29/10/2024
https://d.docs.live.net/0699788b36291492/Documents/Accommodare%20et%20Superess5.docx
Accomodare et Superesse
At 15, I was apparently knocked off my bicycle by a car. I say ‘apparently’ because I have absolutely no memory of that event at all.
Halfway through the second week of our six-week summer holidays, the adult world was fast approaching. My plans for a career had been decided seven years previously – fast jet pilot in the Royal Air Force. Talk about aiming high!
Unfortunately, my educational ability was nowhere near good enough for aircrew. In fact, by the time I was streamed into sets for CSE/O Level, I found myself one set above the bottom of CSE. Having the obligatory eye test of trying to make out numbers from a circle of different colours, I was told, like many men, I was slightly colour blind in blues and greens. I was sure I wasn’t, because I never had trouble in distinguishing even the subtlest of shades. Anyway, I thought so. This was yet another nail in the coffin of my ambition. Realistically, I had as much chance of achieving this goal as becoming a brain surgeon. My education suffered early on from the effects of my parents’ deteriorating marriage, culminating in a painful divorce in 1974. The emotional scars affected me in a negative way for years after.
Already very introverted, this inevitably led to being picked on in school. Despite hearing on the news at that time that two out of three marriages failed, it seemed that among the children in my neighbourhood and school, I was the only one to have a one parent family. Everybody else got the latest bikes, clothes, shoes, bags, kit etc, and my brother and me got second hand items. Boys had either a racer or Chopper bicycles. My brother wanted a racer and got a second hand one, and I wanted a chopper. What I got was the smaller version of the chopper, the ‘Tomahawk’. Skateboards were all the rage in the 70’s and all my contemporaries got the latest flexible boards and non-skid kryptonic wheels. My skateboard was a hard plastic board with solid wheels that would skid if you took a corner too tightly. I was yellow and had the moniker of ‘Albert’ on the front as part of its moulding. Despite the obvious disappointment, they were transport and received much use.
On the day of my accident, 25-07-79, I awoke and was looking forward to the coming weekend. Having joined my local Air Training Corps Squadron at RAF Innsworth in 1978, I was eagerly looking forward to my first RAF Camp, to Royal Air Force Binbrooke. Home to the English Electric Lightning, the RAF’s premier interceptor. A favourite of air shows, it would light the afterburners on take-off and disappear into the sky. A real gas guzzler, it needed constant re-fuelling. It was designed to intercept approaching Russian bombers at long range before they could even get here.
This resulted in sustaining traumatic brain injury. After being stabilised and assessed in the Accident and Emergency Department, the CT scan revealed three major problems. A massive left-temporal subdural hematoma was compressing my brain; there was a developing aneurysm deep in the basal ganglia; and my neck was broken in three places. At my local hospital, Gloucester Royal – led by trauma and orthopaedic surgeon Mr W.M. Lennox – the hematoma was operated on straight away. No sooner had the last stitch gone in, I was put in an ambulance with a doctor and ‘red-lighted’ 35 miles south to Frenchay Neurological Hospital in Bristol. Taken straight to theatre, the operation to repair the aneurysm took some eight or nine hours. One cannot help but admire the skill and stamina of all those involved in operations of this length.
This was in 1979. Unknown to me, the doctors despaired I would ever recover. Their best outlook, if I did, was that I would require 24-hour care in a wheelchair for the rest of my life. With further awareness, I discovered I was paralyzed from the neck down. I also had a tracheotomy tube in my throat to help me breathe.
As mum told me again what had happened, I asked her if they had got the driver? She said they had, and , anticipating my curiosity, bet me I couldn’t guess who
Of all the cars I could have come into contact with that day, this one happened to be driven by my dad’s best mate! He and other witnesses attest to me causing the accident. As I could not remember, I had no choice but to accept that. Besides, in view of the fact it was doubtful I would recover from the brain operations and with returning cognition, I was so grateful to still be alive and on the road to recovery.
I recall there being three specific times when I learned, ‘for the first time’, what had happened. Actually, I had to be told many more times than this, which is quite usual when having experienced a trauma of this nature. The first time was coming round in the accident unit at Gloucester Royal Hospital. With no idea of where I was or the events that had led up to me being there, I was immediately met with a familiar aroma. Back then, all doctors, dentists and hospitals surgeries all seemed to smell the same. The same cleaning product was used. Not a particularly pleasant aroma, but it was indicative of the type of environment you were in. Anyway, my awareness was noticed, and I seemed to become surrounded by a sea of faces. Finding my voice, I asked the inevitable three questions someone in this type of situation wants to know.
