Sick, Overseas and Nearly Dead
It was supposed to be the trip of a lifetime but turned into the holiday from hell.
Four friends from New Plymouth left for Cuba in April 2017, but at several times over the next few weeks it looked like only three of them would make it back.
Keen to celebrate 30 years of being in business together, business partners, Craig Nolly and Richard Toon, along with their wives, Caroline and Grazia, had planned a “no holds barred epic adventure” in Panama and Cuba.
But rather than a celebration, the trip turned into a harrowing affirmation of the work the men do. The pair has owned Abacus (an insurance advisory business, or brokerage) for the past 20 years.
Little did they know as they waited at the luggage carousel in Havana that Craig was about to experience a health issue that saw him net one of the highest payouts for an individual traveller by a New Zealand-based insurer for that year (in excess of $500,000).
“I suddenly felt the urge to use the toilet, but wasn’t able to pass anything,” he recalls. “What I did not know and was not to discover until many hours later, my bowel had ruptured inside me, flooding my abdominal cavity with highly poisonous gut contents.”
After a 2½ hour journey in torrential rain over rough roads to a hotel at Varadero Beach resort for their first night, Craig knew he was in trouble.
“I was in pain. I had no idea what had happened. But I did not tell anyone, I didn’t want to cause an upset when we were embarking on the holiday of a lifetime. But I was not well enough to go out for dinner with the others.”
When Caroline, Richard and Grazia returned from their meal they called a doctor, who diagnosed a food-related stomach bug, injected antibiotics and left.
“By the next day I was much worse, with severe stomach cramps; I was doubled over with pain.”
The doctor returned and called an ‘ambulance.’ It was just an old van, with no medical equipment or supplies — no oxygen, not even a band aid. It was an hour’s drive to the provincial hospital in Matanzas. Caroline was with him, Richard and Grazia stayed at the hotel for now.
“All of this was fraught with language problems because the Cubans speak Spanish; virtually none of them had any English and that was a continuing frustration.”
Emergency abdominal surgery
Craig was operated on immediately. “I knew I was seriously ill and could not just be put on the next plane home to New Zealand. It had come down to open me up or I would die.
“We thought it could be cancer or a burst appendix, all possibilities were on the table. So I signed my life away on a consent that would have said the hospital would take all care and bear no responsibility.”
A phone call was made to Craig’s insurer and from that point they were in the hands of First Assist, which specialises in dealing with such international medical emergencies.
First Assist guaranteed payment to the hospital before the surgery could be started. Amazingly enough, one of the First Assist team managers was a Cuban who, in addition to speaking fluent Spanish, actually knew this particular hospital. So through a complex and prolonged double translation fitted around Cuba’s 17 hour time difference with New Zealand, Caroline was kept informed and this is how she knew what the surgeons were planning. She was Craig’s sole means of direct communication because he was too ill to even use a phone, let alone think rationally. Calls to NZ, incidentally, cost $US5.30 a minute.
In the operating theatre, Craig was cut open from his chest all the way down the middle of his abdomen.
“They took all my stomach and bowel contents out of my body, flushed me out, put it all back, and disconnected my bowel and put a colostomy bag on. That’s how I woke up.”
He was told the colostomy bag was only temporary and in three months he’d have it removed in NZ and be back to normal.
“But it sure did not work out like that.”
Craig had been diagnosed with mild diverticulitis pre-2000 but wasn’t overly concerned about it. Common in 25% of males over 40 and 40% of over 60 males, many people never know they have it. The main symptoms are lower abdomen pain and bloating. It’s typically controlled by diet management and sometimes antibiotics. Severe inflammation can cause a weakening of the colon [or bowel] wall.
“Four months prior to the travel I had a precautionary colonoscopy which concluded that my diverticulitis was mild and that I did not need to present for further screening for 7 years. There’s not much else you can do really.”
Richard Toon will never forget seeing Craig after the operation.
