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The DO | Patient Care | Art of Healing

How my broken leg—and broken life—made me a better physician

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Steven T. Fosmire, DO, was struck on his bicycle by a drunk driver. He says his patients have benefited from his long experience recovering from the accident. (Photo courtesy of Dr. Fosmire)

This essay is adapted from an entry in Dr. Fosmire’s blog, DOctah Dad.

It’s funny how life-altering events often wrap themselves in days that begin like any other. On a beautiful September Saturday in Biddeford, Maine, I went out for a relaxing bike ride. Just two blocks from my apartment, I saw a large white object lurking in my peripheral vision. It was an SUV that was slowing to a stop, or so I thought. Crunch. In a split second, I was airborne. As I flew through the air, I thought, “I’ll wake up any second, this is only a dream.”

I hit the ground quite hard and was in a state of denial as I began to feel an intense burning sensation starting to ramp up in my left leg. My leg collapsed under its own weight as I placed it on top of my right leg. The sensation was brutal and gruesome.

This is the story of my broken leg, hospitalization and lengthy recovery. It happened in 2007 during my second year at the University of New England College of Osteopathic Medicine in Biddeford. The experience provided me with a valuable window into the world of the patient and changed my outlook on medicine.

Specifically, I learned that emotional trauma often accompanies physical trauma, but that physicians usually aren’t trained to recognize and treat it in their patients. Also, I developed a greater understanding of the frustration and helplessness patients with limited mobility can feel.

Following the car-bike collision on that Saturday, I lay on the pavement in pain. The car’s driver, who I learned was drunk, pulled over and asked me if I was OK. Shortly after, the police and an ambulance showed up. I tried to breathe through the pain while the EMTs carefully wheeled me onto the rig. The pain was at such a level that my head was swimming, but morphine helped to alleviate it.

As I was wheeled into the trauma bay I remember seeing a blurry ocean of white and blue. I was bombarded with questions and probing hands as I felt the cold, hard sensation of trauma shears exposing my tattered naked body for all to see. IV lines were placed. Monitors attached. “What is your pain now?” medics asked me. “What is your name and date of birth?”

The effects of pain

Pain can turn an otherwise calm and collected person into a frightened, angry mess. In my case, I also passed out. When I came to, I was in my own trauma room where my nurse was waiting for me to wake up and urinate. I felt the pressure, but I just couldn’t go. She said the two words men fear the most: “Foley catheter.” Wait, no, please not that! But the nurse placed the catheter with the utmost degree of professionalism and empathy. I felt instantaneous relief.

“I had a clouded mind, 10/10 pain and complete exhaustion, and yet I was still expected to answer questions such as ‘How are you feeling?’”
Dr. Fosmire

I had officially become a human pincushion, or perhaps a mega-highway for IV fluids: They entered my hand and left via my catheter with a few stops along the way as my patient-controlled analgesia brought in numbing meds that made me oblivious to the whole ordeal.

The sensation of helplessness set in quickly. I couldn’t move my left leg at all without causing severe pain. I needed help to move around in bed. I had a clouded mind, 10/10 pain and complete exhaustion, and yet I was still expected to answer questions such as “How are you feeling?” from nurses and physicians. How the heck do you think I feel?

Eventually I was wheeled down to pre-op. The last thing I remember prior to surgery was the cold feel of the operating room and rubbery gas mask being placed over my face. Many hours later when I woke up, my wife and a few of our friends were at my bedside. I managed to mumble something nonsensical before drifting back into sleep.

I stayed in the hospital for a week, but it seemed like an eternity. My leg hurt, I couldn’t pee on my own, I had no appetite, I was bedridden and I was completely dependent upon everyone around me. And with my sheet-white complexion, I looked like the ghost of my former self. I later learned that I developed acute blood loss anemia, for which I was transfused two units of blood. I felt depressed and didn’t want people to see me this way.

