Rubber side up
It's taken a long time to get around to writing this blog post - the better part of two years. I didn't want to put too much detail online in the first few months after the crash, while I waited for all the legal and insurance dust to settle, and by the time all that was done I wasn't so keen on revisiting all the events around the crash any more than I had to.
I still think about the crash and its aftermath a lot. I'm forever running into old work colleagues who I haven't seen for a while - including a big crowd of them this week at a conference that I last attended in 2008. So I get plenty of chances to answer the question of whether I'm "all better" - to which the short answer is that I'm close enough to 100% for all practical purposes, and the long answer follows.
First, a happy story. In the crash, I remember the sound of something breaking and my first thought was that it was my bike frame. It might also have been the wing mirror of the car that hit me (which definitely broke) or it might have been the sound of one of my bones (many of which definitely also broke - but I'm guessing they made a more muffled sound - so probably the wing mirror). Anyway, it did turn out that the top tube on my beloved carbon fibre frame was cracked, and when I finally got to the point of deciding what to do with that bike many months later, I decided just to buy a new frame - different model, different color, because I wasn't sure I wanted to be reminded too much of the machine I was riding on "crash day".
Eventually, I took the broken bike and new frame to a bike shop, and had them move all the undamaged components over to the new frame (Orbea Orca, for the curious). When they were done, they told me that the old frame - a nice BMC, similar to what Cadel Evans rode to victory in the 2011 Tour - could be repaired for a relatively small cost. I decided to go for it, and hope I could find someone who'd like to have the frame. Some months later, I discovered that my friend Chris Birch was in the market for just such a frame, and the sizing seemed to work out. It was Chris who, as "Boss of 'Cross" at MIT introduced me to cyclocross when I rode briefly with the team in 2011. She's also a total star, winning the national D2 'cross championship this year. So I couldn't think of a better recipient for the battle-scarred frame, and this week she sent me the photo below, with a note saying how much she loved the bike. Note the visible carbon fibre repair on the top tube. I hope it brings her more racing success.
Back to the crash. I was about 3 hours into a solo training ride as I finished up my training for the "Tour of the California Alps" aka "The Death Ride". Maybe it's not wise to enter events with Death in the name. I had just finished the very satisfying and long ascent up the Western end of Alpine Rd in the hills above Palo Alto, and was making my way down Page Mill Rd. Practicing my descending technique, I was in the drops, leaning into the turns, and trying to find the best line through every turn. I was also maintaining what seemed like a safe speed: GPS would show I was going 28 mph where the speed limit was 25, which I considered a good way to minimize the risk of being overtaken by impatient drivers from behind. There's a double yellow line down the middle of the road, which I was observing, and in retrospect I think this gave me a false sense of security. There are quite a few roads in this area that I won't ride down because they lack a double yellow. Well, Page Mill is now also on my "no-go" list.
The thing that you hear about time slowing down in traumatic situations is completely true. I have a very vivid memory of what happened. I came around a turn, and saw a car coming at me on my side of the road. I was finishing off the turn, and I braked and tried to turn further to the right, but as I squeezed the brakes, I felt them lock, and I skidded into the side of the car. Then I heard the crack of something breaking and next thing I remember I was lying on my back and yelling "f*ck f*ck f*ck call 911 call 911". Fortunately, as I'm told happens with childbirth, I have no real memory of pain. I do remember trying to move my left arm and finding it completely unresponsive.
I'm guessing that from the time I saw the car until the time of impact was much less than a second, but it truly did play out slowly in my memory afterwards. I'm told that your brain works sort of like a high speed camera in these circumstances, so it's like you gather data at 200 frames per second but have the luxury of playing it back at 25fps.
There were other cyclists who had been cycling up the hill as I came down, and one of them helped me crab-walk on my back to get over to the side of the road. The drive of the car had stopped up the hill and was yelling at people coming down the hill to slow down, and my first concern was not to get run over by either car or bike coming down.
I asked the cyclist who helped me to confirm that the car was on the wrong side of the road, and he agreed that it was. When the driver came to see me, I remember saying something like "so we agree this was your fault, right?" and when she agreed, I thanked her for behaving honorably. I will say that I'm really glad I had those 2 conversations, because I remember them perfectly, whereas the certainty of where I was relative to the yellow line, especially after I skidded, is a bit less strong now. The police report - which was compiled maybe 15 minutes later - quotes me, the driver, and the other cyclist all saying the same thing about what happened, and the driver was cited for crossing the double yellow. And I have to say, given the amount of trauma I went through, it matters quite a lot to me that it wasn't caused by my error. Although reasonable people could certainly point out ways that I might have avoided the accident, it is hard to protect yourself against a car on the wrong side of the road.