“He was in an old, tired, cold tiled room. The sheets were soiled, black and blood-stained — they looked terrible. He was a very sick man, wired up to an aspirator. He didn’t know we were there but you could see the fear in his eyes.”
He, Caroline and Grazia did what they could to make things more sanitary and comfortable for him, like buy new sheets.
Craig remembers the hospital staff “changing the sheets” before he got the new ones. It was an excruciating 20 minute process, and all they did was turn the blood and faeces-stained sheets over to the other side, which was just as bad.
Through the whole process Craig says he was very aware.
“There’s a lot of dark stuff that happened in that hospital, deaths around me — life’s cheap in a communist country.”
He particularly remembers a teenager in the bed next to him who died and his family weren’t even allowed in to see him. Craig could see the youth’s family patiently waiting through a window.
“The Grim Reaper would come in the middle of the night with a wooden table and take them away.
“Even in the bottom of the hospital there was concrete saws, kanga hammers … the dust in my room. It’s not a hospital like we know it. It’s an infirmary of sorts.
“Nothing worked … the ultrasound, the x-ray machine … nothing was good enough to tell them what was wrong.”
Most of the time he was alone, unable to speak because he was hooked to the aspirator and because of the language barriers nobody was telling him anything anyway. Visitors were only allowed in for ten minutes a day, so there was very little bedside comfort for Craig.
As for Caroline, Richard and Grazia. those ten minute visits to ICU were preceded by endless hours of waiting. Finally they would be brought some green gowns, led through a men’s toilet and along a corridor to Craig’s room.
“To see him it was the same rigmarole each day.”
The Paperwork
The travel insurer requested documentation, copies of passports, tickets, itineraries etc and this was when “the fun” started, says Richard.
“The hospital had a room with wifi for which you bought a numbered card at the local post office. Sometimes it worked, sometimes not. It was hopeless. I took photos and tried to email via my phone from the hospital. That didn’t work, you could perhaps get one image through, the broadband was so slow.
“They had one computer that looked like an Amstrad 64 and they couldn’t print out. This was a hospital about the size of Taranaki Base, but looked like it was built in the 50s, had an Olympic sized pool, tennis courts, basketball courts. There was an old donkey grazing in the pool, that’s how bad was the state of everything.
“When you visited the hospital you had to step over 4 or 5 dogs at the main entrance.
And there was a man walking around in pyjamas who every day asked me for money for his operation.
“So, to get the documentation to the insurers we had to use the post office to buy more wifi cards, then the photocopy shop, then another shop to be scanned onto a usb stick. We had to queue up outside the post office, where a security guard was letting people in one at a time. There appeared to be three loose kinds of queues.
“I was pointed to the computer queue. I waited about an hour and a half until I was called. The computer was in Spanish and almost every letter and number was worn off the keyboard.
“You had to slow down and work it out. Each step was really difficult, time-consumingly so. I was in a foreign environment, my head was buzzing, I was concerned about my mate and I just had to focus on what was in front of me. Grazia was at my side the whole time and she was fantastic support, as Caroline was for Craig.
“It took us two days to get the documentation through to the insurer. After our experiences, my advice to anyone travelling anywhere overseas, especially to a third world country, is to have your documentation on your phone, on a usb stick and hard copies in your bag.
The Second Operation
A few days after the first surgery, Craig’s tummy became very distended and he had to be operated on again.
“They found the bowel was twisted around my intestines.”
Then the colostomy bag failed and the stoma attachment fell inside Craig and poisoned him again, and they had to go in for a third time to repair that.
“Everything that could go wrong did go wrong. I was too weak to recover (he didn’t have any food the entire two weeks he was in Cuba and lost 14 kilos), I had to get out of Cuba.
“I said to Richard: ‘I’m going to die here, I can’t get well here, the system won’t allow me to. You have to get me out or I will go back in a box.’ That was the plain reality.
“I believed I was just hours from imminent death.”
Each time the respirator was inserted into his throat it was without any sort of anaesthetic. Richard knew that while Craig was in ICU he would not be able to be transported.
