Diane Benefiel doesn’t remember being admitted to St. John’s Medical Center.

Or being taken to the emergency room.

She can’t recall what it felt like when her lungs filled with fluid or what it was like being flown to Salt Lake City.

“The last thing I remember was the shadow of Dr. Meno standing over me,” she said recently at her home in Wilson, referring to Dr. Mike Menolascino.

She woke up in the intensive care unit at Intermountain Medical Center, immobile, a tube down her throat and unable to eat, drink or even talk to her husband. Doctors and nurses were bustling in and out of her room, trying to keep the severe case of pneumonia that had taken hold of her under control. It was the result of contracting the H1N1, or swine flu, virus.

At that point, the 33-year valley resident and emergency medical technician had been heavily sedated for nearly a week, her body run through an intense battery of medical treatments aimed at removing the fluid from her lungs, bringing down her 100-degree-plus fever and basically keeping her alive long enough for her immune system to fight off the severe pneumonia that had ravaged her body.

She was one of three Jackson Hole residents stricken in February who spent weeks in Salt Lake. Benefiel, retired ski patroller Kirby Williams and High Country Linens employee Fernando Jiminez are still recuperating.

“This evening we report Diane is in stable but critical condition,” Diane’s sister Janeen wrote Feb. 10 in an online journal. “This virus has really taken a toll on our dear sister.”

Benefiel spent three weeks in intensive care while doctors slowly coaxed her back to health. Although her family and friends rushed to Salt Lake City to be with her, Benefiel could not have been farther away.

Lost in hallucinations, she was in a log cabin somewhere or part of a Yellowstone National Park display case.

“I laid there a long time before a middle-aged couple dressed in vacation khaki appeared at my bedside,” she said in an online journal, describing one hallucination. “They were making comments as they looked down at me, but I couldn’t understand what they were saying. I realized then that I was part of a display in a remote Yellowstone visitors center. And then everything went black.

“Though it sounds like a goofy dream, it was so real. When I became more lucid, it was easy to accept the hallucination for what it was, unlike some of the others where it became difficult to separate the real from the imagined.”

Benefiel’s progression back to health was slow, at first marked simply by physical reactions, squeezing someone’s hand or waving. Those gave way to written messages and finally verbal responses.

“[Benefiel’s] oxygen requirements have improved a little, and [the doctor] has lightened her sedation a bit, but she is still a sick girl, and going to be for a while,” her brother said in an online message Feb. 15. “She was not awake enough to recognize me, but [her husband] Keith thought he saw a little flicker of recognition. She’s opening her eyes a little, moving her head, arms, legs.”

Deep into her hospital stay, Benefiel wrote her will.

“I felt like giving up,” she said. “I felt like dying. I wrote my last will and testament  because I wanted someone to witness it. But Keith walked in and just freaked out.”

When Benefiel was in Salt Lake, her husband camped in the hospital parking lot, using Intermountain’s RV hookups to set up what would become his second home for several weeks.

The stress of the situation — not knowing whether his wife would pull through — wore on Keith Benefiel, and he often turned to riding his bike as a way to relieve stress.

“He sat at my bedside for three weeks not knowing if I was going to live or die,” Diane Benefiel said in an online journal. “I have absolutely no memory of most of those days. I do remember him giving me daily totals of the CaringBridge messages I had gotten that day. And when I did become aware, I felt him holding my hand.

“He’s my husband, my best friend, my mate for life,” she said. “Under the circumstances, he’s doing quite well.”

As she slowly began to gain strength, her focus turned solely to getting out of the hospital. Doctors wanted to make sure that the level of oxygen in her blood increased, that she could swallow and control the muscles in her throat and that she had built back up her cognitive ability, among other milestones.

At this point, she was so weak that she still could not fully control the muscles in her throat.

“She looked like she had been pulled from a Somali death camp,” Keith Benefiel said. “Her flesh just hung there.”

She had to relearn how to do just about everything.

“The first time I went to wash my hands, I couldn’t pick up a paper towel,” she said. “And I just thought, ‘Oh s--t.’”

Through this time, the updates about her condition eventually began to appear less frequently on the online journal. She required less and less oxygen support. She inched closer to the goal the doctors set of being able to eat 2,500 calories, wolfing down ice cream and Boost shakes to get her weight back up. She regained her thinking and started to build up her body.

Eventually she took over the journal, grading herself on daily tests, chronicling her desire to leave the hospital and cursing the physical therapy she was having to undergo.

As the days turned into weeks and blurred into months, the journal transformed from a forum through which family members and friends could post updates on her condition to a way for Benefiel to process what had happened to her and document the lasting effects of her illness. Nearly six months after she felt that first twinge of sickness, she still updates the online journal.

It is one of many of the lasting, tangible vestiges of her illness that are still very much a part of her life. Those lingering effects also are being felt by Williams and Jiminez, two other valley residents who had severe reactions to the H1N1 virus.

