Accidental Reflections 2023: Thoughts After a Big Crash

I had a mishap this summer, a crash involving myself, a small motorized vehicle, and a forest trail. It could easily have been life-altering but as I survived in one piece, I now look at it as a learning opportunity. And this is, in part, what I have learned.

1.  Avoid Single Vehicle Accidents: If there is one thing you can control it’s your own behaviour.

Through great fault of my own, I successfully engineered a single-vehicle incident involving an ATV (All Terrain Vehicle, quad in this case), while zooming around sand pits and forest trails. Chasing my son… or maybe chasing my youth? No matter, both got away clean. I ended up over the handlebars while flipping the machine on an otherwise routine stretch of trail. Ass over teakettle, as the locals said more than once. Would I do anything differently? Activity choice, no it is still incredibly fun, but technical execution, hell yeah; check the tire pressure, keep a keener eye out for roots, go slower into corners more aggressively out of them, get a vest and neck protection, look at buying a side-by-side with roll cage, and don't crash for no good reason. I can't emphasize this last point enough, avoid the avoidable. 

2. It Takes a Village to Rescue a Person: Praise Be to Good Samaritans and First Responders.

So, there we were, the machine and I, both lying on our backs for a few minutes of quiet time before anybody arrived. A half-dodged bullet; early indications are that one of my guardian angels nudged me at the last second just enough to move this from the “Permanently Life-Altering” into the “Significantly Reflective” incident category, and I have yet another big favor to pay forward.

The response at the scene of the crash resembled a Disney movie. First, the Good Samaritan, walking her dog, a no-nonsense retired nurse, who flags down another, who calls a friend at the volunteer fire department, who has an ATV and rescue equipment nearby, and who coordinates with EMS. Boarded and bouncing down the trail toward the ambulance forty-five minutes from discovery. Pretty amazing, all things considered, and they could have moved even faster if I had been in worse shape. That some were doing their jobs and others following their sense of civic duty doesn’t change their fabulousness and willingness to engage! Calm, competent, self-organized, cooperative, problem solving, all the things one dreams of in a rescue situation and, being in my hometown, delivered with a familiar, comfortable, banter. 

3. Kudos to the Cat: More than just a pretty face.

For the machine, there was no problem at all, before or after. They just flipped it back onto its tires, cranked it up, and drove it home. Kudos to Artic Cat for building one rugged ATV, impressively resilient to (this) operator('s) error. That's why they call them accidents. The only notable damage was a bent handlebar, repaired on-site, possibly where it impacted and cracked my hip as I executed the unorthodox over-the-top dismount with the get-out-from-under twister landing.

4. The Space Between: Nothing More Beautiful than a Forest Without THAT Tree.

The toll was 3 fractures to the pelvis, including hip socket, various dents and gouges, bleeding spleen, and bruised ego - all appropriate outcomes for such tomfoolery. But it could easily have been so much worse. At least there was no tree. Not all trees, or else it wouldn’t be a forest, just THAT tree. You know, the one which would have violently arrested my forward progress, possibly while impaling me. At a minimum, we are talking multiple broken ribs and additional internal organ damage avoided, so we’ll call this miss a huge win in the circumstances. (FYI – I had a helmet on but no vest, neck, or limb protection.) Removing THAT tree from the equation is a large part of what brings the incident down from life-altering to reflective, and something for which I will be forever grateful.

5. The Pain Management Puzzle: Or, A Conspiracy of Constipated Stoners.

Prior to this incident, I had successfully avoided hospitals for decades, aside from a few visits, instinctively understanding that they are dark, dangerous places chock full of germs and sick people. And so they are, as I managed, ultimately, to conclude through a thick fog of modern pharmacology. Being a newbie, I was naively shocked by the outsized role “pain management” plays in the life of the hospital, at least in the trauma unit. The following public service announcement is dedicated to my hospital room neighbor.

The carnage of the opioid crisis in the US opened everyone’s eyes to the dangers of allowing the healthcare industry to be cynically highjacked in order to pedal mountains of powerful, highly addictive, painkillers to an entire population of violent zombie addicts…people who were once your sister, teammate, neighbor, self, whose only initial crime was to be treated for a sports or work-related injury, but who now end up gunned down at the scene of violent pharmacy heists by nervous cops with hair triggers.