When I was discharged, I had a bulky bionic-looking brace on my leg, crutches for getting around my house and a wheelchair for getting around town. I also had the knowledge that I couldn’t walk on my own for the foreseeable future. My hopes of returning to school were starting to fade. My then-pregnant wife, Senta, who is an occupational therapist, would become my personal care assistant. The line between home and work for her would be blurred for quite some time.

As I navigated my home and neighborhood, I developed a new understanding of how wonderful curb cutouts, automatic doors and elevators can be when one is reliant upon a wheelchair and the kindness of others to get places. Unfortunately, I also found that “kindness of others” was not as abundant as I had originally thought or expected from the community.

In my wheelchair, I was sometimes treated like a substandard citizen. Oblivious individuals nearly trampled over me while others ignored me or looked down upon me. Some businesses and parts of my school weren’t wheelchair accessible, so I had a hard time navigating my environment. My wife received looks of pity or horror from people around town as she helped wheel me around.

Emotional trauma

Independence, freedom and the ability to come and go as you please are very powerful. Losing that independence made me feel like a major hindrance upon my loved ones. I was angry with the drunk driver who did this to me. I hated my leg and myself. My life mirrored the damages my left leg sustained—it had become fractured too, and I was scared.

Dr. Fosmire

“In providing comprehensive care to my patients, I try to address their physical and emotional trauma,” Dr. Fosmire says.

Emotional trauma is not easily diagnosed and is often overlooked. Not once did my surgeon, my nurses, my friends or family ask me how I felt mentally and emotionally. Everyone asked about my leg or about my physical pain. Senta asked on occasion because she could tell I was having a hard time emotionally. I couldn’t sleep, I was reliving the accident, and I was afraid to leave my house. Was I going through the stages of grieving?

I wish someone had asked me about my emotional trauma shortly after my accident. In addition to anger, I also had a lot of fear—of losing my Air Force scholarship, of not being able to pay my medical bills, of never again being able to walk or run. The best option, I realized, was to seek help for my emotional trauma on my own. I discovered that my university offered free counseling, and I didn’t hesitate to set up an appointment. It was one of the best decisions I made during the whole rehabilitation process.

I was homebound and out of medical school for the four months that I was unable to walk. Then I started intense physical therapy. After six challenging months, I could walk again on my own with minimal assistance from a cane. These days—six years after the accident—I am still healing after many counseling sessions, four surgeries and tons of physical therapy. But I no longer use an assistive device to get around. However, sometimes I miss my wheelchair because I could really get cruising in it!

I have discovered aspects of myself as a husband, a father, a son, and now a physician that I never would have learned had this not happened to me. I no longer hate the man who hit me. I forgave him long ago.

Revelations

As I reflect on my experiences from the opposite side of the white coat, I have a new appreciation for the saying “What doesn’t kill you makes you stronger.” I know how scary and otherworldly it is to lie helpless and in pain on a stretcher while people stare down at you, asking annoying questions ad nauseam when all you want are pain meds and sleep. And although it was temporary, I also know personally how it feels to be looked down on by society as an individual with a disability.

These insights translated into revelations when it came to patient care. I’ve learned that respect, eye contact, human touch and getting down to eye level are all of paramount importance. Patients also need to be included in discussions about their treatment options whenever possible. I am aware that pain can change a person both physically and emotionally. In providing comprehensive care to my patients, I try to address their physical and emotional trauma.

I know what it is like to learn to walk again, and how much of a struggle it is to reintegrate into society after a traumatic event leaves physical and emotional scars. My patients have benefited from my experiences. I’ve advocated for patients who were helpless or afraid to speak up, such as the gravely ill and those who felt ignored by the system and didn’t speak up for fear of being labeled a troublemaker. I’ve also helped patients take ownership of their own care, something I had to do on my own.

Steven T. Fosmire, DO, is finishing a traditional rotating internship at Berkshire Medical Center in Pittsfield, Mass. He will be moving with his wife and children to Offutt Air Force Base in Nebraska, where he will begin serving as a flight surgeon in July.

thedo@osteopathic.org

9 Responses

  1. Chris Renaud on June 23, 2013, 8:18 p.m.

    Steve,

    Great Story, very nice insight into patients unseen/ unspoken hurts, which we as you and I know trouble almost all trauma patients we encounter and especially our wounded warriors.. Thanks for your words into your personal life.

