Cry of the Damaged Man
Count no mortal happy till
he has passed the final limit
of his life without pain.
When it happened my first thought was, ‘How am I going to explain all of this?’
At that moment it was a very peculiar thought because I had no idea what had happened or why I needed to do any explaining. My brain was stunned and struggled to understand the chaos. I was vaguely aware that the car had disintegrated almost completely, with me in the middle of the mess, but I was unable to shift either my confusion or my legs. For a moment I thought the car had exploded.
My glasses had been smashed from my face so everything beyond my left arm’s length—the only limb I could move—was a blur. All the windows were shattered and slivers of glass had sprayed into my hands and face. Both sides of the car were buckled towards me, the right side crushing my chest and shoulder, while the engine was rammed onto my lap breaking both legs and forcing the gear stick through my left calf.
In that savage moment my life was changed.
The first emerging sensation seeped slowly towards me. It is still eerie to remember the absolute effortlessness of that black silence. Nothing sustained it. Everything had stopped.
Then, with almost embryonic delicacy, I felt a tiny touch of movement like the first frail flutter of a baby in a womb. It was the return of my breathing beginning as soundless whispers then swelling into frantic gasps for air.
The moments before the smash had been ordinary: driving to work on a clear day with morning FM radio filling the empty space between my thoughts about work and my selections for the office footy tipping competition.
But there is nothing ordinary about being smashed by a speeding thirty-tonne semitrailer. There is nothing everyday about surviving the body-shattering effects of such an impact. And yet the awesome momentum of that truck as it raced through a red light was symbolic of the power needed to bring my energetic and messy life to a halt.
A siren seemed to be screaming inside my head. There was damage everywhere. Broken bits of my body and the car were twisted together in a gruesome embrace. Nothing would let go. I could not move.
My brain was still working and I said out loud, ‘Branches of the internal carotid artery’. It was a sort of private prayer to my sharpening conscious state. As a medical student studying anatomy I had memorised the ten named branches of this main artery to the head. In the years which followed, whenever I wanted reassurance that my brain was working accurately, after a dream, or a drink, or a bump on the head, I would try to remember them.
This time I didn’t bother with the details. With profound gratitude I realised that I was alive with an active brain.
I never doubted that I would survive. From the first emerging awareness that followed the impact, after those seconds of galactic darkness, following the exploding tuning fork pitch which penetrated my head with its sickening spinning sensation, during my progressive awareness of the twisted destruction around me, and even after the full extent of my injuries had been explained, I knew that I would live.
It wasn’t human arrogance or bravery, or a denial of the dangers I faced. It was a simple knowing. This was not to be the time.
Even before anyone arrived at the wreckage my mind was racing to make sure that I survived. I moved my left arm to feel my neck and back, searching for an injury which would help to explain why I couldn’t move or feel my legs. My fingers were shaking with the fear of what they might find. But while I managed to wriggle my toes inside my shoes, which told me that I had been spared a dreaded paraplegia, my fingers found fresh damage.
Beneath the skin of my neck and chest I could feel the telltale crackle of air which signalled a ruptured lung. I tried to remember every possible complication of this injury. The one which terrified me the most was a tension pneumothorax where the air leaking from the lung within the chest could pump pressure around the heart and block the flow of blood and air to and from the lungs. I knew that this could kill me quickly. The treatment was easy: to push a cube through the chest wall to let the compressed air out. The only thing I had available was a ball point pen. Using my left hand and teeth to remove the ink fill, I grasped it ready to plunge wondering if it would snap before stabbing through the skin. It was all so matter of fact: no bravery, no pain, no heroism, just a simple act of clinical preparation to save a life.
Holding a pen must have looked strange to the people who had rushed to the car. A bit early to start writing a memoir of the accident. Or perhaps taking the dedication to paperwork a bit far!
Someone appeared at the passenger side of the wreck and asked if I was all right.
‘What the hell has happened?’ I gasped at him.
‘Big bloody truck ran a red,’ he said. ‘They got him.’
They got him. I tried to speak with the same synthetic calm I used as a surgeon when anything really perilous was happening in the operating theatre. In the wreckage my calmness was a cover for the sheer terror I felt. It wasn’t the blood on my hands or face, or the air crackling beneath the skin over my ruptured lung or the pain as I gasped for breath through a chest of broken ribs, or the futile struggle to wrench both broken legs from beneath the engine. It was none of these.
