On Tuesday the 17th of May last year my phone rang at just a little bit past that time at night where you are comfortable having your phone ring. My stomach dropped a little as I looked at my phone, and then it just about fell through the bottom of my feet when I saw it was my stepmom. Thinking of my dad, the the motor bike riding, sky diving, shark diving, risk taking guy made this call, at this time, to suddenly feel so much worse. I paused and took a deep breath before answering.
I only remember the key words out of that conversation: accident. motorbike. hospital. nelspruit. can't move. possible spine injury. spinal shock. on my way. will let you know. I think I asked questions, I can't be sure now.
Heart pause.
Then tears.
I tried to carry on watching whatever it was that we were watching on tv at the time but I completely blanked out.
My biggest mistake that night was to assume that when you have an accident of this magnitude that you either die or that you get lucky and make a full recovery. Nothing could ever have prepared us for the state of limbo we were about to enter.
I don't remember exactly how the rest of that night or the next day happened, if there were more phone calls or not (there probably were) and how much I did or didn't know at that point, but now I have hindsight on my side so whether I knew it then or not, I know now sort of what happened.
The next day I went to work as usual. I had a big meeting and also neither the shock nor the seriousness of the situation had settled in yet. At that stage I wasn't even sure if I was going to need to make the 4 hour drive to Nelspruit because I just assumed that I was going to get relatively good news that day and it would be a matter of waiting for him to come home and get better.
As the day unfolded it became apparent that it was going to be necessary to go, my sister was flying up from Cape Town and we would drive together the next morning. In the meantime my dad had had multiple MRIs, x-rays and scans and the news was not good. He had suffered a T1 and C7 vertebrae fracture and spinal cord compression. I cannot remove the image of the MRI (which I obviously only saw later) showing how T1 had pushed up over C7 causing C7 to stick out a very unnatural angle. The scary part though, was how significantly his spinal cord was being compressed. For reference, C7 is the lowest vertebrae in you neck, it kind of lines up with your shoulders. He also had a degloved and broken left foot. Other than these two major injuries, he was remarkably free of any other major injury. No head injury, no internal bleeding. Not even cuts and bruises, only 1 superficial graze on his calf and a bit of a red mark on his forehead.
He went into surgery to clean the debris out of his foot and also had callipers inserted into his skull so that weights could be applied (to hang over the head of his bed as traction) which would hopefully coax the vertebrae into a better position before his spinal fusion surgery in a few days time.
When Sam and I arrived at the hospital the next day that is how exactly how we found him in the ICU, all braced up, callipers in his head and hands bound to the bed because he kept on trying to swat at the callipers (at least we knew his arms were working at this stage). Despite all of this he was awake, breathing on his own and able to talk to us. He was quite distressed, begging me to get him an energade which I wasn't allowed to get, and it was incredibly distressing for us to see him like that, but now I wish I had held onto the sound of his voice just a little bit more, even if it was just asking me for juice (which becomes a pattern over time by the way).
Here is the thing about ICU. The nurses and doctors there are there to do a job, and the large majority of them take it very seriously (thankfully). It is obviously an all consuming task and for 12 hours straight as well, I hold the ICU nurses with highest respect (well most of them, some I could of done with less of seeing). The beeps and alarms seem to never stop. However this also means that there is usually very little time to hold the family's hand and make them understand what is actually happening. There were times when we felt comfortable when we should have been more concerned and there were times that we were concerned when we should have felt comfortable, but mostly we just felt permanently confused. I wish every ICU would hire a social worker to counsel the families of the patients and put the right emphasis on the medical information in laymen's terms. Just the smell of that place is overwhelming, then trying to take in the monitors, the sounds, the bright lights, the other patients and then also the concern for your family member is too much to handle, never mind trying to process a diagnosis or required procedure.
We met with the neurosurgeon that afternoon. That was when he showed us the MRI images and explained the injury. I was in professional 'hold it together' mode still and just trying to absorb as much information as I could. That delicate shell of holding it together started to crack when my step mom asked how my dad would be able to turn his neck after the fusion and the doctor responded with "well he will have to turn his wheelchair". I will never forget the look on her face, it was utterly heartbreaking. He had already told us that my dad was paralysed at that point, but some things don't sink in until you hear words like that. We still had a defiant hope anyway (which there is nothing wrong with at all), but it makes acceptance hard to come by.
That same evening my dad's oxygen saturation levels began to dip and one of my favourite nurses for that hospital had to explain to us that he needed to be intubated and placed on a ventilator just to help him cope for the time being. The level of spinal cord injury was affecting his ability to use his diaphragm efficiently which in turn was making breathing difficult. In time, and with physio, he would get stronger and be able to breathe on his own again. Or at least that was the idea. She was abrupt and straight forward in her explanation and reasoning. I appreciated someone finally being forthcoming with information, but it was difficult information to take in nonetheless. This was the second big blow of the day, and it was a difficult one.
My dad had always been adamant, and throughout his life it was something he would speak to us about again and again, that he never wanted to be on life support. He had a heart (of the anatomically correct variety) tattooed on his chest with the words 'do not rescucitate' underneath. Just for the record this is not sufficient to actually have a DNR placed so if anyone is even reading this and this is something you feel strongly about, please get a legal living will put in place, and although even that doesn't hold much ground in hospital at least your family are completely aware of your wishes and can make the right decisions in the horrible event that they need to make decisions on your behalf.
However, because the ventilation was being looked at as a temporary measure, we didn't consider it to be life support (it is) and gave permission for him to be sedated and intubated, and he remained that way until his surgery on the Saturday morning.
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