Book Excerpt: 'The Survivors Club'

The publisher provided the following excerpt of "The Survivors Club" to ABC News. The book will be published Jan. 26, 2009. Click here to visit The Survivors Club Web site.

Chapter One: A Knitting Needle Through the Heart

The Three Rules of the Survivors Club:

The knitting needle pierced her heart. Then it saved her life.

Ellin Klor savors the irony, but it wasn't always so, especially when doctors cracked open her chest in the operating room to pry out the wooden needle that had punctured her breastbone and penetrated her right ventricle. Today her ? ngers stroke her yellow blouse, tracing the spot where she was speared. You would think that a spike as thick as a Number 2 pencil in your heart would ? nish you off. But, no.

January 9, 2006, was her lucky day.

It began as an ordinary Monday. The fty-six-year-old children's librarian went to work in Santa Clara, California, then drove the after-school car pool for her daughter and fixed dinner for her family. Klor is a spark plug, pulsing with the energy of countless hobbies and an endless list of projects. Her choice that night was whether to make table deco-rations for a scholarship fund-raiser at school or to go to a meeting of her new knitting group. She almost stayed home but was anxious to show the gang some new patterns. So she grabbed three bags stuffed with books, yarn, and needles, and headed to a friend's house on Portal Avenue in Palo Alto. The knitting circle had been meeting for less than a year, and Klor loved being the teacher.

She parked her tan station wagon on the quiet street lined with London plane trees. Already late, she could tell from the other cars that some of the knitters had arrived. She hoisted her bags from the backseat. "The scourge of a librarian," she recalls, "carrying too much stuff around." Hurrying across the sidewalk, she followed the pathway to the one-story ranch house. The curtains were drawn and the porch was lit softly. Klor climbed the first of two wide steps, hardly treacherous, and then stubbed her foot. Suddenly she was falling down. Hands full with three bags, she tumbled forward and slammed into the ground, landing chest-first on a sack filled with unfnished knitting. She rolled over, stood right up, and scolded herself: You shouldn't have been carrying so many things.

Klor is five foot four with soft hazel eyes and a generous round face. She's admittedly a little plump and has always been a bit of a klutz, banging into things and tipping over, so her latest spill wasn't exactly a surprise. A quick check: Her knee was scraped but her clothes weren't torn. When she took a breath, her chest hurt, but she figured it was nothing. So she collected herself, gathered up the bags, knocked on the door, and was greeted by her girlfriend.

Inside, the knitters were already working in the living room. Klor wanted to get started, but the ache in the middle of her chest was growing worse with each breath. It wasn't an ordinary pang. This was different. She looked down at her red Façonnable sweater and lifted it up. The next image is ingrained in her memory. A jagged splinter of a wooden knitting needle, nearly four inches long, was jutting from her chest. It had broken in half, piercing her clothing and lodging in the middle of her bra right between her breasts.

"Oh my God," she whispered.

Her friends gasped at the needle and urgently calculated the options. First and foremost, should they try to pull it out? "No, don't touch it," Klor declared. It was pure instinct: She didn't want anyone to go near the injury until she was at the hospital. Doctors would say later this was the ? rst decision that helped save her life. Plucking the spike would have been like pulling a plug or uncorking a bottle, and she might have bled out in the living room. Indeed, when Australian crocodile hunter Steve Irwin was speared in the chest by a bull ray while snorkeling in the Great Barrier Reef in 2006, some experts believe his fatal mistake was yanking out the stinger. The ray's venom didn't kill him. Rather, when he ripped the serrated barb from his chest, it wounded his left atrium and ventricle, causing more bleeding and cardiac arrest. The damage from pulling out the stinger was far greater than the trauma of it going in.

Now Klor and her friends faced the next critical question: Should they jump in a car and race to the emergency room? "No," Klor decided. "Call 911 right now." Waiting for the paramedics was a second lifesaving choice. If the needle had moved even the slightest amount in transit to the ER, the injury to her heart might have proven fatal. So Klor carefully sat down on a sofa to wait for the ambulance. She felt alert and even noticed something very odd. She had been impaled and yet there wasn't a single drop of blood anywhere. How was this possible? The next string of images flew by like a strange TV drama about herself. Paramedics. Stretcher. Si-rens. IV. Oxygen. Emergency room. CT scan.

