working on reconnecting, or are preparing to disconnect again.

shady2On January 9, 2014, just three months after completing his thru-hike of the AT and less than a year after finishing his military service, my friend Shady is dead. Shady was a thru-hiker, a war veteran, and an epic hero. At first glance Shady was just a thru-hiker like the rest of us, a part of our community, and a part of my trail family. As thru-hikers we know that, “You can leave the trail, but the trail never leaves you,” and as a vet, Shady had left the war, but the war hadn’t left him. Hiking with him during the day you wouldn’t know that he’d been an Airborne Ranger in the United States Army and that he had served one tour in Iraq and three tours in Afghanistan as part of  United States Iraqi Freedom and Operation Enduring Freedom, respectively. He was kind, generous, and just like we immediately welcomed and accepted him as a part of our family, he immediately welcomed us and accepted us as part of his family. He was a part of our crew, he tried to take care of us and we tried to take care of him.

For most of us questions like, “Would you be willing to die to protect your family, your crew, your country” and “would you able kill to protect your country, your crew, and your family?” are purely theoretically. We haven’t been confronted with the harsh reality, sacrifices, and memories that happen when you’ve lived through answers to those questions. Many of our vets, however, have had to face those realities and either live or die with consequences. For them, sacrifice is no longer a romantic notion, it has become a complicated, messy reality. Facing those realities and living through those experiences disconnects them from the world that they are trying to protect. The sacrifices that Shady had made, had been willing to make, and continued to make were not intangible far away things comfortable tucked away in the land of theory. They stalked him on the trail and ambushed him in his sleep. He did not sleep well.

At night Shady tried to protect us from foes we couldn’t see and only he could know. When a sharp screech pierced the quiet night sky in the 100 Mile Wilderness, Shady threw himself over the person next to him in the shelter to protect him with his body. He thought that an improvised explosive device was going off, and he was going to save as many of us from it as he could. He didn’t hesitate, he didn’t think about what would happen to him, he just did what he could to protect us. None of us had any doubt that Shady was willing sacrifice himself to protect us. It didn’t matter that what he was actually protecting us from was a personal alarm going off in somebodies pack. It didn’t matter that he’d woken us up at 2 am again. I didn’t matter that it took 10 minutes for him to realize that it was actually his alarm in his pack. It didn’t matter that it took him another 10 minutes to figure out how to shut it off (though I may have kindly suggested that he throw the damn thing into the river after the first five minutes). We loved Shady and he was part of our crew.  I wish that we could have protected him the way he tried to protect us.

As thru-hikers many of us find it challenging to transition back into the real world and I can only imagine how much harder it must be for our vets. I am glad that I had the opportunity to walk beside Shady and to call him my friend. I admired Shady for his honesty, his strength, his sacrifice, his openness and his sensitivity. He reminded me of one of my childhood heroes, my dad (a Vietnam combat vet). I wish they could have met each other. Knowing Shady and hiking the trail have both helped me to better understand the sacrifices that Shady, my dad, and many of our nations servicemen and servicewomen make.  Shady restored my faith in heroes. Not the perfect superheroes of my childhood, but the kind of heroes that I can believe in and embrace as an adult. Heroes that are real, that are human, that are conflicted, and that have risked everything to protect us.

Now that I’ve learned to believe in heroes again I am horrified to learn that our heroes are dying… not just out on the battlefield and in foreign lands, but here at home and by their own hands (22 veterans kill themselves each day according to the federal Department of Veterans Affairs). I want to reach out to our veterans, to thank them, and to support them. We need to figure out what we can do to keep our heroes from dying.

My condolences to Shady’s family and friends. Memorial services for Shady will be held on January 13, 2014. In lieu of flowers, memorial contributions may be made to the Wounded Warrior Project, P.O. Box 758517, Topeka, Kansas 66675 or to the Appalachian Trail Conservancy, P.O. Box 807, Harpers Ferry, West Virginia 25425.

Update: The Silence: More thoughts about Shady, Combat Vets, and PTSD.

