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I woke up underwater. Icy cold. Lungs useless. Instinctively, I kicked and flailed. My backpack, clothes, and boots held me down. Why was I having such a hard time getting to the surface? I didn’t know that I had broken a wrist, cracked my skull, and fractured two vertebrae in my neck. I had been fly-fishing the Pack River in the northern Idaho backcountry with my friend John. The day was warm and sunny; hemlocks with their shaggy boughs arched over the water. Sunlight dappled through the needles, illuminating every rock in the gin-clear water. We were fishing a pool near a waterfall with a steep drop. I caught one small trout and then leapfrogged rock to rock, climbing upstream. At the crest of the falls, I waded out into the river. The second I stepped with my left foot, I knew I’d made an unfortunate choice. My feet flew out from under me on the slippery granite. Then nothing. I don’t recall being catapulted over the falls, tossed like a rag doll in a washing mac ....