An accretion of brutality, 12/05/17

“Came up running, maybe faster than anyone she’d ever seen run, straight out across the garage, down the long line of what they’d said was Lev’s father’s car collection. As he ran, each long arch lit up with its glow stuff, so shallow they might almost have been beams, to fade again as he passed below, and she hadn’t imagined there were so many, or how big this place was. As he ran he screamed, maybe how he hadn’t screamed when what happened to him had torn so much of his body off, but between the screams he whooped  hoarsely, she guessed out of some unbearable joy or relief, just to run that way, have fingers, and that was harder than the screams.

Then one last arch faded when he ran beneath it, and there was only darkness, and the sounds he made.”

William Gibson, The Peripheral

The first time I read this paragraph, I thought it was an extraordinary thing – beautifully and terribly human. Here, now, suddenly having my leg free of the metalwork to which I’ve been bolted for 10 months, my eyes shimmer with tears. It describes a man abruptly free of the awful physical injuries that have come to define him and perhaps seeing past the emotional trauma that was grafted on with them. His wounds are far more grievous than mine but, you know, fictional. When I look at the list of what my body has endured over the last 31 months, it’s a blankly terrifying accretion of brutality. I’m glad it was spread out. In summary:


Left brachial plexus neuropraxia – I stretch the nerve cluster that moves my left arm, paralysing it. As I am hanging by it at the time, I fall 5 metres, sustaining an open right tibial fracture and a fibula fracture. I bounce 30-40 metres, during which: fracture left ribs 4-10 (that’s 7 ribs in total); right clavicle fracture; fracture thoracic vertebra 6; fracture transverse processes on thoracic vertebrae 5 and 6 and on lumbar vertebrae 1 & 4; fracture spinous processes on sacral vertebrae 1 & 2. I lie on my own for somewhere between 8 and 9 hours. The sensation of one half of my tibia rubbing across the other half is genuinely the worst thing I have ever felt. I am airlifted to Newcastle Royal Victoria Infirmary.


Picture of surgical scar on author's spine.

Magnificent scar

An intramedullary nail (basically a titanium rod) is inserted into one half of my broken tibia and the other half is slotted over the other end and fixed with screws. A tissue graft is lifted from my right calf and slipped under the open flap of skin, which is then stitched closed. A skin graft is taken from my right thigh to cover the bare meat on my calf.





No, this is a magnificent scar…

The two vertebrae on either side of my spinal fracture are stabilised with titanium Meccano. I gain a magnificent scar. It’s not as magnificent as my leg scar, but it’s pretty dapper.

I’m not sure of the date because: morphine.

At some point after leaving intensive care but before I am moved to Leeds General Infirmary, and deep in the clutches of morphine induced Bruce Willis hallucination (no, honestly), I try to manually remove my own catheter. Even through the opiate cloud, it is eye-watering. Don’t try this at home. Or in hospital. Ow.



The horror, the horror, the horror…

Because my tibia was exposed for such a long time, the bone has not healed. The intramedullary nail is unscrewed and removed – I dread to imagine the mechanics of this process. The surgeons cut 3cm of dead bone from my tibia and shunt the two halves together. Then they put 12 pins through the bone and fix them externally to a series of stainless steel rings – an Ilizarov frame. Just for clarity, my right leg is now 3 cm shorter than it was, and my muscles and tendons contract to the new length.


So that I can stretch the missing length back in with the frame, I have a corticotomy, which is to say that they re-break my leg. With a drill. And a chisel. I Google corticotomy to find out how to spell it; the first search result is a YouTube clip of an actual corticotomy. I’m lucky that way.


The old break is sufficiently healed that I can start opening up the new break. I turn the nuts on four bolts 0.25mm three times a day. As the gap widens, the pins gradually stretch my flesh. It’s an extraordinary sensation. This will continue until 29/09/16.


I snap a pin. The torsion from widening the gap coupled with 4 months of my being possibly more active than the average patient distorts and then breaks one of the pins on the bottom ring. The pin is pulled out and then a new one is driven through my leg. Not in the old hole, no. They make a new hole. Of course. This is my third nerve block. When it wears off, oh my word.


