The Hand of Fate
A theme in adventure riding is things going wrong, and having a better time because of it. We have all been there…broken bikes, getting lost, even minor injuries are all part of the ironic fun. As we ride more and more, we develop our technical, mechanical, and situational proficiency, which leads to increased confidence, a sort of “I got this” state of mind. But occasionally, circumstances can very quickly pivot, putting you way beyond feeling like “I got this”. Saturday, May 30, 2015, was one of those times.
My friend Pat and I were getting in some seat and bike prep time, getting ready for a 2 day event we were attending the following weekend. The plan was to put in a long ride, over a variety of terrain, get our legs in shape, and to shoot a few product reviews along the way. Early on in the ride we rode up on another friend, Jamie, and he joined us. Weather was great, early season dirt was tacky, and all three of us were having a great time. Typical riding day in Bend.
Shooting video early in the day.
After 5 hours of fairly aggressive riding, we were working our way home. At a stop, Pat and I both commented that we both pretty tired, and planned to take it easy. Taking a familiar shortcut, we took down a two track that was nice initially but quickly became technical, dusty, lots of loose rocks, sand, and quite rough. I was second out of three, and taking it very easy. I pulled up to an intersection where Jamie was parked, and we both properly waited for Pat to show up and regroup. Usually I am patient but for some reason after only a couple minutes, I said aloud “this is not a good sign” and headed back to check on Pat.
After 4 - 5 minutes of backtracking I spotted him on the ground, with his 2012 WR250R partially on top of him. No big deal, happens all the time. I pulled up and asked if he needed help. In other than his usual tone, Pat very sternly instructed me to get the bike off him, and not to move him. I moved the bike out of the way and asked him if he was hurt. He replied “I can’t move”.
This rock likely caused crash. Stump is on the upper left.
“You can’t move what? Because you’re in pain?”
“Brian, I can’t move anything. My hands or my feet. Only my mouth.” He raised his intonation on the word "anything" for emphasis. Neither of us said anything for few seconds. I asked if he was kidding me, and he repeated the same phrase with the same intonation. The second time it sunk in. We are way out in the woods, Pat crashed, and is paralyzed from the neck down.
Pat is a quadriplegic.
Pat had been coming down the left side of the two-track, probably at about 30 - 35 miles an hour. Remember, it was very dusty, late in the afternoon, and Pat was third out of three. From what we could tell, we think he hit the large rock in the photo above, about the size of big toaster. Now, Pat does not remember what he hit, and could not get up and retrace his event. But from the marks and the location of his bike, my guess is that he hit this rock with both wheels, the bike bucked up front first, then kicked up the rear, likely very high. After about 15 feet there was a deep plow mark where the front came down, dug in, and turned to the left. A few feet past that was a large pine tree stump, freshly uprooted, that Pat says he remembers hitting with his head. A few feet past that was Pat, with the bike on top of him, facing the wrong direction. Beginning to end was about 30 feet.
Pat remembers hitting this stump with his helmet. It was freshly uprooted.
By our best guess, he went headfirst into the stump, and his head was bent down and to the left. This drove the chinbar of his Fly helmet into his chest making a slight bruise. His visor was broken off downward, as the screws holding it were metal, not break-away plastic like some brands use. He was well past the stump so he certainly continued to fly or tumble, but we could not determine how. The bike was on top of him, sprocket actually touching his torso. (note: if it had been the other side, the rear disc or exhaust would have burned him badly).
Pat was wearing mostly full gear, but he was not wearing a neck brace. He had asked me if he should purchase one months earlier and I did not push it with the same urgency as the rest of his gear. He and I are good friends, if I told him to get one he would have, no questions asked. There are a few reasons I did not, none of them good ones, and in hindsight this is painful. I have enough information to form an opinion on whether they work (I think they do) and enough people that I trust who have weighed in (they think they work also). Going forward we will be recommending them, period. I don't care if you disagree, but I also do not care to debate it with you.
A few years ago, I had read my friend Kurt Windisch’s firsthand account of a medical evac in the Alvord desert. While riding up in the Steens, his friend crashed, breaking his pelvis and a couple vertebrae. Kurt's actions were textbook examples of what to do: stay calm, organize your team, get help, get evacuated, and don't make any mistakes. Upon reading that story, I immediately recognized it was not a story, rather, a lesson. I studied it, and memorized a few key takeaways. I am glad I did.
