We were felling the last tree.
I was standing on top of a small roof about three meters above the ground, and Jan was standing below with the chainsaw. I had a rope loosely tied around my waist to lower the tree in a controlled manner. I hadn't realized three things: that the tree was much heavier than I could handle, that the rope wouldn't slacken that quickly, and that the tree was falling much faster than we expected. The rope suddenly tightened somewhere around my waist. I was pulled off the roof by the weight of the trunk and smashed to the ground. I can't remember it anymore. The first thing I could remember was: I'm lying on the ground, not good, pain, pain, get up, get up. Shit, shit, not good. Trying to stand up. Groan, ouch ouch. I scramble up from between the branches and the weeds. Blood, scratches, left arm is cut open. I stand up. Nothing broken? I don't think so, at least not my back, neck, or pelvis. Pain in my chest. A lot of pain in my chest. Difficulty breathing. I feel something flowing on the right side inside. Right side hurts a lot. Calm down, calm down. Jan and Mach are calling out to me: oh no, oh no. Calm down. I stumble groaning to a nearby chair. Sit down. I try to calm down, not to panic. I feel that something is very wrong with me inside. I can't breathe properly. I hear myself groaning with every breath. Can barely breathe. Don't faint, stay calm. I turn pale, my lips turn blue. Panic, defeat, pain, and disappointment overwhelm me. How did this happen? Something like this never happens to me, does it?
Mach sees the disappointment in my eyes.
At this moment, Jan decides to call 112. Fortunately, the ambulance arrives quickly. I briefly lose consciousness. Everything turns white, and I find myself in a bright, warm, deafened environment. That is pleasant. For a moment, there is no pain, no despair. When I return, four paramedics and nurses are examining me with concern. They have me restrained calmly but firmly, and I am immediately placed in traction. Neck fixation and diaphragm fixation. I have to search even deeper for a place to relax. I cannot move at all now, and the position in which they have fixed me is very painful. I am hooked up to an IV—I think a painkiller and possibly muscle relaxants as well. They have since concluded that a helicopter will be needed. I cannot be transported. They consider the risk of escalation of potential internal bleeding to be too great.
I try to stay calm, but I am in survival mode. I try to make clear in Italian how I feel and where it hurts. But the words have slipped my mind; I can't manage it anymore. Fortunately, I catch it. Dolore? Si, Dolore. Dove? Qui, I point to the right side of my waist. si qui multo dolore. Aspire? Breathing is difficult. Later, Mach will say that I am groaning incessantly like a wounded creature. I am hoisted into a wheelchair by three men. Uno, due tre! I am carried down our little staircase in the chair and hoisted onto a stretcher downstairs. Slided into the ambulance. The paramedics are super nice and super professional. I am not allowed to do anything. But I can't do anything at all anymore. We drive away. No idea where to. I don't register anything there anymore.
From this moment until far into the hospital ward, ceilings are my only view.
I cannot look to the left or to the right, only up. We bump and rattle our way towards a small sloping meadow nearby where the helicopter has since landed. Later, I hear that this is the only helicopter in all of Umbria, and moreover, it has only been in service for three months. Lucky me. I am hoisted from the stretcher onto a heli-stretcher. That one is even smaller and even more uncomfortable. I am now strapped down by my arms and legs as well. Six men lift me up and carry me towards the helicopter. A dangerous undertaking. The meadow is sloping, overgrown with tall vegetation, full of large holes, stones, and completely churned up by wild boars. The ambulance and helicopter crew stomp synchronously and determinedly through the uneven meadow. I almost think it’s going to go wrong. I nearly tip over to the left. Piano Piano. But it goes well. Fifty paces further, the slowly moving rotors of the helicopter appear in my field of vision. I am slid into the heli. I look into the eyes of two concerned people, in yellow aviator suits, yellow helmets, microphones, and masks. Okay? Yes, I'm okay. What else can I say? I get headphones put on. For il rumore. The rotors start spinning, the helicopter accelerates. I think we are flying, but I can't really judge, because I can only look at the ceiling. I do see some cloud formations darting past every now and then. Every minute I am asked if I am okay. I have to do this by giving a thumbs up. I just keep my thumb up, then they won't have to ask anymore.
After about five minutes, the helicopter lands. At least, that is what I suspect, because the rotors slow down. I am unloaded, wheeled into the hospital, and a moment later I am lying in the emergency department.
New eyes look down on me. I am hoisted onto another stretcher again, still fully in traction, extremely painful, but I try to stay calm. I have to explain what happened. No one speaks a word of English. Son catudo dal tetto. How high? Three meters. Dragged into the undergrowth. I am brutally stripped of the rest of my clothes. My only good pair of trousers is resolutely cut to pieces. I am now lying in my underwear and socks, staring at a bright light. I get two new IVs. I get an oxygen mask. That is nice. My superficial wounds over half my body are being treated. Cold, smooth, cream, feels nice too, relief. A gold foil is placed over me. They leave me alone for a while. I try to breathe low, at 50%, that is the best I can manage.
