Until now, this blog has mainly been about me bragging to my friends about my E-pic trips to A-wesome places. This spring I won’t be doing any of that stuff. Instead I will pollute cyber space with long (of course, its me writing) posts about physical and mental rehab. Probably won’t be that much fun reading, but if nothing else, I think that writing about it will help me get my head straight. Today, I want to talk about crisis management, the epicness of friends and family, and of the Swedish health care system.
Different people react differently to crisis. I don’t know what it is that determines how we react, genetics or if it is a skill that we learn. The instant reaction is probably more or less a reflex that is relatively hard to control. My reaction to chock is apparently to document everything around me and to be irrationally optimistic. From the second I saw that big wave of snow charging down the mountain until we got down to the road, I never once thought about death. Yes, I cried when I heard Maria screaming from pain, but I never doubted that we would get down safely, even though that wasn’t sure at all. Its strange, because I am normally a very pessimistic person and I’m terrified of death.The perceived need to document everything is also a bit weird. But looking back at it, I realize that this documentation has been extremely good for my ability to process and remember what happened.
The prolonged post-crisis reaction is more likely to be something that we learn and therefore can change. I hate self-help books (I really really do), but since I used to suffer from panic attacks, anxiety about death and just in general agony, and since I have a psychologist for a mom, I’ve read my share of cognitive behavioral psychology. Two things have stuck in my head. The first one is the importance of being truly selfish. Sounds odd right? Just like an economist to say something like that. But let me explain what I mean. Being truly selfish to me means a strive to be as happy as possible. This means that the question I have to ask myself is how I make myself happy. Not fake happy for two seconds, but truly happy. Since making other people happy is one of the strongest factors influencing our own happiness, true selfishness in my view actually implies altruism (or actually that altruism does not exist since altruism means that there is no benefit for the self… uhm, ok that got messy).
The second is acceptance. Acceptance does not mean that we should be apathetic zombies not doing anything to change the situation. On the contrary. Acceptance means that we need to see the situation, accept it and work from there. IF there is nothing we can do about it, then refusing to accept just implies agony. That’s not very good. IF we can do something about it, then refusing to accept it is not very productive, it is much better to look at the situation, see it for what it is, and develop a strategy to change it.
So here I am. This is the situation: Together with two of my best friends, I am responsible for having triggered a, by Swedish standards, really big avalanche. The avalanche broke both of my legs and gave my best friend a femur fracture. It cost society a whole lot of money in terms of the rescue operation, the health care needed to repair our broken bodies, and in terms of sick leave. I’ve caused feelings of worry and sadness amongst my friends and relatives.
I have to accept that this has happened, because even though I wish I could, I cannot go back in time and change it.
So what can I do now? I know that I want to be as happy as I possibly can. I am an economist after all, so I want to maximize my lifetime utility… So what can I do to be happy? I know that I never want to find myself in the same situation again, and at the same time I still want to be up in those mountains skiing and biking. My injuries has effectively prevented me to go there for quite some time, but if I work hard, I will be able to in the end. So that’s my goal: to be able to ride the mountains and minimizing the risk of doing the same mistakes again.
Worrying about the WHAT-IF:s and thinking about what it felt like to tumble down the mountain in a wave of snow makes me weary rather than happy. Feeling shame and guilt about our mistakes doesn’t help anyone – it won’t get my legs stronger or help me minimize the risk of me or anyone else getting into that situation again. On the other hand, doing my rehab exercises, pushing my legs to get stronger, objectively analyzing our mistakes and telling others about them, and learning more about snow and wilderness first response will do both of these things. So I guess that is what I should focus on.
I’m quite sure that it won’t be a stroll in the park, probably more like climbing Mount Elbert. Being stouthearted in front of other people gives me a lot of pats on the back, and helps me think that I’m brave and good, but sometimes the pain and the sadness of what happened comes flushing over me. I’ve broken down in tears a number of times already and I expect that I will do it many more.
The pain and the total inability to take care of myself has been really hard to deal with. Even though my fractures were simple, I had to do surgery on one of them. I’ve done small scale surgery before, and so I knew that deep cuts hurt. However, somehow, it was impossible for me to imagine exactly how painful it would be to have a titanium nail hammered into my marrow. I think that I’m pretty good with intense short time pain. Apparently, I’m not very good at dealing with constant dull ache, and apparently morphine doesn’t do much for me. The first 12 nights, I didn’t sleep more than 1 hour, and sometimes just 20 minutes at the time. I’ve also had problems accepting how slow my progress is going and how fast my muscles are disappearing: one week in bed transformed my previously relatively strong and muscular legs into useless sticks, making it painfully clear exactly how long it will take to be back on track. I won’t climb any mountains for what to me seems like a very long time. In other words, I’ve been feeling a bit low from time to time.
