This chapter begins with floating. It's a sensation that Joe associates with the Colorado River, except that he imagines Kareen is with him.
But then Joe feels like he's sinking. He struggles, but he feels water rushing over his face. He thinks about what a shame it is to drown when you're so close to the surface and can't move your legs.
Joe starts to see rockets and bombs and white lights, and he hears a hissing sound like steam escaping. There's a pain in Joe's head.
Then everything quiets down, and the pain goes away. Joe thinks that at least he's not in pain. He thinks about how there are worse things in the world than being deaf and armless.
Yes Joe, there are worse things.
Joe can't understand why his head feels heavier than the lower half of his body. He tries to kick out his feet and realizes that they have amputated both of his legs.
At this realization, Joe tries to yell. But he has no mouth, either. Or jaw. Or teeth. Or tongue. Or mouth.
This chapter is a downer, if you haven't figured that out already.
Joe starts to breathe hard but realizes that he doesn't have a nose: he's breathing through a tracheotomy tube (there's a tube in his throat so that air can flow directly to his lungs). This means that Joe can't commit suicide by trying to suffocate, which he does unsuccessfully attempt.
Joe tries to concentrate on his face to see what else he has lost. The hole in his face extends from the base of his throat up to the top of his nose, and includes what were his eyes.
Joe wonders how he can possibly be alive in his condition. He starts to panic, and in his mind, he calls for his mother.