The crux of the problem from the medical perspective is that industrial-scale pain management is necessary. Fentanyl, hydromorphone, oxycodone, tramadol, codeine, etc., the pain ladder they call it, but I see it more like a fishing net, or a sticky fly catcher, with all patients caught up at odd angles, stuck or clinging by fingers and toes, some from need others from habit. And I can see why. I immediately saw the attraction of a shot or two of the good stuff when they started to, none too gently, strap me to a board and bounce me down the rustic trail.

But I am not here to talk about the front-end of pain management, or the opioid crisis in particular, let qualified people do that, rather I am here to shine a light on its back end with some hard talk about one of the minor, non-lethal, side effects of these painkillers “may cause constipation.” While hardly breaking news, it is one thing to know it in isolation and another to see it wreaking havoc across the hospital system.

The dour, brink-of-the-abyss, countenance, and thousand-yard blank stare of patients wandering hospital wards today is due not only to dire underlying medical conditions but more immediately to ongoing pain management treatments that mask an astonishing amount of discomfort in exchange for leaving you stoned out of your brains and constipated as hell. Take my hospital room neighbor, who provided the inspiration and insight for this assessment. A local young farmer with a wife, kids, family, friends, a weekend speed track racer with late-stage cancer and two failed surgeries, given just months to live and recently provided a fentanyl patch to ease his path into the great beyond. Still mobile, good-tempered, and honest about his prospects, his principal physical complaints weren't the cancer nor the cancer treatments, both of which were awful, nor the impacts of the two failed surgeries, both of which were also awful. No, his principal complaints were that he was wasted out of his mind all the time and, even worse, had been stopped up for 13 days straight from the pain meds with no end in sight.  While he could ignore it for short stretches, the smothering blanket of discomfort haunted him 24/7.  And nobody talks about it. A quiet conspiracy of constipated stoners indeed.

It is not all bad news though, at least at the systems level; seriously injured stoned people are largely docile, necessary when running a hospital; patients fixating on personal evacuation issues aren’t thinking about their deeper health or treatment problems, also not a bad thing; and, many people today are wimps, and even more whiners, so why give them further cause to complain? Just load’em up and let the grey fog descend. A dark miasma that blots out the sun, smothers all sense of optimism, undermines healing, and (slowly) poisons you from the inside, it is a Faustian bargain indeed gaining relief from unspeakable pain in exchange for the smothering of your soul.

Unlocking the pain management/ addiction/ constipation puzzle will revolutionize hospital care around the world. Patient satisfaction will skyrocket, healing times will plummet, lives will be transformed, and billions of dollars will be both made and saved.  Until then, the best treatment plan, should conditions allow, is to flee the hospital at the earliest and pull back on the pain meds as far and as quickly as you can handle.  Oh, and eat your greens.

6. Stay Up to Date with Your Protectors: You never know when you’ll need something powerful to believe in RIGHT NOW!

Thanks, variously, to GOD, fate, chance, guardian angels, and an ingrained tuck-and-roll response, the worst did not occur. After lying on the trail for a few minutes taking stock, which involved a lot of wiggling, squirming, gasping, crying, counting, and finally struggling to elbows and knees, it seemed quite probable that I was in one piece, even if I was stuck where I lay.  I felt an incredible surge of gratitude. The medical community will likely attribute this to my body’s release of chemicals counteracting the shock and trauma, and they are no doubt correct, but up in the brain box it was a wash of pure gratitude. Ok, it is not ideal to be down on the forest floor with significant unknown injuries, but my back is (seemingly) not broken, the quad came to rest beside and not on top of me, no tree violently stopped my progress, the helmet protected my head, and it’s a beautiful day outside for a rescue.

So, if you have a terrible accident, but one with the luxury of a split-second warning, you will want to invoke your preferred protector immediately, even as you engage in evasive action, and you do not want it to be a cold call or you will not even get through the introductions before impact.

Until then, stay safe.

Geoff