“Where am I”, I enquired?
‘Gloucester Royal Hospital’, a voice replied.
“Why?”
It was explained to me that I had had an accident. “What sort of accident”, I asked?
As it was being explained to me, I can still remember thinking, “Oh s—t, mum’s going to kill me for this!”
The next time was waking up two weeks later on ITU at Gloucester Royal Hospital. Again, I received the same answers to my questions. This next time up on ward 15, a trauma and orthopaedic ward. This time, the information seemed to stick. It was then I seemed to recall those previous times.
I promised my mother she would have me back as before. With the benefit of hindsight, I know complete recovery is never possible from a major trauma such as traumatic brain injury. However, while the war to recover is never completely winnable, and it is definitely a campaign, we can tip the balance in our favour. You see, in war, victory is rarely achieved by one, big battle. Rather, a series of smaller battles tip the balance of overall victory in our favour. TBI is no different.
The first victory to overcome is acceptance. Firstly, although you may not remember the cause, you must take stock of the damage. Denying it, not facing it, will only act like an anchor. It will impede you from recovering further. Burying the truth in drink, drugs or just not facing the truth openly and honestly will only hinder your chances of reaching your full potential.
If the trauma was caused by you or you had a part to play in it, own it. Admit it to yourself and others. There is no shame in admitting the truth. The truth cannot hurt you as lies do. If the fault was genuinely somebody else’s, that can be tough to forgive; especially so if it was from, say, drink/drug driving. Then the law should be fully applied. Although there will inevitably be resentment and thoughts of revenge, be careful. Odds on they never intended to cause injury.
As far as my accident is concerned, I am told it was my fault. This was initially accepted, even though the only memory I have of that day is from coming to in the accident and emergency department, the transfer to X-ray, the CT, travelling along a long corridor with more curious stares from people passing by, going into the theatre lift that was being held open for us, going up one floor, being wheeled straight in and a mask over my nose.
I understand it was during the second week of the six-week summer holidays. All I wanted to do after leaving school was to join the Royal Air Force as a fighter pilot! Nowhere near academically qualified, I remember my disappointment at taking the entrance test and not being at all surprised that I only passed as a ‘gunner’. I cannot remember when this was. The year before, mum had heard of 2342 Sqn Air Training Corps based at RAF Innsworth. She mentioned it to me one day and told me of the activities that were available. She said there were opportunities to go flying, camping, shooting and asked me if I would like to join. A bit of a wimp, I was far too introverted to dare go on my own, so hatched a plan.
My best friend at school, Chris, also had plans to join the Royal Air Force as a pilot. At school the next day, I enthused about my plan of joining the squadron and said it would be worth his while joining, too, as it would look good when applying. He didn’t seem that enthusiastic but said he would think about it. I kept up my enthusiastic chatter all that day. It worked! Chris cycled up that evening and mum took us up.
We arrived and walked through the door to see the squadron lined up on parade. One of the NCO’s greeted us. Mum told him we were thinking of joining up. We were introduced to an officer, Flt Lt Frank Holman. He took us in and showed us around. I’ll never forget the one line he told us before we signed up. “We’re the best squadron in the Wing. When we enter competitions, the rest don’t bother!” With that commendation, how could we refuse!
Next, and this is something I have learned, NEVER accept a prognosis. To do that means conceding 50% of achievable victory. This can keep you going around in circles for the rest of your life, never improving your situation. Be realistic. To defeat an enemy, you must have as much information on your opponent. This will enable you to form a strategy to defeat him. Being paralyzed from the neck down, first I had to get control of my body. I also had to learn to communicate again. These were the first battles to be won. Over the next five months I made significant gains. My right side had returned - not fully, as I had and still have a shaky right hand. My left side still possessed significant ataxia. I had a lazy left eye, I had impaired balance, a dropped right foot and extremely poor short-term memory and concentration issues. My eye specialist confirmed my brain surgeon's assessment of third nerve damage, meaning I would never again have the use of my left eye and would eventually go blind in it. I reminded him that I was not expected to recover from my coma, or be making the progress I was, so there was no telling how far I could go! From then on, I never looked back. Well, I could not, not with my neck.!
