Conscious throughout

I've carried this around since 1979, never written it down, it often flashes back to me in the middle of the night, I don't know why I'm writing it down now, but I am. Perhaps my recent acceptance of the resulting Chronic Pain condition has fed my compulsion to share or just exorcise old demons.

Conscious throughout,

It was 10:30am, Monday 20th August 1979. A bright, warm sunny summer's morning. The the first day of my two week holiday away from work and I had set out on my pride and joy, my Honda CX500 motorbike. I stopped to pick up my girlfriend, we were childhood sweethearts, having lived opposite sides of the road. We'd known each other for many years. At age 14 she started a saturday job at the grocery shop where my mother worked, I was 16 and we became boyfriend & girlfriend. At the time of this account, we had been together for over two years, she had just turned 16 we planned to tour and camp for the next few days as the weather forecast was good. So we set off from Erith in Kent where we both lived a short distance apart en route to Lewisham where we planned to do some shopping for our trip to Hampshire the following day. At the junction of Wickham Street and Bellegrove Road, I turned right, and straight into the path of a white Renault 16! The driver didn't have a chance to brake. Bang! The most horrendously loud, sudden and incredible violence. The only way I can describe that moment. My right leg taking the full impact, the bike's petrol tank, foot peg frame and the cylinder castings forming a strange shaped anvil into which my leg was hammered by the bonnet of the car. I can conjure up that instant any time since, and it has an annoying habit of flashing back to me daily, every time I make any similar right turn manoeuvre when driving on the roads even now. 

"watching my right leg fold and bend in places it shouldn't"

Disorientated, confused and totally stunned, I dragged myself from under the bike now lying on the tarmac, i remember the image of my right leg inside my jeans and my white training shoe tracing the shape of the bike as if the foot was not connected but just hanging and the jeans leg still covering my leg bending and flowing as if there were nothing inside the jeans. My instinct was to find my girlfriend and see if she was ok. Desperately I clambered to stand, and I did, for a moment, before collapsing to the ground, watching my right leg fold and bend in places it shouldn't, seeing this and feeling nothing, then crumpling to the ground, seeing the red stain seeping through my jeans and the pulsating squirt of blood hitting my white trainer that was facing the wrong way, the toe end now tucked under my knee. I struggle to get my helmet off and I fell back, lying my head on the tarmac, dazed, shocked and seeing only the sky above. It is at this point, 30, 40, 50 seconds after the impact that the pain hits, and hits it does! I will not attempt to describe the pain. It is pointless. Many times in the years since people have asked about the pain. My answer depends upon what I know of that person and their own history and experience of pain. I have concluded that if I am talking to someone who has not experienced that level of fully conscious destruction & mutilation to a major limb or limbs, then only a smile and change of subject will do. On the other hand, when speaking to someone who has experienced the same or similar mutilation to their body, there is never conversation relating to pain, just an unsaid and understanding empathy. The whole pain issue has haunted me ever since, especially when trying to relate to someone who simply does not and cannot understand. It is a very isolating condition and probably what is now considered PTSD.

"I was in a very bad way in terms of shock, and THAT PAIN!"

So, back to that time 50 or so seconds after the collision, lying absolutely still in the middle of a (usually) very busy road, traffic beginning to back up, looking up and then one, two three then more people begin to stand around me looking down. This ever increasing forrest of people surround me. Fate had dealt me a fortunate coincidence in the form of an off duty nurse who lived adjacent to the junction(1). This very kind and professional lady took charge and was the only member of the 'human forrest' not standing, she knelt beside me and. I do not recall any conversation with her or anyone else for that matter, I was in a very bad way in terms of shock, and THAT PAIN! My only question to the forrest of people was asking after my girlfriend. The nurse lady knelt at my side somewhere down near my lower legs. Another 'kneeling' person joined her, a man in shirt & tie. At some point here I attempted to lift my head in order to see my leg, the kneeling man and others encouraged me to lie back, to look away, the phrase ... 

"Nothing to See" - A similar injury to my own

"there's nothing to see, lie back, you've broken your leg, don't look, there's nothing to see". 