I've looked at the Google Earth images of the crash site pretty obsessively (see below) - as you do - and it's pretty clear that the driver had a short section of straight road in which she tried to get around slow-moving cyclists going uphill. She simply didn't have time to complete the maneuver, and was still across the line when I rounded the corner. It's also very clear that if I had arrived slightly later I could have had a head-on crash, rather than shoulder-to-side-of-car. The latter happened because I was moving out from the apex of the turn towards the double yellow, on roughly the "correct" line for the turn.
Some long time (or so it seemed) after the police arrived, an ambulance came, and they put on a cervical collar (as a precaution, they said) and strapped me to a stretcher. Funnily enough, the one thing I remember pain-wise was that the strap hurt my shin, which I had banged on a pedal at the start of the ride. I guess I blocked out the more severe pain from memory. I do remember asking for pain killers in the ambulance, and also thinking that the ambulance ride - about 7 miles of fairly twisty roads - took forever. I was figuring I had a broken collar bone based on the useless left arm, but I also noticed a gurgling sound in my lungs, which the EMT confirmed was probably a punctured lung. He said some reassuring things about the treatment for such a thing so I was still thinking I was in pretty good shape. I didn't expect to stay overnight in hospital.
In the hospital things slowly got less rosy. They managed to get hold of Christy pretty quickly, which was great - especially since I had called her from the ambulance, only to reach voice mail, and left a message mentioning an accident but failing to specify the hospital where I could be found. Memories of the long day in the ER are a bit more jumbled. I probably got put on opiates early on. I do recall having what felt like a bit of a panic attack, talking to a nurse about it, and being reassured that I was in good hands. Another memory, which is crystal clear now, didn't come back to me for a couple of weeks after I got out of hospital. Christy was with me, and was asked to leave for a bit as another patient was coming in and they needed the room clear. The patient was accompanied by a phalanx of doctors and nurses, and after a while one doctor said something along the lines of "do we all agree we're done?" Maybe it was a bit less cold, but it was immediately obvious that they had just given up trying to save the patient. Not only do I now remember this episode clearly, but I also remember the moment when the memory re-surfaced. It was pretty surprising that such a vivid memory could be totally suppressed. I'm sure this is well known, but it's another thing to experience the recovery of a memory. And unlike some recovered memories, at least the broad outlines of this one have been confirmed by a third party.
Over the course of the afternoon I was visited by lots of doctors, and scanned in various ways, and slowly my condition was revealed. 9 broken ribs, broken scapula, broken collar bone (got that one right!), punctured lung (right again!) and 2 fractured vertebrae. You'll need to be away from work for at least a week, said one doctor. (In the end I was off work for 3 months.)
I remember signing a couple of release forms to allow them to do surgery. I like to know what I'm signing, so I asked a couple of questions, and got good answers. Yes, you can die from an infection when we put a tube inside your punctured lung. When we repair the shoulder blade and collar bone, you might die from an infection, or a bleed. My father died in a hospital from a lung infection he acquired after surgery, so I was quite attuned to these risks, but what else can you do?
By night time I was in the ICU, and just hoping I could get through the surgery and not die from aforementioned complications. The next day would be mostly consumed with more scans to gather all the information needed for surgery and to assess the state of my vertebrae. Good news there - very minor fractures, not much risk to the spinal column. They built an awesome 3D computer model of my shoulder blade. By far the worst part of the day was when an ICU nurse decided to change my sheets by rolling me onto the broken shoulder. Again with the forgetting pain thing, but I do remember begging her to stop. She was on the receiving end from some stern words from Christy and it didn't happen again.
Two days post accident was surgery day. I had no idea how long I'd have to wait, but thankfully it was quite early when they took me off to operate. I woke up after surgery and I was told that 8 hours had elapsed. Must have been a long day for Christy. 7 of those hours were spent reassembling the jigsaw puzzle of my shoulder blade. I would learn much later that it had been in 15 or so pieces. I was immediately aware of being in less pain - and also bordering on euphoric, as I reckoned I had dodged the biggest bullet by making it out of the operating theatre. Now I just had to get the tube out my chest, and then get out of hospital, and my risk of a lethal infection would drop rapidly. I guess this might sound a bit melodramatic, but that really was where my head was at - seriously fearing death, but also feeling that I was dodging bullets at every stage. Helped along by some strong opiates, my mood got better and better.
