More than a year has passed since the beautiful summer day I rode my bicycle down a steep hill, crashed, and landed in the hospital, bruised and battered, and no longer an entirely intact human being. I wrote about the experience for Well.
I am happy to report that I was able to successfully return to cycling this past summer, train for a ride to benefit my cancer center without incident and complete the 100 mile course in July.
But what happened in between the accident and the cool bottle of water I enjoyed after crossing the finish line isn’t as simple a story.
My injuries included a few broken ribs and a pneumothorax. Broken ribs never sounded like a big deal to me, until they were mine. Every breath I took from the moment I first hit the pavement became an exercise in pain, repeated approximately 15 times each minute.
But this pain paled in comparison to the agony my broken ribs caused when, exhausted from a day of breathing, I tried to collapse in bed. Broken ribs make it almost impossible to lie flat, I learned the hard way, and I quickly had to relocate to a La-Z-Boy chair each night for the next month. The interruption in sleep, and the subsequent haze of functioning that resulted during daylight hours, reminded me of my intern days two decades ago, when I spent the night caring for hospitalized patients and would do my best to continue to do so the following day. It was a period of my life that I wasn’t eager to revisit.
With a collapsed lung, I was banned from any airplane trips for three months. When airplanes take off, the cabin is pressurized to create a comfortable environment for passengers at high altitudes. That pressure, though, can transform a partially collapsed lung into what is called a tension pneumothorax, in which the lung collapses entirely and is unable to re-expand – a medical emergency. As a result, I cancelled a number of meetings, except for one in Washington, D.C., for which my wife gallantly took time away from work to drive me the six hours each way so I could attend.
Psychologically, the recovery was harder.
A few weeks after the accident, I was driving my car along a slightly curved stretch of pavement when I suddenly started sweating. My heart was racing and I was breathing quickly. I pulled the car to the curb and stopped until I calmed down.
It slowly dawned on me that I was reacting to the topography of the road, which resembled the one where I had crashed my bicycle. Similar waves of panic came over me a few more times over the coming months, though with subsequent events I recognized my symptoms quickly enough to either stop driving or to initiate deep breathing exercises until my fear passed.
In wasn’t until the spring of this year that I summoned up the courage to get back on my bicycle and take to the road.
It wasn’t easy.
On my first few rides, I experienced the same dread that I had in the car, imagining the feeling of my bicycle slipping from my control and the crunch of my ribs hitting the asphalt. I panicked when I saw loose gravel or potholes, objects that could disrupt the thin connection between the bicycle’s wheel and the road and cause me to fall. Gradually, over a period of weeks, I gained more confidence to the point of enjoying going out for a ride again, just in time for the 100-mile event.
But I still haven’t revisited the hill where I crashed. And though I didn’t actually consult the Diagnostic and Statistical Manual of Mental Disorders, or better still a colleague actually skilled in such diagnoses, I’m pretty sure I met some of the criteria for post-traumatic stress disorder.
During that ride, I thought a lot about the physical and psychological ups and downs my patients experience, and soon after saw a man in clinic — an introspective guy in his late 50s who has been in remission from his leukemia for almost three years. He knows that the magic number we often quote for a cure from cancers like leukemia is five years, and was debating whether he was “enough in the clear” to buy a second home in Canada, or whether he should consider retiring early, to enjoy what years he had left should his cancer return.
“I think about the leukemia all the time,” he told me. “I even went online a few weeks ago to look up the prognosis again.” He chuckled to himself as he acknowledged that we had already discussed the numbers a few times. He continued.
“The problem is, I feel like I’m tied to a railroad track, and see the light of the train approaching. And I don’t know if it’s one mile away, or 500. Do you have any idea what I mean?”
I told him that I thought I finally did.
Dr. Mikkael Sekeres is director of the leukemia program at the Cleveland Clinic.
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