Archaeology of a Motorcycle Crash Survivor
Before my accident and traumatic brain injury (TBI) I had been an archaeologist which meant that most of the people I worked with had been dead for centuries. For more than a decade I had worked for the Institute of Classical Archaeology at the University of Texas at Austin. I studied and curated hundreds of thousands of archaeological artifacts and wrote scientific and historical publications. Intensely collaborative, I lead teams of researchers, designed research projects, and put together and edited multi-author academic works. I had come to focus my interests on artifacts which to me represented day-to-day material of the past, the average, all of the stuff which was, at the time, unremarkable and of which we now only have fragments, touched by people who we will never know and who were not remembered eternally. Ironically, being remembered was the ancient Greek way to immortality and I fear that the person that I was previously is now, like the times and places that he studied, lost to the past. I do not remember the accident in December 2018 and my longer-term memory only returned to me in the last two weeks of being an inpatient in the brain injury unit at the end of February 2019. It was a few days before Christmas and I was returning home from buying my three-year-old daughter a much-longed-for gift that she had been asking for. I was riding my motorcycle on I-476 in heavy traffic, moving along in the slow lane at around 65 mph and preparing to filter off to the right late and upcoming exit to Broomall. That was when two deer ran out in front of me and I hit one of them. It was rutting season and there were walls along that part of 476 so those poor animals must have been very frantic. Late December and they managed to run into one of the very few motorcycles on the road! I stayed on the bike because it was a well-balanced racing motorcycle on which you face head first and can duck down and press your body and hug the bike. The deer flew behind me and I managed to get my bike on to the hard shoulder, the brake marks showing that I was slowing down. My luck didn’t hold as there was a sign on the hard shoulder which I careered into and flew off over the front, sliding along for a hundred yards or so. Without a doubt, what saved me was the protective gear that I always wore on the bike (and my insistence on wearing it all no matter the temperature). I had substantial knee pads and plates down the quads and shins but my right femur was broken and poking out through my skin. I had huge armored knee-high motorcycle boots and still broke my lower shin and ankle on my left. So I had two broken legs. My motorcycle jacket had shoulder plates, arm plates, and a large protective backplate which would stiffen up in an impact. I had a bit of damage to one of my vertebrae which suggested that without the backplate I would probably have had a spinal injury. I had protective gloves with wrist plates along my arm and still my left wrist was shattered and my radius snapped. I had a traumatic brain injury (TBI) even with a full-face racing helmet. My skull was fractured on the left side, reducing the hearing in the left ear and disrupted the nerves moving the left side of my face. Closing my left eyelid was impossible and after a few months I had an operation to put a weight into the eyelid so that I could close it fully. The pressure in my skull meant that I had to have a valve put in to relieve the pressure and was almost high enough to require a craniectomy. And of course, I got a shaved head! My accident and aftermath is really a huge testament to all that other people did for me which saved my life and made recovery possible. For me, the help started immediately. An off-duty police officer was travelling with his family on the other side of 476 and stopped to help. I am extremely grateful as I would almost certainly have more severe brain injury if he had not cleared my airway, and that it was worth the spinal risk given what had happened, and his experience as a former volunteer firefighter no doubt came in handy. He even knew a couple of the paramedics and came with me to the hospital. That there are such good people in the world makes me feel that it is worth coming back to, no matter how dark it can seem at moments, and that there are things worth fighting for and real heroes to support and encourage. Speaking of which, my wife. I knew she was a star the first moment that I saw her, when she was a visiting student at Oxford and I fell madly in love and somehow we made our long-distance, trans-Atlantic romance central to both of our lives. That was last century. Has it been so long? Ever the romantic, I loved her truly, madly, and deeply, but it wasn’t until my accident that I got to see the depth of her true grit, the sheer courage and fortitude that lay beneath such a graceful exterior. I am lucky enough to have a good friend who is a surgeon at Jefferson. He tells me that had I been more than 15 minutes from a hospital, I would not have survived the journey there. After my wife called him, he went with my wife to the hospital and could grasp what was happening with me. As it turned out, I wasn’t the only person to have had a bad day – I know someone who was caught miles back near Plymouth Meeting in the huge traffic jam that I had created with some help from that deer. I was taken by ambulance to the nearest hospital, Lankenau, where