Part 1: a moment in time

In March 1987 my life changed forever, one morning on my way to work.  Everything that happened before that day is now categorised in my mind as “before accident.” Statistically I should never have survived, and I certainly never thought I would continue my career and make it to retirement, but I did. However the memories of that day and the following months are still so vividly etched on my brain and always will be. 

How do you compare a life changing major road traffic accident, which affects the rest of your life, with other life events such as getting married or becoming a father? You can’t. One is full of pain, fear, exhaustion and a long, hard struggle.  The others are moments of joy and celebration. But this accident was life changing,  and it is only after I returned that I have had time to think about all of the differences it made, to me as a person, as a doctor, and as a teacher. 

At the time of the accident I was a senior registrar at a hospital in London but on a year’s rotation to a department in Sussex. I lived in London but having had a premature son only seven months before this fateful day, who was in and out of Great Ormond Street Hospital, I drove home every night when I wasn’t on call. I was 31, in the prime of my life, applying for consultant jobs, and very fit as I was training to do the London Marathon for a second time.

March 11th 1987 was a cold and icy morning. I remember scraping the ice off my car windscreen just before 7am as I was about to set off to Sussex. The last thing I remember was wondering where my neighbour was who usually left for work at the same time?  When you do the same journey every day one drive merges into another and I am sure I had other thoughts while driving but I cannot recall them now.

It was about 50 minutes later that my life was to change forever. Just after the M23 became the A23, near the Handcross turnoff, my car left the road. What happened? I don`t know. I have no recollection. All I know is what others have told me. Did I hit some black ice? Possibly. Did I burst a Tyler?  One of my front tyres was shredded. There were several potholes in the road around that area. Could these have contributed? A lorry driver apparently put a duvet over me in my wrecked car, I assume to keep me warm. He then left. Was his or some other vehicle involved? I`ll never know and it would make no difference. What happened, happened. 

My car spun round at what I can only assume was my usual speed of 70 to 80 miles an hour on that stretch of road and hit a concrete lamp post on the offside. The lamp post broke and the top half fell through the roof of the car destroying my briefcase on the floor behind my seat. The bottom half, with its metal spikes, sliced through the floor of the car and my legs. The petrol tank which was full, ruptured and petrol was running down the road. I was trapped in the car for an hour before eventually being cut out by the fire service. My upper body was lying across the passenger seat so I was virtually horizontal. This, I am sure, helped save me as I lost more and more blood.  I have no recollection of any of this although I am told I was conscious throughout.

I do have vague recollections of emerging into a tunnel of daylight and seeing trees swaying and everything feeling so peaceful. I remember no pain. It was only some years later on hearing a talk by Sam Parnia on “near death experiences” that I sat open mouthed through the lecture, realising that what I had experienced that morning many years previously was exactly that, a near death experience – peace and tranquillity, tunnel vision, the swaying branches, and no pain. If this is what death is like then there is nothing to fear about it. 

I was taken to Cuckfield Hospital which now no longer exists. Apparently I had no recordable blood pressure or palpable pulse on arrival in the Resuscitation department. Nobody knew who I was but when someone said I was to have oxygen and the nurse asked “how much”, I apparently responded “six litres” (the recommendation of that time). It was apparent then that I was not a member of “Joe public” but knew something about medicine. I was still practising medicine when critically ill! But what about my injuries? The right leg had taken the brunt of the impact. Two femoral fractures, severed popliteal artery and vein, and multiple lower leg compound fractures  with de-gloving. My left leg had fractures of the mid shaft tibia, femoral condyle and tibial plateau and a common perineal nerve palsy which it later transpired had left me with a complete foot drop. Otherwise a broken ring finger and two cuts on my head.

These were the pre ATLS (Advanced Trauma Life Support) days in the UK and so it was pot luck as to how well you were treated when severely injured. I have nothing but praise for the hospital and those who treated me. I spent a large part of the first three days in theatre having my popliteal vessels repaired and the left knee put back together until on the third day I had my right leg amputated above the knee. Bleeding had been torrential. The injuries to the lower limb were so extensive that it was easier for the blood to leave my leg for the bed and floor rather than to return up the newly repaired venous system. By this stage I had received over 80 units of blood. My wife was told that there was a good chance I would not survive. 

But I did.