That’s ok. It has to be ok to mourn and feel weak. But I’ll have to try to prevent myself from getting stuck doing that. I have to keep reminding myself of where I want to be, of what I want to do when this is over, and how to best get there, to not let those feelings of grief transform into a constant pain. I have to do my rehab to get stronger, even though it hurts, and I have to focus on all the good stuff that I have experienced during the two weeks that has past since the accident, because there has been a lot of good things happening too.
I’ve had friends coming visiting me everyday first at the hospital and later on at home, bringing me candy and champagne, cooking me dinner, and keeping me company.
I’ve felt my parents’ complete support. They have not once burdened me with their worry but instead focused on making me feel happy. They have taken me where ever I need to go, brought me food and home made buns, and rearranged my appartment so that an invalid can live in it (at an age around 70, they carried two beds down a really narrow 25 step stairs).
I’ve seen an intramedullary nail being hammered into my leg while I was discussing downhill skiing with the anesthetist, gotten physiotherapy every per day, had nurses coming to see how I am, helping me to the toilet, giving me food and pain relief 24 hours per day. I’ve gotten all that and 5 nights at the hospital,at the price 500 SEK (about $78).
I’ve seen my face go from something looking like a new Batman character to something almost human.
I’ve had the chance to talk about what happened that day in Kittelfjäll over and over again with friends and family and most importantly with the two persons who were with me that day. I’ve had the privilidge to spread my words here. Talking to Maria and Martin has helped me get a clearer picture of what we did wrong that day, but also what we did right. It has lifted my feelings of guilt and shame and made me aware of what I need to learn to avoid getting into the same situation again. Writing about it here has helped me structure my thoughts and given me enough positive feedback to boost my energy beyond duracel bunnyness.
I’ve gone from not even being able to wiggle my toes, to take a few steps with a walking table, to walking quite a few steps with a walker, to walking around the block on crutches. I’ve made it home and had folk beer.
I know that I have a long way to go, and that it will probably be a bumpy ride back. Its gonna take quite a lot of help from my friends (and my forehead) to get to the other side, but it feels like I’m heading in the right direction.
The Hungry Hen Report 
The head aspect of recovering from injuries/traumas is often the most tricky part. Having been through a 2½ year perioid with multiple knee surgeries (skiing accident) and currently in the finishing stage of recovering from a broken collarbone (mountainbike) I am not sure there is really anything to do but to endure it. Keeping a social life and doing the rehabilition exercises definitely helps. As a former academic now in rehabilitation: Try not to think too much, it doesn’t always improve the situation.
br, Henrik (who lived in Umeå sometime in 2008 when visiting the university while writing a phd, one my friends shared the avalanche story and I subscribed to the blog)
Hi Henrik,
Sounds like you’ve had your share of rehab. I hope you don’t have to do much more of that in the future and that you knees are fully functioning now. Ha ha, yes, as an academic I definitely have a tendency to make everything into a research project. I agree that thinking too much can be bad, especially if it means a lot of worry and over-analyzing. I haven’t had a lot of physical injuries before, so I haven’t got a lot of experience of bodily rehab. But I’ve done my share of mental rehab. Keeping a sober perspective of my situation and focusing on the goal to be as happy as I could worked surprisingly well for me then. I totally agree on the social life part. Thanks for reminding me of that!
Sorry for my curiosity, but what did your do your PhD in and how did you end up in Umeå? I of course totally understand if you don’t want to answer, just had to ask 🙂
Hi again
Knee is as good as can be hoped for. Interestingly enough, it gets worse if I don’t train.
I did my phd in computer science. In Denmark, phd students must (or are at least strongly encouraged) to go abroad 3-6 months. These stays are often arranged through the supervisors network, which was the case here, and I knew a couple of people there already. It didn’t really amount to any joint research, mainly due to the stay being rather late in my phd and I was frantically trying to finish it. But I am very happy about the stay there.
I liked Umeå. I miss having a seamingly endless forest that I could just ride in. The darkness in vinter, not so much.
Remember to do your rehabalition exercises. They will give you precious days when summer comes.
I will (rehab that is)!
Good to hear about the knee! And good to hear that Umeå treated you well in spite of its lack of mountains. I usually like the winter up here since I really like cross country skiing, but this winter has been awful. No snow, just slush. A very good winter to stay in bed in other words :).