At the Stanford University Medical Center in Palo Alto, Klor waited anxiously for the ER doctors to tell her the extent of her problems. To distract herself, she focused on her daughter, Callie. Klor had waited until she was forty-two to have a child and had been blessed with a beautiful girl. Ever since Callie's birth in April 1993, Klor had found real joy in life. Now in the ER with a knitting needle jutting from her chest, she wondered: How can I die when I'm finally happy? The answer was clear: She needed to stay alive for Callie. Her thoughts also turned to her husband, Hal, a research engineer and tough guy who once hiked two miles on a broken ankle. His idea of a vacation involved trekking in the Himalayas, and he sometimes teased her lovingly that she was "a little wimpy." What would Hal say when he heard about this?

When the ER team finally briefed her on the results of her scans, she felt the first flood of fear. Their tone was urgent. The needle had penetrated her sternum, the long flat breast-bone that's supposed to protect the heart, lungs, and major blood vessels from trauma. Over the years, her physicians had extracted every imaginable object sticking from every conceivable body part, but they told her this was brand-new. With fifty million knitters in the United States, there were literally hundreds of millions of needles across the country, but in the trauma world Ellin Klor was a celebrity.

Paparazzi-style, a young doctor snapped her photo and then took mug-shot close-ups of the offending needle. Then the doctors delivered the really scary news. The point of the needle had grazed her heart, nicking the right ventricle. They could see internal bleeding. They needed to operate as soon as possible. Klor gave them her consent, and they rolled her up to the surgical suite and prepped her for the operation. This was her last memory of the ordeal.

Less than an hour after her tumble on the porch stairs, trauma surgeons would cut her chest open and crack her sternum. They would stitch up her heart. They would wire her breastbone back together and sew her up. They would leave a seven-inch scar from her neck to the middle of her chest. They would save her life. And then, by chance or fate, the knitting needle would save her life all over again. In fact, Klor's real struggle for survival was just beginning.

1. The First Rule: Everyone Is a Survivor

On the bright side, it's probably safe to say you're never going to end up with a knitting needle through the heart. But it's equally indisputable that eventually you will face some kind of life-and-death crisis or struggle. Dr. David Spain has a blunter way of putting it. He runs the trauma and critical care department at Stanford Medical Center and sees what happens to regular people all the time. Every day, he says, some of us get dressed, kiss our families good-bye, walk out the door, and get run over by cement trucks. There's no rhyme or reason, but it happens again and again.* I don't mean to depress or scare you. It's just a reality that survivors understand. No matter how hard we dodge, deny, or resist, a cement truck or a hurricane or some other calamity is waiting around the corner for each of us.** Eventually, everyone joins the fellowship of men and women who have been knocked around by life. Admission is inescapable. Membership is inevitable. The first rule of this book is that everyone is destined to become a survivor.

For our purposes, survivor is defined as "anyone who faces and overcomes adversity, hardship, illness, or physical or emotional trauma." Survivors keep going despite opposition and setbacks. They may want to quit but they still persevere. Some even manage to excel under the worst circumstances. They make the most of misfortune. They grow in ways they never could have imagined. They don't just exist or subsist. They live fully. In the jargon of the ?eld, they thrive. Whether they survive six months or sixty years, they make the most of their time. Survivor comes from the French survivre, which means "to live beyond or longer than." It originates from the Latin supervivere. Super means "over, beyond" and vivere means "to live." Survivors quite literally are super livers.

* Fatal accidents involving trucks are routine, but it's a little surprising how often people run into cement trucks. In May 2007 in Puyallup, Washington, for instance, a forty-seven-year-old man was killed when his Mercedes was struck by a cement truck. In April 2007 in Roseville, California, a sixty-year-old pedestrian was killed by a cement truck. In February 2007 in Washington, DC, a homeless man was struck and killed by a cement truck. And in January 2007 in Saddle River, New Jersey, a retired surgeon driving another Mercedes was crushed by a cement mixer.

** According to Time magazine, "91 percent of Americans live in places at moderate-to-high risk of earthquakes, volcanoes, tornadoes, wildfires, hurricanes, ?ooding, high-wind damage or terrorism."

My definition of survivor encompasses people going through difficult times and also the friends and family who stand beside them. In the cancer community, they're called co-survivors or secondary patients. They're the rocks in your life, the ones you grab on to when you're falling down. They're the pals who escort you to the doctor's office for an MRI. They fix dinner when you don't have energy. They comfort you in the middle of the night when you wake up with paralyzing anxiety. While most attention focuses -- understandably --on the person fighting a disease, co-survivors bear a great burden, often silently and without recognition. They suffer a much higher risk of stress, illness, and even death.* In the tiny field of survivor studies, they're pretty much an afterthought, but they know as much as anyone about beating the odds.