“No airline will take anyone who has just had abdominal surgery and he was not in a state for a flight. We just had to battle on.”
Two days later Richard wandered down to ICU to look in on his friend and business partner, just as Craig was being wheeled out.
“He was put in a room with two other Cubans and their families. It was a noisy, confusing, terrible place where the patients were more or less left to fend for themselves. One time about 3am the nurses started dancing to a stereo turned up to high volume.
“Next day we got him into a side room. It was his worst day, he was very uncomfortable and distressed. Later Caroline phoned me to say that while settling Craig down she had found what she thought was an infection and he was starting to burn up.
“At midnight I walked to the hospital and saw he had an infection on his side that was as hot as if you had poured boiling water onto a tea towel and held your hand on it. It was creeping up his body as we monitored him.”
He and Caroline remained there all night applying gauze pads soaked with IV fluid to keep Craig’s temperature down.
“About 3am I got through to the chief medical officer of First Assist and told him I was fearful for Craig’s life. He promised me then they would get him out fast, no matter what condition he was in.”
Happy Birthday
Two good things happened on Craig Nolly’s 56th birthday on May 7th, 2017.
He got his first ride in a Lear Jet, and he finally left Cuba.
Craig was left sitting on the tarmac on a gurney in the boiling sun for 20 minutes while they went through airport security. The fact it was an emergency didn’t appear to matter to the Cubans.
“Then they put me in the Lear jet and it was hotter in there because it wasn’t running. Then we were waiting and waiting and waiting to get the authority to leave.
“People can say what they like about the Americans, but when you have three Americans at your bedside when you’ve spent two weeks in an infirmary in Cuba it’s like God’s sent someone to get you.”
Forty-five minutes later they landed in Florida with Craig transported to Fort Lauderdale Trauma Hospital.
“While the hospital was still a major step-up from conditions in Cuba, it was nothing like the hospitals portrayed on American TV shows with sliding glass doors and what-have-you,” Craig recalls. “It was more like the old Barrett St hospital, with 900 beds.
“I was fighting a superbug so they had to culture antibiotics to deal with that. And I needed further surgery there because I had abcessed from the infections in Cuba.”
Richard and Grazia had to return to New Zealand for the funeral of a family member, and so Richard could look after their business.
Getting Craig and Caroline home to New Zealand ended up taking six weeks.
No airline would take Craig in the condition he was in: unable to walk, with open abdominal wounds, and still fighting infection. They did not want the risk of having to turn back mid-flight, or the patient dying.
Unknown to Craig, Caroline had arranged to have their four adult children fly over to be with them. They arrived on the 8th May.
“I didn’t register it was them when they walked in …”
“They were wearing hospital gowns,” Caroline points out.
“Yeah they were all dressed up like Handmaid’s Tale I suppose,” Craig grins, “and all of a sudden I recognised them when they got closer to the bed … I was so overwhelmed. That was pretty cool. We had no confidence I would ever see them again.”
One of the ‘lucky’ things to have happened was that the family were planning an epic holiday to the US later in the year to celebrate Caroline’s 50th birthday, so all the kids’ paperwork was in order to make the emergency dash to Fort Lauderdale. Funds that had been set aside for that trip were used for the kids’ airfares to Florida.
Not so lucky was the fact the holiday had to be cancelled.
“The kids stayed for between 2 and 3 weeks and I am certain that was an important factor in my recovery because we are a very close family.”
Homeward Bound
Nearly a month after arriving at the Fort Lauderdale Trauma Centre, a doctor and nurse were sent from New Zealand to assess Craig and prepare him for travel.
“When those two guys arrived at my bedside in Miami I was overcome, that someone thought I was important enough to come from the other side of the world to help me get home and I just broke down.”
They flew out on June 3 in a bedside to bedside transfer to Taranaki Base Hospital.
