Accidents may happen – Gaining a companion, having a day off… and a trip to intensive care 

Day 8 – Wednesday 2nd August, 2017 – Brunswick, GA to Savannah, GA

Strangely, my only company at breakfast on Day 8 were two inspectors from the Department of Health and Human Services poking around with temperature probes and clipboards. Hoping they weren’t there following a complaint, I tucked into the buffet before getting ready and hitting the road – psyched for a big day.

With the iPod in from the onset, I rode hard in blocks of about an hour – pausing in between to take on food and fluid. When chatting to a guy at one stop, it marked the first instance where someone on this trip has had real difficulty understanding me – despite my best efforts to maintain good diction. He himself had a wonderful, husky country accent.

A particular attraction I enjoyed passing was the “smallest church in America”.

It was fairly warm but there was a good level of cloud cover and the wind was little bother at long last. The legs were responding well and the cycling was as fast as it had been all tour – partly owing to some sections where a straight bit of road opening up before me would coincide with a particularly uplifting song coming on my iPod and I couldn’t help but ride like a maniac for a short while. Needless to say, it was looking like I’d make it to Savannah before sunset.

Whilst sat outside a petrol station on a break after 84 km, I saw another cycle tourist pass by – also heading North on the US 17. When I resumed, I eventually caught him up when he paused to read a plaque by the side of the road. His name was Vincent – a 36-year-old physicist from Montréal who’d set off on his bike trip nearly three years ago from Canada and travelled all the way down the Rockies and Andes to Ushuaia on the Southern tip of Argentina before bending back round and coming home via the East Coast of South and North America. A truly incredible adventure and one that made mine seem like a quick weekend getaway in comparison. When it arose that we were both heading to Savannah, he asked if I had somewhere to stay. As always, I was just planning to get to Savannah and then wing it but he said he had a Warm Showers host expecting him and he kindly asked on my behalf if I could also stay. When this got the thumbs up, it was a nice load off my mind and we rode off together – two-abreast wherever possible.

Vincent was a lovely bloke (as Canadains often are) and we had some interesting discussions as we cruised along. ‘Cruise’ would be the appropriate word as he had even more luggage than me so the pace of the day slowed right down and I soon waved goodbye to my hard-fought 24.3 km/h average. The story of the day, for that matter, is illustrated very well in Figure 1 which is a plot of my heart rate as a function of time.

Things got a little hairy when he navigated us onto what appeared to be a fully-fledged motorway. Not only that, it was one with road works causing the hard shoulder to close for a bit of it. I had to admire his calmness as he breezed over the chevrons and slip lanes that came at each junction but I suppose you don’t get through a trip like his without being a little ballsy.

It was a relief to be done with that road still alive and not having had anyone rat us out to the cops. There was then just a short ride through a residential area before arriving at the house at 8ish.

We were greeted by a man named Austin and his partner Martha-Jane with a cold beer and some freshly-baked bread. After some delicious tacos for tea, we started talking about the following day. I had had it in my head for a while that I would take my first day off in Savannah which, incidentally, Vincent planned to do too. So with very little said, I was granted a second night. In a remarkable display of trust, Austin also said I was welcome to drive his car into town – a UK driving licence seemingly being all one needs. Naturally, I leapt at the opportunity and only wished I’d brought the suction cup mount for my GoPro.

We later got talking about guns and how I was hoping, whilst in America, to go and shoot some stuff at a range. Vincent was keen so we put it on our list of things to do. Austin, who was clearly pro-2nd Amendment, then disappeared off and returned with two loaded handguns of his own. He later said that he has a 9 mm on his waistband whenever he leaves the house for “personal protection”.

After the gun show, Austin took himself off to bed and Vincent and I wrote our respective diaries before retiring to our beds.

Day 9 – Thursday 3rd August, 2017 – Rest day (Savannah)

Unfortunately, despite the best efforts of me, Vincent and Austin’s son, Caleb, we couldn’t get the car to start so got a quick Uber to the shooting range. Straight away, one or two of the preconceptions I held about the range were proven to be false. I expected the staff to be deadpan and no-nonsense in order to discourage any horseplay around firearms. However, we were greeted warmly with beaming smiles upon entering as if we were there to buy a puppy. Vincent and I were sorted out with a 9 mm each as well as plenty of ammunition, targets and ear and eye protection for a very fair grand total of around $30.

