A devastating fall changes this doc’s life forever

This PhREI Network post is via Ian Cook, MD from Carpe Diem MD, and tells the deeply personal story of a devastating fall and the changes this caused in his life as an ER physician.

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Editor’s note: Life can change in an instant. In this deeply personal story, PhREI network member Ian Cook, MD shares the story of the devastating fall that upended his life. His story is an inspiring story of triumph over hardship. It teaches us the importance of appreciating the present day and also adapting to life as things change.

This post first appeared on Carpe Diem MD.

The date was January 30^th 2014.  I was getting ready to leave for my 4p to 2 am ER shift but decided to do a few quick chores before leaving.  We were getting the house ready for our annual Super Bowl Party/Lauren’s Birthday Party.  I decided that I needed to clean some cobwebs from the entryway and using my sleep deprived brain decided to clean these webs with a broom while standing on a ladder…. To make the situation a little more moronic I decided to throw a broom to reach the highest webs.  (This is literally why women live longer than men). I did this not once but three times and on the third try I lost my balance and fell 15 feet to the ground landing on my right side.

The pain was immediate and I simultaneously felt and heard my body break.  I looked at my wrist, it was grossly deformed (Colles’ fracture) but at least it was closed.  I was unable to move my right hip and the pain was beyond description.  My first thought was that I dislocated my hip, wishful thinking….

I was home alone, laying on the floor trying to diagnosis my various injuries.  I could breath, my ribs hurt, probably broken.  I didn’t hit my head, that was lucky.  The broken right wrist and my hip broke my fall….  Ok, now what.  Luckily, I had my cellphone in my left pocket… the problem was that I had flipped instinctively after the fall from my right side to lay on my left side and the phone was trapped in my pocket.

After some twister like moves, somehow, I was able to reach my left pocket while laying on my side.  I pulled the phone out and was never happier for that iphone finger print unlock.  After that, I just needed to pull off the one handed 911 call.  The 911 dispatcher took the call and help was on the way… she was about to hang up but I asked her to stay on the line until the fire paramedics arrived.   We talked about the upcoming game, Broncos vs Seahawks.  I thought Peyton Manning and the Broncos were going to win (l needed to keep my mind off the pain).  Looks like I got that one wrong… Seahawks 48-Broncos 8.

The paramedics arrived shortly after.  I was worried that they were going to have to break down the front door and I was stuck laying in front of it. Luckily, the garage door was open.  They did a great job on scene and got me out of there quickly.  I tried to be the best patient I could be with the exception of requesting weight-based morphine dosing to handle the pain…. This was not a 2mg Morphine injury…. More like 8mg with an 8mg chaser.

The paramedics got me to the ambulance and I asked to make some quick phone calls before I made it the ER. I knew I didn’t have a lot of time before my phone privileges were gone…. My first call in the ambulance was to my EM Director to let him know that I would not be making my 4p shift… It was 2:30p… I felt awful.  My next was to my Mom to tell her what was happening and to prepare her for a call from Lauren, my beautiful and very forgiving wife.  My third call was to Lauren… I did not know if I would be able to reach her because she was in the middle of her Interventional Radiology Fellowship.  The call was something like “I fell and I am on my way to the hospital, I’m pretty messed up, I’m sorry.” 

This was truly awful.  We had just bought our home.  I was out of residency and the main source of income.  We had two daughters under two (13 months apart) and Lauren was in the middle of her IR fellowship…. Did I already mention that she is awesome….?

At the Emergency department they performed a hematoma block and set my right colles’ fracture. I was grateful.  I had the full classic trauma scan which confirmed that I had a severe right sided comminuted acetabulum fracture, the hip was fine, but the pelvis was dusted.  My femur had become a hammer that was used to smash my pelvis like a plate.  This level of trauma was too severe for the Emergency department that I was at so I was transferred to a tertiary center.

At the tertiary hospital, I was admitted to the ICU.  While there, the pain in my wrist began to gradually increase and my sensation decreased.  The pain was so severe that is was more painful at times than my shattered pelvis.  This is what it feels like as your median nerve in compressed via acute carpal tunnel syndrome. 

The following day January 31^st I was taken to the OR for an ORIF of the right wrist with carpal tunnel decompression/release.  The pain resolved but the loss of sensation remained.  The loss of sensation in my right hand (I’m right hand dominant) was devastating.  That night in the ICU I experienced an excruciating episode of pain as my pelvis inadvertently shifted. I was blessed that Lauren was there and was able to convince the resident and nurse to increase my pain medication.