Worst hospital experience aside from the sheet-changing: sharing my ICU room for 3 days with a methadone addict (I suspect this wasn't his only problem - but it was one I heard way too much about). I never saw his face or learned what was wrong with him that had required hospitalization. Let's just say that he didn't seem as broken as me, but he sure did whine for 11 hours out of every 12 as he tried to persuade the nurses that he should be getting more than 2 hits a day.
After 3 days total I was moved out of the ICU, then next day the chest tube came out, and I started physical therapy. To my great pleasure, I was discharged after 5 nights in hospital.
Before I left, I had a conversation with the orthopedist who'd done the shoulder reconstruction. He said "you need to do your PT. If you don't, your shoulder will freeze up, and in 2 months you'll be in worse shape than when you arrived in the hospital." Hey, at least I wouldn't have a punctured lung, I thought, but I took him seriously. I still do shoulder exercises today. More on that another time.
I never got back in touch with the driver, although I think about doing so from time to time. I decided, after much deliberation, not to sue (it's not such a cultural norm where I come from) and just collected what I could from insurance. The driver had only $100k of coverage, and my five days in hospital cost about $140k. Fortunately I had health coverage of my own, and even my own car insurance policy surprisingly came through with a bit of "underinsured motorist" coverage - which applied even though I wasn't driving a car. I didn't get much for "pain and suffering" but at least I didn't have to worry about how all the bills would get paid, or the cost of replacing my bike - a rounding error, as they say.
In keeping with long-standing Cantabloggia tradition, here is some vaguely related music. I listened to a lot of Regina Spektor in the hospital.
Laughing With - Regina Spektor
I still think about the crash and its aftermath a lot. I'm forever running into old work colleagues who I haven't seen for a while - including a big crowd of them this week at a conference that I last attended in 2008. So I get plenty of chances to answer the question of whether I'm "all better" - to which the short answer is that I'm close enough to 100% for all practical purposes, and the long answer follows.
First, a happy story. In the crash, I remember the sound of something breaking and my first thought was that it was my bike frame. It might also have been the wing mirror of the car that hit me (which definitely broke) or it might have been the sound of one of my bones (many of which definitely also broke - but I'm guessing they made a more muffled sound - so probably the wing mirror). Anyway, it did turn out that the top tube on my beloved carbon fibre frame was cracked, and when I finally got to the point of deciding what to do with that bike many months later, I decided just to buy a new frame - different model, different color, because I wasn't sure I wanted to be reminded too much of the machine I was riding on "crash day".
Eventually, I took the broken bike and new frame to a bike shop, and had them move all the undamaged components over to the new frame (Orbea Orca, for the curious). When they were done, they told me that the old frame - a nice BMC, similar to what Cadel Evans rode to victory in the 2011 Tour - could be repaired for a relatively small cost. I decided to go for it, and hope I could find someone who'd like to have the frame. Some months later, I discovered that my friend Chris Birch was in the market for just such a frame, and the sizing seemed to work out. It was Chris who, as "Boss of 'Cross" at MIT introduced me to cyclocross when I rode briefly with the team in 2011. She's also a total star, winning the national D2 'cross championship this year. So I couldn't think of a better recipient for the battle-scarred frame, and this week she sent me the photo below, with a note saying how much she loved the bike. Note the visible carbon fibre repair on the top tube. I hope it brings her more racing success.
The repaired bike, ridden by Chris Birch
Back to the crash. I was about 3 hours into a solo training ride as I finished up my training for the "Tour of the California Alps" aka "The Death Ride". Maybe it's not wise to enter events with Death in the name. I had just finished the very satisfying and long ascent up the Western end of Alpine Rd in the hills above Palo Alto, and was making my way down Page Mill Rd. Practicing my descending technique, I was in the drops, leaning into the turns, and trying to find the best line through every turn. I was also maintaining what seemed like a safe speed: GPS would show I was going 28 mph where the speed limit was 25, which I considered a good way to minimize the risk of being overtaken by impatient drivers from behind. There's a double yellow line down the middle of the road, which I was observing, and in retrospect I think this gave me a false sense of security. There are quite a few roads in this area that I won't ride down because they lack a double yellow. Well, Page Mill is now also on my "no-go" list.