If you or someone you know needs to talk, here are some hotline numbers:
(877)838-2838 …..1-877-Vet2Vet Veterans peer support line
(800)442-4673 …..1-800-442-HOPE Speak to someone NOW
(800)784-2432 …..1-800-SUICIDA Spanish speaking suicide hotline
(877)968-8454 …..1-877-YOUTHLINE teen to teen peer counseling hotline
(800)472-3457 …..1-800-GRADHLP Grad student hotline
(800)773-6667 …..1-800-PPD-MOMS Post partum depression hotline
If you are thinking about suicide and have trouble reaching out consider reading this article.

Complications: The 0.1%

Before the trail even ended, I was already starting to miss it. I was almost reluctant to finish up the 100 mile wilderness and to summit Mt. Katahdin because it would mean that my amazing adventure and awesome thru-hike of the Appalachian Trail was done. Then again, I was cold and hungry, and I missed my family, my friends, indoor plumbing, buildings with four walls and heat, and all of the tasty tasty food associated with civilization.

As I got into the car with my mom to leave the mountains and head home, I was in a state of shock. It was over. I had hiked the entire Appalachian Trail from Georgia to Maine and was officially a thru-hiker. I was awash in the sights, the sounds, the foods, and the people of civilization, and it was overwhelming. Most people take some time to get used to all of this and transition from their carefree (only concerned about their own survival) life on the trail to the stresses and demands of modern society where there are a myriad of things that are constantly competing for our attention.

Per usual, I found myself taking the crash course… I went from hiking the trail one minute to sitting in the hospital reviewing CT scans and consulting with my fathers surgeon the next minute. The minor issue that had landed my dad in the hospital as I headed into the 100 mile wilderness had gotten complicated… complicated enough that when I researched it I was only able to find a couple of cases similar to his in the literature. Research was what I did for a living before I headed off on my Appalachian Trail adventures and now, less than 24 hrs after I summitted Katahdin, I had unlimited access to high-speed internet and was researching my dads condition. It felt good to be learning and using my brain in ways that I hadn’t been using it for a long time, I just wished that the circumstances had felt less dire.

I remembered a lot about my dad’s general condition from some courses that I’d taken at Harvard Medical School, but now I became a self-proclaimed expert in all of the nuances of his particular complications and his particular case. By all accounts he should have been getting better and improving day by day, but instead he was slowly getting worse. Why?! With my dad’s permission I reviewed his CT Scans, his medical history, his current lab reports, and his current medications before delving into the literature. I was determined to solve this medical mystery and to save my dad!

It wasn’t until the wee hours of the morning that I finally figured out a potential reason why he wasn’t getting better. They had told us that the IV antibiotic that he was on was the ‘top gun. It was the newest, latest, and greatest antibiotic out there and there wasn’t anything better, stronger or more effective out there. Normally, roughly 99.9% of the time, that would be true for people with my dad’s condition, but things with my dad had gotten complicated. It’s not always good to be different and unique, he was the 0.1%, and they were wrong. The fancy new antibiotic that they were using was the only antibiotic in it’s class that the literature said would be completely ineffective when it came to treating my dad’s case.

I knew that my dad’s case was unusual and complicated, but was it possible that a simple misstep in the choice of antibiotic was responsible for his deteriorating condition? The more I looked into it the clearer it became… it was not only possible, but probable. When I returned to the hospital the next day I double-checked the antibiotic hanging from my dad’s IV pole, it was as I remembered and was definitely the wrong antibiotic. We paged the nurse and told her that we wanted to talk to the doctor as soon as possible and then we waited… and waited… and waited for the doctor to come and speak to us.

Waiting for the doctor to come and help ease the suffering of someone you care about is almost impossibly hard. In my experience pain does not breed patience, and if someone I know and care about is in pain I want to fix it and I want to fix it NOW! Unfortunately the doctors usually have at least a dozen other patients that are all looking to him/her to ease their suffering, so we had to wait our turn.

The surgeon was the first doctor to wander into the room. He came to tell us some good news, whatever was going on with dad, it wasn’t going to require surgical intervention. Since he was there I told him my thoughts about the antibiotic. He was willing to discuss it with me, but he said that the hospitalist was the person in charge of that aspect of my dad’s care. He and I looked through my dads chart again and verified that I was right, the IV antibiotic they were giving my dad was not not the right one for his infection. The surgeon offered to back me up, and then helped me get a hold of the hospitalist.

