Key Insights from Rehabilitation
In honor of National Rehabilitation Week, I am happy to share with you a few key insights I learned during my rehabilitation from traumatic injury.
My rehab journey started in August 2022, after I was hit by a drunk driver while cycling. As a result of the accident, I was faced with life threatening injuries including two broken hip sockets, six broken ribs, a broken collarbone, organ damage, and extensive skin wounding. Despite this list of injuries, I consider myself to be very lucky - that I survived, and that I was blessed with a great medical team and the support of my family and community.
Rehabilitation for me included: healing from two major orthopedic surgeries and an exploratory laparotomy, rebuilding strength after weeks of muscle wasting, relearning how to walk, and returning to my pre-injury level of activity. As of 13 months post-injury, I can happily say that I am about 90% healed, thanks to many hours of Occupational and Physical Therapy.
Key Insights
Slowing Down is an Opportunity
Before my injuries, my lifestyle could most accurately be described as over-active. Exercise has always been a source of happiness for me. I filled my weeks with multiple resistance training workouts, approximately 100 miles of bike riding, and daily yoga movement.
Being injured forced me to slow down. In the early days I was bed-ridden, watching minutes, hours, days, weeks pass while I stared out my hospital room window. But even as I gained more independence, my body was weak and vulnerable to re-injury. Everything exhausted me, even as I moved in slow motion to accomplish the most basic tasks.
When I started driving myself to physical therapy, just getting down the stairs safely consumed my entire attention. Soon I started going to the grocery store by myself, carefully crutching inside from my handicap parking space, and gingerly placing my body into a handicap scooter to drive around the store. Within a couple of weeks I graduated to using a walking cane, growing stronger and more confident daily.
While I was out of work on disability, Physical Therapy was my only time-sensitive commitment; the rest of my day was un-scheduled. This made it possible for me to take long sit breaks on benches outside, catching my breath and watching the world around me. Because I was in no hurry, I reveled in the opportunity to TAKE MY TIME with anything and everything. I drove slowly, walked slowly, interacted with other people in various states of injury and disability. I used handicap bathroom stalls and showers at the gym. I scooted around the grocery store and read nutrition labels ad-nauseam. I went to Target to practice my walking and limped down every single aisle, studying every single product for sale. I sat in the massage chairs at the mall for as long as I wanted to.
My sense of time slowed down, and I felt myself relax into it, like warm bath. Moving slowly was liberating. But it was also safe, and appropriate for me during physical rehabilitation. Healing takes time, rushing through the process does not help. Instead, there is fulfilment to be found in taking each step intentionally, studying the process, and building a relationship with what is true each day.
Even now, more than a year out and in a state of physical Ability, I find myself reaching back to those moments of slowness, content to watch time slowly tick away.
Loving Kindness is the Antidote
When my injuries were acute, my pain was unbearable and mind-altering. It took every ounce of patience I had to muster kindness for the people around me. Even as my nurses performed my daily blood testing a wound care, through gritted teeth I worked to be kind to them, and always say thank you for everything. I was determined to not lose myself to pain, to stay true to my values, and the values of the yoga practice.
The first steps in the eight-fold path of Yoga relate to the ways we treat other people, and ourselves. The very first observance of the practice is Non-Harming (ahimsa), which applies to every relationship and interaction in our lives. It is a reminder that no matter the setting or context of a moment, we should seek to treat others with loving kindness (metta) through our words and actions.
The more I worked to apply kindness to my interactions with nurses and family, the easier it became. Like a muscle, my ability to express gratitude for others grew stronger the more I used it. I learned that the phrase “Thank You”, could be used in any conversation, and in many contexts, and especially when I didn’t know what else to say.
I realized that gratitude is a well that never runs dry. It is the most universal form of connection. The more I was kind to others, the more kindness I received.
This loving kindness was healing in itself. It made me feel better about myself and my condition to know that I was still held by my community, that people still cared for me despite the burden of my medical care. I realized that with the support of the people around me, everything would be okay.
No matter what my future looked like, I could always give and receive love. I could always exchange loving kindness with others. This was a major source of comfort for me. Giving love made it possible to receive more love in return.
Post-rehabilitation, I have been working to apply this loving kindness to my relationships in the workplace. At SwimRVA I work mostly with two groups of community members: children in economic disenfranchisement and seniors in various states of ability and disability.
Finding loving kindness for our children in swim lessons looks like: compassionately navigating trauma and fear surrounding water, staying patient despite disruptive behavior, maintaining a calm voice tone, upholding structure and expectations, learning and remembering their names.
Finding loving kindness for our seniors looks like: actively creating opportunities for social interaction, explaining things patiently, slowly and repeatedly, offering help even if it may not be needed, designing programming with disability at the forefront of the conversation, re-designing spaces for safety and ease of access, setting aside time to deeply and actively listen.
Humans are social creatures by nature. We have survived throughout history in the safety of community. That’s why so many mental health disorders are connected to feelings of isolation and unworthiness. We yearn to be accepted by others, and so expressing compassion and acceptance for the people around us is the kindest thing we can do for each other (and ourselves).
Mortality is a Blessing
There’s nothing like almost dying for shaking up your perspectives on life.
Fighting for my life absolutely brought my own impermanence into sharp focus.
The most vivid glimpse was the day I developed a life-threatening blood infection. More than two weeks into my survival, after breezing through all of my surgeries without complication, I took a turn for the worse.