For a few minutes, I was in a strange fog, hoping that Pat would just sit up and be fine. I think this is a natural response, but for reference it is NOT a good one. In some situations, any hesitation can have consequences, so crisp, quick decision making is critical. Remember this, in case you are in a situation where that is needed.
Personally, I will never forget being jolted from my fog when Jamie said the words “I am calling 911”. Immediately, I knew I needed to focus, and got to it. Jamie and I began running through what we needed to do, starting with getting someone who could sit by the phone and act as a communications hub, then conveying where we were.
Jamie was on the phone with SAR, to his credit he was calm and clear. I got our GPS coordinates, passed them on to Jamie. My T-Mobile phone was out of range, so I used Pat's Verizon-based iphone to call my wife. Cell service was spotty but I was able to give her our location and get her prepped in case we lost battery or service. She has a list of people to call in case I am out riding, and something goes wrong. I asked her to begin reaching out to those people. Of course I downplayed Pat’s situation.
One small thing occurred that I count as a lesson. I wanted Jamie to get on his bike, ride out to each end of our road, and hang a jersey as a marker. The 911 operator wanted him to stay on the phone, and give her directions for how to reach us. This was absurd; and I started getting kind of pissed off at asking something so stupid. I asked Jamie for the phone and briefly began arguing with her. However, I quickly realized that a calm flow needed to be maintained, and I was jeopardizing it. I gave the phone back to Jamie and refocused on Pat.
Pat asked me to keep talking with him. Frankly it was hard for me to stay focused; I cannot imagine what was going through his mind. Anyway, we began a conversation that was a stream-of-conscious mix of encouragement, problem solving, and some typical guy humor. Random stuff, block the sun for me, help is coming, you’re killing my Saturday, etc. I remember feeling kind of pathetic, he held down that conversation more than I did, he knew it and I knew it.
As we chatted, I was trying to assess just how bad his situation was. He repeatedly said that his arms and legs had the numbness / pain one gets from “sitting on the toilet until your legs fall asleep”. Yet, there were a few signs that were positive. He could feel poking in the palms of his hands, arms, and lower legs. He could feel ants crawling on his hands and wrists. As a joke, I poked him in his privates, and he told me in no certain terms ONCE IS ENOUGH, breaking the tension a fair bit. He had actually regained the ability to – just barely - move two fingers on his hand. But he also kept telling me that his leg felt like it was on the right side of his body, an indication that his spinal cord was not working correctly.
By now, about 45 minutes had passed. Jamie had hiked to the main road and was gone. A white Chevy Tahoe from the Deschutes County Sheriff started coming down the road toward us. Sergeant Eric Kozowski, a BMW 1150 GS rider and customer of ours got out. I have never been so happy to see those flashing lights; the fact that it was someone I knew was superlative. Eric was calm and professional, and ran through the usual questions, what happened, how are you feeling, etc. This, plus the fact that he had a radio took things down a notch.
Sheriffs Officer Eric Kozowski, a moto guy.
Things began to pick up. An Airlink helicopter appeared and began circling overhead over head. They made several passes, at one point dropping so low that I had the crazy thought the medics were going to rappel down. Once they verified there was nowhere to land nearby, the went to a spot about a half mile away and landed.
From the other direction, a huge Ford F350 Quad Cab rolled up, driven by Sergeant Ronnie Dozier from the Deschutes County Sheriff Search and Rescue Division. I had come back up this “road”, it had all sorts of rocks and camber, and was rough for a dirtbike, let alone a long wheelbase pickup. It was also grown in quite a bit, and must have made a mess of the paint. Officer Dozier was as relaxed / funny as Officer Kozowski was relaxed / professional.
Sergeant Ronnie Dozier.
From the other direction, two Lifeflight Medics, Kathy D. and Jason C., came walking down the trail with supplies and a backboard. They set up, began cutting his clothes off, and started evaluating his condition. Pat was talking and joking with the responders, and his mood was good considering what had occurred.
It was now time for the most important part. Several people gently rolled Pat onto his side, keeping his helmet aligned in the same position, and gently slid the backboard under him. Even doing this as carefully as possible, it caused Pat to lose movement in his left hand again. His helmet was taped in place, and his arm was taped to his chest. It was decided that they would put him in the back of Officer Dozier’s truck to transport him the half mile to the helicopter.
Prepping for helicopter evac.