We found the hospitalist and before long the hospitalist and I were having a high level discussion about the nuances of each antibiotic in the class of antibiotics that my dad was taking. The hospitalist insisted that the antibiotic that was hanging was the correct antibiotic for my dad. I was frustrated, but I understand where the hospitalists was coming from. The antibiotic he was using was from the right class of antibiotics, and under normal circumstances it would be the right antibiotic, in fact in 99.9% of cases it would be right, but my dads lab reports showed that his case was different and in his anomalous case that antibiotic was ineffective. It was becoming obvious (both to me, my dad, the hospitalist, and the surgeon) that I knew a lot more about this class of antibiotics and this antibiotic in particular than the hospitalist did. This wasn’t at all fair to him since I only had one case that I needed to be an expert on and I had just reviewed all of the information about my dads case and all of the antibiotics in question the night before. I understood that this was an unusual case, I just wanted it to get fixed and wanted my dad to get better. Eventually the hospitalist switched tactics, hedged his bets, and reluctantly agreed to look into it the nuances of the antibiotics that we were discussing. I had made my point and then some, and though I didn’t think he was handling things with as much grace as I had hoped, I did have the feeling that he was going to go look into the antibiotics issue as soon as he left the room. At that point we quickly wrapped up our conversation, and the hospitalist left (hopefully to go look up the damn antibiotics).

After the doctor left, my dad squeezed my hand and said, “I thought that you handled that well.” I looked at him with confusion, “What do you mean?” “Well, you didn’t get angry, you didn’t call him an idiot, and you gave him a way to save face. Not everybody would have handled it that way.” I wasn’t so sure, the wrong antibiotic was still hanging, and my dad was still sick.

20 minutes later (lightening speed by hospital standards) the nurse came in and switched my dad’s antibiotic from the ineffective one to the one that I had suggested. Would that be enough to turn the tides and set him back on the path to recovery?

The short answer was yes, within 24 hours both quantitative and qualitative measures showed that my dad was getting better, but the complications didn’t end there. To our surprise when the weekend shift came on we had a new hospitalist, and a new plan of care. They were going to send my dad home that day, and even more surprisingly, they were going to send him home without any antibiotics at all! (I could only assume that the insurance company and the hospitalist that came in over the weekend didn’t realize that dad had only been on the effective antibiotics for 24 hours, they just saw that he’d been on antibiotics for over a week and was doing better now). I was skeptical (at best) about this course of action, but I hoped that I was wrong and that all would be well. Unfortunately, I was right and in less than a week dad was back in the hospital and undergoing emergency surgery. That should have been the end of it, but once again my dad was special. He was the 0.1% and ended up having complications from the surgery. As soon as they started getting those complications under control they decided to send him home again.

I was skeptical. Sure he was improving, but he’d undergone some major interventions just the day before and I wasn’t convinced that he had really stabilized, but they assured us that he would be fine. Once again, within a week we had to bring dad back to the hospital where he was readmitted and put under the knife. You’d think that that would be the end of it, but no, dad ended up having complications from this surgery too. We were now dealing with layer upon layer upon layer of complications. I was definitely getting very, very tired of complications, but sometimes the road is long and arduous, and there were still a couple more complications that were going to crop up before they finally released dad from the hospital for what we hope was the last time.

Instead of getting off of the trail and focusing on me and what I was going to do next, I was completely occupied with advocating and caring for my dad. I felt very lucky to get to spend this time with my parents, though the circumstances were far from ideal, but now that dad is starting to improve again, it’s time to start thinking about what’s next for me again.

As the days since Katahdin have turned into weeks and months, I find myself missing the trail more and more. I miss the simple sense of purpose that hiking the trail gives me, I miss knowing that I am going to wake up every morning and do something that I love… I miss walking. Life on the trail was simple, it was beautiful, and I loved it.

So, what do I want to do next? The answer is obvious, I want to return to the woods, I want to explore, I want to wake up every morning and walk. I’ve decided that I am going to continue to follow my dreams, which for now means heading west to the Pacific Crest Trail (PCT) this spring to embark upon a new adventure!