Originally posted on January 19, 2014 @ 7:58 AM
A typical Sunday in New Zealand
James Kell is an adventurer, incredible photographer (see example on right) and great thinker – James wrote the the foreword in Dr Rob Long’s latest book “Real Risk”
James has a blog called “Carpe Diem” (Seize The Day) and writes great stuff on the realities of life and his photography is absolutely astounding.
I have been given permission (and I consider this to be an honour) to republish one of his latest stories: A Typical Sunday in New Zealand
This is one of the most positive, beautiful and inspirational stories I have ever read. It tells of the realities of living, seizing the day and shows that risk aversion is life denying. It is the story of a young man and his survival after a normally life threatening spinal injury. His survival was due to the calm and intelligent response by his first aiders, the support and love of family and friends, the humble skills of the medical teams, but mostly his positive attitude in the face of adversity. After his miraculous recovery, instead of shutting down, being careful and avoiding risk, James embraced it! He now enjoys every day to the fullest, grateful for being able to use his limbs, his family and the bonus 20 years he received. YOU WILL REALLY ENJOY THIS – PLEASE TAKE 5 TO READ IT
As James concludes:
Every single day is a gift. Pure and simple. Carpe diem may be a cliche but I don’t care. Carpe diem.
A typical Sunday in New Zealand
Twenty years ago today I was on a beach in New Zealand, near the small town of Rangiora on the South Island. Nineteen years old, I had spent the summer working as an apprentice carpenter. Every weekend my sister and I would head off on a different adventure. We’d use those weekends to rock-climb next to rivers at Payne’s Ford, cycle across the huge valleys of St James’ Station and walk up the classically sharp ridges of Arthur’s Pass. This particular weekend was all about surfing. The day before in Kaikora there was a five foot shore-breaking wave, sucking up everything so that the only thing under the wave was the pebbles. Foolhardy surfing conditions yet fun for an invincible 19 year old. This day however was different. Perfectly blue skies, a swell that struggled to reach two feet, conditions that would have been great for a malibu but the only thing I had was the busted up “six-one” board I’d bought from a carpenter in Sydney before I left.
We were surfing at the lovely little beach of Waikuku, an hour north of Christchurch. It was a typical South Island summer’s day; crispy mornings that warm up slowly, the air NZ-clear. I caught a few tiny waves, pumping the board to stay on them, not surfing well, just loving being out there. I was wearing my brand new wetsuit, not because I needed to but because it was new. Little did I know this was to save my life. Kate was bodysurfing and my mate Tom was on his bodyboard. Oblivious to the significance of the next wave, I stood up and pumped the board just like I had done on several others that morning. At the end of the wave, for a bit of fun, I somersaulted into the milky-blue water.
Imagine you are slapped on the top of your head with an open palm. Then your whole body turns into a buzzing tuning fork. You lose perception of where your limbs are. You lose all movement. You are in the water. The realisation of not being able to move is sudden yet non-negotiable. Holding your breath, your wetsuit gives you some flotation allowing you to take a breath. All you focus on at this point is breathing between the waves. Things become simple as your options are so limited. Breathe, say help. Breathe, say help. You hear yourself say “help” in a soft murmur. You don’t have any power to project those words. You have no power at all. Breathe.
After a short time another surfer came over and asked if I was ok. Between waves washing over my face I told him I couldn’t move anything and asked if he could get me out of the water. Brent, father of three boys, working in a video hire store with no formal first aid training, thought keeping me still was a better idea. He ignored my request and braced me. After my wetsuit, Brent was the next piece of luck I experienced that day; his decision – to leave me where I was – most likely prevented my spinal cord from being completely severed. He continued to brace me and yell for help, this time with some volume, and as more people came to see what was going on he told them to act as a sort of breakwater between me and the waves.
My sister Katie and Tom came over soon after. An ambulance was called. Katie has always been unflappable and today was no different. She saw that Brent had the situation in hand and noticed that the volunteer lifesavers who were approaching with a stretcher – some teenagers who were doing their bit for the community – were clearly out of their depth with the situation. They reluctantly came over to fish me out. Katie wanted the ambulance to do this and made things a lot simpler for them when she said “if you move him and he dies, I will blame you”. Harsh but nice and clear. They seemed relieved to let me be.