One of the hardest battles has been with depression. I am not talking about the 'fed-up' type that we all come out of, but the insidious, nasty, all-pervasive type that overshadows your entire horizon; blotting out any c***k of hope for you to aim for. It almost convinced me to give up on many an occasion. This starts with mourning the life you have lost, not helped by a dire prognosis for your future. You lose the ‘pecking order’ of established life. Within the family, for me, I was no longer the bigger brother. Loss of control of your physical self is one thing, but the disinhibition seemed especially disturbing. I became very extrovert overnight. This newfound freedom to express myself was very welcome but I could not seem to engage brain before putting mouth into gear. This caused no end of misunderstandings and hurt, and the guilt was piling up. A planned move had been brought forward by a year and mum and my brother had joined her long-term boyfriend on the Isle of Wight to get the house ready for my arrival a week later. I felt desperately lonely that last week in hospital. By this time, I was well on the mend and visits had trickled to one or two that week. My friends were getting ready for their mock exams so I couldn’t blame them. The last two days saw me moved to a side-room on ward 9 and then to a private room on ward 17. I was taken from GRH to the Isle of Wight by ambulance. That was December 17.
I was given physio exercises to do and had two months of home schooling by a lady much older than my mum. Informing my new tutor I had wanted to join the Royal Air Force before I had the accident, I said that pilots were my boyhood heroes, especially Douglas Bader. She told me that her husband had been a pilot in his squadron in the war. I said that I wish I could have been all ‘stiff upper lip’ like him. She said that although he was undoubtedly like the portrayal of himself by Kenneth Moore in the film ‘Reach for The Sky’, she said he was actually inconsolable for the first two weeks following his crash. The film rightly omits this detail. For a moment, this made him human, like the rest of us mere mortals, and inspired me even more.
The novelty of my new home quickly wore off, and I missed being among my friends and extended family back in Gloucester. Friends kept me informed of what was happening. I really wanted to go back for the end of school disco but was just not well enough. I felt so alone.
A couple of months later, I started at the local school. By then, I was 16 but had put myself back in the penultimate year, hoping to catch up. I was still in a wheelchair with leg braces for my dropped foot, even though I had progressed to a walking frame before leaving Gloucester. I was slow and could not stand for too long. My balance was still poor as was my short-term memory and concentration. My mouth and behaviour often got me into trouble. I couldn’t blame anyone, it was me that had changed, not them. I discussed the opportunity of intensive rehabilitation with my doctor, and he said he would make enquiries.
In the meantime, I got the opportunity of earning a bit of extra money by helping an old lady. She had 200 logs delivered outside her house and wanted them taken round the back. She provided a wheelbarrow. I went to pick the first one up with my right hand and then thought, ‘No. if I don’t ever use my left hand, it will never get any better.’ So, opening up my hand as far as it would go, I placed it on top of that first log. As I carefully lifted it up, I thought ‘Don’t drop it, put it in to the barrow’. I did the first one. Repeating it with the next two, I felt something ‘give’ in my left hand. Not in the sense of physically breaking, but a sort of ‘release’. This galvanised my efforts to the degree that I dropped several in my excitement and had to check myself to be more disciplined. Taking the first load round the back, I repeated the process many times until I had finished. I felt tired but elated! I used my uncooperative left hand whenever I could, even practicing writing with it. The results were very childish but still legible, to a degree. Being right-handed, it didn’t matter anyway, but the therapy was paying off. I still do the thumb and finger-tip exercises even now – I guess old habits die hard!
My inability to engage brain before speaking was continually causing misunderstandings and hurt, adding to the depression. Even my own mother and brother found it such a strain and arguments and fights frequently occurred. It wasn’t their fault. I would have been the same if it were my brother who had the traumatic brain injury. I even cursed God! How was it His fault?
The last time was in 2008. I was on the roof of the hospital, having followed an engineer up. My home life had deteriorated to the point where I knew I had to move out - but had nowhere to go. I had accepted medical retirement on the grounds of ill health and that was the last day of a job I had been in for 18 years and thoroughly loved. I walked to within two feet of the edge of the roof. The wind was strongly gusting against my back. I caught myself just in time and moved back a good five feet from the edge. If depression had been a person, I would have felt a hand shove me off the roof without a second thought.
