It was the most momentous occasion in my life to date, which makes it all the more bizarre that I can't remember a single detail. Although it took only a fraction of a second for the event to occur, that tiny point in time was enough to change my world forever and turn the lives of my family and friends upside down.
The "event" was a car accident that took place in 1999, and the crash was a horrific one. I only know this because my best friend, fortunately for me but unfortunately for himself, saw it all happen in the rear view mirror of his car. My car swerved off the dual carriageway it was driving along, and slammed into a tree, roof first. To this day, as I have no memory of the actual event, I have no idea of how it happened, or why. What was I doing? How was I distracted? I not only became another road accident statistic, but I joined more than a million people who suffer a head injury in Britain every year.
It is estimated that out of every 100,000 of the population, between 10 and 15 people will suffer a severe head injury, 15 to 20 a moderate injury and between 250 and 300 people, a mild one. The number of friends and family members who face the shock, helplessness and uncertainty of such a situation is unquantifiable. The death rate following traumatic brain injury is less than 1%, but this leaves a large proportion of young survivors, along with their friends and families, to cope with the aftermath of the injury, and deal with the feelings of helplessness, frustration and uncertainty that this brings.
July 18 is a date now scored in my memory as one of some significance. For me it is a date to celebrate, simply for still being here, and each passing year is another "anniversary" of sorts. On that date in 1999, I was celebrating a friend's birthday at his parent's house near Oxford. It was while following a friend's car for directions back to London that I was involved in the accident.
Driving along a busy A road, my friend tells me, I was veering over into the wrong lane and, on seeing oncoming cars in that lane, had tried to move back into the correct lane. But overcompensating, I pulled too hard and lost control of the car. It swerved, hit the kerb, and went flying into a tree, leaving my head to bear the brunt of the impact and injury. Thankfully there was no one else involved in the accident, and there were no passengers in my car. All that was left on the side of the road was a mangled combination of the tree, the car and me.
The result was to put me in a heavy coma, for the first two months of which I was judged to have a Glasgow coma score of three. The Glasgow coma scale is a standardized scoring system used to evaluate brain injuries: the lower the score, the more severe the brain injury. The lowest mark possible is 3, and the highest is 15. My injury appeared to be just about as bad as it gets.
On arrival at hospital, the MRI scan showed that I had a large haematoma, or collection of blood, in the tempero-parietal lobes on the right hand side of the brain. I was transferred in the early hours of the morning to the Radcliffe Infirmary in Oxford where I was operated on immediately when I arrived. The haematoma was successfully removed, but the prognosis for my chances of survival was not good.
Although I had gradually inched my way a little higher up the Glasgow coma scale by the end of two months, scans of my brain were showing a very visible "mid-line shift". Because there was so much swelling and pressure in the brain, one side was squeezing the other as it competed for space. My family and friends were told that due to the length of the coma, the damage to my brain could be "everything or nothing", and that if I emerged from the coma there was a 95% chance that I would do so entirely incapable. As my brain had suffered quite a lot of trauma and possible shearing of the connective tissue running through the brain, it was difficult to say how much, if any, of my brain had either died or ceased to function properly.
As a journalist, a news reporter for Channel 4's children's news programme First Edition, my life had, until that point, been filled with a list of achievements, including two degrees, learning to fly with the RAF while at university, a lead role in a Channel 4 feature film, and a year off travelling the world. When my mother was told that I would never be able to return to work again, she began to question whether she should turn the life support machine off. It was very possible, if I survived, I would have to rely on others for even the most menial of tasks. I was only 25 years old at the time with my whole life ahead of me - would I have wanted a life like that? Thankfully she didn't switch the machine off, and thankfully the doctors' anticipated scenarios were wrong.
After having been in a heavy coma for two months, there was no single blinking-of-eyes moment of waking. But I gradually became more responsive to stimuli, and after a further month where I was slipping in and out of the coma, I fully emerged. I have only a very patchy memory of this period. I knew that I had been hospitalised because I had been involved in an accident, as all my friends and family had explained this to me as soon as I emerged from the coma. But it was only after relentless questions that I eventually pieced together a picture of the horrors that they had all been through. For two months, they had battled uncertainty and had repeatedly been told that I "probably would not make it to the following morning". As my mother said later: "What was the scariest was not only not knowing if you would come out of the coma, but who would come out of the coma."
