Understanding trauma - The hard way!

It was a busy work day on 19th November 1996. I was driving to work, preparing to counsel my first client – A woman with post-traumatic stress disorder, as the result of a head-on collision on a freeway. I was carefully calculating my speed to ensure I would make my appointment on time, when her trauma suddenly became my reality. I collided head on with a car travelling down the wrong side of a double lane highway. The combined speed of the accident was about 160kmph and I broke about 11 bones in my legs, pelvis, left arm and various other places. I don’t remember the collision itself, but woke up an hour later, as if from sleep, noticing people around me, the car a different shape and slowly realised that I was in a great deal of pain. I didn’t know what was going on. It was all a blur. I asked what had happened and they told me that I had been in an accident. I vaguely recalled seeing a flash of what I had thought was a yellow Toyota to my right and that is the only memory I have.

The car I was in was only small and the impact had caused the whole front to cave in and pin my legs. I was trapped. They decided that the only way to get me out was to lift off the whole roof and then cut off the steering wheel. I lapsed in and out of consciousness during this time and only have snippets of memory – someone holding up an intravenous drip, a fireman training a hose on the car at all times; a shop with a ludicrous model of Quasimodo hanging from it. All the time this was happening, my only concern was for someone to ring my receptionist and cancel my appointments. I figured I wouldn’t be making it to work that day! The emergency workers seemed to be a little more concerned about saving my life than ringing my office.

The struggle to part driver from car lasted a total of two hours. When they finally removed my crumpled body from the wreck, the pain was so severe that I blocked it from my memory! I was then airlifted to the Alfred Hospital Trauma Unit by helicopter. My only ride in a helicopter and I missed most of it! The next few hours came and went without much of it making sense on my part. I thought that I would have to wait in casualty for hours – I didn’t realise that my injuries were far too severe for me to be left lying on a trolley in a corridor. Doctors came and went. My clothes were cut from me, including a pair of shoes I had only just proudly bought at an Op Shop!  Scans and x-rays were taken, drips put in – all done before I realised the implications of what had happened. The next few days in the high dependency unit helped me to become stabilised. I had to have an operation on my foot, bones were set, traction put on, a tube was put into my side to drain all fluid as I had received a pneumothorax injury, due to one of the drips having pierced the lining of my lung.

I thought this would be the start of a few weeks in hospital and then back to my life – how wrong I was! I was in hospital for 3 months and spent the following 6 months rehabilitating.  I am now back at work but the recovery process became long and draining, although compared to many severe accident victims, the first phase of my recovery was reasonably quick. I still struggle with generally more sensitivity to anxiety and my wife is still struggling to relax after the shock of it all, especially when I am driving!  During my hospital stay she carried the load of the family for both of us, so that there are after-shocks still continuing to this day.

Having to be on my back for 6 weeks and largely in a wheel chair for another 8, made me feel very vulnerable. The helplessness experienced meant that I needed frequent doses of encouragement from those around me. Frequent short visits were appreciated – long ones were tiring. It was a new lifestyle, this recovery process, and it needed to take up every ounce of energy I had. Recovery was my whole life. To recover well, I understood that I would need to accept the trauma, the resulting physical limitations, my labile emotions and go with it rather than resist what was happening to me. For quite a while this meant that I often thought of little more than my injuries, making it necessary at times to consciously resist a tendency toward becoming too introspective. However, this is often a natural stage of recovery because little extra energy is available to do more than work on healing. Many times I wanted to recover more quickly and yet improvement has only occurred smoothly as I have accepted the natural pace of healing.

The need was constant for my wife and I to be able to discuss the accident and related events again and again. To outsiders, this may have seemed monotonous, but for us an important part of recovery. Both of us needed to have the chance to tell our own stories as each has had a different experience. The time spent in the rehabilitation centre was valuable for this to occur as everyone there was in the same boat and everyone wanted to tell and listen to each others stories.

One of the hardest things to do, not just for me but for my whole family, was to return to ‘normal life.’ Humpty Dumpty fell off the wall and not all of the pieces fitted together again. Some are now missing or floating around in the wrong places. Adrenaline gets you through the crisis and although this was an extremely difficult time, I manage to cope, but the adrenaline for me has tended to form a habit of continuing to surge to this day. Nobody warned us about how hard getting back into life would be. Feelings of fear and inadequacy accompanied the long-term physical limitations that have taken months and even years to overcome in certain ways. Questions about my life and purpose have been frequent.  This trauma has forced me to look at my foundations, lower my self-expectations and accept my own frailty. My thinking processes were affected in that it was harder to maintain focus for some months, after so much time out of circulation. I have discovered that appearances can be deceptive in that although I looked alright, mentally and emotionally I was not 100% for quite some time.  It was difficult feeling pressure from people expecting me to have fully recovered just because the bones were knitted together. It has been a real relief when others indicate understanding that the amount of recovery time required can be a long while.

So, what of facing life? I’m a little more edgy about facing everyday situations – you never know when you’ll wake up after an accident! However, I must say that fear of driving has not been that great. It has probably affected my wife’s driving more than mine.  I believe that because I was knocked out, perhaps I don’t have the data in my brain that tells me that driving is dangerous. No data – little fear. My wife on the other hand was fully conscious when she was trying to find where I was when I hadn’t turned up to work as well as when the police pulled into the driveway. The shock of all she went through that day has made her very wary when driving and she finds it hard to trust that drivers are conscious of what they are doing. She was experiencing some degree of secondary post-traumatic stress for some time as well.

The accident has brought about another surprise – the overwhelming insecurity that I now feel because I am acutely aware of life being so precious. I am tempted to feel my great insignificance in relation to the hugeness of the reality of life that I face day by day. Things that ordinarily would not have bothered me sometimes become very big issues and I often feel like giving up. Things that happen on the news or to others I know have left a huge impact on me (although 12 years later the stress has diminished quite a bit) and I feel very fragile in relation to my life, still. The fact that I am a fragile human being has been brought home to me and amplified a hundred times more than previously.

I still believe in a God who is bigger than my reality and that He is deeply interested in every detail of my life. Hope comes from this and also seems to come from the little things that I am capable of doing from day to day. My acceptance of my feelings and limitations as well as the challenge of living in the here and now have given me a way of life that enables me to take pleasure in simple things so that I can continue on. Numbness and slight pain still remind me of the event.  I have discovered recovery to be ongoing and the story continues.

By Phillip Milligan