The thing that you hear about time slowing down in traumatic situations is completely true. I have a very vivid memory of what happened. I came around a turn, and saw a car coming at me on my side of the road. I was finishing off the turn, and I braked and tried to turn further to the right, but as I squeezed the brakes, I felt them lock, and I skidded into the side of the car. Then I heard the crack of something breaking and next thing I remember I was lying on my back and yelling "f*ck f*ck f*ck call 911 call 911". Fortunately, as I'm told happens with childbirth, I have no real memory of pain. I do remember trying to move my left arm and finding it completely unresponsive.
I'm guessing that from the time I saw the car until the time of impact was much less than a second, but it truly did play out slowly in my memory afterwards. I'm told that your brain works sort of like a high speed camera in these circumstances, so it's like you gather data at 200 frames per second but have the luxury of playing it back at 25fps.
There were other cyclists who had been cycling up the hill as I came down, and one of them helped me crab-walk on my back to get over to the side of the road. The drive of the car had stopped up the hill and was yelling at people coming down the hill to slow down, and my first concern was not to get run over by either car or bike coming down.
I asked the cyclist who helped me to confirm that the car was on the wrong side of the road, and he agreed that it was. When the driver came to see me, I remember saying something like "so we agree this was your fault, right?" and when she agreed, I thanked her for behaving honorably. I will say that I'm really glad I had those 2 conversations, because I remember them perfectly, whereas the certainty of where I was relative to the yellow line, especially after I skidded, is a bit less strong now. The police report - which was compiled maybe 15 minutes later - quotes me, the driver, and the other cyclist all saying the same thing about what happened, and the driver was cited for crossing the double yellow. And I have to say, given the amount of trauma I went through, it matters quite a lot to me that it wasn't caused by my error. Although reasonable people could certainly point out ways that I might have avoided the accident, it is hard to protect yourself against a car on the wrong side of the road.
I've looked at the Google Earth images of the crash site pretty obsessively (see below) - as you do - and it's pretty clear that the driver had a short section of straight road in which she tried to get around slow-moving cyclists going uphill. She simply didn't have time to complete the maneuver, and was still across the line when I rounded the corner. It's also very clear that if I had arrived slightly later I could have had a head-on crash, rather than shoulder-to-side-of-car. The latter happened because I was moving out from the apex of the turn towards the double yellow, on roughly the "correct" line for the turn.
Google Earth picture of the accident site.
Green line is my estimate of my path into the side of the car
Some long time (or so it seemed) after the police arrived, an ambulance came, and they put on a cervical collar (as a precaution, they said) and strapped me to a stretcher. Funnily enough, the one thing I remember pain-wise was that the strap hurt my shin, which I had banged on a pedal at the start of the ride. I guess I blocked out the more severe pain from memory. I do remember asking for pain killers in the ambulance, and also thinking that the ambulance ride - about 7 miles of fairly twisty roads - took forever. I was figuring I had a broken collar bone based on the useless left arm, but I also noticed a gurgling sound in my lungs, which the EMT confirmed was probably a punctured lung. He said some reassuring things about the treatment for such a thing so I was still thinking I was in pretty good shape. I didn't expect to stay overnight in hospital.
In the hospital things slowly got less rosy. They managed to get hold of Christy pretty quickly, which was great - especially since I had called her from the ambulance, only to reach voice mail, and left a message mentioning an accident but failing to specify the hospital where I could be found. Memories of the long day in the ER are a bit more jumbled. I probably got put on opiates early on. I do recall having what felt like a bit of a panic attack, talking to a nurse about it, and being reassured that I was in good hands. Another memory, which is crystal clear now, didn't come back to me for a couple of weeks after I got out of hospital. Christy was with me, and was asked to leave for a bit as another patient was coming in and they needed the room clear. The patient was accompanied by a phalanx of doctors and nurses, and after a while one doctor said something along the lines of "do we all agree we're done?" Maybe it was a bit less cold, but it was immediately obvious that they had just given up trying to save the patient. Not only do I now remember this episode clearly, but I also remember the moment when the memory re-surfaced. It was pretty surprising that such a vivid memory could be totally suppressed. I'm sure this is well known, but it's another thing to experience the recovery of a memory. And unlike some recovered memories, at least the broad outlines of this one have been confirmed by a third party.
