F*** Motorcycles

November 2019

It began with a backpacking trip to Asia in 2019. I was visiting Singapore and Thailand. I arrived on the 4th of November and intended on returning to Toronto on the 18th.

All the promised fun!

After visiting ClassPassers in Singapore, I met friends on the tiny Thai island of Koh Samui. That night we headed to the Full Moon Party. We took a small speed boat to Koh Phangan for the night, had a blast, and began recovery on the next day.

I was on a health binge and exercise streak. The small island lacked access to my preferred weight-lifting, yoga, or cycling. So I decided to go on a run. I ran on the side of the road, cautious of the cars whipping past an arms-length away. I rarely ran, but when I did, I'm always in awe of the human body as an engineering marvel.

I made it back, and someone suggested renting motorcycles. As someone with a motorcycle license and with little experience riding, I thought this was a marvelous idea; riding motorcycles around a tiny remote island in Asia.

We picked up our motorcycles the following day, and I led our expedition to our first destination, the Big Buddha. I loved all aspects of the monuments that we visited. We decided to make our destination "The Magic Garden." It's our White Castle minus the drugs. It's highly rated.

Our route for the day.

Our path turned from a paved road to a less-paved road on the route. I didn't make much of it. There were a lot of other riders and plenty of online reviews.

Once we reached our destination, we took in the ambiance. I hopped stone to stone, amazed that our eyes, brain, and lower limbs made these movements appear trivial.

It began to lightly rain, as tropical weather does, and we decided to call it a day. I led our pack back towards the paved road. At the bottom of a hill heading downward on a curve, my motorcycle began to slide. I was going roughly 25km/h. I've been on a bicycle going faster. The difference here is that the motorcycle weighs about 250lbs or 114kg. I tried stopping the slide with my foot. The motorcycle tips over and continues to slide with my right leg underneath.

Now, I was on the floor facing down, the bike on my right leg. I thought I'll do a Willy Wonka front-roll and tada! Sanjay is all good everyone. Nope. I couldn't even budge the bike. I beckoned my friend over. He cautiously came to a halt and lifted the bike. To my horror, a bone around my ankle was sticking out.

I should have worn boots. The lack of warning and other people wearing sandals had me thinking otherwise. It's tough to say if boots would have prevented this.

Well fuck. At this point, there's one thing I could do. I focused on my breathing, and I trusted my SF buddies to figure out the logistics. I waited for my airlift; instead, 30 mins later, I was in the most technologically advanced ambulance that Koh Samui offers.

A modded pickup truck.

The ambulance resembled a funeral car. I'm strapped to a surfboard-like object as the vehicle bumped up and down. I urged the nurse to support my foot as it hung off to the side. There was a language barrier. There was no action. There was a lot of pain.

We pulled up to a charming hospital, all things considered. I'm grateful for the funeral car, but I hoped this wasn't foreshadowing. I rapidly see a few doctors, they even spoke English, and they even had an orthopedic surgeon. An ortho surgeon on a remote island on a Wednesday night? This accident might be common. Okay, well, if he could fix my ankle, I wasn't complaining.

I met the anesthesiologist who spoke English and reassured me that I'm in good hands at the private hospital. A few moments later, she informed me that my oxygen levels were low and that I needed a blood transfusion. She said there's a chance of getting HIV, but it's very low. It didn't seem like I had a choice. I signed the forms after my good friend verifies my insurance. The transfusion was smooth and it turned out my thalassemia contributed to the measured low oxygen.

I was constantly thinking of family and friends. I pushed those thoughts to the back of my head. I didn't know the severity of all of this. A tear ran down my right eye to my bed. I looked right and see my friends. I pulled myself together.

I was actually in the CAT scan room. A few moments later the staff informs me that the CAT scans aren't good enough. The doctor said my ankle would require "advanced medical imaging". I took the next set of images. It was confirmed to be a trimalleolar fracture with shards of bone. I was wheeled to the surgery theatre. I dozed off seeing the surgeon in black scrubs, hands behind his back, eyes closed, whispering to himself.

I woke up the next morning and remembered thinking, "oh nice, I'm alive". I had my Kill Bill moment of trying to move my toes with no luck. Moments later, I had intense pain in my foot. It felt like the bandages are too tight. I informed the nurse, she calls the doctor, and they open up the cast. My foot is a balloon.

A shaved sasquatch foot.

At this point, I rescheduled my flights. I still thought I would be out of here in a few days. I invoked the "Act of God" clause on an abs challenge that I planned with my Toronto friends. There was no way I was going to get abs in 5 months. Meanwhile, I didn't want to ruin my Bay Area friend's trip. I insisted that they continue to Bangkok after a few insisted on staying. I said if anything goes wrong, I'll reach out no problem, but sitting around isn't going to help.

