I was asked at my recent yearly training assessment interview what my greatest achievement over the previous year had been. My reply was returning to work and learning to intubate again. (The honest answer being the completion of my fifth, sub three hour London marathon despite missing six weeks’ training.) “You should write a personal view,” was the response. Although initially sceptical I have relented.
Owing to the mild weather my 12 mile cycle to work had enjoyed a continuation well into winter. I had been proud of my non- car use and my mode of transport on these dark mornings from my rural location had been noted as a tolerable eccentricity.
On 1 December 1997 I remember setting off . My next thoughts were why had I been sleeping in the middle of the road in the village and why was this man standing over me? He kindly helped me to the side of the road: it was still dark. He then drove away. I had no idea what had happened and got back on the bike which was lying some distance away. A glance at my watch revealed it was 7 22. I had never been fond of the 24 hour clock and I had removed this function which I now regretted. Was it morning or evening? Was I going to work or coming home? I had no idea which list I was anaesthetising for—I had seen all the patients the previous evening.
I began pushing my damaged bicycle home, my mind had begun to race: all was not well and I realised that I must have come off my bike.
My neighbours were surprised to see me for breakfast, especially as I asked them which day of the week it was. Their children enjoyed the novelty of seeing me blabbering incoherently. My right hand came up to my left clavicle and a large step was obvious. A call to the intensive care unit was taken by a puzzled colleague; my rotation there had finished two months’ previously so he was bemused as to my reasons for telling him I wouldn’t be in for work. My erratic behaviour resulted in an ambulance being summoned. At this point I began to shed clothing as I was determined that the casualty department was not going to cut through it. Some dignity was maintained and the neighbours restricted my nakedness to the upper half by the time the paramedics arrived.
“I hope you can intubate, this might be my lucid interval,” was my greeting. They looked understandably perturbed and blue lights and sirens were used for the entirety of the trip.
Being admitted to the accident department in a state of endorphin induced euphoria seemed to take everyone by surprise. As I live alone a night in the ward was arranged. I managed to undress myself and was provided with hospital issue pyjamas but was completely incapable of using the tie cord around the waist; when the trousers fell down during my first attempt at mobility a safety pin was hurriedly provided.
A restless night ensued as pain began to emerge. I had seen plenty of fractured clavicles as a casualty officer but was realising now that it is far from being a “minor” injury. The sleep deprivation was completed by the door being flung open at 6 30 am and the lights put on. Nothing happened for a further hour; does this happen on all wards? It did seem a little unnecessary at the time.
Skull x ray examinations had revealed a suspicious line in the temporal region. The large split right through the left half of my cycling helmet immediately polarised me into the pro-helmet camp. I shuffled up to my department to scrounge a lift. The lack of public transport within two miles of my house was now assuming greater significance.
“Listen to others when they tell you you’re not yourself”
The cat was pleased to see me but as I could not use a can opener it had to go hungry. I slumped in a chair and eventually retreated to bed. I had to rely on my neighbours to help with shopping and other chores for a month.
After four weeks the muscle wasting in my left shoulder was noticeable. I had already caused chaos in the Christmas rota and was beginning to feel guilty. I decided to go back early under supervision until I felt able to be left alone. I sensed an attitude that by being at work I was declaring myself fully fit. Even lifting a laryngoscope was a problem and difficult; intubations could not be attempted. Several successfully concealed dizzy spells were evidence enough that I should have swallowed my pride and had a couple of extra weeks’ convalescence. I resumed training for the marathon, driving half way to work and running the rest.
The accident and emergency consultant had warned me of fatigue and poor concentration after my head injury. I had donated my helmet to his teaching collection and thought perhaps that he was being a bit alarmist; he was right. Two and a half months after the accident I was ready to be back on the rota but what had all this taught me? Firstly: not to underestimate the effects of even minor illness, and, secondly, listen to others when they tell you you’re not yourself.
I am still cycling to work.