Today’s guest post comes from Alex von Ungern, IFMGA/UIAGM-certified mountain guide and founder of Andean Ascents and Andes 2 Amazonas. Alex, who is originally from Switzerland, fell in love with Bolivia during a year-long cycling trip through Latin America. He currently lives in La Paz with his wife and children.

I first met Alex when he planned our amazing Bolivia trip in 2018. Unfortunately, soon afterward, he was involved in a near-fatal car accident while guiding a group of clients to the Uyuni Salt Flats.

Throughout his long recovery, Alex was the consummate professional. Realizing he would not be able to climb with us, he hired other excellent guides to lead us. Even when he was still sleeping 16 hours a day, he would get on video chat to answer our questions about the trip. And when a hurricane blocked our first attempt at flying to Bolivia, he somehow rebooked pretty much everything so we could make a second attempt. He came out to dinner with us on our last night in La Paz and was quite excited to be out on the town without crutches.

One year later in 2018, we were lucky enough to climb with Alex and Andean Ascents in the Ecuadorian Andes. After hearing parts of his story, I felt that it could definitely inspire other mountaineers and backpackers who were striving to come back to the sport after being sidelined by injuries.

Alex’s account of the accident and his recovery appears below. While it makes for painful reading at times, I also found it uplifting and full of hope. May it inspire you as you work through the inevitable setbacks that occur in every hiking and climbing career.

Sarah xx

Content warning: The following post contains realistic descriptions of traumatic injuries and medical procedures. If you’re squeamish about these things, you might want to skip down to the lessons learned.

The accident

It was one of those days when, I can say in retrospect, destiny was trying to warn me.

Our group left Cochabamba in the morning and encountered a roadblock just as we reached the Altiplano. (These are fairly common in Bolivia.) It had just been set up, and our caravan of a dozen cars managed to detour around it on a rough dirt road.

Once in Oruro, we stopped at a gas station, only to find a second roadblock at the exit of the city. Once more, we finally found a way around it along a very bad dirt road.

When we reached the newly asphalted highway to Uyuni Salt Flats, there was almost no traffic. We were following what is currently the best road in Bolivia to our destination. Even though we were a little behind schedule, we were still planning to arrive at a reasonable time. I remember that myself and the four passengers in my car agreed to keep cool and calm and avoid any crazy speeding.

As I arrived at the bridge of Rio Mulatos where the road makes two curves to cross the river, I saw a Mitsubishi Montero 4-by-4 vehicle coming at me in the opposite direction — in my lane. I flashed the lights, swore, leaned on the horn, and got a big adrenaline rush.

I considered avoiding him by crossing into his lane, but worried that he would swerve back, causing a crash and making me responsible. So I held my lane, assuming he would see me and move over. I also started an emergency brake.

The other driver never reacted (it turned out later that he was roaring drunk), and we had a frontal collision. I estimate that he was driving around 50 mph, and I managed to break down to a speed of 10 mph.

Up to that point my memories are astonishingly clear.

In the car

I woke up. I might have cycled in and out of consciousness a few times first. This time, I made a conscious decision to stay present.

Like in the war movies, I couldn't hear anything, only a strong humming in my ears. I was astonished that I was still alive.

I started to assess myself. I felt my right ankle and left thigh throbbing, and I had pain in my right ribs and could see my tendons through a gash in my left forearm. I knew that I was seriously damaged but felt somehow reassured that I wasn't about to die within minutes.

I didn’t suffer too much as long as I didn’t move, but I moved enough to realize that I was trapped in the remains of the car. I knew I wouldn't be able to get myself out of this on my own.

I tried to stay calm. But after what seemed like a long time, I lost control and yelled, “Why isn't anybody doing anything?” My breathing accelerated, and I entered panic mode. Then I somehow realized that if I was about to die, I might just as well do it being calm and relaxed, and I managed to take control of my breath and calm down.

Approximately 1.5 to 2 hours after the accident, an ambulance and some civilians arrived on scene. They tore the front door of my car open with pure strength — and were about to tear me out the same way. Thank god I was conscious and knew that it wouldn't work out well if they pulled me in this direction. (I had now had over an hour to figure out how I was trapped.)

I was able to communicate and told them the way to take me out was upwards in the direction of the back seat. I knew that this was a do or die moment and did my best to get my shit together. I used my left arm (the one where my tendons were visible and actually the only limb still functional) to pull on the roof. It was painful, but I knew I had to get through it.

The rescuers on scene were probably impressed by how much I was able to assist them. Once I was free, they thought I could walk the 20 feet to the ambulance. I knew I couldn't. They assured me I could. I begged them to carry me, but they assured me again that I could do it and told me they would help.