Papers are being filled out. Fortunately, Mach has already prepared everything at home and had my passport and insurance papers copied. So they know who I am. And that is nice, because I am absolutely nobody anymore. I have no wallet, no ID, no phone, nothing but my underpants and socks. Devastated. I still think that I will go home soon; I want to, I want to.
I am moved, wheeled away to the TAC department. I have to think for a terribly long time to realize that this is a CT scanner. A surly man asks if I am allergic to iodine. I have no idea. I just say no and am injected with contrast fluid. I don't fit in the CT scan. I have to hold my arms above my head. That only works with my left; with the right is really impossible. Okay, then only with the left. So there I lie like a wounded monkey, slowly being slid through the CT scanner six or seven times. I hear a computer voice say: “trattenere il respiro” and “respiro”. I have no idea what that means. It takes a few tries before I conclude from the context that I am supposed to hold my breath while the CT scanner is working. So that's what I do.
It is a slow process. In the machine, out of the machine. I am getting tired, but I try to stay alert, accepting the absurd position I find myself in, and remain focused on the present and far away from my bruised body.
Then suddenly the surly man comes back in and says: a posto. Done. I am wheeled back to the emergency room. It has become busy by now. There is a lot of staff walking around. In all sorts of colors. Blue, green, white, yellow, red. I am parked in a strategic spot right next to the door where all the staff walk in and out. The hose of my oxygen mask is attached to the wall, but all the staff have to walk underneath it. My mask is constantly being pulled. I try to keep count because I have nothing else to do anyway, but I quickly lose track. No one cares about me, despite the fact that I am constantly being stared at for just a little too long. But no one makes real eye contact.
I think I lay like this for two hours. Waiting for what is to come. I want to go home. It is all so surreal. It is all so crazy. I try not to think about what ifs, but try to stay in the now. In my underwear, with my socks sticking out over the way too small and narrow stretcher, with a small gold foil over me, in full traction, with two IVs and an oxygen mask on.
Eventually, I am approached by a head nurse. The doctor will be right there. And indeed, a short time later, a jovial, well-groomed man of my age enters my field of vision. "Alora," he says, "I am going to operate on you now." Whaaaat? Operate? What do you mean? Huh? Can't I go home then? "No, you are being operated on now, and then you have to stay here for a week to recover." "Why?" "What are you going to do?" "You have a collapsed lung and a perforated lung; there is fluid and blood in the space between them, and that needs to come out. And oh yes, you also have five broken ribs, one of which is complex."
The surrealism level is rising to the ridiculous. What? Collapsed lung? Perforated? Broken ribs? Five??? Stay here for a week?
Moments later, I am lying under a lamp, thankfully taken out of traction and somewhat more comfortable, with a green napkin over my head, resignedly undergoing the outpatient procedure. The doctor makes a 3 cm hole in my chest on the right side, diagonally above my nipple, and pushes a tube through it. Sharp pain. Three pushes. I think it must feel like getting a bullet through you. Pain? I say: only when I laugh. Haha, you are funny, you are the Flying Dutchman.
Then the green napkin is removed from my field of vision. All done. It didn't take long. The anesthetic took longer. The doctor is pontificating. Three very young nurses are standing in line next to each other, listening attentively to the doctor.
The doctor is happy. I'm just joking. Can I go home now?
I ask for my wife, for Machteld. Is she here? May I please see her? That is being arranged. Tua moglia arriva. Out of the corner of my eye, I keep a close watch on the door. It still takes a while before I see her come in. She looks strong, very worried but grateful. She holds my hand. I tell her what happened. Like me, she is surprised by the severity of the trauma. But she also says: you were lucky. It could have ended very differently. Very differently. I don't realize that yet. I am so happy to see her, I want to hug her, I want to kiss her. I want to laugh and cry, but I can only act sheepish behind the oxygen mask.
I ask how long she waited. Hours and hours she was in uncertainty. That must have been terrible. I ask what time it is: "half past nine", she says. What? That late already? Wow. So I’ve been lying here for about five or six hours already. Mach is so sweet.
A little later, I am taken to the ward. Another Fellini experience. I am wheeled into a room, the bed is placed right between two older gentlemen. I baptize the man on the left the Professor (87), the man on the right Scrooge (60s). They are both in quite a mess. Scrooge is awake but is letting everything go, and the Professor is sleeping and just groaning. The Professor's wife sits beside him and does not leave his side for a moment. For the next 60 hours, she sits beside him. Day and night. It turns out she is 82 years old. It is a loving sight; every now and then the Professor opens his eyes, looks to his wife and then falls back asleep, reassured his beloved one is still there. He has had an attack and is waiting for a blood transfusion, or so I understand.