They were not the only ones hit by it — St. John’s Medical Center treated dozens of patients for flu-like symptoms, and there were hundreds of confirmed cases of H1N1 across the state during last flu season. But they were the most severely affected, and they became sick at a time when flu activity seemed to be subsiding.

At the time, staff at St. John’s said they had not treated anyone for flu-like symptoms — defined as a fever greater than 100 degrees, a cough or a sore throat — since November, and many national health officials were saying that the virus had peaked in October.

Voyaging in his mind

Williams spent much of February hopping between exotic locales across the globe as part of an elaborate series of hallucinations, a result of the sedatives he was being given and the general shock to his body.

He spent time in northern Africa with a friend, traveled to the Daytona 500 and went cruising along on a scenic boat ride in Canada.

“I was in Algeria with a friend of mine,” said Williams, 67, recounting one adventure. “We were walking down this muddy trail, and there was this group of people living in all of this old equipment — trucks and tanks and old military equipment — along one side of the road. They had tall, dark faces and were sitting on the machinery, looking at us. They invited us in to have a snack every day. They would always cook us some soup, and then we would keep walking.

“We would come across a plane in a field,” he said. “There was always a lot of people getting on and off the plane,  and we could never make it. The one time we did get on the plane, we flew to the opening ceremony of the Olympics.”

In one instance, Williams hallucinated that he was on a sightseeing boat near Vancouver, British Columbia, with his wife, Stephanie, drinking the finest scotch he had ever had.

“I had her writing out my will,” Williams said. “I was telling her to give my fly rods to this guy, my drift boat to this guy.”

While all of this was going on, Stephanie Williams was at his bedside, holding vigil.

“Kirby was struggling with the breathing, with his heart rate, respirations, temp and blood pressure going up. ... We were in a bit of a yellow zone for about half an hour,” she wrote in an online message posted Feb. 10.

Kirby Williams had been in the hospital for several days at this point but had not been lucid since he left St. John’s.

He started to feel sick at the beginning of February.

Stephanie Williams had also been feeling sick, and the couple spent a few days “just sitting around not talking or eating,” as he described it.

She got better, though. He did not.

He was vomiting, had a fever and, strangely, had a case of the hiccups that lasted two days, he said.

Williams, however, doesn’t remember the lead-up to being flown to Salt Lake, nor does he remember the two days he spent with his wife when they were both sick.

“When I woke up, I was in Salt Lake, restrained and on a ventilator,” he said.

By the time he was released — 26 days later — Williams could barely walk.

Much like Diane Benefiel, he had a slow, laborious recovery.

He often felt restless, and when he first woke up, he could think of nothing but drinking water.

When he was finally allowed to have an ice chip — about an inch wide and  3/16  of an inch thick — he said it was “phenomenal, like I had died and gone to heaven.”

Throughout his stay at Intermountain, Williams struggled.

“It was frustrating,” he said. “There were a couple of nights before I was released when I just couldn’t get comfortable. One night I made it out of bed, but I fell and bashed my head, and I had a huge hematoma on my hip. There were times when I just thought, ‘I can’t do this anymore.’”

Still only 60 percent

Jiminez has been employed at High Country Linen for 16 years.

The 48-year-old used to work as a driver for the company, loading and unloading hefty piles of linens onto the trucks.

“He’s different now,” said Angie Gabbitas, production manager at High Country Linen. “He used to always be picking at everybody and making jokes, but he’s not really able to do any of that stuff anymore. He doesn’t want to use up that much energy.”

It’s been roughly five months since Jiminez first contracted the H1N1 virus, and yet he still uses oxygen at night. On Monday, he said he feels like he is only “about 60 percent.”

After spending about a month in bed at home and landing in the hospital again because of breathing difficulty, Jiminez returned to work June 11.

He has not, however, been able to resume his normal duties. Instead of hoisting heavy loads of linens onto the company’s trucks, he now works in the plant, handling napkins and lightweight loads of linens.

As with Benefiel, the onset of the virus came quickly for Jiminez.

“He called in sick on Monday, saw a doctor on Tuesday and went to Urgent Care Wednesday and Thursday,” Jackson Mayor Mark Barron, who owns High Country Linen, said in a previous interview. “Then they flew him to Salt Lake on Friday.”

Jiminez said he doesn’t really remember much of his time at Intermountain.

“He woke up and just thought, ‘What am I doing here?’” Gabbitas said, translating for him. “By that time,  he had already been in the hospital for weeks. They put him in a coma, because even doing something like lifting his arm took too much energy.”

Jiminez spent approximately seven weeks at Intermountain Medical Center. For much of that time, he was heavily sedated and was struggling to stay alive.

“He couldn’t smile or blink,” said Amando Perfecto, Jiminez’s brother, who visited him at Intermountain.

Progress was slow. Jiminez’s health swung from good to bad to everything in between. During his stay at Intermountain, doctors thought he had had a small stroke.

“It took six and a half weeks to just get him out of bed and help him walk,” Perfecto said. “He was just really, really weak.”