Then the pain came. I had never known pain before this moment. The pain was so great that I was afforded the opportunity to black out more than once. It was so great that death was a real option. An option! The casualness of this choice was striking. I remember not being afraid of it. It felt like it had the same importance as “…should I head to the shops or stay at home?”. Wisely I was urged to stay awake. I heeded that advice.
The ambulance arrived some forty minutes later with a hard collar and scoop stretcher. Getting in the ambulance was something of a relief, as was the discovery that I could move the big toe on my right foot. I told them that and cracked a joke about it saying that I’d be fine. It felt strangely right to be cracking jokes in this situation – it seemed to relax everyone which helped to relax me. Humour gave me a sense of control in an otherwise helpless situation. I kept up the humour whenever I had the chance.
The trip from the beach to Christchurch General hospital normally takes an hour. This took much longer as I could feel every individual bump in the road and the driver took this into account. It literally felt like a heavy hammer being smashed into my spine every time we drove over each tiny bump. The empathy of the ambulance crew was admirable.
Arriving at Christchurch General I went in for x-rays. The CAT scan showed that I had broken the top two vertebrae in my neck: a type 3 odontoid fracture of my C1 and C2 in what is commonly referred to as a “hangman’s fracture”. A specialist in Sydney, Prof. Ryan, was to tell me a few months later that of the 63 recorded cases of this on his database, there had been no survivors. At the top of the spine the nerves critical to the functioning of the body, allowing breathing for one, branch out to their respective organs. Cutting them or even stunning them means breathing is affected – usually resulting in death. Somehow I had managed to keep enough air going in until the ambulance and its all-important ventilator had arrived.
The doctors returned with the scans, took my sister aside and told her that they did not expect me to survive the night.
Not that I was told much of this at the time. I was concerned with the bed next to me in the ER, where a young man had a few minutes ago been pronounced dead from alcohol poisoning. His family were dealing with the sudden realisation of that. It was a dramatic ER that day in Christchurch.
I was transferred to the Spinal Injuries Unit (SIU) at Burwood, a suburb of Christchurch. This single level hospital with rooms opening out to a lovely garden was a carbon copy of Stoke Mandeville, the legendary SIU in England and the birthplace of many innovations in spinal care. Burwood SIU itself is a little-known hub of innovation in the field of spinal injury rehabilitation.
Meanwhile on the other side of the world my parents and younger sisters were waking up in the beautiful skier’s village of Grindlewald, Switzerland. My father took the call. In a state of shock he grabbed his daypack, went downstairs, stood in front of the nearest car and started his long, solitary journey to Burwood, hoping to get there in time. My mother followed shortly after with my two younger sisters. Dad ended up travelling through the snowstorms that shut down Washington, then a few days later the earthquake that stopped LA. A pretty difficult journey he later confided in his understated way.
Before the accident Katie and I had been living with our godparents in Christchurch, Auntie Sue and Uncle Paul Williams. In times like these family becomes critically important, and the Williams were the best surrogate family you could hope for. Sue was on call 24/7, cooking meals, controlling visitors, doing what a great godmother does. Grandpa also flew over from Sydney, sitting quietly by my bed in the acute care ward, describing the rabbits that were outside in the morning and reading the history of the family building company to me during the day.
The first few days were a bit of a blur. Waking up on those mornings I remember hoping that this was a nightmare and that I was actually OK, only to land back in the reality of the situation. I had refused morphine on principle and was in agony as a result. As a child I had seen an episode of M.A.S.H. where the soldiers were addicted to morphine, so decided not to take it. Other painkillers were not working. As my father entered the SIU the first thing the nurses asked him was to convince me to take morphine. With dad’s approval I relented, and the beauty of that drug revealed itself. The pain was not removed, it just became irrelevant. It was moved from front-and-centre of my attention to a back corner. As dad told me, it is hard to become addicted if the drug is balancing out the sort of pain I was in. Nevertheless I remember my body’s reluctance to let it go when I was weaned off the drug.
