I got home from Utah and went right to bed.
That was the plan, anyway.
The Wrist
Somewhere in the middle of my first night home, still running on fumes and whatever residual medication was still in my system, I pulled the wrapping off my broken wrist in my sleep.
I don't remember doing it. I just woke up and it was off.
So it was back to urgent care. They rewrapped it. I went home.
But something had changed since Utah, and it wasn't just the wrist. I had started having serious tactile issues. Everything that touched me the wrong way — a sleeve, a seam, the edge of the wrapping — I had to fix it immediately. I couldn't let it go. The sensation was unbearable in a way I couldn't explain and couldn't reason my way out of. It made me restless and irritable in a way that I'm sure made me very easy to be around.
The next day I saw the hand surgeon. The orthopedic surgeon decided a proper cast was needed to hold everything in place until surgery. I went home, laid around, tried to get the rest my body was clearly begging for.
Jen and I went to bed early. It had been an exhausting day.
Midnight
About two hours into my sleep, I woke up.
And I was consumed — completely, urgently, totally consumed — by the need to get the cast off my arm. Not soon. Now.
I went through every option I could think of. None of them worked fast enough.
And then, with complete calm and what felt at the time like perfectly sound logic, I arrived at a conclusion: I was going to have to cut my arm off.
I want to be clear that in that moment, this seemed entirely reasonable. Not alarming. Not extreme. Just the obvious next step.
Fortunately — and I don't use that word lightly — I had just enough of myself left to know that I needed help. I woke Jen up.
"We have to go to the ER. Now."
I know I scared her. But she got up, got me to the car, and drove me to the emergency room without hesitation. That matters more than I can properly say.
The ER
I told the triage nurse that I wanted to cut my arm off.
That will move you through triage fairly quickly.
I spent the next 18 hours in the emergency room psychiatric suite. I was still fixated on the cast. Every hour or so I would make my case to whoever was nearby — staff, other patients, the general universe — that the cast needed to come off immediately. Nobody agreed with me. In hindsight they were right.
After many hours, the psychiatrist came to see me.
It was the same doctor who, a few years earlier, had diagnosed me with Bipolar 2. I recognized her immediately. More importantly, she knew me — knew my history, knew how I presented when I was stable, and could see clearly how far from that I currently was. Having that existing relationship in that moment was one of the luckiest breaks of the whole experience.
She prescribed Ativan.
Here's the thing: the original intake doctor had already prescribed it. I had never received it. Jen and I are both fairly certain the nurse on the ward was pocketing the medication. We'll never know for sure. What I know is that after my psychiatrist put the order in herself, I finally got my dose.
It didn't knock me out. But it slowed the engine down enough that I stopped lobbying the staff about the cast. That was enough.
The Ward
After a few more hours they found me a bed. In the psychiatric ward. At the same hospital. This was lucky — genuinely lucky — because the alternative was being transferred to another facility, and I was in no state for another journey anywhere.
They took me up, Jen beside me.
The route to the psychiatric ward was one of the stranger things I've experienced. The corridor was empty and quiet in the way that hospitals are at 3 AM. Light fixtures overhead, some of them flickering, some of them half-detached from the ceiling, casting that particular unsteady light that belongs in a different kind of story. It had the feeling of a place that had been forgotten about. The day after tomorrow, but fluorescent.
At the door to the ward, Jen hugged me and told me she loved me and that everything was going to be alright. She'd be back for visiting hours in the morning.
I believed her. I went in.
The Ward, Continued
A nurse took me to my room. I was given medication to sleep. I lay down.
The toilet was broken. It kept flushing itself. Every few minutes, unprompted, relentless — whoosh. The universe, apparently, was not done with me yet.
I lay there for a while listening to it. Then I got up and walked the ward in a stupor, looking for someone, anyone, who could tell me how to make it stop.
A nurse found me drifting through the corridor. She took me to another room — a room with a functioning toilet. She was calm and kind and completely unfazed by a man in a hospital gown with a cast on his arm wandering around at 4 AM asking about plumbing.
My Florence Nightingale. I am grateful for her.
I fell asleep.
14 Hours
I didn't wake up for 14 hours.
When I did, it was the most sane I had felt since the crash in Utah. The fog was still there, but it had lifted enough that I could think in straight lines again. Enough to have a conversation. Enough to be present.
Over the next few days, I had sessions with doctors and specialists. They ran their assessments. They looked at the timeline — the crash, the helmet, the behavior since, the escalation, the 2 AM certainty that the only logical solution was amputation.
The diagnosis was traumatic brain injury.
The erratic behavior, the tactile hypersensitivity, the catastrophic thinking in the middle of the night — all of it was the brain, injured and misfiring, doing its best and making a mess of it. Not a character flaw. Not a breakdown in the ordinary sense. An injury, like the wrist, but one that couldn't be seen on an X-ray and couldn't be set by a doctor in a ski town.
It explained a lot.
Jen
She came every day.
Every single visiting hour, Jen was there. We talked through the diagnosis, the treatment plan, what came next. There were hard conversations. There were also easier ones. She brought things from home. She sat with me.
I've thought a lot about what that stretch of days would have looked like without her — in the ER at 2 AM, in the ward, in the days that followed. I don't think I want to finish that thought.
Some people hold the line when things go sideways. Jen held the line.
Part 4 to follow.