At a regular x-ray, I point out that the two pin sites in the middle of my calf weep quite a bit. As the pins are supporting the old break, which has healed, and provide a potential avenue for infection, they are removed. With pliers. I get gas and air. It’s not painful exactly, but when you pull metal through skeleton, it generates friction, which generates heat. When the hot metal emerges from your skeleton into your flesh, it is quite odd. Oh, alright, yes, it is also painful. Ow. Again.


I snap another pin. No, I don’t understand either. It’s like they don’t make these frames for people who, I don’t know, walk about. Anyway, this time, my consultant just takes out the pin clip and puts in a longer clip that reaches in to grip the snapped end. This means I do not have to have the pin replaced. All of the hurrah. The frame tinkering transmits all the vibration directly to my skeleton. The piercing nausea is quite distracting. Also, I have an ingrowing toenail on my big toe. It’s clearly not the gravest of my woes, but straws and the camel’s back, eh?


My consultant tells me that if I promise not to rock climb, he will loosen off the frame and then remove it in three weeks. He takes the nuts from the supporting bolts. As they are under tension from holding up 76kg of idiot, they have seized up. Another surgeon has to hold the frame while he loosens them. Again, the vibration is transmitted directly into my hard infrastructure. It last seconds and forever. Ow. Again, again. In addition, now the that the nuts are gone, the frame can flex. When the bolt threads rub across the rings, it is a brand new crack in Hell’s paving.


After a further x-ray, the consultant decides that the frame can come off. The pins are all


As good as new. Well, better than broken.

snipped through with bolt cutters. Some of them take some cutting. As the pins snap, the tension they are under is released directly into my skeleton. One of the pins at the bottom is actually really loose – I watch the nurse prod it back and forth with her finger before she plucks it free. The rest are not loose. Oh, no. They are well and truly ossified in place. Most of them are heaved free with some accompanying sacrilege on my part. (Honestly, they’re missing a trick here; if they mixed helium with the gas and air, this could be primetime viewing. The show would have it all: blood, drama, tension, human frailty, really squeaky blasphemy. I digress.) A burly male nurse is brought onto the pitch for the stubborn pins. He is able to shift all but two of them. I invent some new compound swears. My surgeon is brought in. He takes what is basically a drill chuck on a T-handle, and clamps it to the end of a pin. Two nurses hold my leg down. The surgeon heaves on the pin. The third nurse hits the pin from the other end; I have my eyes closed and have no idea with what. I inhale gas and air all the way down into my pelvic girdle. My left leg (the good one) actually goes into spasm. There’s a fair bit of blood. One more pin to go. See previous pin. Peace, the charm’s wound up. My leg is dressed and encased in a rigid protective boot and I am released into the care of a responsible adult*.


Tibial triptych. It’s a bit more colourful than the Isenheim altarpiece, but about as grim.


And here I am. In actual trousers. And socks that come up over my ankles. And underpants that don’t contain Velcro. It’s been an astonishing process: humbling, painful, life-affirming, somehow simultaneously bright and befuddling. I’m sure that I have not been easy to deal with; I can only apologise. If it’s any consolation, it’s been less fun being me than being around me. To everyone who has altered clothes for me; visited me in hospital (especially if you bought coffee); done shopping for me; dropped by at home to see how I’m doing; taken me to the pub, cinema, shops or physiotherapy; done laundry for me; cooked for me; changed the bedding for me; carried stuff for me; put up with me on Twitter, the ‘phone or real life; driven me to, waited around for me at, or driven me home from the hospital; done something for me that I’ve forgotten – thank you all, I am in your debt. A special thank you to my team at work, who have been so supportive of me whilst probably dealing with me at my worst: you rock.

And just for clarity, although this post references brutality, the care I have received from all of the staff at both Newcastle Royal Victoria Infirmary and Leeds General Infirmary has been superb. I am grateful to them all and sorry that, on occasion, my circumstances have got the best of my temper.

*no, really

4 thoughts on “An accretion of brutality, 12/05/17

  1. Great to hear Lyndon… back to normal now then? I look forward to seeing photos on your blog from your next foray into them there hills….

    Well done for coming through it with humour too.




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