A First Hand Account
I opened my eyes and saw chips of old gray concrete floating in a pool of bright red blood. The blood, I knew, was mine. The chips of concrete came from the step I’d rammed with my forehead. You’re in big trouble, I immediately thought.
It was a simple move. One that I’d done a thousand times in hundreds of different places. A move so commonplace I’d never thought about it. I simply had to hop over a three inch high barrier marked No Parking and proceed up the steps into the doctor’s office. I never thought about clearing the mini-hurdle. I never really saw it as an obstacle; I just moved forward.
But this time the edge of my sandal sole caught the top of the barrier and I fell—not a fall like I crumpled on the side walk, nor a fall in which I could break the impact with an outstretched arm. This fall was like an Eagles line backer. I went sailing horizontally until my head was stopped by the concrete steps.
I saw stars. Man did I see stars. It was the Fourth of July on the National Mall in triplicate. With the stars there was a momentary flash of black but it was reassuring that I never lost consciousness. Amidst the pyrotechnics I felt a flush of warmth in the back of my neck, as if someone had poured a cup of warm water on me. Fleetingly, I wondered Is this what whip-lash feels like? Medical personnel poured from the doctor’s office to which I was headed. Help from the 911 dispatch arrived quickly. The first attendant on the scene called, “Do we need a back board?” “Yes,” was my weak but clear response.
As medics hooked me up to monitors, started IVs, checked and rechecked my blood pressure, I retreated into a black space. Thoughts of how bad is it? How long will I be out of commission? Will I have permanent damage? Will I come through this okay? crashed into each other as I tried to push them away.
In the emergency room the ER doc said he’d call a plastic surgeon and then get a CAT scan of my head and neck. The plastic surgeon placed some 40 or more sutures in my forehead explaining that this wasn’t a linear cut. It was more like a star burst and there would be scaring. I tried to lighten the moment and make myself feel better by joking, “If I wear a black eye patch and have a scar, will I look like James Bond?” “You already do,” was his quick response. But somehow, the blackness barely lightened. I didn’t find that reassuring.
After the skull x-rays and the CAT scan, the ER doc returned to say my injury was more complicated than he’d first thought. I didn’t bother to recount for him the number of times during my professional life—as an ER physician—I had given similar news to a patient or their family. There was no need to sound apologetic. He’d done all the right things.
“In your fall,” he said, “You’ve broken your neck. There’s a fracture of the cervical spine at the level of C-2. We’ll have a neurosurgeon see you.”
“Thanks,” was all I could muster as my personal cloud of fear and gloom engulfed me. I was supposed to meet my partner, returning from an overseas trip, in a few hours at the airport. I was due to leave in the morning and spend the week at the beach with my daughter and granddaughter. I didn’t have time for a broken neck.
Lying immobile on a back board, and groggy from pain and anxiety, I recalled from my earlier days in medicine that all the vital nerves course from the brain through C-2 on their way to arms, legs, lungs etc. Respiration, movement, sensation, all are at risk of damage or loss with an injury to C-2. But I could wiggle my toes, I could feel sensation in my arms and legs, I could breathe without assistance. Maybe, I’d be lucky.
After his examination, the neurosurgeon explained that this was the type of fracture that in the past required a halo above the head supporting metal braces to the shoulders in order to keep the head immobile during the healing process. “Now,” he continued, “we no longer use the halo. Instead, we make an incision at the side of the neck and put a screw directly into the cervical spine and screw the spine and the broken piece together. The screw replaces the halo.”
Painful as it was to smile, I responded to his explanation. “I’m sure I’m not the first guy whose halo has been knocked off by a good screw.”
The neurosurgeon squeezed my hand. “Humor is important. Keep it up.” I wasn’t sure what he wanted me to keep up, so I let that one pass hoping I’d get out of this mess easy. I spent three nights in the hospital in a foam neck collar that restricted my motion. Then I went home for untold nights of the same.
But I did get off easy. Now, ten days after the fall, I no longer need to use the collar at home. I don’t have to wear it around the condo or at night when attempting to sleep. I still need it if I’m traveling as a passenger in a car. I’m allowed back in the pool for exercise but not swimming (too much neck turning the way I swim). But the danger of bleeding, paralysis, and other bad outcomes has long passed.
Certainly, look where you’re going, or keep your feet on the ground would be appropriate morals to draw from this very personal tale. But, perhaps more importantly, I’m overwhelmed with the knowledge of how quickly life can change. One misstep, a fraction of an inch, a fraction of a second can bring each of us closer to facing what we fear most—Life? Death? Incapacity? They are all only a miss-step away.
John Siegfried, M.D., a former Rehoboth resident, lives in Ft. Lauderdale. He is the author of Gray & Gay, A Journey of Self-acceptance. Email John Siegfried