The forrest of people was joined by my girlfriend, who was pillion on the bike & fortunately unhurt having been thrown clear. The girlfriend I mention in this piece later becomes my wife & mother of my eldest three children. There will be more about our life together in another post sometime. 

The "there's nothing to see" chorus I seem to remember coincided with her coming into view, the look on her face as she burst into tears having looked directly at my mangled leg told me all I needed to know. At some point here, due to the camber of the road I became aware of the wet road on this sunny dry day, the wet was of course my own blood running down the camber of the road and past my head. I noticed the kneeling shirt & tie man helping the nurse, his hands, forearms and shirt covered in blood. The nurse aided by this man and possibly some others carried out the necessary but absolutely agonising procedure of straightening the leg, again, unless you have experienced similar there is no point me trying to explain.

"Remember this is 1979, ambulances are fairly basic, no paramedics or doctors on board, just a driver & assistant, first aiders basically"

I have absolutely no idea as I write this of how much time has elapsed since the collision and subsequent blocking of a busy road by my mangled and bleeding body. The collision was approximately 10:30am, it may now be 10:45, I'm aware of some activity behind my head. A large truck was being guided past, inching slowly, its huge wheels seemed way too close to my head as I recall, much shouting and delicate guiding of said huge truck past the accident scene. I guess I will never find out what important journey justified such a delicate & risky manoeuvre. I am now aware that some of the human forrest are wearing police uniforms, notepads in hands, asking questions. I remember thinking to myself 'why am I conscious? This is unbearable, they pass out in the films'. Other uniforms appear, the ambulance people. Remember this is 1979, ambulances are fairly basic, no paramedics or doctors on board, just a driver & assistant, first aiders basically. They proceed to take over from the lovely nurse(1), I think I thanked her profusely and the shirt & tie man also who was consoling my still sobbing girlfriend, apologising for his ruined shirt etc. The ambulance driver and mate start messing about with my leg, more agonising movements as they lift the leg and place it in an inflatable splint, again any attempts by me to see what is going on we're met with "no, don't look there's nothing to see"! But there was plenty to feel. I asked if I could have anything for the pain, no sorry was the reply, you are going to need to go to the operating theatre when we get you to the hospital, we can't give you any drugs because of the anaesthetic they will be giving you. You can have some gas and air in the ambulance they added. So at this point, not only quite devastating denial of pain relief but also the first mention of surgery. The realisation that this is genuinely serious hitting me now, not just me perhaps not coping too well, operating theatre and soon. The ambulance men had now very unpleasantly inflated the 'splint' and were now assembling a contraption around me, it was a kind of split stretcher, with tapered wedge like halves that were slid under me from each side, again very uncomfortable as any movement at all was. The stretcher was locked together with various clicks and clunks, and then I was lifted onto an adjacent wheeled stretcher and painfully manoeuvred to the open ambulance doors. The forest of people had now either  disappeared or my full attention had been drawn to the approaching insides of the ambulance. A frightening sight (Years later the sight of an ambulance, lights flashing and especially the back doors open, brought me out in a cold sweat), all those bits and pieces of medical equipment, pipes gauges etc, etc. The trolley thing raised with an agonising jolt, then slid me and the split stretcher into the ambulance. My girlfriend climbed in still crying & in shock herself, I do not recall any conversation with her. She was too young to put on a brave face and attempt to comfort me, she was horrified at what she'd seen and absolutely petrified at the thought of what was going to happen to me. The ambulance began its short but bumpy thus incredibly painful journey to the Brook General Hospital.

"it did nothing for me in terms of pain relief, it just added another negative feeling"

I was 18, I was frightened, I'd been in intolerable pain for more than half an hour, and I'm not ashamed to say that I was pleading for pain relief. The ambulance man handed me the mouthpiece of the gas & air, this I grasped and sucked on manically, too manically apparently, it did nothing for the pain but it made my head spin and buzz in a way I've thankfully never experienced since. It was not a pleasant experience as many say it is, it did nothing for me in terms of pain relief, it just added another negative feeling I could well do without! During my maniacal session with the gas and air, the ambulance man with us in the back proceeded to mess about with my leg again! This time to position a contraption that I got a better look at later in the A & E department. It looked like a long metallic box and it's positioning was agony.