Over the course of the afternoon I was visited by lots of doctors, and scanned in various ways, and slowly my condition was revealed. 9 broken ribs, broken scapula, broken collar bone (got that one right!), punctured lung (right again!) and 2 fractured vertebrae. You'll need to be away from work for at least a week, said one doctor. (In the end I was off work for 3 months.)
I remember signing a couple of release forms to allow them to do surgery. I like to know what I'm signing, so I asked a couple of questions, and got good answers. Yes, you can die from an infection when we put a tube inside your punctured lung. When we repair the shoulder blade and collar bone, you might die from an infection, or a bleed. My father died in a hospital from a lung infection he acquired after surgery, so I was quite attuned to these risks, but what else can you do?
By night time I was in the ICU, and just hoping I could get through the surgery and not die from aforementioned complications. The next day would be mostly consumed with more scans to gather all the information needed for surgery and to assess the state of my vertebrae. Good news there - very minor fractures, not much risk to the spinal column. They built an awesome 3D computer model of my shoulder blade. By far the worst part of the day was when an ICU nurse decided to change my sheets by rolling me onto the broken shoulder. Again with the forgetting pain thing, but I do remember begging her to stop. She was on the receiving end from some stern words from Christy and it didn't happen again.
Two days post accident was surgery day. I had no idea how long I'd have to wait, but thankfully it was quite early when they took me off to operate. I woke up after surgery and I was told that 8 hours had elapsed. Must have been a long day for Christy. 7 of those hours were spent reassembling the jigsaw puzzle of my shoulder blade. I would learn much later that it had been in 15 or so pieces. I was immediately aware of being in less pain - and also bordering on euphoric, as I reckoned I had dodged the biggest bullet by making it out of the operating theatre. Now I just had to get the tube out my chest, and then get out of hospital, and my risk of a lethal infection would drop rapidly. I guess this might sound a bit melodramatic, but that really was where my head was at - seriously fearing death, but also feeling that I was dodging bullets at every stage. Helped along by some strong opiates, my mood got better and better.
Worst hospital experience aside from the sheet-changing: sharing my ICU room for 3 days with a methadone addict (I suspect this wasn't his only problem - but it was one I heard way too much about). I never saw his face or learned what was wrong with him that had required hospitalization. Let's just say that he didn't seem as broken as me, but he sure did whine for 11 hours out of every 12 as he tried to persuade the nurses that he should be getting more than 2 hits a day.
After 3 days total I was moved out of the ICU, then next day the chest tube came out, and I started physical therapy. To my great pleasure, I was discharged after 5 nights in hospital.
Before I left, I had a conversation with the orthopedist who'd done the shoulder reconstruction. He said "you need to do your PT. If you don't, your shoulder will freeze up, and in 2 months you'll be in worse shape than when you arrived in the hospital." Hey, at least I wouldn't have a punctured lung, I thought, but I took him seriously. I still do shoulder exercises today. More on that another time.
I never got back in touch with the driver, although I think about doing so from time to time. I decided, after much deliberation, not to sue (it's not such a cultural norm where I come from) and just collected what I could from insurance. The driver had only $100k of coverage, and my five days in hospital cost about $140k. Fortunately I had health coverage of my own, and even my own car insurance policy surprisingly came through with a bit of "underinsured motorist" coverage - which applied even though I wasn't driving a car. I didn't get much for "pain and suffering" but at least I didn't have to worry about how all the bills would get paid, or the cost of replacing my bike - a rounding error, as they say.
In keeping with long-standing Cantabloggia tradition, here is some vaguely related music. I listened to a lot of Regina Spektor in the hospital.
Laughing With - Regina Spektor
posted by DrBruceD | 9:44 PM
5 Comments:
This comment has been removed by a blog administrator.
Came to this via a re-tweet. It reminded me of a similar accident when I was 15 years old. Luckily I bounced over the car and escaped with all but cuts and a bruised back- younger bones I guess!
The 'bullet time' moment for me is still vivid, nearly 35 years later. As I somersaulted over the handlebars my shoe caught something, came off my foot and travelled through the air with me. I can still see it rotating in slow motion as we both awaited our fate!
Anyhow, I'm pleased to hear all ended well for you too.
Regards,
A random bloke in the UK
This comment has been removed by the author.
UK Bloke - thanks for the story. This slowing down thing seems pretty universal.
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