After a week, to the surprise of the doctors, I was still alive and stable and so was moved into a four-bed ward. Spinal Injury Units are disproportionately filled with men. Alcohol and testosterone are the two drugs responsible for most spinal injuries. I was put “on mirrors” so I could see what was going on in the ward around me. My right foot and a bit of the left leg was moving at this point. I still didn’t have any feeling or movement in my arms and hands. At that time Christchurch did not have an MRI unit – the machine that can provides images of soft tissue and therefore determine whether a spinal cord injury is “complete” or not. By complete they mean a severed cord. Without this knowledge the doctors were unable to tell me what the likely outcome would be. “Each day you improve is a bonus” was what they told me. In the beautifully dry humour of the kiwis, people who walk out of spinal units are called “duds”. How I longed to be a dud. I remember hearing an electric wheelchair zoom past my room in the early days and the conviction that I would never, ever be in one of them. I was probably just in the denial phase of my condition.
I thought about a lifetime of paralysis. Although the prospect was a huge concern, I had come out of a bout of depression the year prior and remember thinking “I’d rather be here now in my current situation than back to being depressed”. Interesting. I came across some impressive souls who as part of their ongoing treatment would spend a week or two each year here. The most memorable was Jackson, a wise, quietly spoken Maori who spent a couple of weeks in our ward. His grace and cheerful acceptance of his lot was another big lesson for me as I lay in bed during those uncertain weeks.
Katie would come by to visit on her bike. I remember my reaction to her riding to the hospital given that I would probably never be able to ride a bicycle again. There was no resentment whatsoever, I just wanted to know that she was appreciating the tremendous gift of the ability to ride – to use her arms and legs – not taking it for granted. That was all. I thought of all the people who don’t use their bodies in any real way, who drive everywhere, who play video games, who watch TV, and wondered why one of them couldn’t be here instead of me.
The head of the SIU was a specialist called Mr Bean. A brilliant, somewhat absent-minded physician. As he screwed the bolts holding the halo to my skull for the traction, needing something on which to rest my head he used a hardcover book which we later found was titled “Do It Yourself Home Mechanics”. Bean was one of those people who quietly operated in the background to save people’s lives, for instance changing the rules of rugby to substantially reduce spinal injuries in that sport. A unique, tremendous man.
The guy on my right was an Olympic cyclist who fell off a balcony when he was drunk. The guy opposite was a mining truck driver who drove his car home after a few drinks at a party. When the car stopped rolling he immediately knew his situation. They were both paraplegic. The third fellow in the room had lost an arm and was also paraplegic. At that time I was diagnosed a tetraplegic (aka quadriplegic) with 95% disability. Although at nineteen I was the youngest in the room, the others were only a year or two older than me.
I learnt one big lesson in the first few days in this room where I had little to do but observe. Although the cyclist and truck driver had similar injuries, they dealt with the situation in two very different ways. The cyclist was positive, always cracking jokes, and generally fun to be around. The truck driver was morose, withdrawn and angry. Neither I saw as being right or wrong, they just carried different consequences. The stark difference between the two was fascinating, but even more so was the response that these different behaviours elicited from visitors and nurses. The cyclist simply received more attention, more positive attention, than the truck driver. I noticed that their behaviours were self-reinforcing. Negativity seemed to be an energy-sink. Positivity attracted positivity like a magnet. I decided that I would follow the cyclist’s lead. A decision like that is a conscious decision. It is not a matter of personal strength, it is just a decision like turning on a light switch. You decide to act a certain way and then the habit forms. This doesn’t mean that positivity is always there. There were times that I saw my situation for all its negativity. That is natural. But the default was positive, joking, having fun. Making the most of the situation. This I recommend.
