A Close Encounter of the Worst Kind
Saturday, August 13 was a clear, cool, beautiful morning in Richmond - a perfect morning for a bike ride.
Jonah and I rendezvoused at the Virginia Museum of Fine Arts just after sunrise. She was running a few minutes late, but we still had time to venture out for our agreed upon route: through the city to the Virginia Capital Trail, down Osborne Turnpike to the Lilly Pad, then back to town through the National Battlefield Park, and across the river to take yoga class with J Miles at the Sankofa Community Orchard.
My memory of the morning starts to fade out here. I have vague wispy memories of seeing other cyclists out on the road and following Jonah downtown on Grove Avenue. I remember her telling me that she was uncomfortable riding two abreast in our lane because Virginia had just rescinded the formation’s legality.
And that's where my memory ends.
I woke up four days later in the ICU at VCU Health. My first conscious moments were full of panic and confusion. I was intubated - with a breathing tube strapped to my face and inserted down my throat, obstructing my ability to speak. There were IVs inserted into the carotid arteries on both sides of my neck, and my wrists were restrained to the bed - to prevent me mistakenly damaging the systems that were supporting my vital functions.
My pain was immense - searing, throbbing, heavy and exhausting - even through massive doses of fentanyl, oxycontin, and lidocaine. But I recognized my partner and parents in the room with me, and through panicked gestures convinced them to give me paper to write. I scribbled confused questions:
Where am I? What happened? What about my bike? Did my supervisors at work know?
And then finally, the breathing tube was removed - at last I could speak!
I asked about Jonah. Though delivered gently, the weight of their response was unbearably heavy.
Jonah was killed in the accident. She died tragically, but quickly, and doing something she loved.
The only words I could find were “I will have to live for Jonah.”
Survival
Over the next few days, I became privy to the details of what happened that morning:
At approximately 7:30am, just minutes after turning off of the bike path onto Osborne, we were hit from behind by a teenage drunk driver. He was reported to have been driving erratically at least 60mph. My survival was due to the fact that after being hit, I was launched off of the road and into the ditch. Jonah was not launched into the safety of the ditch, and so was not spared the full brunt of force from the driver’s Ford Explorer.
The chances of surviving a direct impact by a vehicle at 60mph is around 15-20%. I survived a very close encounter with death.
My injuries were extensive: a grade three liver laceration, extensive road-rash skin damage, six broken ribs, broken facial bones, a broken and horribly displaced right collarbone, a fractured sacrum, a broken and displaced pubic rami, and two broken hip sockets - one of which was broken laterally to the back of my pelvis.
It was difficult for me to accept my injuries. I was thrust into complete uncertainty about my future. Would I ever walk again? Would I ever ride a bike? Practice yoga? Would I ever regain the confidence in my body to play and explore? What would this mean for my partnership? Would our relationship survive the demands of disability?
My emergency room surgeons saved me from death by internal hemorrhage, but the lifesaving exploratory laparotomy meant that my stomach was incised from my sternum to below my navel. My collarbone and pelvis needed surgical repair, but the orthopedic surgeries had to wait until my blood pressure was stable enough for general anesthesia.
And so I waited, as patiently as I could manage, for days. I focused on my breath - watching my lungs fill themselves and push against my broken ribs with every inhale, and struggled through each painful exhale. I counted the seconds, minutes, hours. I drifted in and out of a drug induced slumber.
On day five, my collarbone was repaired with two plates and twelve screws. After I recovered from surgery, I was moved out of the ICU and into the Trauma Ward - which I was not totally enthused about at first. But my nurses were kind and attentive, and I quickly grew to enjoy the hustle and bustle of the busier unit, which distracted me from my painful reality.
These were my worst days. My left hip socket was damaged so extensively that my leg was kept in sixteen pounds of traction around the clock. The pain and muscle cramping in my left leg was nearly unbearable - at times so intense that I was unable to speak. My condition required daily x-rays in my hospital bed, for which they slid imaging plates underneath my broken pelvis and ribs. My bloodwork was constantly monitored to ensure my liver was recovering despite the massive doses of pain medication. I received twice daily stomach injections of blood thinner to prevent blood clots. I was painfully constipated from opioids, so I refused to eat. My body was wasting away and my patience was wearing thin. My room was shared, with another patient just on the other side of a curtain in the middle of the room. She was loud and complaintive. When she wasn’t demanding more ginger ale, she was hosting loud bible study and prayer circles in a room barely fit for one guest at a time.