Finally, I stepped on my right leg. It hurt, but I didn’t collapse. (I had a broken ankle and fibula, but the tibia was still in one piece.)  But my sixth sense kept telling me not to step on my left leg. I begged again, “Please, no, please.” The two people “helping” (grabbing me under the armpits) lost patience and gave me a little push forward.

I stepped on my left leg, and my broken femur popped out. It was now an open fracture. I fainted.

They now helped me to the ambulance, but I started losing blood.

The ambulance

The ambulance was an old Toyota Land Cruiser with two planks screwed to the floor in the back. The nurse applied a tourniquet to my leg to stop the blood flow, which they left on until I reached the hospital approximately three hours later. The night set in, and I got hypothermic.

Maybe 20 minutes after we’d left the accident scene, the nurse told me we had reached the health post of a little village, but asked whether I wanted to go on to a proper hospital. I went for the second option.

Another passenger from my car was lying next to me in the ambulance. I could recognize in his moans that he was suffering from something worse than scrapes or broken bones. Something was definitely wrong in the tone of his voice.

Another hint that the situation was dire came when the nurse told me that the driver of the other car had died. (It later turned out that he survived and the nurse was covering him.)

As the ambulance arrived at the hospital, someone released my tourniquet all at once. I remember the feeling of warm blood flowing back into my limb. I also remember thinking that this was not the way to do it. I felt the cold blood from my leg running into my heart, almost causing it to fail.

The hospital

When I arrived at the Hospital Natividad in Oruro, a city better known for its copper mines, the doctors saw me and wanted to intervene immediately. Thankfully, they realized that the other passenger was about to die, left me, and saved his life. (He suffered internal bleeding, and the doctors later told me that they estimated he had 15 to 30 minutes more to live.)

I somehow managed to get a call through to my wife. When she arrived at the hospital, the doctors told her that I was stable for now, but they didn’t want to make any predictions about the future. I’d already received 2 liters of transfused blood. (A loss of more than 2.5 litres is usually fatal in adults.)

My wife’s sister and a friend of ours drove to the accident site, where they found the police dividing our belongings among themselves. Had they arrived an hour later, we would have lost everything. My sister-in-law later told me that she had grabbed the coagulated blood from my seat to bury in the earth as an offering. I was thankful for this.

The next morning, a team of two nurses and two doctors entered my room, where I was sitting with my wife. I was conscious but pretty high on painkillers. It felt like floating on a cloud. I noticed the nurses were holding me down, and heard the doctors counting down. I knew that something was about to happen, but couldn’t guess what. My poor wife had to help them hold me down.

3 … 2 … 1 ….

They pulled on my left leg to realign my broken femur, which was still sticking out of my skin 15 hours later. While seconds ago I’d been struggling to grasp reality, I became more lucid than ever within a fraction of a second. The adrenaline rush was like nothing I’d ever experienced before. I remember being trapped inside my head, shouting as I wouldn't be able to under normal circumstances. Time stopped, and the pain was definitely intense.

I soon underwent surgery to place an intramedullary pin in my femur, two screws in my ankle, and four screws and a plate in my fibula. After that, some interesting stuff started to happen that I honestly don’t remember. I’d began to trust the doctors, nurses, and my wife to take care of me. In other words, I did not have to keep my shit together anymore and could let my guard down. This, combined with my shocked state and the side effects of the painkillers, caused me to lose control a bit.

In addition to insulting the medical crew as I woke up from surgery, I also would wake up at night and tear my bandages apart, pull the intravenous needles out, and beg to go home. The nurses would come to hold me down, and if the IV was still in place, they would sedate me. At some point, the doctors told my wife that they hoped I would calm down, because I was reaching the maximal dose of sedative allowed.

Looking back at it, the treatment is similar to a rhinoceros captured in the Savannah  getting prepped for transportation. It’s really interesting how much energy a hurt animal still can gather!

One night, I was ashamed to wake up the nurses to ask for a urinal. I thought that as a 5.12 climber, I should be able to climb down from my bed, which I did. I then dragged myself on the floor to reach the toilet, pulled myself onto it, then somehow crawled back to the bed. After all that, I realized that I had no strength left to get back into bed, and the floor was freezing. Thankfully, I reached the alarm button and woke up the nurse.

I also remember a lung specialist giving me a local anaesthesia in my back and cutting through my skin, pleura, and lung to insert a tube to drain the fluid from my right lung. (I’d strained 4 ribs and broken one, which punctured the lung.) All this was done in the hospital room next to another patient. It hurt, and I remember the doctor telling me that 8-year-old girls handle pain better than myself.

Having a tube in your lung, sucking up blood/lung juice is not very comfortable. I also do not recommend sneezing with broken ribs.