The next day February 1^st 2014 I gave Lauren a birthday present that I will never live down.  The present was 8 hours of waiting while I went back to the OR for an ORIF of my acetabulum fracture.  Some great friends visited Lauren and celebrated her birthday with a cupcake in the cafeteria.  The surgery was long but the outcome was good.  My hemoglobin had dropped to 8 and I was weak but recovering well…. The hard work was yet to come.  I asked Lauren to go home and have a Super Bowl party tomorrow… she about slapped me.

After about 5 days in the ICU I was transferred to an Inpatient rehab for the next two weeks and it was the best thing that could have happened to me.  I had twice daily rehab sessions and occupational therapy.  The focus was on regaining sensation and movement in my right hand and learning to use a walker… with one hand while hopping.  I was prescribed non-weightbearing status for two months to allow the right pelvis/acetabulum to heal…

Learning to hop on one leg and use a walker with one hand was a challenge to say the least.  I rarely slept during my hospital stay and I was so thankful for the Winter Olympics.  I think I watched every event.  Lauren and I love to snowboard and I set a goal to someday make it back to the mountain.  I would consider myself recovered when I could ride again… It seemed like a ridiculous goal considering that I was hopping on one leg and could not feel the fingers in my right hand… I had more important things to worry about… The nurses both named Angel were amazing and kept me going.  My wife and family kept me positive. 

I learned during this hospital stay to practice visualization and to work on my mindset.  I was terrified that I would never be able to practice Emergency Medicine again. How could I intubate if I couldn’t feel the endotracheal tube?  Would I be able to walk?  I was broken…

After two weeks I was discharged to home on Valentine’s Day.  My wife and family had set up an amazing home hospital room for me to continue my recovery….  (Yes, I ordered flowers, with our wedding colors from my hospital bed to be delivered before we got home).  I was still in a lot of trouble….

I did not sleep more than an hour at a time for the next 2 months due to severe pain, both musculoskeletal and neuropathic.  Physical therapy kept me motivated and I went 4 days a week.  After 2 months I was cleared for pool therapy which was a great day.  It was an amazing sensation to touch my foot to the ground after two months of non-weightbearing status.  The pain in my leg began to decrease… Gradually, I advanced to using a cane and then to walking solo.  After some time, I was able to go upstairs and eventually sleep in my own bed.  I went to physical therapy/Occupational therapy 4 days a week for 9 months…

Eventually, I was able to return to work.  During this time, I was practicing Emergency Medicine and Wound Care.  I spent my recovery time increasing my Wound Care knowledge as I did not think I could ever return to Emergency Medicine.  I also spent this time working on photo albums and spending everyday with my two daughters Lily (21 months old) and Bri (8 months old). 

This was one of the toughest experiences of my life and it was life changing.  I loved Emergency Medicine but this experience made it clear to me that my time on this world is not guaranteed.  I was so grateful to be a practicing EM after my injury that I was willing to work through shifts with severe pain.  The pain decreased over time and the shifts improved but the pain has never left completely and I knew that I would not be able to practice Emergency Medicine until retirement.  I continued to practice EM but overtime I gradually increased my Wound care practice and increased my time home with my family. 

I spent years feeling guilty about cutting back on Emergency Medicine.  Emergency Medicine was my specialty and my identity, how could I change.  How could I practice Wound care, a field that is completely different than Emergency Medicine…?  What I found was that my experience in Emergency Medicine was a perfect fit for Wound Care.  I found the practice very rewarding and over time I gradually increased my Wound Care practice.  I am grateful that I found Wound Care and it honestly allowed me to practice and appreciate Emergency Medicine longer than I would have without it.  I retired from Emergency Medicine February 2020.

Ps.  Two years after my injury I made it back to the mountain.  We ride as a family now and it is one of the great joys of my life.

Pps.  Thankfully, I had bought disability and life insurance one year prior to this fall.  The disability insurance saved us financially and I recommend having both.

What do you think of Dr. Cook’s story? For me, it’s an intense reminder to value and take advantage of the blessings of the present day. Because life can change in an instant. It’s also inspirational proof that time and intentional evolution can reveal new paths forward on the journey of life.

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