Vincent and I clearly looked like novices as a member of staff ushered us onto the range and gave us a demonstration on how to use the guns we’d hired. I couldn’t get over how brief this induction was – not least the fact that it was optional.

When it was my turn to have a go I proceeded tentatively – struck by how heavy the gun was . Firing the weapon, however, was truly exhilarating. The emphatic thumping noise, the recoil, the shell flying out. This was the real deal (and I was shamelessly enjoying it).

I was distracted at one point by some particularly loud bangs coming from my right. I looked over to see one of the most American sights ever to be projected onto my retinas. A boy of about 16 with his cap on backwards was firing an M4 Assault Rifle while his mother watched on proudly. In all likelihood, the boy had been using the weapon on Call of Duty the previous night and thought he’d have a go himself.

Once we’d shot through all our ammo, we headed to downtown Savannah to have a wander round and be proper tourists.

Savannah is a very atypical American city. It has some lovely old buildings circa. 1800s, cobbled streets and a plethora of small parks all of which help draw in the hordes of tourists it receives. One thing you notice walking round the place is that Americans love to shoehorn the word ‘historic’ in wherever they can. As a European, you can’t help but feel a bit smug that you have a much richer history at your disposal.

For lunch, I committed a bit of a tourist faux pas by suggesting a British themed pub but I was curious to see how well they’d execute it. The authenticity was brought into question early doors when the waitress asked what vegetables I’d like with my meal and I didn’t recognise either of the options. Or perhaps this says more about me and how worldly I am…

Just before leaving, it was a lovely surprise to spot a drawing of Durham Cathedral on the wall where, just weeks earlier, I had attended my graduation ceremony.

Later that evening, Austin treated us to some fabulous homemade pizzas (pictured below) before Vincent gave us a slideshow of his trip’s photographs.

Day 10 – Friday 4th August – Savannah, GA to Coosawhatchie, SC

It was a slow crawl out of Savannah before getting out to the countryside but once we did, we soon came across the state border after about 30 km.

Vincent’s style of cycle touring couldn’t have been more different to mine. I took a more rock ‘n’ roll approach where I would typically set off at half 10 and ride hard but sustainably taking regular breaks. Vincent on the other hand would make an early start and ride at a low intensity with much fewer breaks. He was also someone to almost always set off with a target in mind and not leave it open-ended as I had got in the habit of doing.

After a while riding in the hard shoulder of a dual carriageway I heard a short ‘whoop’ of a police siren but didn’t think much of it. When it was repeated about 10 seconds later I swivelled round to see a police car crawling right behind me in the hard shoulder. Since I had stopped a short while earlier to fiddle about with my GoPro, a considerable gap had opened up between myself and Vincent so I was to face the music solo.

As expected, the officer informed me that bicycles weren’t allowed on that road and after five or 10 minutes chatting he escorted Vincent (who had returned by this point) and I off at the next exit. Very kindly, he chose not to give us a ticket which I wholly expected him to instead choosing to take my details and make me sign something. After a short pause to have a drink and discuss the remainder of the day’s route, Vincent and I pedaled off.

It was at this point the lights went out.

The next thing I remember is lying on a hospital bed in intensive care with my head immobilised in a neck brace and people moving all around me. I’d been changed into a hospital gown, wires were attached to my body and needles were in my arms. On at least three occasions I recall complaining of feeling really sick before staff manoeuvered me onto my side and I either wretched or chundered violently into a receptacle a man was holding. The memories are very patchy indeed though and continue to be for the next few days. In fact, I had to revisit the family Whatsapp group to assist in writing this blog post as my phone was much better at storing data than my brain was.

The following day I was deemed stable enough to be transferred out of intensive care to another part of the hospital. After a while I noticed my phone had been placed next to me so I instinctively joined the hospital’s wifi and started to make contact with home. Someone had told me that they’d been informed as to what had happened so my first message was simply a caption-less selfie as shown below.

Only ten more messages were exchanged in fact before the conversation ends with me abruptly falling asleep. Of the four days I spent in this hospital, I feel like I spent about 90% of it asleep. At first, I assumed this was due to the morphine I was being administered but the fatigue continued long after I switched to the less hardcore opioid painkiller ‘oxycodone’ and I didn’t start sleeping normal amounts again until about six weeks post-accident. It was almost as if my brain was like a computer that had to restart to install important updates.