But I endured. I spoke kindly to my nurses, I thanked them for helping me, for bathing me, for adjusting my body in bed, for massaging my cramping muscles, for wiping the tears from my eyes. My partner and family were with me in shifts morning, noon, and night.
Through these terrible days, I came to realize that even though I could not practice yoga with my body, I could dive deep into the practice with my mind. I had no control over what was happening around me or in many cases, to me. But I maintained absolute control over how I responded to these stimuli. I could control how I interacted with the people around me, how I greeted people with a smile, how I said thank you to every person who helped me, even the outlook I chose to take on my situation. This was my yoga practice: returning to my breath, remembering my values, acting with intention, treating others with loving kindness.
And in return, I received an outpouring of support from our community outside of the hospital. My family shared with me the news stories and messages of encouragement I missed (my phone was still locked in the Henrico County Police evidence room). They showed me pictures and videos from memorial bike rides and yoga classes and ice cream fundraisers that were organized by people who cared about what happened to me and Jonah. My community gave generously to a GoFundMe account dedicated to covering my medical expenses. I felt encircled with love, and it helped me to maintain a positive mindset in spite of my injuries.
On day nine, they wheeled me down to the operating room for my pelvic repair. I was ready for the next chapter of post-operative recovery. So I happily trusted my outcome to a soft spoken surgeon named Dr. Jibanananda Satpathy. I closed my eyes with hope and excitement.
Recovery
After my pelvic repair, I returned to a different room on the Trauma ward - a single room with a nice view. Already I could feel a sense of renewal.
The next couple of weeks slid by in a repetitive haze of protein shake breakfasts and Naked and Afraid reruns and round-the-clock blood tests. The days were punctuated by imaging scans, which required that my weak and vulnerable body be moved out of my bed and onto a stretcher to be transported to different wings of the building. MRIs, CT Scans, X-Rays, Radiation Treatments - it felt never-ending.
But in my quiet moments, I returned to my breath, came back to study each inhale and each exhale. My breath was the path that led me through pain, uncertainty, exhaustion, and frustration. And while there was so much discomfort - it was mirrored by moments of love and laughter and ecstatic joy, time well-spent with my visiting family and friends.
Things were on the up-and-up, but my looming hospital discharge has us worried. I was still unable to put any weight on my legs or use my right arm for anything. In short- I was still at the absolute mercy of my nurses, who dutifully saw to my every need. My nurses were my guardian angels, my saviors. I could never have survived without them, and I can never thank them enough for their tireless dedication to caring for me.
At about 2.5 weeks, I developed a life-threatening blood infection (likely caused by the damage to my skin). I first noticed feeling feverish, then suddenly my heart rate was spiraling up out of control reaching nearly 190 bpm while laying down. The rapid-response team of nurses got things under control, but for the next three weeks I would receive daily IV antibiotic and blood thinner treatments. This meant more frequent blood work. It also required a CT scan guided needle aspiration of a pocket of fluid in my abdomen. But it bought me a few more days in the comfort of the Trauma Ward.
Eventually all great things must come to an end, even extended hospital stays. In the last 48 hours before discharge, a physical therapist came to teach me how to get out of bed and transfer into a chair. I was so weak from muscle wasting that I could not move my legs even one inch without help. But I was determined to use the bedside toilet rather than the bedpan, and so I mustered all of my willpower to get there.
At 3.5 weeks, my stretcher was wheeled out of the Trauma Ward for the last time, headed for a medical transport to skilled nursing at Beth Sholom.
A Time for Resilience
Now began the work: On September 6, I arrived at Beth Sholom and was welcomed into a beautiful private suite in the rehab wing. My care team at Beth Sholom was outstanding: my nurses were patient, sassy, and motivating. I knew they had my back. My first few days were rocky, I was uncomfortable, my IV antibiotics were frustrating, and my new body position of sitting upright in a chair caused a lot of pain in my pelvis. But it was a new chapter.
