Lone Pine ER

In the morning I didn’t say anything to Test until we were all packed up and ready to set off. By that time I had decided to go down off the trail. We hardly knew each other, but still it felt a little like I was failing her…. But she said she thought I had made the right decision.

We walked together a mile to Cottonwood Pass, where a strong wind was racing over the saddle. In the lee of a boulder she shared some of her water with me and we said good-bye. Then I headed east and down, she headed north and up….

I dropped 1200’ in two miles, then walked three more miles along a valley bottom to Horseshoe Meadows, passing a few weekend backpackers along the way. I found a half dozen cars at the trailhead, but as it was early in the day people were arriving rather than leaving….

Eventually I walked another half mile down the road to a turn-off to Cottonwood Lakes. Here I’d have a better chance at a ride…. I sat down in the shade of a big Jeffrey pine and tried to read…. But when trying to get a ride it’s hard to think of much else.  I was also wondering what I should do next…. The trail was easy, just walk everyday as far as I could. But now what? A short break in Lone Pine? Jump ahead to some other part of the trail? Bail and go back to the Boise? Get the van and do other stuff? But I’d put so much into planning this hike…. But what was up with this chest pain?

After a half hour a set of three cars passed, but all were fully loaded with people and gear, and the drivers waved apologetically…. Another twenty minutes before the next car—but no, they passed on by….

Fifteen minutes later a brown Prius occupied by a couple appeared, and the driver pulled right over. I said I was hoping to get down to Lone Pine and they said, okay, we can do that. They both got out of the car, a man and a woman, both about seventy, their dog got out too, and the woman opened the rear hatch so I could put my backpack on top of theirs. They had been up in the mountains on a three-day walk, much of it off-trail and across country.

The woman sat in the back with the dog, and I sat up front. They introduced themselves as Dennis and Sydney, and I told them why I had come off the trail, and Sydney said, “Well, Dennis is a doctor.” Retired, but still volunteering occasionally at a prison. He began to quiz me about my symptoms, and Sydney participated too, her questions suggesting she also had a medical background of some sort.  They weren’t shy; at one point Sydney asked me if I was constipated.

The eighteen-mile drive down to Lone Pine was spectacular—a 6000’elevation drop, much of the road clinging in big, exposed switchbacks to the eastern front of the range. The temperature rose noticeably as we descended….

Besides my health, we talked of their hike and mine, of living and working in Inyo county…. They had lived in Mammoth, but it was a resort town, and now they lived in Big Pine, which Dennis referred to as a “real town.” They were both remarkably fit, Dennis small and compact and grizzled, Sydney with a gray bob and surprisingly low cut shirt. When we were talking about the effects of high elevation, Dennis alluded to Sydney’s experience at Denali and in the Himalayas, but she waved off further explanation. “That was another life time,” she said.

They asked if I would like to have lunch with them, and I of course said yes. We went to the Alabama Hills Café on a side street in Lone Pine, and Dennis and I both ordered the lunch special, a turkey and avocado sandwich on a croissant. Excellent, especially after several days of trail food, and the potato salad on the side was as good as homemade.  We each also had a huge mug of iced tea.

After lunch Dennis drove by the hospital to show me where it was, then they took me to the Mount Whitney Motel on the main drag. He wasn’t willing to diagnose me but said my chest pain could be from the elevation, or it could be some sort of reflux, or it could be my heart, though he seemed to think that latter possibility unlikely. But still worth checking out.  “Go before three,” he said. “That’s when the lab people go home. If you want to get results today, don’t wait.” Before I got out of the car, Sydney gave me their phone number and said if I wanted I could come stay with them, just call…. I kind of wanted to go home with them right then, but I figured I better first try to figure out what was going on…. They both got out to get my pack, and Sydney said, “I need to give you a hug,” and then she did.

The room was tiny and on the crappy side, but serviceable, and I showered and lay down on the hard bed and put a baseball game on…. I thought I might just spend the night in Lone Pine, see if the chest pain went away at the lower elevation (Dennis had said that sometimes with pulmonary edema people had to go all the way back to LA and sea level; but he also said I didn’t have most of the symptoms of edema).  But after an hour, with the pain still persisting, I walked over to the hospital, a half dozen blocks away….

