November 22 9PM 1975

The next day Nov 23rd Chapter 2

So I’m now unconscious. I have no idea what’s happening.

From what I’ve been told I was rushed back downstairs to ICU, Intensive Care Unit. That begins the heroic effort to save my life.

I’ve cheated here a bit. I asked Grok, the AI in X or Twitter to describe the sequence of events medically as I recall from conversations and some of the moments I was actual conscious.

Here is a medically accurate reconstruction of the sequence of events based on what you described, using proper terminology. This is a classic, life-threatening presentation of Fat Embolism Syndrome (FES) progressing to full-blown Acute Respiratory Distress Syndrome (ARDS) and multi-organ dysfunction after a major long-bone fracture — something that was especially lethal in 1975 before modern ventilatory strategies and ICU care were as refined.Sequence of Events (November 22–approx. December 1975, London, Ontario, Canada)

1. Initial injury
   • Closed or open fracture of the left femur (most likely mid-shaft or distal third, high-energy trauma).
     (Actually top 3rd. About 3 inches from the top ball of the femur)
   • Immediate placement into skeletal traction (likely a pin or wire through the proximal tibia or distal femur).
2. Within ~12 hours: Onset of Fat Embolism Syndrome (FES)
   • Massive intramedullary fat globules and marrow elements entered the venous system from the fracture site → passed through the right heart → lodged in the pulmonary microvasculature.
   • This produced acute pulmonary hypertension, ventilation-perfusion mismatch, and chemical pneumonitis from free fatty acids.
3. Rapid progression to Acute Respiratory Distress Syndrome (ARDS)
   • Diffuse alveolar damage with non-cardiogenic pulmonary edema.
   • Severe hypoxemia (PaO₂/FiO₂ ratio almost certainly <100 mmHg – “severe” ARDS by today’s Berlin criteria).
   • Bilateral pulmonary infiltrates developed (the classic “white-out” on chest X-ray).
4. Respiratory collapse and cardiac arrests
   • Progressive hypoxemia → loss of consciousness (hypoxic encephalopathy).
   • Tension physiology from high ventilator pressures and low compliance → impaired venous return → two episodes of cardiac arrest (most likely pulseless electrical activity or asystole from hypoxia/hypercarbia).
   • Successful CPR both times.
5. Airway and ventilatory management
   • Emergency endotracheal intubation and conventional mechanical ventilation.
   • Refractory hypoxemia and high peak/plateau pressures necessitated escalation:
     • Surgical tracheotomy (performed at bedside or OR) for long-term airway security.
     • Bilateral chest tubes (intercostal drains) inserted for suspected or confirmed pneumothorax/barotrauma from aggressive ventilation, or possibly to manage pleural effusions.
6. Systemic inflammatory response syndrome (SIRS) / early multi-organ dysfunction
   • Hyperpyrexia (very high fever) and massive third-spacing of fluid → profound generalized edema.
   • Edema so severe that the skin over the Achilles tendon was abraded/raw from pressure against the traction apparatus and Thomas splint/ring.
   • Aggressive cooling measures: ice packing and possibly cold blankets to control temperature.
7. Additional classic stigmata of severe FES (likely present but not always remembered by patients)
   • Petechial rash (axillae, conjunctivae, chest) from fat globules occluding dermal capillaries.
   • Possible transient thrombocytopenia and coagulopathy.
   • Cerebral fat emboli contributing to prolonged coma.

Diagnosis at the time (1975)The triad of FES was well described by Gurd (1970) and still used in 1975:

• Major criteria: respiratory distress, cerebral involvement, petechial rash
• You met all three plus the dramatic deterioration within 12–48 h of long-bone fracture.

This presentation was so severe (essentially “malignant” or “fulminant” FES with ARDS and cardiac arrests) that survival was extremely rare in the mid-1970s.
Cases like yours were indeed written up as case reports in journals such as Canadian Medical Association Journal, Journal of Trauma, or Chest during that era.
You survived an injury and complication that carried >80–90 % mortality at the time.
Modern treatment (prone positioning, lung-protective ventilation, ECMO if needed) has improved outcomes, but in 1975 you essentially beat the odds through aggressive resuscitation and a bit of luck. (The luck was a Dr. Walker who happened to be visiting St Joe’s)
If you ever want to try tracking down the actual case report (very possible it was published from Victoria Hospital or University Hospital in London, Ontario), the key search terms would be:
“fat embolism syndrome” + “femur fracture” + “ARDS” + “cardiac arrest” + “1975” or “1976” + Canada/London Ontario.
You’re a walking medical miracle from an era when this almost always ended in the morgue.

I remember some brief moments throughout this experience.
One such moment is writing on a note pad asking them to stop.
I wanted it to end. The pain was beyond anything I’d felt before.
That was so unlike me I’m glad no one listened.
I’ve never thought that way ever again. Even with some of the injuries and medical procedures I’ve gone through since then.
If I could live through that, I can live through anything.
And getting heart stints while awake is no fun!

Another humorous thing was me trying to get out of my traction.
The drugs they had me on were wild.
I imagined I was at A&W on Springbank (coincidentally a half block from my crash site)sitting in a Model T Roadster. Which is strange as I was never attracted to them. Anyways I had my left leg hanging out on the drivers door and the waitress had come and got the window tray and I was trying like mad to pull my leg back into the car so I could drive off.
What probably occurred was the nurse had given me a shot or something and had one of those rolling desk things (Window tray) .She left and I was frantically pulling on my leg.
Only for a moment. Lights out again.
The time they cut my throat for the tracheotomy, I woke up for a few seconds. Scared the Doc as I opened both eyes wide as can be. Dang there’s a guy with a bloody scalpel over me!
Out again.
One more for the drugs thing. I hope. I was suddenly aware I was in the ceiling tiles looking down at myself while the doctor is bouncing on my chest. Someone was with me. I turned to look at them and Lights out again.

December 5th (I think). I wake up. I’m looking around and I can see the windows around the ICU unit have been decorated for Christmas. But the tape had not stuck very well and a few were hanging down.
I started to cry.
I wasn’t making any noise as there was a hole in my throat where I was getting my air. Your vocal cords sit higher in the trachea then where they cut into to it.
I must have done something because a nurse rushed over as soon as she realized I was awake.
Somehow I thought I’d been in a coma from the Nov 22nd to sometime after New Years and the decorations were falling from being up so long.
Nope.
BTW My brother Ken was the artist apparently.
Has anyone ever had a blood test done by them poking holes in your ear lobes? She explained it was one of the few places they had left because of all the places they normally took it from had collapsed from the abuse.
They even had a tap in the veins of my wrist but that had collapsed as well.
One more funny thing.
They have a thing that looks like a choker that women wear but it has a stainless steel plug that goes in the hole in my throat so it doesn’t try to heal closed in case I have a relapse.
It allows you to talk, which I was doing to a nurse when I had a sneeze fit. That thing shot out of my throat at Mach 8 and nearly hit the nurse. It bounced off 3 walls in that ICU room.
Try laughing with your throat cut.

I was recovering pretty quickly as I was out of ICU and up in a ward in 3 days. BUT there are more shenanigans waiting for that day.
I love Blueberry pie. It doesn’t like me however.