Falling off a mountain changed my perspectives as a patient and physician
In my experience…all 57 years of it…I’ve found many of us have that singular “line in the sand” moment after which nothing will be the same…absolutely nothing. Mine happened on March 18, 2001. This was the day I had a catastrophic ski accident and was forever changed. It was the day I went from being Dr. Dickey to Mrs. Dickey in the blink of an eye.
The morning of March 18th was snowy. My family and a couple of friends were celebrating the St. Patrick’s holiday at a condo near Copper Mountain, Colorado. This was back in the day when ski helmets were just coming into vogue. Recently Sonny Bono and a member of the Kennedy family had died on the slopes. We took the precautions of getting our kids ski helmets, one they could grow with for a few years. As parents we believed (and still believe) in leading by example so my husband and I invested in higher tech helmets for ourselves.
Our usual family skiing pattern had my husband leading the pack, all three kids in the middle, and me skiing clean-up to help anyone who fell. This particular morning two of our kids went with our friends and our youngest son skied with us.
“Why don’t you go ahead first? You never go first, and this would be a good day,” said my husband. He loved skiing fastest and this was a lovely gesture.
“Sure!” I said, delighted he would be skiing clean-up for this one run.
Snow conditions for the day were powder/packed powder with snow in the morning predicted to clear in couple of hours. It was to be a glorious blue-sky crisp spring skiing day!
From here I remember only scattered impressions of the day. Most of the rest of the next few weeks I know only through stories that have been told to me by my friends and family.
As they tell it I got ahead of them and out of sight as expected. Toward the end of the run somehow my left ski was up in the air as I was falling on my back. This I do remember. It’s like a freeze frame in my mind. Then I hit the back of my head on the snow, and most likely a rock covered by snow, then flipped and hit the front of my head.
Then I was standing and trying to retrieve my ski when they caught up with me. I remember having an incredible headache and the feeling of a blow torch on my inner wrists. But I was up. There was a ski lodge resting and eating place close by on the middle of run. We went there and were met by one of our friends who was having trouble with ill-fitting new ski boots. My headache and burning wrists were not getting better. She suggested we walk up to where the ski lift dropped off skiers and ride down. It was only about 50 yards away. We started for there and the others went on to ski another run.
At the lift the operator asked why we wanted to ride down. No problem for the skier with sore feet. When I described my issues suddenly there was a change in the operator. I was bundled up, taken down the rest of the mountain by the ski patrol and dropped off at the small medical area.
Exams and x-rays gave the physician the impression I may have a cervical spine injury. As it was still snowing the medical helicopter was could not take me to a Denver hospital. I was bundled up in an ambulance and driven to the hospital I worked at in Colorado Springs, about 2 hours south of Copper Mountain. I’m sure a lot happened in the next few days including a stint in the neuroICU. Ultimately, I was diagnosed with a serious traumatic brain injury and swelling cervical spinal cord that was being compressed by an unknown critical narrowing in the spinal canal of my neck. I eventually underwent reconstruction of my cervical spine about a month later. My left knee was injured which may have been the reason for the fall in the first place.
So now with the grace of time I can see this fall was my line in the sand. Even more importantly, it was the line in the sand for my husband. He was suddenly a solo bread winner, a single father, and a caretaker while in shock and in grief … all while I was essentially oblivious. And nothing has been the same since.
The initial medical prediction of when I could return to work was 3 months. This was before the extent of my head injury was known. Slow, very slow progress seemed to be happening. I reached the maximum benefit traditional therapies could offer and was not able to return to work. At the 18 month point my practice had to let me go and fill my position. About this time an independent neuropsychologist told me and my husband I’d most likely not be able to practice as a physician again. The results of the testing were not favorable. My insurance stopped when I lost my job. My kids were not coping well, especially the older two. I was not coping well from a number of perspectives.
There are many stories to tell from here. How I coped. How my husband and kids coped. How I developed work arounds. How the brain continues to make connections and heals well after initial therapies have ended. My experiences of a changed identity in leaving Dr. Dickey behind and becoming Mrs. Dickey for the next 2 years. How I did eventually make my way back to medicine by a rather convoluted route nearly 3 years after the ski accident. How I went on to become medical director and Chief of Neonatology against all odds but not without PTSD symptoms. But what I want to leave you with is this: Lines in the sand happen. Maybe for better, maybe not. I can attest today that I am not the same person, not the same wife, not the same mother, and mostly not the same physician as I was before that day in 2001.
I’ve become a staunch proponent of improving the experience of health care for patients, family members, and for those who so joyous choose to enter the many professions of healthcare to help those who cannot help themselves. I’ve learned a few things along the way of recovery. Technical competence in our providers is generally assumed. What we as humans seek from our health care relationships is help in alleviating our pain and suffering…not necessarily absolute relief from them. It is this feeling of being “cared for” that we need the most…that I needed the most from those who cared for me. I have a vivid recollection of a nurse who helped me shower for the first time after the accident. Naked, alone, afraid, newly disabled, clinging to my dignity by my dirty fingernails…and a physician. Vulnerable barely scrapes the tip of the iceberg. This is who she had to get out of bed and somehow get to the shower. Her task was to bathe me from head to toe while I was crying and could not make my limbs work as they should. Comfort me while I tried to communicate my needs and feelings but not making any sense. She saw me for who I was, someone I could barely see in my own mind’s eye. I was suffering and she eased my suffering.
I now work to try to improve the system of health care that I need to use as a long-term patient. I work to improve critical listening and communication between patients and those who care for them. As a physician and patient, I can see it from both perspectives. I’ve come to realize we will never really care well for patients until we in the health care professions learn to value and care for each other. I cannot help the patients and families I serve feel “cared for” until I listen to their story. I work now with the mission of engendering trust and providing an experience of medical care that includes compassion, kindness and humility. It’s about the process of healing. It’s a privilege to be with people at moments of their greatest sorrow and also of greatest joy. Technical outcomes may be taken for granted by patients but the process and feeling of care is not. I did not learn this as well as I should have in medical school though I did become very technically competent.
For me, it took falling off a mountain and crossing a line in the sand I did not know even existed for me to truly understand what I kind of care I should be providing as a physician and healer. Absolutely nothing has been the same for me since that day and I now appreciate that perhaps that’s a good thing.