On "waking", my long-term memory, barring the day of the accident and the two-month coma period, was intact and unaffected, though my short-term memory was badly affected for a while. The bigger problem at this stage was that I was unable to move independently. I had no control over any of my limbs, I could not hold my head up, and I couldn't stand or walk. It took three physiotherapists simply to get me to move and to help me to exercise my limbs.
My mother is a nurse, which has been both a blessing and a curse. It was certainly a blessing for me to have someone around who was medically trained and could translate the jargon for me. She kept a vigil over my bedside in hospital, constantly repeating the physiotherapy and speech therapy exercises, both to keep my brain stimulated and to encourage me to talk. I'm told that my first words when I came out of the coma were "good morning" to the nurse, whom I called by name. How I knew his name I have no idea.
But being a nurse was also extremely difficult for my mother, since for those two months she was fully aware of the worst-case scenarios. I also had a 15-year-old brother, who was about to do his GCSEs that summer, and a 27-year-old sister. Then there were the friends who commuted weekly, or sometimes even daily, from work in London to Oxford in the evening, going back to work the next day. This network of friends and family served to surround both me and them with a cocoon of love and support.
My mother had hoped and expected me to go to the Royal Free hospital in north London for the next stage of my treatment, but because they had staffing difficulties, I was refused a bed. Consequently I was transferred to the local hospital - to the colorectal ward, where the staff were not specialised in treating patients with a head injury. I was eventually transferred to the rehabilitation ward at Northwick Park hospital in north London, where I underwent most of my intensive physio; this finally got me out of the wheelchair.
But once I had got my body back in working order, it was time to focus on my brain. I was introduced to the concept of cognitive rehabilitation, and referred to the Oliver Zangwill centre, OZ, in Ely, near Cambridge. Cognitive rehabilitation is not about waving a magic wand and "curing" whatever problems you have as the result of a brain injury. It is about introducing strategies to compensate for problems, so that everyday life can be managed and continued as independently as possible. Securing a place at one of the very few centres of this kind in the country is, however, incredibly difficult. Usually the local health authority is responsible for funding but, frustrated by the delay, my parents considered taking out a second mortgage on our home to pay for it themselves. Thankfully the tireless support of our local GP saw that the funding was pushed through. I found out later that the average waiting time for a place at the centre is three to five years.
Within a few months at OZ my friends were already noticing an improvement in the communication problems I had been experiencing. I would constantly interrupt people when talking, repeat myself and veer off on tangents during conversations. We devised a strategy whereby everyone would raise their finger whenever I had just interrupted them, and slowly I began to stop myself unaided. Repetition was averted by pre-empting almost every point, story, or question with: "Have I told you this already?" After referral to another cognitive rehab centre in London, and a series of successful work placements, I have just been declared "fit and ready" to return to the real world and get a paid job.
While I certainly haven't escaped completely unscathed, I seem to have come out of the accident as lightly as I possibly could. And now, nearly three years on, I am constantly amazed at how lucky I've been, to have had no internal injuries, no broken bones, no extensive facial scarring. The most common consequences after a brain injury are problems with memory, concentration and fatigue, and mood swings which can lead to anger, sadness and depression. I escaped effects to my mood and emotions because the region of the brain that directly controls them was not damaged. But for quite a while my first thought in the morning would bring a big smile to my face and a quick whisper: "I'm still here!"
As time passes and as I meet more and more head injury victims - either those fortunate enough to have secured a place at my current rehabilitation centre, or those who have a partner, friend, or family member trying to secure some kind of help - I realise how incredibly fortunate I have been to have been given a place at two fantastic rehabilitation centres. I have also spent a period of time in a state of complete amazement. How was it that I had managed to escape from my accident so lightly? And how had the doctors been so wrong in their prognosis? The brain, I have learned, is an unknown and unpredictable territory. It's worth remembering that for all the desperate need for facts and prognoses, doctors are not always right, miracles can and do happen, and a little faith can sometimes go a long way.