    Chris

    Chris Renaud DO
    CPT MC US ARMY

  2. C Moon on June 30, 2013, 8:22 p.m.

    My PCP (MD) of thirty years just retired and I am seeing a DO for the first time. This is how I came across this researching OD medicine.

    Beautifully written!

    My horse tossed me into a gravel driveway and I so relate. Hopefully my new physician will be as understanding as you.

  3. Matt Mittiga on July 5, 2013, 1:08 p.m.

    Steve,

    Wonderful article. So happy to hear you’re doing well. Thanks for taking the time to write this.

  4. melissa on July 5, 2013, 1:38 p.m.

    Great article…good words and thoughts to share!

  5. OMS4 on July 5, 2013, 2:32 p.m.

    Steve,

    That is a great article, thank you for sharing. I had a similar experience with a leg injury, extensive surgery and rehabilitation, it was complicated with compartment syndrome and moderate residual damage.Having been a patient with significant morbidity is actually one of the main reasons I went to medical school.

    I still look down at my scarred up leg and sometimes feel sorry for myself, but my ordeal has made me a better person, and will hopefully help make me a better physician in the future.

    I hope you continue to recover, good luck in your career!

  6. John M. Peterson, D.O. on July 5, 2013, 6:45 p.m.

    BRAVO Steve…Great article!!! I had my only bicycle accident after I attended UNECOM in the opening class and was already in private practice for several years.

    While I didn’t have any broken “bones”, I had a severe concussion and several chipped teeth as well as abrasions, etc. The driver of the large truck that hit me wasn’t drunk, but he was in a big hurry going over a very tight, twisty section of two lane road around a blind corner to get back home.

    When I arrived at my local hospital, they were going through a trauma drill…and I was left unattended for nearly an hour. To say the very least, I was not in any state of mind to complain about anything!

    When I got through the triage bit…no one ever asked me anything about my mental state either. I was very confused, very angry and very scared!

    It took me many months to recover and I was never fully able to resume biking on any public roads. Any time that I heard a large truck coming up behind me…I just froze!

    Besides all “those things that we do” for traumatic physical injuries, we always need to consider the mental status of the injured patient as well.

    Best wishes for your future career! I know that you’ll be a better Doc because of your unfortunate personal experience. John

  7. Ryan Smith, D.O. on July 6, 2013, 9:59 a.m.

    Steve,
    Fantastic story. As a psychiatrist who often does consultations in the medical hospital, I often hear from patients that non-mental health doctors rarely address mental health issues in their acutely ill patients. Very happy to hear UNE Counseling was able to guide you in a good direction. Keep up the great work; talk soon.

    Ryan

  8. Karen on Jan. 2, 11:44 p.m.

    Thank you for sharing your story. As I write this I am in the hospital room of my niece who was hit head on by a distracted driver three days ago. She has extensive damage to her legs. Her left has already had a rod placed to repair a broken femur. Her right has a shattered kneecap and ankle and compound fracture of the lower leg. She has had surgery on the kneecap and awaits surgery for the ankle. She is 21, a dedicated nursing student and has dreams of becoming a nurse practitioner. She has her whole life ahead of her and we are all trying to come to terms with a potential of life long pain. I just thought I would try and find some uplifting stories and came across yours. I fear that there will be emotional scars from this accident, she was trapped in her vehicle for a half hour. She is fortunate to have lots of people gathered around her but I fear most feel as powerless as I do. Again, thank you for sharing. I will do my part to help her get attention for the emotional aspects of all of this, and share your story of healing with her.

  9. Steve Smith on March 27, 7:32 p.m.

    Steve, this is beautifully written. Your own trauma has deepened your capacity to care for others and to treat them with both competence and compassion. I’m proud of you for the man you’ve become. Wishing you and your family all the best!

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