An important point: I knew Pat’s helmet would need to be removed, potentially exacerbating his injury. The cheekpads of most helmets hug the jawline, and usually pull your head, ears, etc. when you take them off. Pat was wearing a Fly Racing helmet, and I knew the cheekpads were removable, held on by three small snaps. I was not going to touch it, and you should NOT do this yourself. But I explained it to the medic, and he carefully removed the left side pad, leaving the right as it was supporting Pat’s head. I made sure that Pat knew to instruct whoever removed his helmet at the hospital to take the other one out. This is worth remembering.
Pat and I had decided I was to call his wife when he was on the way to the hospital. I knew that I had to strike the right tone, to get her to act but not become too upset to drive. I called her, explained that Pat crashed, was hurt, and was being flown out. Of course she initially replied that I was "full of shit". I told her I was not kidding, that he was hurt but now in good hands, and that she needed to get to the hospital immediately. I did not tell her he was paralyzed.
A few words about helicopter evacuations in Central Oregon: first, they are not covered by insurance. No joke, the bill for an evac is approximately $25,000 - $30,000 (!!!). You can actually sign up and buy insurance to cover an evac for about $100 per year, BUT, there are TWO different companies here that do them, Airlink and LifeFlight, each taking turns. If you have insurance for LifeFlight, and your number comes up Airlink, you lose. That is not even the crazy part…. get this…..the two providers are owned by the same parent company! In Pat’s case, he had Airlink, and he got lucky.
Once at the hospital, he was X-Rayed, given a CAT scan, and an MRI. He had fractured the pedicle area of cervical vertebrae #s 6 and 7 (C6-7). These vertebrae affect the low cervical nerves, controlling many things including the movement of your arms and legs (For reference, injuries to C1 – C4 can be a more severe event, as they can affect breathing). Any injury to this area is about as bad as it gets, however, his particular injury was about as good as it gets. His C6 and C7 were fractured, but there were no fragments and no displacement. His spinal cord had taken a hit, but his doctor felt it was bruised and not damaged. Most importantly, his injury had just occurred, and he already had some movement of both hands and both legs.
Some info on this: www.spinalinjury101.org/details/levels-of-injury
He was initially placed in the ICU, after 2 days his condition had stabilized and he was moved to a room. Now that he was safe, his treatment was the focus. For several reasons, there was insufficient confidence in his neurologist, one reason being he had placed him on a very heavy dose of a steroid. It was decided that Pat's team would ask to change to a different doctor. I lobbied to be engaged in communicating that to the hospital staff. I knew it would be difficult for his wife, where I was not going to take any shit. I was right, the nurse initially started to fight me, but correctly followed our request.
3 days in.
At 9 days post-crash, Pat was moved to the in-patient rehab and therapy section of the hospital. They started him on a program of PT that can best be described as reconnecting the wiring in his nervous system, and building strength back. His trajectory was incredible, due at least in part to his boundless will and positive attitude. This pic was at 9 days:
9 days in.
I am not being hyperbolic at all when I say that you do not come any closer to losing everything. For 24 hours, he had been paralyzed from the neck down, one of the most grim situations one can fall into. At 5 days, he could move all his limbs with fair control. At 9 days, he was standing and doing light PT exercises. At 14 days he was home, and supervised a crew of people helping him move. At 17 days, he worked out at the gym and walked home, a mile. At 23 days, it was 6 miles. There are still problems, but they are small in context. In fact, since this event, for him and for I, most everything we can complain about seems small in context. Because, Pat can make a sandwich. Pat can dial the phone. Pat can walk.
Despite the fact that some serious things went wrong, an extraordinary sequence of positive events fell into place. First, everyone involved was well prepared, made no wrong decisions, and a few good ones. We had communication, GPS coordinates, and enough people to manage the situation. Timing, daylight, and weather went our way. We lucked into a perfect team of responders and medical professionals. Nothing else went wrong. Even Pat's physiology seems to have helped, he is as strong as it gets mentally and physically. All the details post crash aligned perfectly. As bad as it could have been, it actually turned the other way, so much so that I struggled to summarize how happy everyone is. They say a picture is worth a thousand words, and I can do no better than this.
12 days in.
UPDATE AUGUST 2017: It is now 2 years later, and Pat has passed the "18 - 24 months" period that his doctor said would be necessary to recover. Stated another way, after this period elapsed, additional gains were unlikely. He did have a surgery in late 2016 to remove the rear of the C6 - C7 pedicles, to remove pressure from that area that was causing some numbness and pain. He is working and living normally, including easy mountain biking and skiing. That said, his motor control and strength have not fully returned, they remain somewhere around 85% - 90%, which will be a permanent state. Conversely, his attitude and love of life are better than most anyone you will meet.
- Brian Price