JACKSON HOLE, Wyo. — Lying on his side, Alfons Moreno twists his face into a grimace and groans in pain.
Wound-care specialist Mark Weaver is carefully removing staples 48, 49 and 50 from around the edges of a gash in Moreno's back about the diameter of a Frisbee and 2 inches deep.
"Are you OK, Alfons?" Weaver asks during an appointment last month. "If I'm hurting you, tell me."
Every now and then, plastic surgeon Michael Gellis uses a hair dryer to send a few blasts of cool air over Moreno's back to dry a new skin graft on the wound. Scrawled across still-intact skin just above the wound is a large tattoo: "Pura Vida" (life is good).
The gash, along with a compound fracture of Moreno's left arm, a fractured scapula, two broken ribs, a fractured pelvis and likely nerve damage in his left hand, occurred after a delivery truck hit Moreno as he was cycling along Highway 26/89/191 in Grand Teton National Park in May. Moreno was training for this year's LOTOJA, a 206-mile bicycle race from Logan, Utah to Jackson.
"Getting hit by a car is no joke," Moreno says.
Months after the accident, his recovery is just beginning. Instead of enjoying the outdoors, the 55-year-old surfing and cycling fanatic goes to a doctor's appointment almost every day. His left hand barely has enough strength to pick up a cell phone. An Edward Scissorhands-like contraption keeps the nerves in his hand and wrist from stretching too far. Walking is slow and difficult. It takes Moreno about eight minutes to get out of bed to go to the bathroom.
Now, Moreno prays a lot. He prays for almost everyone he meets: his friends and employers at The Lexington at Jackson Hole, the doctors and nurses who take care of him, and the paralyzed patients he met at a hospital in Salt Lake City.
Moreno also prays he recovers enough, both physically and mentally, to ride his bike again.
Moreno grew up in California, eventually moving to Costa Rica in the mid-1990s in search of better waves. In 2002, he met Tim Waycott while surfing off of Playa Grande on Costa Rica's west coast.
From that encounter, Moreno began a friendship with Waycott, his wife, Diana, and their two sons, who all essentially adopted him as a member of the family.
In 2005, when the Waycotts opened The Lexington, a hotel in downtown Jackson, they asked Moreno to move up and help.
For about five years, Moreno has lived and worked maintenance at the hotel in the summer, traveling back to Costa Rica in the winter to surf.
"Al is the kind of person who, when anything happened at night, he would go check on it and he would never put any overtime hours in," Diana Waycott says.
While Moreno never took to skiing or snowboarding, he found a new passion when the Waycotts gave him a carbon-fiber Orbea road bike in about 2006. Three years later, he completed his first LOTOJA.
"It's something that I really love," he said. "It's like going to church. I'm out there with a couple of guys, and we're gone."
About that same time, Moreno fell in love with Gloria Mejia Camarena, a citizen of Mexico who worked across the street from The Lexington. The Waycotts were best man and maid of honor at the wedding.
When Moreno wasn't working or riding his bike, he was in the pool at the Teton County/Jackson Recreation Center training to catch next winter's waves.
All that changed May 11 when a northbound delivery truck hit Moreno about a mile north of Airport Junction. The accident occurred on the same stretch of road where a cyclist was killed by a drunk driver in 2001.
"I don't remember getting hit," Moreno says. "I just remember talking to the person who was over me, and I said, 'Just answer me one thing: Do I have all my limbs?' I thought I lost my arm.
"Then I saw Diana and the boys and Tim (at the hospital), and I knew I was all right," he said. "Then I went out."
The next time Moreno woke up, doctors were cutting off his custom-made Lexington bike jersey.
"That's all he was worried about for 20 minutes," Diana Waycott says.
"We'll get you a new jersey," she told Moreno.
The driver of the delivery truck was cited for unsafe operation — "failing to maintain that degree of control of a motor vehicle necessary to avoid danger to persons, property or wildlife" — and fined $125.
Moreno spent the first weeks after the collision at St. John's Medical Center as doctors tried to troubleshoot the infections and other complications resulting from his injuries.
To make matters worse, Camarena had returned to Mexico, and immigration entanglements prevented her from coming back to Jackson to take care of her husband.
Then, Moreno was rushed to Salt Lake City by plane when an infection in his back became severe.
"They had a team waiting for me," he says. "They said I only had 10 hours to live."
Doctors later learned the impact caused a shearing injury that separated the skin on Moreno's back from the fat, muscle and bone beneath it, and the wound had become infected.
In August, Dr. Gellis had to remove more of the separated chunk of flesh so the injury could heal properly, hence the crater beneath the Pura Vida tattoo. Strips of skin were taken from Moreno's leg for the skin graft. It's Moreno's leg that really hurts most of the time.
"He had an injury, and it was infected for a long time," Gellis says. "If you're infected for two weeks, you're two weeks behind."
As he and Weaver work on Moreno in late August, the plastic surgeon explains to Moreno what the wound looks like.
"All the skin is gone," Gellis says. "All you see is muscle. (The infection) has killed off all the skin and fat above the muscle."
Moreno groans again. "Sorry Al," Weaver says. Only 15 staples to go.
Outside the room, Tim Waycott is frustrated.
Before the accident, Moreno was 55 and in excellent shape.
"After this, he'll be about 60," Waycott says.
As for Moreno, he has oscillated between feeling grateful he's still alive and in the care of such good friends and feeling angry that he's hurt, that he can't work and that he can't see his wife.
Moreno has also felt angry he can't ride his bike.
"That anger built up in my heart," he said of the collision and how he feels about the driver who hit him. "It's slowly going away from me."
To compound matters, Moreno has no health insurance. He and the Waycotts hope a lawsuit will pay for the medical bills. The Waycotts continue to let him live at the hotel.
The good news is, the doctors say Moreno is healing well. Gellis told him the skin graft looks fine, and Moreno's positive attitude is helping.
"He is the best guy to deal with this," Gellis said. "He's so grateful to be alive and to have people taking care of him."
Another of Moreno's doctors, Jim Little Jr., encouraged Moreno to make riding LOTOJA a goal next year.
"He didn't say I couldn't do it," Moreno said. "That made me feel good."
Moreno attributes his progress to the doctors and nurses who took care of him, as well as the Waycotts and the other people at The Lexington who have helped since the accident.
"Being around loved ones, people who support you and care for you, that makes a big difference," he said.
"That's why I started healing so quick," he said. "I had a lot of support here at this hotel. People would knock on the door and say, 'Do you need anything?'"
As the rest of his hotel race team prepares for this year's LOTOJA, Moreno is upset he can't join them, but he's already got a plan to make next year's training easier.
"I'm going to start spinning in the wintertime," he said. "That will take some of the shock out."
The mental recovery is another challenge.
"I cross the street, and I'm still shaken up," he said. "Hopefully, I'll get some more guys on the team.
"If my body gives me the A-OK, then I can get on the road without being shell-shocked from the cars, hopefully. I'm going to have to give that my best shot."
Information from: Jackson Hole News And Guide, http://www.jhnewsandguide.com