That day I received a radiation treatment on my pelvis to prevent muscle over-growth post-surgery. As I laid in the basement radiology unit of the hospital, I started to feel feverish. Within a couple of hours I was cold and shivering. The shivering devolved into muscle spasms and my resting heart rate rose up to 170 bpm - that’s when I knew something was really wrong. The nurses called a “Rapid Response” team into my room and pumped my veins full of sedatives and antibiotics. The doctors got my infection under control, they saved my life a second time. I trusted that they would. But there was one moment that I will never forget, when time stood still for me: as my heart rate spiraled out of control, I was absolutely helpless, not knowing if I was going to survive.
I saw my life flash before my eyes, and I found peace in radically accepting my own mortality.
They prescribed me a 21 day tract of IV transfusions of a powerful antibiotic called Meropenem. Though I was still bed-ridden, my health improved, and I was discharged from the hospital into skilled nursing at Beth Sholom Senior Living.
At Beth Sholom my care was fantastic and the food was much better than in the hospital. I attended Occupational and Physical Therapy sessions 6 days per week. In the shared PT gym I interacted with the other patients, most of them 50 years or more older than me. I watched them working through injuries and age-related physical decline. Often fellow residents would pass away, a regular occurrence in an old-age home. In this environment, conversations didn’t shy away from death. The end was close for so many of the residents, they seemed to wait patiently for their turn. Those who enjoyed the company of loved ones tended to have a greater quality of life in their final days.
All of these observations made one thing crystal clear for me:
Live in the Now, because tomorrow it may be gone. Our own impermanence is what makes the present moment so valuable.
If we lived forever, time would pass too slowly. The days would blur together into mundanity. We would grow bored of our loved ones. Nothing would taste as sweet. We need the looming darkness of death to bring meaning to our days.
Humans have a natural life span and most of us generally follow a similar trajectory from birth to death. Rather than resisting or avoiding thoughts about our own deaths, it could be beneficial to consider:
What do I want to accomplish before I die? What is the legacy I will leave?
How do I want to die? How can I better prepare myself to live well in my final days? Who will accompany me in my final days?
What is my purpose? What would it look like for me to live out the rest of my days in alignment with my values?
Sitting with these questions in my hospital bed helped me find clarity in my purpose (dharma), and the goals I have for my future. Though I am the same person, I know deeply that facing my own near-death has helped to bring greater quality to the rest of my life.
Radical Acceptance Builds Resilience
Surviving and recovering from my injuries has absolutely been the hardest thing I have ever accomplished. Pushing through immense pain and uncertainty required every ounce of physical and mental fortitude that I could muster. I found strength within that previously I didn’t know I had.
Accessing this strength was only possible by practicing Radical Acceptance. This distress tolerance practice teaches us that suffering does not come directly from pain, but from one's resistance to the pain. (Pain x Resistance = Suffering) Radical acceptance is letting go of the need to control, judge, and wish things were different than they are. [1] Marsha Linehan breaks down Radical Acceptance into three stages of practice:
Accepting Reality as is it, in its Wholeness
For me, this started with accepting the severeness of my injuries. When my breathing tube was removed on day four, and my sedation was allowed to wear off, I woke up in a state of confusion and despair. I remember wishing that I could leave my injured body in the hospital and go back to my old life. The moment I finally found acceptance was when they moved me out of ICU into a Trauma Unit room overlooking Richmond’s East End, housing projects, and the City Jail. Things came full circle for me, having worked for years in this part of town to create opportunities for disenfranchised youth. Watching the sun rise each morning over my beloved East End, I accepted that I was exactly where I was supposed to be.Accepting that the Situation causing Pain has a Purpose
Ultimately, I came to realize that the difficulty I was experiencing was mine to bear, that I was uniquely capable of bearing the burden, and that enduring would make me stronger than ever before. In drug-induced haze, promised that would “Live for Jonah”, a comment made first in despair that grew into a community rallying cry, and a sentiment that I return to daily even now. I have created Purpose in my experience by using my voice for community good: raising awareness and support for bike and pedestrian safety in our community, and spreading notions of forgiveness as we heal from Jonah’s death.Accepting Life is worth living even with Painful Events
My time in recovery was dotted with moments of deep despair. But all of these moments were mirrored by moments of happiness, and love, and just the ecstatic miracle of being alive. Being a in hospital bed granted me to the opportunity to spend a lot of quality time with my visiting family members. I was gifted with the opportunity to build deep connections with my nurses, who cared for me around the clock. I watched silly shows on the television with my Mom, spent time looking out the window and watching birds eating from the feeder.
I hosted visitors in my room at Beth Sholom, including Brantley Tyndall, whose suggestion that I get involved in bike/ped advocacy inspired me to find Purpose, and start writing this blog.
Yes, there were moments of tears, but there were just as many moments of laughter and gratitude.
Life can be bitter, but if you look carefully, you will find that it is even more sweet.
Accepting the wholeness of my situation made me a more resilient person, and ultimately will help me to weather whatever storms come my way in the future.
There is life after Traumatic Injury.
There is still beauty and hope and happiness available in each and every breath.
No Matter what comes, you are strong and you have support.
There is strength in knowing how and when to ask for help.
We can triumph over tremendous setbacks by maintaining our dignity and remembering our values.
Your worth is not rooted to your physical ability, but in the way that you show up in your community, and treat the people around you.
Overcoming adversity is the greatest opportunity towards discovering your purpose.
It is my honor to be here, alive, and sharing my story with you. I hope these Key Insights can help support you on your journey to Rehabilitation. If there is anything else you would like me to share, please drop me a line here.
With Love and Gratitude,
Natalie