Thinking back, what is odd is the lack of fear – or indeed any strong emotion – I experienced in the wake of the incident. I had no idea what had happened, where I was or where all my valuables were. But I wasn’t troubled by this. At one point in intensive care I remember waking up from a sleep with a sudden urge to cough and in doing so bringing up a fair bit of blood. But looking down at the red splat on the floor I didn’t think more than “that’s odd” before rolling back onto my back and logging off again. What is more, I don’t remember any feeling of upset that one of the most incredible and liberating adventures of my life had been curtailed before I had a chance to see the real attractions of Washington DC and New York (with the greatest respect to the South).

At some point that day, a doctor paid me a visit to explain what had happened. It turns out that shortly after leaving the road that the police officer stopped us on, an old lady drove into the back of me as I cycled and I had sustained, amongst other things, quite a serious head injury. My skull had fractured in two places and the CT scan revealed ‘bilateral frontal haemorragic contusions’ and ‘epidural haematoma’ – that’s bruising on the front of the brain and a build up of blood inside the skull to you and me. He also mentioned that my left eardrum had perforated as a lot of blood had escaped via this route. At the time, this was thought to be the cause of the deafness in that ear. However, the drum has long since healed and the hearing remains at zero – so something else is at play there…

The doctor went on to stress how lucky I was and, at the time, I felt like saying “I think lucky would have been the car just missing me”. But as the days and weeks went by I really did come to understand what he meant by that remark. For example, I later found out that in the crash my body was thrown onto the opposite side of the road – at a moment when there was no oncoming traffic. But it wasn’t until about three weeks after the accident when I was casually perusing my medical notes that I first started have thoughts of ‘How am I still alive’?

“Patient was riding bicycle when he was hit from behind by a vehicle going approximately 50 – 55 mph”.

Reading it made my stomach turn as I’d just assumed up to that point that the driver had applied the brakes long before I was struck. It made the fact that, from the neck down, I had no fractures or internal injuries truly remarkable. It also made me start to wish I could remember the crash or at least that there was footage of it as I grew increasingly curious as to what it must’ve looked like. This would have also helped provide explanations to some of the unanswered questions that still surround the incident such as what caused the mysterious ‘lion scratch’ on my back.

It’s worth noting at this point that the crash happened during one of my helmet-free spells. From an early age, I’ve spent an awful lot of time on a bicycle of which at least 99.9% has been helmeted. For convenience reasons I began phasing it out in my last year at university but would always opt for it if on a bike ride. On this tour, the heat and humidity was a strong factor in me removing it if the roads were deemed quiet enough which was about 25% of the time.

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I remember so little of the time I spent in the first hospital – partly because I wasn’t awake for much of it but mainly due to the amnesia. I know that I was very kindly paid visits by Austin, Martha-Jane and Vincent but I couldn’t tell you how many times they came or what we talked about. Vincent had also been hit by the car but the negligent motorist had slammed the brakes on by that time so he’d come off a lot better than me with only a few grazes (smart move also landing on the grassy verge). He was, however, in need of some bicycle repairs so he would be sticking around for a little while.

Looking back at the messages I sent home, I complain of agonising headaches above anything else. I can’t remember how bad they were at this point but I know that for the four weeks or so that followed they were not only very intense but unrelenting in how frequent they were and how long they’d last. The month of August was essentially one giant migraine.

Some other, more unusual symptoms presented themselves such as the complete absence of any appetite. I think I only ate about twice in the four days that followed the crash and even that was because someone would urge me to. When I did eat, I was puzzled to note that I couldn’t taste anything but I thought little of it since it was trivial in comparison to the incessant headaches. When I still had no smell function three weeks later I was growing concerned as it was one of two symptoms (the other being the deafness) that wasn’t improving at all. I duly carried out research on this but the findings were deflating. Loss of smell or ‘anosmia’ is a common symptom reported after a serious head injury since the neurons which detect odours in the nose pass through a bony plate and can be easily sheared if the brain is drastically shifted relative to the skull. This is a double whammy as well as it is smell that gives us our ability to perceive flavours in food and drink.

I’ll never forget the first time I tried walking post-accident. Two physios arrived at my bedside and very gingerly helped me out and on to my feet. I felt incredibly unsteady and my head felt like it weighed a tonne. Grabbing on for dear life to the two ladies either side of me, I walked at a snail’s pace out the room and down the corridor and back. I don’t remember being particularly struck by how disabled I’d become or concerned that it would be permanent. I just remember really looking forward to getting back in bed as my head was complaining after the jolt from every footstep.