Scrooge is an unkempt, snapping man who is constantly scrolling through Facebook on his phone at maximum volume. A cacophony of chaotic, aggressive, senseless sound fragments bombards my brain. When he finally spends ten minutes staring, fascinated, at a video of loudly screaming and moaning people, I ask him if he would please turn down the volume. He looks at me and shrugs in an attempt to explain that he doesn't know how to do that. I tell him how, and he actually obeys. The Professor's wife and I breathe a sigh of relief.
Mach is still with me. Just go home, I say. There’s nothing more you can do for me now anyway. Reluctantly, she gives in. She will be with me twice a day for the next five days, morning and evening. Forty-five minutes there, forty-five minutes back, twice a day. Three hours of travel a day. Over the bumpy Italian roads with oncoming traffic that invariably swerves across the line. How often we get a fright from that. I shouldn't feel guilty, but of course I do. Even though I realize what she says: you could have been permanently disabled or dead. So I am glad you are still here. And I enjoy coming. And otherwise, I would just be bored anyway. I am happy when she comes and wistful and sad when she leaves again.
I am in the regional hospital in Terni. Terni is an old working-class town that once flourished during the Second World War due to its strategic location for the production and storage of coal (it lay just out of range of the Allied gunboats), but has been in decline ever since.
The hospital is also in disrepair. The wallpaper is peeling off the walls, the lights only work halfway, and the toilet doesn't work. The staff is professionally friendly. They don't speak English—at least, they can, but they don't. No idea why.
You have to ask for everything: water, food, toilet (in a bottle they call Pappagallo), medication, care. If you don't ask, nothing happens. They walk right past you. Not even asking: how are you doing? It is common here, but I do have to get used to it. Only highly educated staff are professionally empathetic and communicate in English.
The nights are characterized by loud wailing, moaning, and screaming. It is terrifying, but above all, of course, just very sad. Old people with dementia who have broken a hip or arm and who no longer know who or where they are scream for help. All night long.
I hardly sleep the first night. Fortunately, Machteld brings me the noise-canceling headphones the next morning, and they will save the following nights.
I cannot move. The seriousness of the situation is slowly sinking in. I can do nothing but accept and endure. Fortunately, I discover a remote control for the bed and place it within reach. Now at least I can sit upright to feel awake.
On the second evening, I haven't peed for 14 hours. My body is protesting, and my bladder has locked up. No matter what I try, it doesn't work. I have retention. The nurse gives me an hour but comes back five minutes later with a catheter. A tube just under a meter long. After four attempts, it finally works. It is a terrible experience. I am writhing in pain. Now I can't do anything at all. I am rock bottom. Oxygen mask on, IVs in both arms, tube in my chest, tube in my penis… I am defeated, sad, and don't want to be in the here and now anymore. I have to cry terribly; suddenly I feel very sorry for myself. Fortunately, Mach is there to comfort me.
Fortunately, later that night the ward doctor sees my pain and has the catheter removed after a few hours. What a relief. From that moment on, I promise myself to find a way to avoid this in the future. I must be able to urinate independently.
And I find a trick! Brahms Symphony No. 1! I know this piece well. It was one of the first pieces I listened to on the gramophone as a small child. Now I only have to play it in my head and I'm off. But now I also have my noise-cancelling headphones! I put them on, open Brahms No. 1 on YouTube Music, and sure enough, it works. The music takes me to a place far from the here and now. I forget where I am and I can pee again.
Dissolved.
After two days, I am starting to get used to hospital life. The nursing staff is starting to get used to me too. The ward doctor consistently calls me The Flying Dutchman, which leads to great hilarity. The staff works hard. They are constantly busy putting out small fires everywhere. I try to make as little use of their services as possible.
I have also discovered the sleeping pill. I only have to ask for it. With this pill, I have been sleeping for the last two nights. Although I wake up in exactly the same position I fell asleep in. I can't move, let alone get out of bed. Moreover, I am also hooked up to a suctioning pump that sucks the air out of the space between my lungs. On the third day, I really need to go to the toilet. With a lot of thinking and very slow movements, I manage to stand up, and together with Machteld and the pump, we attempted to do our business. The toilet has no seat; it is much too low. But I still find a way to squat down and up using only my leg muscles. Success! What a relief.
On the fourth day, I get a visit from the doctor who operated on me. He has come to remove the tube. It is pure pandemonium again. In his wake, at least five men come to watch him do the trick. A light anesthetic, “little pain,” says the accompanying anesthesiologist, that cloth over my head again, take a very deep breath, and, wham, in a fluid, rather brusque, movement, he pulls the tube out of my body. Pain? No, only when I laugh. “No Push, No Pull for a month!” says the doctor. “No Sex?” I answer him complainingly. Hilarity all around. That’s not something people talk about here.