Home

After a week, and a lot of insisting, we were allowed to go home, where our three kids were waiting with their step-grandmother. I’d developed no internal infection (a wonder), no embolism due to bone marrow diffused in my blood (another wonder), no amputations, no disfiguring scars, and only superficial head injuries.

I am very thankful that I negotiated the amount of painkillers I was prescribed with the doctors before I went home. They just smiled and recommended that I buy them all, have them next to me, and use them when needed. But after a week in the hospital taking the near-maximum dosage, I never needed a painkiller again. I was in pain each time I tried to move in the beginning, but it was manageable. And when lying still I wasn't in much pain.

To give you an idea of how powerful painkillers can be, it took me two weeks to have enough strength to sit up on my own. (Amazing, considering the nurses struggled to hold me down in the hospital bed when I had a little “go home” crisis.)

After five weeks, I was allowed to stand up on my left leg. And at six weeks, I started making little exploratory missions with a walker for old people. “Walking” 50 feet on flat ground was so exhausting that I would then need several hours siesta.

On average, I would sleep 16 hours a day. Reading a book, watching a movie, or just participating in a conversation were really exhausting to me. I am however very thankful for the many visits I received during that time. After 45 minutes, I would fall asleep, leaving the visitors to chat among themselves.

After two months, I was strong enough to get myself into a cab and walk to the rec center. I then started to go to the pool twice a week. Once in the water, I could start moving again without fear of making a wrong move that might hurt my weak body. Interestingly, I finished hypothermic each time, as my body was still too weak to thermoregulate properly. I also did a few Ashtanga yoga asanas, but it was a little too soon for me to pick yoga up seriously.

Three-and-a-half months later, I was able to walk with crutches to the base of the crag and lead climb 5.12 rock again. However, I promised my parents to not climb mountains before Christmas, and thus climbed my first 6000-meter summits, Barrancas Blancas and Uturuncu, while guiding seven months after the accident.

Less than a year later, I was able to complete my IFMGA mountain guide training.

Today, though I still can feel the injuries if I concentrate on them, I am as functional as before.

Take home message

The drunk driver who invaded my lane is the brother of a mayor from the political party that is currently in power in Bolivia. He never felt the urge to take responsibility for the accident.

I ended up paying most costs related to the accident out of my own pocket. I had dropped my car insurance three weeks earlier after the price went up, and I was still looking for new insurance when the accident happened. Only one-third of the car was paid off at the time.

My experience has been that health insurance does not cover anything anyway, so I didn’t have that either.

However, I consider myself very lucky! I love what I do with my life, which was probably the best incentive to get back on my feet. I also received an outpouring of care from my family and friends. If a relative is in bad shape, visit them. It will help. My 4-year-old son was another good reason to keep motivated.

A few things I learned

• I wanted to write this story after noticing a lot of climbers struggling to recover from injuries. Even when the injury is relatively minor, it can be tough physically and psychologically to come back. I hope that my testimony will help people find the necessary courage and faith to recover well.

• The accident reminded me that life is not guaranteed and can end without warning. Live while you can, and never take health and freedom for granted.

• This experience convinced me that you should not count on your embassy to save your ass if shit happens to you abroad. One woman, a passenger in my car, did rely on her embassy to coordinate her rescue — and it took her five days to reach a hospital. She was close to death at that point, and it took days to stabilize her so she could have needed surgery. So if you are involved in an emergency abroad, take whatever steps you can to assist yourself. You can always inform the embassy later.

• I am neither religious nor a strong atheist (which goes with the territory for an evolutionary biologist). But I do believe I felt a certain presence watching out for me, especially between the accident and the hospital. It most probably was my guardian angel, though it would be easier for me to accept this feeling if religion were a bigger part of my life.

• It helped a lot that I was spared guilt over the accident. Nobody died, and all my passengers recovered (or are still recovering) well. This is also a good reason not to speed or drive after drinking. Because how would you live with yourself if something happened?

• If you do something you love with your life, you will have a lot more drive and motivation to get back to it.

• Be motivated to recover, but beware that too much motivation can be dangerous. Motivation must sometimes be balanced with patience.

• Being rather non-religious, it feels strange to say this, but having faith is super important. Having faith that everything would be fine really strengthened and mentally invigorated me through the hardest parts of my recovery. Have faith!

• Stay in good shape. I came really close to death, and I am super glad that I was in good physical condition when it happened. I am not sure I would have made it otherwise.
  
  

Sarah here. I hope you enjoyed Alex’s story and that it will help you as you work through setbacks big and small in your climbing career.

Have you come back from an illness or injury to climb again? If so, comment below to share your hard-won wisdom.

Originally published April 23, 2019.