As I stood there, I considered the trauma I would be giving to anyone who saw me jump, those who would have to clean up the mess after. The damage to my own credibility: how my story had given so much inspiration to others, the example I had set would be lost in a moment of rashness, but the ramifications would last for years. No, depression was going to lose again.
The result? Well, now I live happily and independently with my dog in a home of my own (council owned, but who cares?) Oh, remember I told you about the third nerve damage and that they said I would never be able to move my eye; that I would one day I go blind in it? Well, one year at the hospital, I had the opportunity to remind my surgeon what he had said. I also told him I got an eye-test annually and that one of the opticians had remarked that he had never heard of someone with my condition where the eye had improved year on year. Although not in sync, minimal diplopia still being present, over the years the lateral movement has got better. I said that one day, I would get vertical movement, too. He said if ever I achieved that, he would love to know how I did it. 37 years after my accident, I finally achieved a noticeable degree of vertical movement in my left, lazy eye. My former consultant surgeon has long since retired and has most likely passed on by now. I am not ashamed to have leaned heavily on God’s promises – “Whatever is asked in my Son’s name, I will grant”, or words to that affect.
Of course, I did eye exercises when I remembered to. Looking up, down, to the side, diagonally. I kept feeding impulses along the nerves, strengthening the pathways, subconsciously ‘ordering’ my eye to move. I kept trying to read newspaper print with my left eye. At my last eye test, I was told I have 20-20 vision in my left eye and 20-40 in my right. It is my body, and it exists to serve me, not the other way round.
It may have taken 37 years to achieve it and it is still not properly in-sync, but it is getting there! Never give up!
Ever since my mother informed me that they said I should not have been able to pull out of my coma or start making the gains I was doing, I began to realise I could achieve whatever I put my mind to. I will say this, though. There were many people who contributed to my success. I was told early on that if I were not prepared to help myself that I would not get far. Although I made great gains while in hospital, it was not until after I left, away from all the support and praise I was receiving, that I began to realise just how much I had to do. That realisation kicked me up a gear and from then on, that is when my fitness really accelerated.
Recovery continues, and you get better results by being honest with yourself and others. Never accept defeat. Look after yourself. Give your body the best chances to get better. Do not abuse it. You are stronger than you believe you are. Adversity does not create character, it reveals it. None of us are aware of what we can do until we need it.
Lastly, please be aware that I am no superman. I am not possessed of any ‘superpower’ other than the extent of my determination to overcome. Faith, not only in God, but in myself and possibilities also helped considerably. I would love to say I was all ‘stiff upper lip’. That is not how it was. I have been ‘trembly bottom’ lip many times. Not that I am ashamed of it anymore.
The benefits of releasing that harmful, negative emotion are that you do not bottle it all up, where the pressure eventually weakens and breaks you. It is a breeding ground for depression. Many turn to illegal drugs, drink or smoking to cope. Neither am I celebrating or criticizing these sorts of crutches. If you were using any of these before your traumatic brain injury, your reliance upon them will be greater after. Because of that reliance, your focus on improving your situation will take second place. As such, your true potential may not be realised.
Eleven years after my tbi, I had the privilege of working for the NHS, at the same hospital that saved my life. A porter for 18 years, I had the opportunity to explain to doctors what it is like from the perspective of those with tbi. I was even asked by consultants if I would mind taking questions from junior doctors new to this field of study. I do not even mind being pulled over by the occasional police patrols. On seeing me, my lazy left eye and impaired balance, I am not insulted at all by being asked to walk in a straight line, toe-to-toe or being asked to blow into this bag. I usually reply with something like “With my balance problems? You’ll be lucky!” and use the situation as an opportunity to educate. Of course, the crystals stay green. Next, they are suspicious of drugs. “Only medication” I reply and can prove it there and then. It is not their fault They are only doing their job.
Oh, one more thing. It is common with traumatic brain injury to receive the ‘gift’ of disinhibition. Gifts, though, do not always come in little boxes tied with a neat bow. Some must be unwrapped, taken out of the box and we must use our imagination and ingenuity to figure out what we have been given and how to use it to our best advantage. I am implying it metaphorically, of course. It has taken many years to mould this gift into a form where I can constructively use it as, for example, a bridge building tool, an ice breaking mechanism or, even more importantly, as a tool for displaying empathy. This was what I meant by speaking about the gift of disinhibition. Using the analogy of breaking in a wild horse, we must learn to use that gift to help ourselves help others. In turn, that validates our lives and strengthens our resolve so we can face anything that life throws at us. Come on, how many times in a person’s life do we wish we could start again, knowing what we know now? Not exactly the sort of thing any of us had in mind, I know, but that is exactly what the trauma of brain injury gives us. We can become the person we would like to be, based on the genetic blueprint of the original.