If you look around right now -- in the coffee shop, airport lounge, or public library -- chances are that someone nearby is a survivor. Perhaps the woman next to you is going through chemo and her hair is starting to thin, but she's doing everything she can to look normal. Maybe the man across the way just lost his wife in a car wreck. He's wrestling with depression and wondering how to go on with his life, let alone raise his kids. The guy in the corner may have been let go from his job -- he's got no savings -- and he doesn't know what to do next. Perhaps the woman across the way is trying to figure out how to help her father with Alzheimer's. Should she put him in a nursing home? How will she afford it?

* Every year, more than fifty million Americans provide care for friends or family with chronic illness or disability. The stress of caregiving can shave ten years off your life, according to one study. Another study of couples over sixty-five shows that if your husband is hospitalized, your risk of dying within thirty days increases 44 percent; if your wife is hospitalized, your risk of death jumps 35 percent. These findings are consistent with the well-known Bereavement Effect: If your spouse passes away, your risk of death within thirty days increases 53 percent for men and 61 percent for women.

It's a parallel universe, this unseen world where survivors and co-survivors wage their battles, surrounded by the rest of us, seemingly oblivious. Many survivors describe two coexisting realities. They live with one foot in the regular world and one foot in an invisible realm of hardship and loneliness. Ours may be a confessional culture, but in this other sphere, most people face their struggles quietly, trying not to draw attention. Sure, some survivors appear on TV, give speeches, and write books, but most don't choose to publicize their ordeals. They endure adversity without talking about it. They don't want to burden anyone else. They don't want pity. They just want it to end.

The desire and drive for normalcy are very powerful. When most people get sick, they want to heal quickly. Knocked down, they try to get back up. For many of us, life is supposed to operate like a seat or tray table on an airplane. On command, it should easily return to its original upright position. Unfortunately, that's not the way it works. The best survivors un-derstand that normal is just a ?eeting state of mind. Indeed normalcy may seem steady and constant, but it's really just the intermission between the chaos and messiness of life. Survivors accept that life probably won't ever return to the way it used to be. So they let go, adapt, and embrace the "new normal."

Of course, every survivor is unique, and the word itself generates considerable controversy. Some people reject the label survivor because they don't want to be branded for life. Like some sort of stigma, they want their ordeal -- their cancer, car wreck, or assault -- to be expunged. Others prefer to be called cured and not reminded of the uncertainty, unpleasantness, and struggle along the way. Some oppose the seriousness and gravity of survivor. They dealt with their problem, put it behind them, and press forward without looking back. Others object to the passivity of survivor and prefer a more dynamic moniker like activist, conqueror, or warrior. Some feel that veteran best captures their battles and victories, while others believe that graduate describes their learning experience and sense of accomplishment. Some abhor what they perceive as the emotionalism of survivor with its connotations of heroism, bravery, and courage. In the case of some patients with disease, they prefer the factual phrase living with stroke or HIV.

Whichever term you embrace, survival is typically seen as a pass/fail proposition. The medical establishment focused for decades on those who were cured and those who were not. Either you lived or you died. Scientists call this binary thinking. Only two variables matter. A = life. B = death. You're either one or the other. In reality, of course, survival is messy and complicated—a bumpy road, not a final destination. The path from crisis to normalcy isn't smooth, straight, or one-way. In fact, it's wild and wavering. As the experts say: It isn't linear.

Survivors aren't superheroes who vanquish adversity every time and live happily ever after. If you think they're always triumphant, you're wrong. They're regular people who win some and lose some. They share a mind-set but they don't all possess the same personality. They overcome adversity but they don't necessarily accomplish it the same way. They aren't always adaptable and optimistic; they feel stuck and gloomy, too. They don't always live to a ripe old age; sometimes they only make it a few months. Ultimately, what defines a survivor is the talent for making the most of life, however much remains. Survivors figure out what's right for themselves and their families. They're true to their feelings. They don't necessarily spend every moment ?ghting, say, Lou Gehrig's disease, or raising money to cure Parkinson's. They have bad days. They struggle. They succumb. But even when they're physically gone, they're still survivors. They remain with us in other, more enduring ways. They're super livers even when their time on earth is cut short.

2. The Second Rule: It's Not All Relative

It was Friday the thirteenth, and Nando Parrado and his rugby club were flying from Uruguay to Chile for a holiday weekend of sun, fun, and sport. For reasons still unknown, their twin-engine turboprop clipped a craggy peak in the Andes Mountains and crashed onto a glacier. Of the forty-five passengers aboard Flight 571, twelve died on impact and another ?ve per-ished that ?rst night in the freezing cold at twelve thousand feet. Parrado, a lanky twenty-one-year-old college student, lay for three days unconscious in a coma. His head was cracked open in four places. The other survivors had given up on him, dragging his body to a pile of the dead.