Four days post-accident my parents arrived which was a delightful addition. When they first told me they were coming over I thought they were nuts but, looking back, it’s a bloody good job they did as I was incapacitated for a lot longer than I thought I would be.

Later that day at about 11pm, a man came and helped me out of bed and into a wheelchair before wheeling me to his van and driving off. I was being transferred to a rehabilitation hospital across town where I would undergo physiotherapy and occupational therapy for the next week.

It just so happens that my mother is a physiotherapist by trade and so has spent the last thirty years helping people walk again after unfortunate circumstances such as strokes, falls etc. As expected, she came along to all of my physiotherapy sessions and lurked in the background like a caged animal. She later became quite a prominent figure in my rehabilitation in the weeks that followed.

Unhelpfully, two symptoms appeared at about Crash Day +4 which greatly hampered the first few days of rehab. One was my hamstrings contracting to an unprecedentedly short length such that everyday movements became near impossible. The cause of this was unclear but I later noticed huge green patches on the back of my thighs making some of the biggest bruises I’ve ever seen so maybe this had something to do with it. Either way, when a physio asked me at one point to try and bend over and touch my toes, she didn’t expect me to not to be able to even touch my knees! The other issue was an incredibly stiff neck which, coupled with the hamstring problem, imposed a great deal of rigidity on me for a few days.

As lovely as the staff were at the rehab hospital, I couldn’t wait to leave. It was exceedingly boring and it seemed that every ten minutes someone was coming in my room to measure my blood pressure, give me a pill or inject me with something. Further to this, I was developing a tolerance to the oxycodone so its efficacy was wearing off despite the fact I was continuing to be ravaged by headaches. It also later provided some rather unpleasant side effects.

One of the lower priority symptoms was a numbness on the right thigh which was attributed to damage to the ‘lateral femoral cutaneous nerve’ (pictured below). At the time of writing, there is still a numb patch but I’m pleased to say it is shrinking (albeit painfully slowly).

While I’m not emoting it in the pictures below, it was a great relief to finally be discharged and return to being a civilian. It wasn’t home time just yet though as I had to meet with a neurosurgeon in order to be given the all-clear to fly.

 

 

We spent the next week-and-a-half at a hotel in Savannah not getting up to an awful lot. I remained horizontal – occasionally with a bag of ice on my head when headaches struck and my parents-turned-carers fed me, clothed me and drugged me for the remainder of our unorthodox family holiday.

When we got the green light to fly home, we didn’t hang about and were on a plane to London two days later after a final goodbye to Austin and Vincent. By far the worst sections of the trip home were the first and last 0.1% i.e. the taxi to and from the airports. Car journeys had been nightmares as every single bump and undulation in the road, however subtle, shifted the brain against the inside of the skull and so I just shut my eyes and grimaced to get through them.

Because of this dislike of transport as well as, of course, my reduced mobility I remained housebound for several weeks somewhat shut off from the world. As time went by, the headaches became more infrequent and less severe. The problems with balance, dizziness and nausea slowly improved and the appetite returned. Weighing myself three weeks post-accident, I was shocked to see I had lost two stone in weight as, looking at myself in the mirror, I didn’t look any more toned than I was pre-crash. I later realised that my body hadn’t scavenged fat for aid in the healing process but instead muscle. The extent of this I didn’t fully acknowledge until about eight weeks post-accident when I tried doing press ups and had to stop after five.

The trouble with head injuries is the invisibility. Once I retired my walking stick around six or seven weeks post-accident. I would have looked, to many, like a fit and healthy member of society. In reality, I was having to concentrate on walking in a straight line and just a glance to one side was enough to throw me off course. Quite recently in fact, I spent a rather embarrassing 20 seconds navigating from the front of a bus to a seat at the back grabbing onto everything within arm’s reach along the way!

Until fairly recently, movements of the head have had to be slow and steady otherwise my vision would blur and I’d feel dizzy rather like one would feel after a session on a playground roundabout. This is something which is only a few weeks away from returning to normal.

A slightly annoying feature of post-concussion syndrome has been the hypersensitivity to sound. The counter-intuitive thing is that this doesn’t make hearing in social situations easier but instead much more challenging. In settings with a great deal of background noise such as a busy restaurant you feel bombarded and unable to filter out the din and listen to whoever’s talking to you. There have been some notable occasions where, what were previously tolerable loud noises, such as the screech of a train on its tracks or the roar of a crowd at a football match have been a bit overwhelming.

