29 November 2012

"Media vita in morte sumus"

"In the midst of life we are in death." This antiphon is attributed to the Benedictine monk Notker I of Saint Gall, who died in 912. Legend has it that the musician and poet wrote it when he saw construction workers building a bridge hover over an abyss. Most likely, however, the hymn is much older and originated in France around 750.
Probably everyone can tell one or more stories entitled "How I Almost Died."  Here is my latest one.

We were in the process of transferring an immense pile of mulch from the driveway to some trails in the woods.  My wife had pitchforked about 3 tons of it over an embankment to a lower level where I was moving it to tarps to drag to the woods.


I've walked those woods hundreds of times, for chores and for contemplation.  On a sloping hill towards the back I've passed this set of old cut logs -


- which have been there for years without rotting, so are certainly hardwood and probably oak.  On this almost-fateful day I had dragged the tarp of mulch to this trail segment and was turning around to rake it level when I started to fall.

When I was a little kid I contracted polio, which left me with one weakened leg, so over the years I've become quite experienced at falling down.  As a person walks or turns there are different muscles and different fascicles of each muscle that have to activate in turn to generate motion or provide stability; when the sequence doesn't activate smoothly, down you go.  I've become quite adept at falling - not quite "balletic" in gracefulness, but certainly able to catch myself and suffer no consequences except torn knees of trousers.  But this time I fell backwards...

When you fall backwards, it's very hard to modify the fall.  On this occasion I could do nothing, and factoring in the slope of the hill my head experienced a free-fall of about six feet before encountering the log.  It was basically equivalent to getting slammed in the head with a baseball bat.

Going down backward, I had no idea what I had hit.  It was a powerful blow, and since we have quite a few large boulders embedded in the ground, I assumed that was what my head had hit.   I remember the pain and the flashes of light, and my first response was to reach my hand back there to palpate the site, expecting to find a depressed skull fracture.  There was none (and not even any blood).

I did follow Dylan Thomas' famous advice not to go quietly into that good night.  I let out a series of screams - which no one heard.  My wife was in the house and no neighbors within earshot.  I got to my feet and with some dizziness, falling once more, managed to get myself back to the house.  Over the ensuing hours, wondering if I had a subdural hemorrhage, I waited to see what neurologic defects might develop, checking my pupils and cerebellar function.  Nothing happened, and I seem to be o.k.

When I went back to the woods later, it struck me how incredibly lucky I had been.  My  head had hit a smoothly-sawed-off stub, probably squarely in the center; had it struck to the side, the cut edges would have lacerated the scalp and perhaps fractured the cranium.

And the point of impact on the skull was almost exactly on the point of the occiput, which is a relatively robust, dense bony area of the cranium.

The xray at right shows a lateral view of the neck.  I've added a yellow oval at the region of the occiput.  Just an inch or two lower is the cervical spine (red oval).  I have no doubt that if that log had impacted my c-spine with the same force that the skull sustained, that I would have incurred a spinal fracture.  The results would have depended on the location of the break.

If the spine had been transected low, I could have been rendered paraplegic, with loss of function of the legs.  A little higher might have made me quadriplegic, with all four limbs paralyzed.  And at the top, damage to the phrenic nerve would have paralyzed the diaphragm, making it almost impossible to breath (especially in the supine position).  I would have been unable to call for help, and before anyone would have found me, I would have been dead.

But I'm still here, and with a week having passed, apparently healthy without any complications.  It's little "memento mori" like these that remind us how precious - and how tenuous - our lives are.

36 comments:

  1. I'm glad you are ok. please take it easy for a bit

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  2. I just read and Oliver Sacks "Hallucinations" that it's easy to sever the nerves that connect your olfactory nerves with your brain in a head impact. Once you've lost your sense of smell, the brain often hallucinates odors (apparently specialized areas of the brain get bored with no sensor input).

    Thanks for this memento mori.

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  3. I value your blogs far more than your yard being tidy. My exceedingly selfish request is that you find some strong boy or boys in need of pocket money to haul away your mulch in the future.

    Glad that you're ok.

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    1. Fourthed. Though I would also be ok with some strong girls being given the opportunity as well.

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  4. So, not "I will live to tell this one day", but " I will live to blog this one day." How modern!

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  5. Earlier today I read your post on death bed regrets and I watched the link to the blimp disaster. I thought, momentarily, that death has been a bit of a preoccupation on here lately. (The immersed sheep also.) Now I can see why it might have been on your mind!