Oops.
Another night. A night among the old men. Scrooge hasn't had a visitor all week. No one has come to support him. His phone does ring constantly, though; everyone has their own ringtones. Lambada, Macarena, that sort of ringtone. So he can certainly handle that on his phone. I have gotten to know the Professor's family a little by now. A son and his wife are there every afternoon. And the Professor's wife does not leave his side. He is doing better. He has had his transfusion and is actually awake; they are reading the newspaper and a book together, and speaking in calm tones. They are fine people.
And then I get to go home. For four nights and five days, I have barely moved. I have pressure sores on my buttocks. I can no longer stand properly on my legs. My right thigh is badly bruised. I have wounds, scratches, and bruises over half of my upper body. I have a constant burning pain on my right flank.
But I am back on my own two feet. I am being disconnected from the system by both arms, hurray, and am allowed to leave. But not before a medical discharge report has been drawn up for the insurance. SOS int, with whom we are in constant contact, has strongly urged us that we really must obtain these papers, before we get out of the hospital. We have to wait for it. Meanwhile, the paramedics taking me home are getting impatient. But by now we know how things work here. We wait patiently and gesture to the paramedics that they should just go complain to the staff. That helps. After half an hour, The Report finally arrives. Completely in Italian, but fortunately there is Google Translate and Gemini, which has converted it into normal human language:
In short: the scan was performed after an accident (trauma). The main findings are a collapsed lung, multiple broken ribs on the right side, and some bruising of the lungs, but fortunately, the internal organs (such as the liver and kidneys) and the vertebrae are not severely damaged.
Below is the translation in plain language, subdivided by region:
1. The Chest (Chest and Lungs)
Pneumothorax (PNX): A pneumothorax is visible on the right side. There is a layer of air between the lung and the chest wall. At its widest point, this layer is 33 mm.
Lung contusion and fluid: At the bottom of both lungs, spots are visible indicating a severe blow (post-contusion). On the right side, there is also some blood near the pleura.
Airways and heart: The trachea is clear and there is no fluid around the heart. This is good news.
2. The Abdomen and Organs
Internal organs: The spleen, liver, and other organs in the abdomen show no damage from the accident.
Splenic cyst: A fluid-filled cavity (cyst) of 32 mm has been found in the spleen. This is likely something that was already present and is usually harmless.
Kidneys and bladder: The kidneys are functioning well and are draining the contrast fluid normally via the ureters to the bladder. No leaks were found.
Bile ducts: The gallbladder looks normal and there are no gallstones.
3. The Blood Vessels (Aorta)
Arteries: The main body artery (aorta) has a normal width. Some atherosclerosis is visible in the lower abdomen and pelvic vessels, but this is a sign of aging and not acute damage caused by the accident. No tears or hemorrhages were found in the vessel wall.
4. Bone fractures (Skeleton)
Ribs: On the right side, the 3rd, 4th, 5th, and 6th ribs are broken. The 7th rib is broken in multiple places, and the bone fragments are no longer properly aligned (displaced).
Spine (Neck, Back, Lumbar):
No fractures were found in the vertebrae.
However, there is wear and tear (osteoarthritis), particularly in the neck (C4-C5) and lower back (L2 to L4). These are chronic complaints and are not caused by the accident.
The canal through which the nerves run (spinal canal) is on the narrow side, but still within limits.
What does this mean?
The focus of the treatment will likely be on the recovery of the broken ribs and the collapsed lung on the right side. The doctor will monitor whether the air and blood in the lungs clear on their own or if additional assistance (such as a drain) is needed. The other findings (such as the splenic cyst and wear and tear in the back) are 'incidental': things that were seen by chance but have nothing to do with the accident.
So actually, only good news. On the way back home in the ambulance, I realize how lucky I actually was. I could just as easily have broken my neck, or suffered a spinal cord injury, or both my legs. I had absolutely no control over my fall. Jan later told me that, in a reflex, I curled up into a ball to protect my head.
I am very sad. Sad because I really can't do anything anymore. Sad because now everything really falls on Mach's shoulders. And life here is already complicated. And now she has to do everything on top of that. And she does everything for me. Doesn't complain, is just so sweet and understanding, grateful that I am still here. She even says it out loud: if you were no longer here, I wouldn't know what to do. I would go completely crazy,
And so the story ends for now. I am back at the place where it all went wrong. I don't dare look at the place where I fell yet. It will take time. Just as I will now need time to recover, heal, and find myself again.
I do know that I am broken. Physically and mentally. That I am at a breaking point. I have done a lot of crazy things in my life, but until now I have never had to pay the price for them. And the fact that this is the case now feels strange. Something was wrong at the time of the accident, something wasn't right. But I don't know exactly what that was yet.
And maybe I never will.
May 18, 2026
