After a consultation with a neurosurgeon at Southampton General Hospital six weeks post-accident my perspective on everything changed quite significantly. As he thumbed through my medical notes from the US hospitals he stopped to read the reports of the CT scans I had had after the accident. At one point his eyebrows raised and he exhaled sharply. What, to me, was just a paragraph of jargon to him read as something not consistent with how I’d ended up. It seems that the extent of the bruising and bleeding on the brain was significant and to have walked into his office (albeit with the aid of a stick) not presenting any signs of brain damage or memory loss took him by great surprise. He later remarked that it was “interesting” that the facial nerve on my left hand side was completely intact – facial paralysis seemingly being another thing I’ve fortuitously dodged.

So the general message from the consultant was: “I understand you’re pretty bummed about losing smell but you’ve recovered miraculously well and managed to avoid so many things much, much worse than anosmia. Be positive”.

And I since have been.

Looking forward 

To use an unimaginative cliché, the past twelve weeks have been quite a journey. A journey punctuated by a series of small victories. Showering whilst standing up; getting dressed without assistance; walking without a stick. The first instances of these seemingly basic tasks were cause for celebration as they were very clear indicators that progress was indeed being made.

The accident has taught me how vulnerable we are and just how fine the line between life and death is – even for those who live cautiously. If you were to replay my accident in a simulator, say, ten times, it’s safe to say a few outcomes would have been much worse than where I find myself. The dice was rolled – and I got lucky.

I’m now in the safe hands of the NHS who have provided excellent support since returning to the UK. I am soon to undergo an exhaustive battery of tests with a neuropsychologist which may highlight cognitive deficiencies not readily apparent. While I feel myself, a few troubling episodes such as leaving the house and forgetting to lock the door on a couple of occasions have made me not 100% convinced my brain is fully functional.

The only thing stopping me from starting my PhD recently has been the slowest-improving symptom – poor balance. However, I am assured this will return to normal in due course once one side of my brain takes over the balance mechanism from the other side (all very clever). Some symptoms, however, will be around for the long term.

For example, the loss of hearing. At the time of writing, the exact cause of the deafness in the left ear is still a mystery and it’s unclear at this point whether any of that hearing will be recovered.

The outlook for the anosmia (loss of smell) is more bleak but after a few weeks mourning this I made my peace with it and it’s now become the subject of jokes. Luckily, careers as a chef, perfumer or wine connoisseur were never really on my radar. In fact, as a synthetic chemist, I can’t say I’ll miss certain odours.

Of the facial scars, the longest and most bulbous is conveniently masked by upper lip hair but, unhelpfully, one of them passes over the left eyebrow so it doesn’t look like those hairs are growing back. Good job eyebrow slits are in fashion.

Shame I’m not the sort to have one…

Acknowledgements

I’ll end with some much-deserved thank yous.

Firstly, to all the kind strangers I met along the way who stopped to talk to me and offer kind words of advice or encouragement. Spending the last four years in the progressive, liberal bubble of Durham University, you come to think that being socially conservative and a decent, moral human being are mutually exclusive. My two weeks in the South well and truly debunked that idea.

Thanks to Jim for welcoming me into his home one night and giving me a lift to Yulee.

Thank you also to the emergency and hospital staff who scraped me off the road, treated me and helped me walk again.

Massive thanks also to Austin who not only granted me two nights accommodation, cooked me my last supper (that I’ll taste) and paid me a few visits to check on my recovery but also had the unenviable task of ringing my mother to tell her her son had been hit by a car and was in intensive care.

Thanks to Vincent for providing great company for a few days before circumstance cruelly intervened. I hope the remainder of his trip is fulfilling and free from mishaps.

And lastly, a huge thanks must go to the parents who were just hours away from heading to the airport for a holiday when news of the accident came in. If I list everything they’ve done over the last twelve weeks for which I’m grateful it’ll sound schmaltzy and OTT so I’ll just say this. They’ve been fab.

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Appendix

Tour statistics

Cycling days: 9 (inc. Crash Day)

Total distance: 898.0 km

Riding time: 41 hours 1 minute 3 seconds

Average speed: 21.9 km/h

Total Vertical Ascent: 1685 m