The afternoon was hot, 99 degrees, and I sought the shade of the few tees as I walked down the side street to the hospital, a small, one-story building. I went in the Emergency Room door, but didn’t immediately find what I was looking for…. Down a hallway I came to a section that was a nursing home for the elderly, where someone directed me back the way I’d come…. A woman at reception took my i.d., told me to sit down, and a minute later a nurse appeared and took me into the Emergency Room, which was indeed one room, just big enough for two beds, a small work station for the nurse, and a desk for the doctor.

Tammy was about my age, dressed in a brown uniform, a little pudgy, chatty and competent, with reddish hair and red fingernail polish sprinkled with white dots. She had me lay down on one of the beds and commenced her work…. She wired me up for an ekg, put an i.v. line in my right wrist, took blood from my other arm, and quizzed me about my symptoms and medical history, asking questions I would be asked over and over during the next twenty-four hours….

Eventually a doctor appeared, a man named Todd Emerson, late thirties, shaved head, black jeans and running shoes. Later I learned that he lives in LA, works at Azusa Pacific University, but comes up occasionally to work for a week in Lone Pine. Other doctors from the coast do the same sort of moonlighting, for extra money. He said he wasn’t a hiker but he was thinking about it; he and his brother were going up Mt. Whitney in August. He asked me many of the same questions Tammy had, and more…. He had Tammy give me a nitroglycerin pill, to melt under my tongue, and they asked if it helped with the pain. I thought it did, maybe…. They gave me a second.

A large bearded man with a New York accent appeared with a wheelchair and wheeled me two doors down the hall for chest x-rays…. Back in the Emergency Room I lay on the bed, waiting, listening to the small talk between Tammy and Emerson and the occasional other hospital personnel that drifted in…. Tammy had brought me an old Newsweek and two 2009 issues of Reader’s Digest. I went through all three several times over the next hours, each time with enough extra narrative desperation to read articles I had dismissed before, until I had read everything, from the Middle East coverage to the diet stories to the tales of heroic dogs.

My initial blood test came back negative—my heart enzymes, or something like that, were normal. But the usual practice was to do a second blood test, four hours after the first. So I was going nowhere soon….

I’d thought I would be in and out of the hospital, that I would be spending the night in my hotel room. But I was wrong. The doctor had spent a long time looking at the ekg print-out, and later at the subsequent two Tammy ran…. He detected a couple small anomalies, and while they were probably nothing, he wasn’t taking a chance…. A couple hours in, he told me that I needed to go to the hospital in Reno. And how would I get there? By helicopter.

On the walk over to the hospital I had tried to call Naomi, for advice, but the cell reception in Lone Pine was poor to non-existent (“Sun spots,” Tammy hypothesized). I had managed to make a connection, but then lost it after just two rings. I kept trying throughout the afternoon, from the Emergency Room, but without success. This provided another source of anxiety.  Eventually Tammy’s phone started working, and so I was able to get through to Naomi, but only a couple hours after I had worried her with the first call….

Dr. Emerson worked the phones, sitting just a few feet away from me, and I listened over and over as he described to other doctors my condition. Eventually he got through to a cardiologist in Reno, who they had faxed the ekgs, and this doctor was less concerned. So, to my great relief, no helicopter. But it was agreed that I should be kept overnight for observation….

Turns out, though, that the Lone Pine hospital doesn’t have the machinery or whatever to monitor a heart patient overnight. Or something like that. The point was, I’d have to be sent elsewhere, and I would have to go by ambulance, and a nurse would have to come along to watch over me…. Options included going south to Riverside or north to Bishop, and I lobbied for north. But that was a matter of if they could get another hospital to take me. More phone calls, explanations…. At one point I asked the doctor to call Naomi and tell her what he’d been telling other doctors up and down California and Nevada, and he did.

Tammy’s shift ended and another nurse, Brian, came on. They called in a third nurse, Paul, for the ambulance ride. Tammy went over to the motel for my pack (she knew someone who worked at the motel, and she said she had gotten them to credit my card, but later I discovered they’d only returned $20 of the $66, the only folks in this whole episode who were less than ridiculously generous). The ambulance arrived from Lone Pine Fire and Rescue the driver, Carl, and his associate, Earl, were both in their late thirties with goatees and large mid-sections. I got onto the gurney, after Tammy gave me a hug good-bye, and Carl strapped me down…. He and Earl took turns picking up my pack and making jokes about the weight, entertained by the silliness of backpacking.