"it was a contraption for collecting blood. My blood, lots of it"

None too soon the agonisingly bumpy ride came to a halt, doors opened, bumpy trolley, open air, those old swing doors bumped painfully open by the feet end of my trolley (none of those automatic doors back then), the still sobbing girlfriend taken aside by a nurse and the nightmarish scenario of the fluorescent ceiling strip lights sliding past above. I say nightmarish because I was totally overcome by fear at this point, no control over my body, my destination, my fate. I was really scared at what lie ahead. I believe that it was at this point a feeling, a kind of 6th sense, something I experienced just once more a little later and thankfully never since. Difficult to describe a real dread. Now due to some extreme wet weather recently, the normal A & E department was out of action, there was a temporary makeshift emergency department where the usual separation of serious / less serious incoming emergencies were for a time at least, lumped in together. I mention this as I later learned this fact when recovering for weeks on the ward, but I did feel for the other patients who were sitting waiting just beyond the knee high curtains hurriedly drawn around my trolley bed thingy. I was lifted bodily by the porters and slid over on the split stretcher and 'metal box device' sideways onto another bed. It was here that I discovered the function of the 'metal box', it was a contraption for collecting blood. My blood, lots of it, as I was moved it spilt it's contents onto the floor, the first sound of blood splattering onto the shiny hospital flooring, what a nightmare for those poor people sitting close by waiting to be seen with their minor injuries!

"Every new professional I saw I asked (pleaded) for pain relief"

Semi organised chaos prevailed from this point on. The porters & ambulance men departed and a gaggle of nurses uniforms & white coats fussed around me, cutting off my clothes, shoes everything except underpants. Blood pressure cuff on on one arm, and the other (left) arm held out straight by two male nurses, (meaningless at the time) blood pressure readings were being called out & the two male nurses commanded me to make fists etc, there was a sense of professional panic or perhaps just haste and I was aware that my leg seemed to be less of a priority than the plans they had for my left arm! On went a tourniquet, one of the male nurses started tapping, banging then thumping my inner arm at the elbow, there was an urgency and the nurse taking blood pressure continued to call out numbers that meant nothing to me but their professional concern and tell tale glances to each other conveyed that there was a problem to be sorted. I later learned that this initial problem was quite a simple, basic but potentially life threatening problem, I was bleeding to death. The artery in my lower leg had been severed by the broken bones on their way out through my leg and into the open air, I had lost so much blood (which is confirmed by the falling blood pressure) that my veins had collapsed and therefore getting a 'line' in was very difficult. Thankfully, those doctors & nurses in A & E struggled to find a vein in my arm, they cared, they fought hard and they re-assured the frightened 18 year old boy lying before them. More doctors appeared and peered at my leg, there seemed to be a succession of doctors appearing, looking, whispering to each other and more than once asked me what exactly had happened? Had my leg been 'run over'? All I could say was that I didn't think so but didn't really know either! Everyone new I saw I asked (pleaded) for pain relief, no sorry, was always the answer due to imminent surgery. About now the porters reappeared, painfully & messily (another huge splash of blood onto the floor) as the blood collecting contraption was moved with me, the stretcher and now bags of blood being transfused into my arm all en-route for x-rays. So I was on the move, fluorescent lights passing by again on the ceiling, me the porters and a young nurse escort who held my hand, explained and reassured me from this point onwards. The x-rays were a horrendous ordeal, those poor radiographers had the delicate & very messy job of x-raying my mangled leg. I was so grateful to the young nurse who held my hand and joked to take my mind off of the horrendously painful procedure. Often think of her and just by her manner, words and genuine caring, she helped so much. The 18 year old me in 1979 owes much to these professional people.