It was the smell of petrol. I did not want to burn. I could not get out. I pulled and pulled helplessly using the power of my thighs on the clamped legs to get them free. But they were like bad teeth resisting extraction: they cracked and crunched.
A few weeks later I was grateful for the chance to embrace the ambulance driver, who, together with a no-nonsense truckie with big biceps, tattoos and a lot of hair, heaved the engine from my knees with a delicately inserted crowbar. As I lifted my shattered legs from under the crumpled dashboard and shoved them onto what was left of the passenger seat there was no pain. At least not until someone responded to my plea that I could not breathe by reaching inside the car and pushing the back of the driving seat down flat. Then I cried out with panic because I had not realised that the whole right side of my chest was pushed in with a double row of smashed ribs. Lying flat, with my diaphragm pushed up, I could not breathe at all.
‘Get me up! Get me out!’ I urged with two desperate gasps.
‘Stay calm,’ said the younger ambulance man.
‘Stay nothing,’ I hissed with grim intensity. ‘Please mate, I’m a doctor, I have subcutaneous emphysema, a pneumothorax, a flail chest and I can’t bloody breathe.’
‘Oh shit,’ he said.
‘For Christ’s sake,’ I pleaded with real concern, ‘get me to the Royal Melbourne Hospital quickly.’
They lifted me gently from the wreckage and when I croaked, ‘Don’t forget my briefcase,’ they almost dropped me with laughter.
The peak hour traffic was banked back as far as I could see and as they turned the stretcher around to load me into the ambulance, I saw what was left of the car and nearly retched. There just wasn’t enough room left for anyone to fit inside it. Debris was everywhere and all sides of the car were crushed. I didn’t see the offending truck or its driver—not then nor in the seconds before it hit me.
The man in the car waiting to turn right from the inside lane did see it coming and watched it strike me. He saw what could have happened to him and was brave enough to act as a court witness months later in spite of his nightmares.
The scars of the smash are still on the road seven years later: two sweeping gouges on the surface. The semitrailer slammed into the side of my car then crushed it into the bitumen before spinning it on into the traffic poles. One of them still leans away from the intersection with its side stripped rust-bare by the grind of raw metal from the car. It is a colourless corner.
Months later, when I could drive, I went back. I drove across the intersection from every direction, coldly, like a test pilot, precise, proud and vulnerable. It was a private visit. No audience, no applause, everyone else going their motoring ways. I didn’t look at anyone and I didn’t tell anyone. I drove away knowing nothing had been proved. It contributed nothing.
I still shout at trucks. No-one ever hears me above the massive roar of their engines. I shout, ‘Fuck off!’ with a hoarse defiance that surprises me. Watch one the next time it rolls up alongside you at the traffic lights. Look at its front steel bar protectors, smell its size. It’s worth a shout. My shout is a celebration. I know that whatever controls the larger order of things will never send a second semitrailer to damage me. I am safe from that.
As the ambulance progressed up Elizabeth Street, I knew the injuries were serious. I could feel my brain drifting into dullness. I remember trying to stay conscious, at least until I arrived at the Royal Melbourne Hospital, by anticipating all the landmarks along the way. Lying on my back in the ambulance I saw the Post Office to the left, McGills’ Stationery and Ted’s Camera Store to the right, Myer’s to the left, the Victoria Market to the right and finally the Dental Hospital which told me I was nearly there. These days I rarely have the need to travel up Elizabeth Street.
I was not a good driver. I drove the way I lived. We all do. Read Zen and the Art of Motorcycle Maintenance. Just as we leave the impact of the way we drive on our cars we leave the imprint of the way we live on our bodies. Look at the inside of your car, then look at your face.
I was a bad driver. I hurried, I was tired, preoccupied and disregardful. And I will admit that in the decades prior to this smash I had been involved in six minor or major collisions each of which was predominantly my fault, and none of which caused anything but a minor injury to anybody. Ironically, this accident, for which I was completely blameless, almost killed me. It is easy for me to admit that the tiredness in my hands and the tension in my mind had contributed in a general way to my earlier careless driving temperament. To this accident, however, these defects contributed very little.
When the glass doors of casualty shut behind me, I closed my eyes with relief, believing I was safe. The hospital had been my home for almost twenty years during my days as a medical student, junior doctor and surgeon. But nothing in that long apprenticeship had prepared me for what I was to experience during the years of my recovery.
Like a wild animal leaving part of its legs in a trader’s trap as the price of its escape, I had survived the metal jaws to face the days ahead.