As I said, I liken the experience of traumatic brain injury to trying to break in a wild horse. We suddenly find ourselves ‘saddled’ to this wild ‘beast’ over which we have little control. This disinhibition creates no end of difficulties, not only in our lives but those around us, too. Like a wild bronco, it throws us off at every opportunity. We inevitably hurt ourselves and others time and time again. Many admit defeat and are carried off to lick their wounds (resign themselves to what they believe they have no control over). The ‘horse’ (traumatic brain injury) wins. Others make the effort to get back in the saddle (they feel the guilt and frustration but resolve to try and overcome it). Eventually, with time and effort, we break this beast and learn to have it living with us under our conditions, not the other way around. It is not easy. You will be tempted in so many ways to make life easier for you. If you choose to do this by the use of alcohol or illegal drugs, this will reduce your chances of improving your life further. You owe that to yourself, not to mention all those involved in saving your life.
This is what I meant by the analogy of getting ‘thrown’ and going off to lick your wounds (feeling sorry for yourself). Look, how many times in a person’s life do they wish they could ‘start again knowing what they know now?’ Not as we would have it, I know, but this is exactly what trauma of this kind gives us. When I awoke for the ‘third’ time in a side room on ward 15 and mum told me again what had happened, she said she had been warned there was only a 50-50 chance of me recovering from either brain operation and, even if I did, was cautioned I would be in a wheelchair for the rest of my life, needing 24-hour care. I promised her there and then that she would have me back just like before. Although I meant it, I had no idea of the hardships I would have to face to get to where I am now.
I have learned that recovery takes place first in the heart – the rest follows. Yes, others can help you, but if you aren’t prepared to put in the effort and sustain it, you will not make progress. It is not a race, more of a marathon.
It helps immeasurably to keep your body as fit as you can. Before my accident, I had been quite lean, not skinny, and was a fast sprinter. That enabled me to be quite good in athletics. In games like football and rugby, I was poor. No ball control in football and I hated the contact in rugby! Academically, I was in one set above the bottom in CSE’s. Emotionally scarred from my parent’s failed marriage and divorce, I was and am emotional. This was always my Achilles heel. The earliest time I think I became aware of this, was probably at my first day at play school.
For a tragic few, far too many, the hurt and the challenges prove too much. They take the final option.
Believe me, I have come uncomfortably close to taking my own life. The last time was in 2008. My family situation had become so bad that I had bitten the bullet and knew I had to move out for the best. I was faced with losing the job I loved so dearly. That cloud of despair was obscuring any c***k of hope for the future. I overheard an engineer saying he was going up to the roof to do a job. I got off on the ninth floor and walked up to the tenth. I walked out onto the roof. No sign of the engineer. It was quite windy. I walked over to within five feet of the edge. Depression was screaming at me to jump. It was trying to reason with me that I had run out of options, so might as well jump. I could feel the wind against my back. I had balance problems anyway. If depression had been a person, no doubt it would have physically shoved me with enough force to send me to my death,
I remembered those previous times when I could have killed myself. But something my mother chided me the first time I told her how I felt, and rightly so. Her response? “How dare you think so selfishly. So many people had fought so hard to save your life, how could I be so selfish to think like that?” She was right, of course. As many of us know, however, depression takes no prisoners. Well, it was not going to win this time, either.
So, what happened after? I live in a bungalow with my dog, am co-chair of my local resident’s association and have a much better relationship with my ex. That includes a far better relationship with our children. Could not be happier.
In conclusion, we have to adapt and survive. By doing that, we win for ourselves and others.
*It is not unusual, at all, for those with a major brain trauma to repeat the same questions and receive the same answers. In fact, it can take quite a while to recover the use of a better function in short-term memory and improved concentration. Behaviour following the early stages of recovery can be disturbing for families. Mum told me I used to spit and bite those looking after me in hospital. This shocked me, I was not brought up to behave like that.
Of course, I gave my apologies to all concerned. They told me not to worry as I was not in control. Even so, it did not make my me feel any better.
Accomodare et Superesse (Adapt and Survive)
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