(I learned later [Warning Some Links Graphic] the X-rays revealed several breaks to the Tibia with two open'compound fractures' broken fibula again compound, severed Anterior Tibial Artery,

 severed Tibialis Anterior 'lower leg muscle', dislocated ankle and fractures to the knee)

The bags of blood were in duplicate. As one drained it's contents into my arm the valve on the other would be opened and the empty bag replaced with another full bag. The blood capture contraption was failing miserably and the x-ray table, plates & floor were getting covered, the now familiar 'splash' on the floor was heard again in the x-ray room. I learned later that the successful start of the blood transfusion is not in itself a life saving happy ending. In my case, the blood was haemorrhaging from my severed artery faster than the top up from the transfusion bags. I was still bleeding to death basically. Of course I didn't know this at the time, or did I? I've wondered if it would be possible to articulate the next part of this account. It may be the reason I've felt compelled to write it all down. Somewhere about now in the timeline of this few hours on that Monday morning/afternoon, I became overcome by a feeling I'd never experienced before or since. A real creeping feeling of dread. I guess it is a primeval instinct or awareness of hopelessness. I believe at this point, something happened within my mind, brain, consciousness, whatever that is. I became aware that there was a real, unsaid, instinctive realisation that I might not survive. But no panic or hysteria, I was too weak perhaps for that, but I had lost so much blood (I learned later) I was in mortal danger now. I could literally feel the life draining from me. An awful feeling that perhaps like the pain cannot be communicated to anyone who has not been in that same situation. I remember thinking that this was a crazy way to go, a road traffic accident, how pointless, ridiculous, what a waste, only a couple of hours earlier I had routinely closed my front door behind me and set off like any other day. But that feeling, that feeling of indescribable dread and hopelessness, I couldn't move, I just lay there, the life draining out of me with absolutely no control over my destiny whatsoever. Perhaps this is why to this day I love and respect those people who dedicate their lives to helping others. I have absolutely no time for those who, I suspect with no experience themselves, knock and disrespect the NHS and it's staff. They simply have no idea, without those wonderful people I would have died and from something as 'comical' in some contexts as a Broken Leg. Anyway, whatever that instinctive feeling or sense was, I would not wish it on anyone.

The medical talk around me now was of imminent transfer to the operating theatre. They had looked, they had assessed, seen the x-rays of the internal damage not obvious, and the gory external protruding bones, muscle, flesh and blood. The porters re-appear and proceeded to take me and an escort of nurses, doctors to the theatre. In the anaesthetic room I was parked between benches and shelves of equipment, the double doors with their circular 'port hole' type glass windows waiting closed. A man approached in full surgeons gear, with his assistant. He introduced himself as Mr Ono, he was very jolly and down to earth, he proceeded to explain that he was going to 'clean up' the ends of the broken bones and put my smashed leg back together. In a more serious tone he told me that he could not 'promise' anything, but he would do his best. At least once more he repeated 'No Promises'. I'm not sure that I really understood what he meant by that at the time, later I realised he meant that I may or may not wake up with two legs, but I do know that despite that impossible to describe feeling of dread I've already mentioned, I never once doubted that I would wake up (Was that the Fight for life of which people speak?). Things happened very quickly from here, still conscious I was manoeuvred into the theatre and onto the hard and very narrow 'table' everyone here hatted, masked and gloved with only eyes showing, the anaesthetist was fussing around and I was petrified. It is now approximately 12:45, the last two and a bit hours had been a living nightmare for me. As the longed for relief from the pain, the tension, fear and dread all all began to fade into a blissful pain free sleep, the 18 year old boy drifted off into the dark unconsciousness to awake several hours later a physically, emotionally and mentally changed man.

Thank you for reading

Next: PhysicalRecovery - The First Three Days ...

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I write this stuff as therapy. And it works for me. Somehow getting the thoughts out of my head and into written words reduces the frequency of unwanted flashbacks. I like to think, and from feedback I know that to some extent these accounts help people who have experienced similar. And for those who have not, I hope you never do but encourage empathy maybe for many who suffer in silence. However, these experiences are what have made me the person I now am, for that I am strangely fond, even grateful for having selected by fate to join this exclusive club.

There will be more of this story and my recovery. Life threatening shock. Months in hospital. Bone grafting, learning to walk again and the psychological effects. 

(1) - belated thank you to the neighbour/nurse. was it you? Here: maps / junction, and the shirt & tie man.