apparently I am still famous for all of the protective armor that I was wearing which had clearly saved my life. Still, I lost a lot of blood (the irony is that as a UK resident in the 1990s during the ‘Mad Cow’ BSE period, I am not allowed to give blood in the US, so I cannot return the favor). I was in surgery for over six hours as they patched my legs and arm back together while watching the pressure in my brain. I had a blood clot in my leg and they thought at Lankenau that I may have had a blood clot in my carotid artery, which would be a huge problem and they decided to send me to Jefferson. I was flown by air ambulance into the city: Of all the things that day, it is a great regret to me that I don’t remember that one! I was in Jefferson ICU for two weeks. My friend the surgeon had patients in beds in the ICU near me and was able to check on how I was doing regularly. I was on a ventilator. My wife was there for me, and my sister came to see me from Calgary. My mother would have come from England but in one of life’s little ironies, she had fallen off her (not motorcycle) bike and broken her ankle and wasn’t allowed to fly until the operation was done. While I was on the ventilator, I could communicate by moving my hand. It wasn’t until I was off the ventilator and preparing to move to the brain injury unit at Magee Rehabilitation Hospital that my wife could see how affected my brain was by the accident. I didn’t remember where I lived, what country I was in, that I had a wife or a daughter. When the brain is damaged, I think that it protects itself by separating the sense of self and memory and other aspects and components. At that moment, my brain was a temporary phenomenon and not working too well at all. The long-term prognosis was cautiously good, but I believe that for my wife at that moment it must have been awful and when I imagine it I just want to be with her and give her comfort. But ‘I’ wasn’t there. I had to relearn to walk with two broken legs and to perform tasks with motor coordination like eating and drinking. I had physical therapy and plenty of help. My memory only began to return in the last two weeks of being in Magee so I only know of this period second hand and from photos and videos. It is very odd that my memory was not there for something so important to me! Outpatient Rehab On leaving Magee Rehabilitation Hospital in early March of last year (2019), I did an intensive two-week daily outpatient program at Magee’s annex in south Philadelphia. During this period I was able to do more physical therapy in the last few days because my boot and hand splints finally got removed. I really liked Magee and the wonderful speech, occupational, and physical therapists. I continued my recovery at Bryn Mawr Rehab doing physical therapy, occupational therapy (mostly small motor work and coordination) and speech therapy. I continued weekly at Bryn Mawr Rehab throughout the rest of 2019. Cognitive Fatigue: Different Brains, Different People? The major factor for me to the present is cognitive fatigue. Complex thoughts can happen but limited in time, in bursts. It is as though I am very different people at different times, in the ways that I am able to think, to perceive, to respond, and what I can focus upon. I have memory fragments, massively reduced memory from before, which seems more like the memory processor doesn’t work as effectively. As if all the books in a library that you used a lot were all moved to a new building and you just don’t know your way around but can look things up and know that most things, at least, are there. With awareness and patience I try to just take things in, trying to lower and limit the energy used by the brain and the processes that it must perform. Concentration can be done over the very short term, with fatigue taking days to recuperate from. After overdoing it, my brain feels exactly and reminiscently like that I had on leaving the hospital, then the next day like the one I had six months ago, then the next day three months, until we arrive back and the present. TBI and an Uneasy Relationship Between My Complex Thinking and Me The more complex parts of the brain, the thinking, the concepts, all the things that I used to rely on and trade on in and for my career are limited now by cognitive fatigue as a result of the traumatic brain injury. Being a person with the ability to have interest, to be engaged, to be stimulated by conceptual frameworks, the build models in thought and to play with them and tinker with them, and test them against data, and discard or rebuild them, and all these things of mind. If only I had known to appreciate them rather than just living with and in them and taking them for granted. I had taken my thoughts and the mental world within my head to be as much an unchanging part of nature as gravity, until my brain injury showed me through direct experience that this was not the case at all. I had believed in a lot of my own illusions, couldn’t distinguish them from how I saw the world around me. Now I could see the slow, granular thoughts and that I existed too in the gaps in between them as I waited for thoughts to drip-drip-drip their way into my consciousness. It struck me that this conscious awareness was all I really had and as my memory returned I could trace it all the way back to a very different time, place, and the person that I had been though the last four decades.
