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'I'm a Neurosurgeon Who Can't Move. Now What?'

— My ski accident reminded me to keep my patients' humanity front and center

MedpageToday
A photo of a skier laying face down in the snow after a crash

I knew I was still breathing. I laid on my belly in a Superman position -- albeit with zero superpowers. Veering in a different direction from my friends while skiing left me physically and medically humbled by a new version of an old sensation: powerlessness.

As a friend led us down the ski run in Colorado, I saw on my path a 6-foot snow berm leading to a smooth cat track, the flatter trails used by snowcats to move around a mountain. The last thing I remembered was skiing across it. Then I awoke on the ground. My neck was turned to the left and the ground's surface was hard on my right cheek. I noticed blood on the snow next to my nose and reached out to stop it. Well, I tried to reach out and stop it. My arms were pinned behind me and wouldn't move.

That was the moment I realized I couldn't move my legs. I'm a neurosurgeon who can't move, I thought. Now what?

"I'm a quadriplegic," I screamed to a fellow skier who asked how I was doing.

I waited for ski patrol because it was all I could do. I became anxious and felt complete loss. The idea that I'd utterly failed my wife and children washed over me.

I thought about the tremendous impact my new, physically limited physical self was going to have on me and my family. I imagined how my wife, Nancy, would take care of me. I thought of my son seeing me in distress, just as I'd seen my own dad after his stroke when I was just 22 years old.

I've screwed up my life, I thought. For a few minutes I cycled through fear, anger, disbelief, and loss. There was no controlling my emotions.

Even before the accident, I was not the picture of the . I know the limits of my professional powers and skills. That has shaped me into a surgeon who strives to connect with my patients and offer them not just surgical precision, but empathy. It's a point of pride for me and a daily reminder that I entered this field for personal reasons. I'd lost my dad to a stroke; it would be a disconnect for me to manage my work without my whole heart.

Laying there with my own livelihood and life on the line, I wondered, would physicians and surgeons embrace my humanity, the way I did for my patients, or would they see me as a bunch of broken parts?

Pain overtook me. My neck hurt so much that it was painful to speak.

I won't have to worry about operating anymore, I told myself. I can sell my city apartment -- maybe trick out our house to be wheelchair accessible.

I continued to reimagine my life as I waited for the ski patrol: I'd walk my children down the aisle at their weddings in an electric wheelchair. My wife would have to take our dogs for long .

When the ski patrol arrived, I told them I was a neurosurgeon with a cervical spinal cord injury.

"I need an airlift from the mountain," I said, knowing I was too unstable to make it down several ski trails secured to a backboard and sled. As they took me away on a sled, I watched the sky and trees and snow. The thought that this might be my last time on a mountain was interrupted by shock waves of pain from the bumpy ride to the helicopter. When the pilot asked me which hospital I wanted to go to, I let the ski patrol decide. I leaned on others to be the experts.

I noticed in the helicopter that I was able to tap my toes together. An incomplete injury, I thought.

The flight nurse offered me hope, compassion, and pain relief. After my arrival and evaluation at a Denver hospital, a neurosurgeon in a Broncos sweatshirt diagnosed me with central cord syndrome: my spinal cord was injured, but only temporarily. I would regain function in my arms and legs, then my motor and sensory function in time. I was able to open and close my hands after the CT scan.

The team confirmed my diagnosis with an MRI. The next morning, I could use my hands to feed myself. I could elevate my legs. I felt I'd have enough strength to stand despite the medical team placing me on full spinal precautions and complete bed rest.

Having Nancy and my brother by my side for the next few days, as I navigated standing, walking, and severe pain, gave me strength. Though my wife had bought tickets for our flight back to New York, the health system where I work arranged for an ambulance and hospital flight to bring us home.

Feeling valued and humbled, I returned home to my own team to repair my spine -- the team included a close colleague who had previously had to make a about his own medical and surgical care. I can understand why doctors go beyond their own health systems for care to avoid workplace complications. For me, though, it was the most natural decision to ask my colleagues to heal one of their own -- and they have. They had the knowledge, skills, and experience required. My emotional connection with them was a draw, not a deterrent.

Since my accident I feel a new type of power. Things that previously caused me anxiety have dissipated. I'm aware of what I can't control and am at peace with those -- with my -- very human limits. The incredible care I received, both in Colorado and at home in New York, reminded me to keep my patients' humanity front and center.

It'll be another kind of journey for me to return to the operating room. But I don't want to rush it, just as I won't return to my life exactly as it was before. I do want to hold onto this experience -- to allow it to shape me, enlighten me, and show me what's next.

It's a tough process, emotionally and physically. But it's one that I'm embracing because, luckily, I can move and feel everything.

is the chair of neurosurgery at Lenox Hill Hospital and vice president of neurosurgery for Northwell Health's Western Region.