But the gurney and I got no further than the hallway. A heart monitor was required before we could leave, and Carl and Earl had thought the hospital would supply one; but the hospital only had the one and couldn’t take it out of the Emergency Room. Or they did have a portable unit but couldn’t find it.  After some discussion, Earl made a call to the station, and the woman there, Wendy, had to find the key to someone’s office, but she couldn’t at first but then she did, and after about a half hour a red pick-up screeched to a dusty halt in the gravel outside the doors of the hospital and Wendy jumped out, a portable heart monitor in one hand, a tall can of Monster energy drink in the other.

Wendy was about forty, a jumpy woman with a ravaged complexion and green braces on her teeth. She put the monitor down and took a big swig of her drink. Paul, the nurse, discovered that the monitor had no battery.

A fruitless search of the hospital ensued, and many jokes about incompetence were made. Eventually Wendy dashed off in her pick-up back to the station, soon after returning with an armful of batteries and a fresh can of Monster.

Just before he closed the back door of the ambulance, Carl said, “Don’t worry, I’ll just drive 90.” When he got into the driver’s seat he felt it necessary to call back, “You know I was just kidding, right?”

My heart did its usual work on the 65 mile drive up to Bishop, as registered by the monitor. Earl took my blood pressure every fifteen minutes, as Tammy had, and that was good too. The nurse Paul and I talked about the NBA Finals and he said he didn’t much like LeBron, and I said I did. I watched out the back window, as the last of the day’s sunlight crept up the White Mountains to the east.

At the Bishop hospital, which was a bit larger and right next to an almost completed new hospital, I was wheeled into the Emergency Room, but they had already reserved a place for me, and so Carl and Earl retraced their steps and took me to the end of another hall and into a double-occupancy room, but I didn’t have to share.  I moved from the gurney to the hospital bed; I wasn’t having any trouble walking, but I still had to ride everywhere, it’s just policy.

The nurse had brought a scale into the room first thing, and Carl and Earl used the opportunity to weigh my pack (42 pounds, without water). The nurse, Cynthia was tall and slim, about forty with brown hair and a gentle demeanor. She asked me all the familiar questions, any allergies to meds, and so on, and took my vitals, and another woman, the respiratory person, applied a stethoscope to my chest, and the doctor, an older man, Dr. Kamei out in a brief appearance. Just in the doorway, as he was leaving, he suddenly jerked violently and slapped at his neck, and some sort of big insect dropped onto the floor. Cynthia said, “earwig, those hurt,” and reached down with a tissue to capture the insect. The doctor smiled and said, yes, then departed rubbing his neck.

He came back later and we had a long talk, only about half of it about my health. For the rest, we chatted about hiking, and Bishop, and Minnesota, about our kids…. He was a short man, bald, a little gaunt, with a moustache and a friendly, genuine manner. Later I would learn, though, that he can be peremptory and demanding with the staff. When I told him that Naomi was a second-, almost third-year resident, he said they had a position open. “I came here for just a year, but that was thirty-five years ago.” He was a bit overworked lately, he said, with his private practice and being some sort of director at the hospital, but “I love my job,” he assured me.

After he had gone, Cynthia asked if I was hungry. “The kitchen’s closed,” she said, “but I can get in there and make you a sandwich. Turkey?” I said, yes, please, and though it was the second such sandwich of the day, it tasted very good. Cynthia showed me how to work the television, and I flipped between the channels before settling on baseball highlights…. At the end of our talk, the doctor had said he thought my heart was probably fine, but they would be doing further tests in the morning to make sure….

I felt comfortable, assured, if a little concerned about the cost of all this treatment (how much will my insurance pay?). It had been a long day, a bit worrisome at times, but everyone had been so good to me, so appealing and likeable and interesting….

A new nurse came on at eleven, Renee, younger and blonde, with the cute good looks of a wisecracking sidekick; and she smelled good too. She checked my vitals one more time, and said, “we’ll try not to bother you now, so you can get some sleep.” It had been a full day.