It's Thursday, and the ortho surgeon informed me that he flies in during the weekdays and flies out over the weekends. I didn't make much of it. In the meantime, I had another doctor. Over the next few days, I developed a fever. The wound turned black. The temporary doctor said we need to be careful. A skin infection could lead to an infection of the bone, leading to infection of the blood and sepsis. I slowly nod my head. I haven't heard of the term sepsis. Once he left, I turned to Wikipedia. 😀

Sepsis will prove fatal in approximately 24.4% of people, and septic shock will prove fatal in 34.7% of people within 30 days (32.2% and 38.5% after 90 days)...

The ortho surgeon returned after the weekend and said there would be no way that they sign off on my scheduled flight. I had to go into emergency surgery. The surgeon apologized profusely and said that he would do the surgery for free but of course, the staff would need to be paid. I knew he felt terrible for leaving over the weekend.

At this point, I was concerned about my insurance coverage. I was to pay out of pocket and then get a reimbursement. My credit card had a limit that I kept low at $10,000. I called my credit card company and they happily raised my limit to $35,000. As a spoiled Canadian, I had many thoughts on private health care. What were their incentives for healing tourists to the best of their ability? Was this going to be surgery after surgery? Did they even want me to leave since they have to sign off on my flight when I'm in a cast? What if I were someone less fortunate? It's a deep rabbit hole.

This entire time my girlfriend insisted on coming to Ko Samui. So finally, emotionally drained, I took her up on the offer. I don't want her flying for 18 hours through 2 layovers but now felt like the right time.

Fun fact, health insurance covers corpse shipping — less hassle for everyone.

I was sent into my second surgery, and now they removed the skin to avoid an infection.

I still love zombie movies.

For the duration of the stay, I had two different antibiotics pumped into me intravenously every 4 hours. I couldn't sleep with the needle in my skin. The surgeon changed my wound dressing every two days. I spent my time programming since consuming content didn't preoccupy my mind enough. My girlfriend arrived a few days later, on the 21st, and I was elated. She brought healthy food from a local shop for every meal, a boon after 8 days of hospital food.

After rescheduling many flights, we flew out on the 23rd. The doctor warned me about thrombosis and gave me an anti-blood clot syringe for the two layovers. I couldn't wait to hit Canadian soil. A few flights later, we arrived in Canada. The border agent looked at my passport and said, "Welcome back home" I wanted to cry. 😭

It was late on the 24th, so we went to Toronto General Hospital in the morning. The doctor, maybe an intern, took a look and prescribed antibiotics and said to go to Toronto Western Hospital on Wednesday. That's great. Perhaps this wasn't as bad as it seemed. The doctor didn't check me into the hospital.

At Toronto Western Hospital on Wednesday, I met my new ortho surgeon, who exclaimed, "You're not leaving today." I checked into the hospital for a few days. The doctor prescribed a wound vacuum and a broad range of antibiotics. I had a few checkups weekly. I went to a nurse's clinic to change my wound dressing 3 times a week. If the wound vacuum doesn't work, I would need a skin graft. Things are beginning to look good. I wasn't going to die alone of a blood infection in a foreign country.

January 2020

Fast forward to late January 2020, the Infectious Disease doctors couldn't reach my number. Why didn't they email me? They had an entire profile on me. They said they reached out to 416 --- ----. I immediately facepalmed. My number is 415 --- ----. I always stressed this point and asked admins to make a note on my file. The area code for Toronto is 416. My number is from San Francisco which has area code 415.

An x-ray in late January revealed that my ankle joint was thin. I didn't know what that meant. The surgeon said likely bacteria are clinging to my hardware and eating the joint. They'll need to do surgery to remove the hardware. He's not comfortable doing it this early since the bone hasn't healed, but the chance of further infection is high. At this point, news of COVID is spreading across the nation.

February 2020

I'm wheeled into my third surgery for hardware removal and a washout a week later. It was supposed to be an overnight stay but turned into a 5-day visit. The Infectious Disease doctors wanted to keep me around to administer antibiotics as soon as possible. A sample of my tissue is sent to a lab. The technology is extraordinary.

It's decided that I'll be getting a PICC line and will have to carry a bag of vancomycin for the next month. More fun facts, vancomycin was discovered in Kho Samui, where the accident happened. It's a powerful intervenous antibiotic. They perform tests in a lab and determine that it is effective against the bacteria.

A few days later, I was home. I'm dripping in all types of medical swag. I had the wound vac with a tube going down to my ankle, constantly sucking on my wound. I have the PICC line connected straight to my heart, technically just outside my heart, through a hole in my arm. When the timer on the antibiotic pump went off, it began pumping, and I could feel the cool corrosive vancomycin in my chest.

I've had better days.

I didn't take a day off work aside from the surgery dates. I worked remotely, I love my job, and I found that my work keeps my mind off the current situation. I had the PICC line removed a few weeks later. I began walking (poorly) 6 weeks later. I had my wound vacuum removed a few months later. The wound healed; I usurped the Hayflick Limit. After 3 months, I could walk with a severe limp. It was painful. My first steps in the morning were a valuable memento mori.