On day one, I was visited by an occupational therapist who assessed my physical limitations. She gifted me a wheelchair, which after nearly a month of being trapped in a hospital bed, felt like freedom. I would need to build the strength to wheel myself around, but I was inspired by the challenge. I pushed through my daily PT sessions with determination to regain my independence.
At 4 weeks, I stopped taking oxycontin cold turkey and started eating everything I could get my hands on. I was ready to re-establish my digestive regularity and regain the 25 pounds of muscle I lost while in the hospital.
At my four week orthopedic follow up appointment, Dr Satpathy gave me full weight bearing status on my right leg and right arm. I was fired up. More weight bearing meant I could do more in PT and accelerate my progress towards self-sufficiency. I worked hard to regain autonomy around getting in and out of bed, moving around my room, and taking care of my basic hygiene. I wheeled myself around the facility and out to the patio every afternoon to soak in the sunshine. I practiced modified yogasana in my wheelchair. I breathed deeply through moments of uncertainty.
In mid-October I convinced my mom to take me and my wheelchair to an outdoor yoga class at the VMFA - the “last Saturday Salutations” hosted by PYR and taught by none other than J Miles. Practicing wheelchair yoga surrounded by friends and loved ones was a balm for my soul.
It was my first moment of knowing deeply and intimately that I would rise again, no matter what my long-term limitations might be.
At 8 weeks, I was given permission to put partial weight on my left leg, meaning it was time for crutches. Within two days of standing and walking with crutches, I was ready to go home. We practiced crutching on the staircase a few times in PT, and then it was time - I returned with confidence to our second story apartment and crutched up the stairs beaming with hope.
I had finally returned to my life - two months away felt like a lifetime, but I was home.
My Future is in my Hands
Outpatient PT was the next stop on my journey to recovery. I was able to crutch myself out of the apartment and drive my car, so after a few test runs with my mom, I felt confident to drive myself across town to the Bonaire Sheltering Arms clinic.
Over the next month, I made diet and exercise my priority. I continued the protein shake for breakfast habit that I picked up in the hospital, and I credit this dietary change with helping me to regain my strength. Being weak is exhausting, but it also leaves you vulnerable to reinjury. I was determined to not be vulnerable.
On November 7, I went for a follow up appointment with Dr. Satpathy. He gave me full weight bearing status on both legs. I graduated from crutches to a cane. A week later, I returned to work full-time.
Working at a pool meant I had ample opportunity to swim, and swimming felt amazing. It was the only thing I could do with ease and grace. On land I struggled against gravity to balance and move my legs through movements they were just recently re-learning. But in water, I could move in any direction without the fear of falling down.
And so I swam, and swam, and swam. And finally, I returned to the yoga mat in November, relinquishing my place in Elizabeth Shurte’s class.
On New Year’s Eve, I participated in SwimRVA’s annual New Year’s Challenge, completing 8,000 yards of freestyle on a 1:30 interval in under 3 hours. I was thrilled - on top of the world.
I realized then that I was reclaiming the narrative of my life. No longer just the victim of an unfortunate accident, now I was the face of dogged determination, and the stubborn will to rise again.
I WALKED into 2023 with my head held high.
The Long and Incremental Path Back to Normal
Every January 1, I set a personal intention for the year ahead. In 2023, my intention has been “Mind over Matter”, and I have been working to live this intention daily.
My keystones for continuing to revitalize my body include daily yoga practice, weightlifting 4-5x per week, cycling 1-2x per week, and at least one adventure every week (which now includes whitewater rafting and dirt biking).
I am grateful for the second life I have been gifted. The truth I have learned through my experience is that the Work never ends, it is lifelong.
I believe it is my purpose to spread awareness about our crash, the aftermath, and the community impact. I feel called to use my voice and my platform to share positivity and speak about the importance of a concerted community effort towards increasing traffic safety for ALL PEOPLE.
I continue to show up with hope for our future. I continue to work in faith that my efforts will benefit the people of my community.
I continue in honor of Jonah.
With Love, Natalie
In Loving Memory of Carla “Jonah” Holland
Friend and Mother
1973-2022