“I was lying in business class upstairs with a doctor and nurse either side of me for the whole flight. They were administering morphine through the flight and I had a big vac-pack across my abdomen to protect my four large open wounds. The infected fluid was being pumped out also.
“Arriving home was an emotional time for me, I got my appetite back that day. As we came in to land I looked out and saw the Taranaki coast and I never thought I would see that again. I just cried and cried.”
Craig spent three days at Taranaki Base Hospital.
When he walked into his home for the first time and saw the familiar surroundings and views, he cried again. “I realised I had everything I needed to be happy right here.”
But Craig’s medical journey was far from over.
“I might have been home a week or so, ten days, and I got the fright of my life when stuff started coming out of my wounds.”
Craig drove himself up to the Emergency Dept and that “stuff” turned out to be bowel contents. They didn’t want to open him up for a fifth time as Craig had lost so much weight and was incredibly weak. So he was sent home to eat nutrition-rich foods and get healthy enough for another operation.
The district nurse came every day and flushed out his wounds.
“I spent nine months in my bathroom.”
Craig reflects that in a way it was lucky he had so many large open wounds as they provided an outlet for his body to get rid of the bowel contents.
Finally, on 20 March 2018, Craig went in for his operation to remove the colostomy bag and “make him whole” again. That was when the doctors realised that the leakage problem was caused by all the bad surgery Craig had in Cuba.”
Looking Back
“We were lucky there was four of us. It would have been impossible for just two people to have got through this terrible time,” Craig believes.
“Caroline was a rock, my lifeline. And without Richard’s support and First Assist’s involvement I have no doubt I would not have survived this,” he adds. “They were incredibly good.”
When Craig returned to work at Abacus on June 6 he was apprehensive and anxious after 14 months absence.
“I wondered about my confidence because it’s not something you can slip back into easily. I now appreciate what it must be like for someone who has been made redundant perhaps and faces the challenge of returning to working life. The preparation for my return has been a 4-6 week plan agreed with my insurer. I have had guidance from a psychologist, an occupational therapist and my GP.”
Caroline Nolly says she had to find some real deep inner strength to get through the adversity “and I now know that I am a stronger person because of this.
“The days in Cuba were long and many days I was only able to visit Craig for 10-15 minutes at a time. In a country that is 60 years behind the rest of the developed world and speaks Spanish, we had to find our own food, water and basic supplies and those simple tasks became our survival mode.
“Richard and Grazia were my rocks, I cannot speak highly enough about them both and the challenges that we all endured and just got on with it, but what other choice was there? I could not have coped in Cuba on my own and don’t even want to think about what the consequences could have been had I not had them with me during this time. Our children were also fantastic support. Luke stepped up and took over making sure every one of our kids and extended family was kept in the loop as to what was going on. It was very difficult for them to deal with being so far away and I am proud of how they bonded together. This has made them all a lot closer also.
“At times like this you also realise how much the love and support of extended family and friends is needed. This support was so important in the tough days and boy there were a few.”
Craig adds, “The visits and messages right through my convalescence … everyone has been outstanding and we can’t thank everyone enough.”
Craig is now even more grateful for those things in life we all tend to take for granted.
“What a privilege it is to be able to get up and go to work. To be able to provide for your family, to walk outside, all those simple things.”
When asked how he now feels about what happened to him, Craig surprises me.
“If you’d asked me to plan my life for the next five years, there’s no way I would have put all what I went through in there. But would I take it out of the journey now? I don’t think so. We’re sitting here now aren’t we? Certainly I would like to be not as mutilated and have the scars that I now have, but in a roundabout way it’s the road map of where I’ve been.”
He’s chosen to look at the good things that have transpired from this event.
“There’s always an itch to scratch or scab to pick if you want to find it … you can keep on going until you find the negative. It’s too easy to go there. But we’d rather go the other way … look for the good in things. I could choose to be traumatised by what I went through and the things I saw, or appreciate the great things in life that we have.”
So … would he ever go back to Cuba?
There is absolutely no hesitation and the answer is firm.
“No. I will never go back.”