August 2020

I started professional physiotherapy in August of 2020. It was delayed due to the pandemic. I walked to physio with my limp, knowing that this might be a permanent state. I would have to get used to the staring. My physiotherapist is phenomenal. He's young and would push me each session. By December, it became clear that my joint wouldn't miraculously heal. Joints don't heal like your skin. It's why arthritis is so prevalent. My surgeon told me this many months earlier. I wishfully thought I was young enough. I had to take action and get another surgery.

Now there were two options, an ankle fusion or ankle replacement. I was recommended an ankle fusion due to my age. That means that my ankle wouldn't move but would be pain-free potentially. I researched extensively and decided that ankle fusion was the right option. I spoke to my physician, who listened to my story and reached out to the top ankle surgeons in Toronto. My top pick got back to me after a few weeks.

February 2021

I had an appointment with my ankle surgeon in February 2021 and he said that given my age, this would be relatively straightforward and that he would expedite my surgery to June 2021. The waitlist that he has sometimes takes 2 years. I'm grateful that he recognized my situation.

For the next few months, I continued physiotherapy. I wake up, all veggies no eggs. I hit the gym, all chest no legs. I actually bought the Bowflex dumbbells, and foldable bench, and worked out in my condo because of the ongoing pandemic.

June 2021

My girlfriend and I planned to get married on June 8th before the surgery. The pandemic delays that, and we tentatively reschedule to September 8th. I left my job on June 4th to pursue my startup. I went into day surgery on June 11th. The next few weeks post-surgery consisted of me listening to Future, popping Percocets, and working.

After 8 weeks, I was able to put weight on my freshly fused foot with a soft boot. There's pain, but I assume that I have a ton of healing to go through. My wedding is quickly approaching. For a Punjabi wedding, you walk around an alter. I'm unable to walk without a boot. I strategized with my surgeon, and he said that I could remove my boot on September 8th, and put on a brace.

September 2021

On September 8th, I took my first steps without a boot with my wife.

❤️

November 2021

November 2021, we reboot the abs challenge. I continued my check-ins with the doctor. By Q1 2022, it's the first time I can walk pain-free and limp-free. I won't be able to run again, but that's okay. I'm able to do yoga, lift weights, and cycle daily.

March 2022

I'm in the best shape of my life, and I was ready to check into my abs challenge 3 months early. Every day, I strive to be better than the Sanjay that I forked from on November 13th, 2019.

Still in progress. Pardon the thirst trap vibes. DMs will be ignored. 😌

Life is back to normal. I didn't die. I'm grateful every single day. I've learned so much throughout this adventure on many spectrums. I've learned about human physiology. I've learned about the topic of bacteria and infections. I've gained a deep appreciation for mass spectrometry and what tools like AlphaFold are going to bring to humanity. But, one of the most important lessons I've learned is F*** Motorcycles.

FAQ

Do you think bicycles should be banned?

No. Some cities have good bicycle infrastructure and it works.

Can you run?

Nope.

Are you sad that you can't run?

No, I didn't run before, and now I just have to think a few steps ahead to avoid situations where I'll need to run.

Did you get HIV?

I tested when I got back home, and I did not.

Is life back to normal?

Yes, although I don't squat in the gym anymore. But, let's be honest. That's a plus. I find other ways to work out my legs.

This is anecdotal. Is there more evidence that I shouldn't ride motorcycles?

Yes. An excellent write-up is available here. It'd be cool to dissect that in the future.

Do you have regret?

I did initially. I now believe this was a net positive from what I've gained. I have a better sense of life and death. I can protect loved ones better. I focus more and can double down on what I'm really good at. I don't romanticize about playing some physical sport really well — more focus. A concrete example, I don't believe that the forked Sanjay would have checked into the abs challenge 3 months early.

If we weren't living in the information age, my answer might differ. 🤓

Do you limp?

Nope, people can't tell.

These videos gave me a lot of hope.

This guy is even dancing.

Do you hate Thailand?

Not the slightest. I love the people and the culture. I'm looking forward to visiting again.

But how do you really feel about motorcycles?

My perception has changed immensely from being cool to being a burden on society and loved ones. Think of all the resources we're taking away from the progression of science. We're creating incentivized loops for brilliant people in the medical industry by keeping these around. I'm looking forward to our AI-enabled cars that keep everyone safe.

The trade-off with motorcycles: fun for potentially your life or several years of walking and independence. That doesn't encompass all the emotional stress caused to people around you.

Closing Note

Thanks for reading; share with others who might need convincing. A few people like to say they know folks who have been riding for a long time. Keep in mind that there are people who smoke cigarettes and are fine for a long time. There isn't causation, but certainly, there's a correlation. The fact remains that many things remain outside your control when riding a motorcycle. Is riding a motorcycle worth years of pain or death? You can decide. Elon Musk has stated his position on motorcycles if you need further convincing.

Elon Musk on why Tesla will not be making motorcycles.

Elon Musk on motorcycles referring to Neurallink.

Live long and prosper. 🖖