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  6. M'Stan, you should get checked out medically ASAP. Symptoms of a subdural hematoma may not show up for as long as two weeks. Emergency medical attention should always be sought after any head injury. You're probably OK, but why take chances?

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  7. I'm with Swift Loris - get it looked at, please. What would we do without you???

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  8. Glad your okay. This is my favorite blog.

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  9. Signing under the S. Loris petition - let's have a log at change.org - and hoping you are really ok. You're a shine in our lives, Stan, please don't go away anytime soon.

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  10. I fourth (fifth?) Loris' petition. Please get it looked at. We almost lost my grade ten math teacher after he was sideswiped on his motorcycle. He shrugged it off as cuts and bruises, saying he was fine. Which he was, for a week or so. Then they hauled him off in an ambulance after third period one day. He survived - after a two-month induced coma and three surgeries - but he never taught again. Remember Berry Oakley!

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  11. Wow! Yes, get it checked out! I'm glad you're OK! It's amazing what our bodies can cope with. It's also amazing how it would take just that one little slip an inch to the right and it could end terribly.

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  12. Reading your post, my thoughts were, "I'm glad he's ok!" and "Subdural hematomas can occur up to weeks after any head trauma. He should stay diligent and get checked out." I see that others share my same thoughts, but I'll echo them here anyway. I'm impressed at your neurologic self-evaluation, by the way.

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  13. I'll add my voice to the others that have suggested that you be evaluated by medical personnel. And I'll second mehughes124 on hiring out massive chores such as this. You might also include log removal to the mulch spreading job, just for safety's sake.

    I'm glad you're feeling fine and hope all goes well.

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  14. Glad to read that you are on the road to recovery.

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  15. Here's another vote to go get it checked out. Your head is pretty darned important!

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  16. I'm glad to see you're ok, Stan. I was away on a short vacation, and never expected to come back and read this story. Anyways, I hope you'll be able to keep on building your bridge over the abyss for many happy decades.

    It is true that controlling backward falls is not as easy, but not impossible. There is one Aikido exercise called "koho tento undo" that with enough practice should allow one better protection if falling backwards. I'm saying especially because it has allowed me on the rare occasions when I slipped on ice to roll safely and come back on my feet before I realized what was happening.

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  17. Please go to the doctor! As everybody has mentioned, subdural hematomas don't always show up immediately.

    I am so glad you're all right. Just so you know-- you make my day brighter whenever you post something, even when it's a disgusting undersea creature. Your weird little factoids are highly appreciated by all of us.

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  18. I am truly glad that you seem to be ok. :D

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  19. Congratulations on continuing to Do Stuff even with combined age and post-polio. Please don't get scared off the outdoors by the occasional mishap, even a serious one like this. Glad you're okay.

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  20. O.K. already. Done. I have an appointment with my internist tomorrow (Saturday) morning at 10:00. If you hear nothing more from me (about this), that's good news.

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  21. Glad you are okay man. That is scary stuff.

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  22. Hahahaha I am happy to see you listen to your readers! I hope we don't hear anything else about this and so glad that you are O.K. after that fall. Good luck tomorrow!

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  23. Dang, that was too close and too easy. While part of me wishes we didn't have to pay for such small missteps with our lives, that's exactly what happens every day to every earthling. So glad you dodged that bullet. I hope you and your wife now have a plan. (I'm sure there's an app for that.) --A.

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  24. I'm VERY glad you are going in to be seen ~ My ICU/ER personalities were screaming for you to do so!!

    Hope all is well after XRs, etc ~

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  25. Yours is one of the finest blogs- I am relieved you are okay after a close call and more relieved that you are going to the doctor just to make sure of that fact.

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  26. Oh dear Stan, don't do that to me. Just the thought is very upsetting!This is the very reason I hated biology in school. Down here in Missouri for the most part we just assume we're fine and carry on, every now and then someone dies or gets killed.
    Although now that I care for my 84 y.o. mother, falling is about the most dangerous problem we face.
    I don't know your age, but I'm just glad you're okay!

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  27. Neuro exam within normal limits.

    Head CT scan showed nothing - which probably qualifies me to be a blogger.

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    1. Glad to hear it. Hope you take it easy. --A.

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  28. That's great news. That old saying of better safe than sorry still holds true.

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  29. Get some recovery time in Stan!

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