The nurses were exceptional. The SIU at Burwood is in many ways a nursing hospital and at that time Mr Bean ran a fairly radical, certainly innovative “educate the patients” approach to his unit. Each week they would wheel us into a room where we received a lecture from the specialists on the spine and nervous system. Their aim was to have each patient know more than most doctors about their specific injury and the treatment options. Ultimately I was given a choice whether to have my spine “fused” (which the orthopaedic surgeon was very keen to do as I was an unusual case – a fairly chilling thought in retrospect) or simply wait to see if the bones bridged naturally. Given I couldn’t move much at the time, I elected to wait and see. This was the right decision in my case. As well as the complications involved in operating at such a high level, a fusion would have left me with a permanently stiff neck. Given I was in a “wait and see” mode with regards to the natural bridging of my bones, I was in the hands of the nurses. They were wonderful.
Three things helped me substantially at this point. First my parents. When mum arrived, her reaction was completely different to dad. The nurses told me later that they see this a lot. The physicality of their son is fundamental to a father. For a mother it is different. Mum was calm, dad was emotional. I was very moved by both their reactions. One of the first things my father said to me was “I would give anything to swap places with you right now”. In a fairly Calvinistic upbringing this sort of display of emotion was huge – I could only see strength in my father’s openness and honesty at that point. Mum spent every day next to my bed until I left the hospital months later. She subsequently studied nursing, specialising in depressive illnesses and continues to help people to this day.
Next were the get well cards. I was a year out of high school and my headmaster Rod West was a legend in the community. He knew every boy by name and most of their parents and siblings. Mine had been a school of 1,500 boys. When I let it be known how much I appreciated receiving cards, he marshalled his 1,500 charges to each write get well letters to me. One that I remember was scratched on a piece of paper ripped out of an exercise book and went something like “Dear James, I am in year eight and have never met you. Anyway right now I have to write a get well letter to you which suits me as it gets me out of German for a bit. Good luck, Jack”.
The third thing that helped was the prayers. My school was a Christian school. Whether you are an atheist or a devout practicing Christian (I am neither), the simple, strong feeling that people were meditating about my recovery was a very powerful one. To this day I am a big believer in prayer and meditation. Rod let me know that I was in their prayers constantly. For that I thank him.
Auntie Sue brought a visitor one day who told me “I once had a spinal injury – I broke my neck. Before my injury I was playing in the B comp for tennis. Now I play in the A comp.”. This had a huge impact on my attitude and therefore recovery. In her declaration I wasn’t hearing a motherhood statement, rather I was hearing a specific case. To know that it was possible to fully recover from such a condition was a great boost to my morale.
I did deals with Providence. “Please just give me a bit of movement in my arms and I will help people with spinal injuries for the rest of my life”. That sort of thing. My limbs slowly started working again. My left hand was the last to come back, and after a couple of months had lost its claw-like status and could move, albeit weakly. There are so many people that helped me during that time. The guys on the beach. The paramedics. The doctors and nurses at Christchurch General and Burwood SIU. The Williams and all the families that helped them. Trinity and Rod West. My friends. My family.
What is the result of all this? Did it change me? Yes, but not as one might expect. Rather than becoming more careful in life, I became somewhat more reckless (to the dismay of my parents). There was and continues to be more urgency to live my life to the fullest, which inherently involves taking risks. I stopped watching television. I became a surf lifesaver at Coogee in Sydney – a beach that sees more spinal injuries than any other in Australia. I became fitter than I was before the accident. I take the stairs, not the escalators. I eat well. Every morning when I wake up I am grateful to be able to use my arms and legs. I am grateful for my family. I am grateful for the twenty bonus years that have been gifted me.
Every single day is a gift. Pure and simple. Carpe diem may be a cliché but I don’t care. Carpe diem.
Dr Rob Long
Latest posts by Dr Rob Long (see all)
- HOP is Traditional Safety - October 9, 2024
- Defining Safety by the Absence of Accidents, Injury and Harm - October 9, 2024
- Visual and Verbal Mapping of Risk in SPoR - October 7, 2024
- Making Nothing Happen in Safety - October 7, 2024
- Understanding the Nature of Performance and HOP - October 5, 2024
Do you have any thoughts? Please share them below