¿Nando, podés oírme? Nando, can you hear me?

Those were the first words Parrado remembers when he opened his eyes on October 16, 1972. Immediately he was puzzled: Why am I so cold? Why does my head ache so much? Parrado's hand moved to his temple. He found the ridges of the wounds above his right ear. When he pressed, he could feel what he calls "a spongy sense of give." The sensation was sickening, pressing his shattered skull into the surface of his brain. Parrado soon learned that his mother, Eugenia, had died in the crash. His nineteen-year-old sister, Susy, would later succumb to injuries and bitter cold, slipping away in his arms. Despite the devastating losses, Parrado refused to let himself shed a tear. A voice in his head told him: Do not cry. Tears waste salt. You will need salt to survive.

After sixty days on the glacier, facing slow starvation and imminent death, Parrado and two others embarked on a last-ditch "expedition" to save themselves. One of the men turned back after a day, leaving Parrado and Roberto Canessa to climb alone. With only the primitive tools they had scavenged from the shattered fuselage, they scaled a seventeen-thousand-foot mountain and discovered -- to their astonishment and disappointment -- that they were nowhere near civilization.

The plane had crashed right in the middle of the mountains, known as the cordillera, a lifeless expanse of ice. But they trekked for ten days with Parrado "pulling like a train, leading all the way," determined to save themselves and the rest of the group back at the crash site. Malnourished and exhausted, they somehow managed to walk forty-five miles through frozen wilderness, guided by what Parrado calls "an indestructible longing for home." When they ?nally came upon a man on horseback, they knew they were saved, and Parrado scrawled a note for the rescuers: Vengo de un avión que cayó en los montanos . . .

I come from a plane that fell in the mountains . . .

Later at the hospital, Parrado's father asked: "How did you survive, Nando? So many weeks without food . . ." Confronted with the horror of imminent starvation, Parrado said they had no choice. After intense debate, they decided to harvest and eat the ?esh of those who had perished. Without ? inching, his father replied: "You did what you had to do. I am happy to have you home."

The sixteen survivors of Flight 572 were hailed as heroes and cheered as celebrities, and today Parrado is a successful businessman and television personality in Uruguay. Married for twenty-nine years with two teenage daughters, he travels the world, racing cars and giving motivational talks. He tells me about one powerful experience in Salt Lake City, Utah. While delivering a speech about his ordeal in the Andes, he noticed a rather unkempt woman crying in the audience. Her hair was untidy; her clothes looked rumpled; and her face was color-less and without makeup.

When Parrado was finished, she approached.

"You saved my life today," she told him. "I was dead. I was born again today."

A few years earlier, she explained, she had accidentally run over her daughter while backing out of the driveway. "I killed my baby," she told him. "I've been dead." She explained that she didn't care about anything anymore. She didn't look after herself. She had stopped living. Parrado didn't know what to say. He pulled the woman into his arms and hugged her with all his might. No, this disheveled woman hadn't survived seventy-two days on a glacier. She hadn't lost half of her family and her two best friends. And yet, he thought, Could there be any doubt that in the ways that mattered most, she had suffered as much as I had?

Until that moment, Parrado tells me, he had always felt a strange, uncomfortable pride about his survival struggle. Only those who stood on that frozen slab would know the depths of despair, the killer cold, and the horrors of starvation. Adventure magazines had always ranked the ordeal in the Andes at the top of every list of history's greatest survival stories. Movies and documentaries were made about their struggle. With the woman in his arms, however, he discovered something deeper and more universal. "We all, at times, face hopelessness and despair," he writes in his remarkable memoir, Miracle in the Andes. "We all experience grief, abandonment, and crushing loss. And all of us, sooner or later, will face the inevitable nearness of death." After hugging the woman for a long while, words came to him and he whispered: "We all have our own Andes in life. You also have your Andes."

When it comes to adversity, it's human nature to make comparisons. Which is worse? Getting trapped in the freezing Andes or accidentally killing your child? These questions are inevitable but lead nowhere. While some challenges appear to be more daunting or excruciating than others, if you're going through your own ordeal, it doesn't make any difference where it ranks on some imaginary Richter scale of survival. The second rule of the Survivors Club is that it's not all relative. Sure, adversity comes in many sizes and shapes, but if it's happening in your life -- if it's got your undivided attention -- if the stakes matter to you -- then contrasts are irrelevant. The Big One is happening to you, right here and right now. Relativity doesn't matter. No matter the crisis -- on a glacier or in a driveway -- the second rule of the Survivors Club means that your challenge is just as big a deal as anyone else's.