Lasting effects

Long after the hysteria surrounding the H1N1 pandemic has faded from the national stage, Jiminez, Williams and Benefiel are still dealing with the lingering effects of the virus. Many thought the pandemic peaked in October, almost four months before the three were sent to Intermountain.

They all made it out of the hospital intact, but their lungs were damaged, they had weeks of physical therapy ahead of them and, for Jiminez and Benefiel, they had a stack of bills to deal with. Williams is on Medicare and said much of his care was covered.

Having just survived a near-death experience, all three had to try to make sense of what had happened and piece back together their lives.

“They almost died,” said Dr. Menolascino, who treated Williams and Benefiel before they were flown to Intermountain and saw Jiminez when he returned to Jackson. “It was pretty tenuous for a while when they were in Salt Lake. They weren’t just sick. They were world-class sick.”

As a result of the H1N1 virus, the three were stricken with a severe form of pneumonia, said Menolascino, a general internist and hospitalist at St. John’s.

“Viral pneumonia attacks the entire lung,” he said. “It can devastate normally healthy people. Your lungs will bring air in, but they can’t get it into the blood because they’re damaged and don’t work. They’re full of pus and fluid and infection. Most viral infections will infect your bronchial tubes, but this goes after the lung itself.”

Through a combination of anti-viral therapy and antibiotics, doctors basically try to treat the H1N1 virus and the secondary infections that often came with it by bolstering an individual’s immune system so that it can reboot and fight off the infection, Menolascino said.

The fact that Jiminez, Williams and Benefiel all contracted the virus just at the moment when it seemed to be headed to its nadir highlights the mercurial nature of the illness.

“More than anything, it’s just chance,”  Menolascino said. “Your wife could have a cold that lasts a day or so and you could get it and be down for weeks.”

Jiminez, Williams and Benefiel all had been relatively healthy and did not have any lingering medical conditions that might have contributed to their severe reaction to the virus. Williams and Benefiel also had received doses of the H1N1 vaccine.

“Vaccines are not foolproof,” Menolascino said. “Some people just don’t develop the protection that they need.”

In the past several months, through physical therapy,  Jiminez, Williams and Benefiel have slowly rebuilt their lives.

Benefiel, although she still needs oxygen at times, now regularly rides her bike and goes on hikes. She has had to readjust to doing what many consider to be run-of-the-mill tasks, such as driving, going to the grocery store and riding a bike — with an oxygen tank. She approached her recovery like she would a job. Each day she set out small tasks and exercises, with a renewed zeal for the little things.

A different outlook

“I may have looked the grim reaper in the eye but I must say there’s been some good things that have come out of it,” she said in an online journal entry. “I’m getting to know my friends better, I’m exercising more and drinking more water, I’ve learned to move slowly and deliberately instead of constantly bouncing of the wall as I did in my previous life. And, I find it easier to let the small stuff go.”

This was a marked shift for her.

“Before I got sick, I tried to do too much,” she said. “I worried too much. I cared too much about everything but myself. It got to the point that I wasn’t doing anything well at all.

“I was suffering from depression and lost my will to engage. I spent days watching mind-numbing TV, rarely exercising. I could barely muster the energy to go to work. Keith was understandably frustrated, and I tried to put on a positive face to mask my misery.”

She continued, “And then everything changed. ... I went to sleep one day and woke up to a different life. Out of the clear blue, Keith turned to me a few nights ago and said, ‘You almost died.’ I’m reminded of that reality nearly every day when I run into friends. There’s relief and joy on their faces, but I sense it’s a little like seeing a ghost.”

She has also had to deal with losing her job and trying to deal with a mounting pile of bills. In April, staff from Jackson Hole Fire/EMS told Benefiel that Teton County could not hold her job any longer. She already had exhausted all of her leave, including vacation, family and medical time and compensatory time.

She signed up for COBRA, which allows individuals to buy into a company’s group health care plan after they have lost their job, and began sifting through her options — Social Security, state unemployment benefits and worker’s compensation.

She found little respite in any of those programs.

“Worker’s Comp won’t take me because they can’t pinpoint the moment of injury, denied by Unemployment because I’m too disabled, and Social Security says I’m not disabled enough,” she said in an online message. “I seem to be stuck in a weird limbo.”

Jiminez, too, had to deal with mounting bills.

He had health insurance through High Country Linen but still faced a substantial amount of expenses.

In May, to help defray the cost, Jiminez’s friends and family held a fundraiser at the Virginian. They hosted a silent auction and a catered dinner to help cut down some of his bills.

“He still hasn’t finalized all of his bills,” Gabbitas, Fernando’s co-worker at High Country Linen, said.

Williams, too, slowly processed those weeks that he spent in the hospital.

“When I got back home, I would just sit in the house and look out the window,” he said. “Rain or shine, I would just feel so grateful. This whole thing definitely changed my appreciation of things, like just opening my eyes in the morning or my dog licking my face, my wife, my family.”