3. The Third Rule: You're Stronger Than You Know

The gun at his ear was the first clue, followed by a rough shove into the backseat of the green Mercedes. Terry Anderson remembers thinking: I am in deep shit. I am in real bad trouble. And it's not going to be over soon. His instinct was absolutely right. The Associated Press correspondent in Lebanon would be blind-folded, chained to a wall, and held hostage for 2,454 days.

Early on the morning of March 16, 1985, Anderson had just finished playing tennis with a friend in West Beirut. On a narrow road, he encountered three scruffy men with guns. "Get in. I will shoot," one man said, pointing the pistol at his head. He hurled Anderson to the floor and threw an old blanket over him. After a short drive, Anderson was bound in tape, blind-folded with a filthy strip of cloth, and interrogated.

Later he was chained to a steel cot with his hands and feet in shackles. He could not stand, let alone sit up straight. He was forced to relieve himself in a putrid plastic bottle next to the bed. After twenty-four days prostrate on the metal frame, Anderson thought he would go mad. He told one of his captors: "I can't do this anymore. I'm not an animal. I am a human being. You can't treat me like this."

"What do you want?" the guard asked.

"A book. A Bible . . . You must loosen these chains. I will go crazy."

The next day, Anderson's restraints were relaxed, and they brought him a brand-new red Bible. They let him take off his blindfold to read for thirty minutes. He savored the smell of the fresh ink, the new binding, and the ?rst words of Genesis: In the beginning . . .

When we speak, Anderson is finishing a home-cooked lunch of pasta and salad. He's drinking a glass of South African pinotage, a red wine. He keeps seven hundred bottles in his cellar, and there's room to grow. It can hold three thousand. He lives on a 250-acre ranch in Athens County, Ohio, where life is good.* He boards and trains about a dozen horses. Earlier in the morning, he tried to teach some manners to a two-year-old Missouri fox trotter named Scheherazade. Now he's looking out over a two-acre pond, horse pastures, stables, and paddocks.

I ask him how he and the other hostages survived all those days in captivity. "We all had to reach inside ourselves to ?nd whatever we had," he explains. "It is extraordinary what people are capable of doing." A marine in Vietnam, Anderson was a correspondent on three continents and reported on every kind of natural and human disaster. In his long career in journalism, he regrets that he didn't write more about ordinary people doing extraordinary things. His most fascinating laboratory was his captivity in Lebanon, where he met nine other hostages. He's kept careful track of the others over the years. Of roughly twenty long-term hostages who made it home, Anderson says, one went straight to a mental hospital and never emerged while another spent ten years in and out of institutions.

"All of us were damaged in some ways," he says, "but I believe we have recovered well.**

* After his release, Anderson sued Iran for sponsoring his kidnappers. In March 2000, a federal judge awarded him and his family $341 million in damages for their pain and suffering. Anderson says he never received the whole amount but was given a substantial sum from frozen Iranian assets.

** Anderson is quick to point out that at least ten hostages perished or were executed in captivity.

"Survival is one thing," he continues. "Survival with grace and dignity is another." Anderson believes one of the greatest surprises of his ordeal was the way his fellow hostages got through the very worst without compromising their decency and humanity. He remembers some of his worst days when he wanted to give up, when he couldn't face any more abuse, isolation, or the revolting bowls of fatty lamb and rice. "I can't do this, God," he would say. "I'm finished. I surrender." "But at the bottom," he writes in his powerful memoir, Den of Lions, "in surrender so complete there is no coherent thought, no real pain, no feeling, just exhaustion, just waiting, there is something else. Warmth/light/softness. Acceptance, by me, of me. Rest. After a while, some strength. Enough, for now."

Anderson believes that he reached this state of grace once or twice. "A few hours later, it fades, and the anger and frustration and longing are back," he writes. "But the memory is there, the sense of presence. And sometimes the place is reached again, briefly. Not often, but sometimes.

"Meanwhile, the hours are endured, the days gotten through. And the nights are spent in prayer, and thought, and the effort to get back to that place." We all can find this kind of power in ourselves, Anderson believes. It's there. Inside us. Waiting to be released.

The third rule of the Survivors Club is that you're probably stronger than you know. When you face a real crisis, you'll discover strengths and abilities that you never knew existed. In interviews with survivors around the world, every single one described this phenomenon. Sometimes, they uncovered hidden capabilities they didn't realize they possessed. Occasionally, qualities that they'd always believed were flaws -- like stubbornness -- ended up saving their lives. The third rule underscores the Japanese proverb that adversity makes a jewel of you. When you're put to the test, you may even be stunned by your own power. It's just waiting to be called into action.

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