Sticks and Stones (may break my collarbone)
I recently broke my collarbone. I had to undergo surgery and am now half man, half machine. This article is my attempt to make sense of the experience and share some thoughts and tips that helped me.
This is my first personal article; I hope you find it at least somewhat entertaining. It is also an inquiry into what we take for granted, and our ability to get used to many things.
Hour 1: The Fall
It was a sunny day on Tempelhofer Feld on Easter Sunday. I was playing Spikeball with two friends and my partner, having a lot of fun. Then, during our last game, as I was trying to reach for a high ball, I slipped on the wet grass and fell directly on my shoulder.
I realised something was wrong the moment I hit the ground. I heard a “click”. I already knew that I would not be going to Fontainebleau for bouldering the following month. I also realised that I would not run the 10K I was preparing for in July. Intense pain was mixed with frustration. Tears of anger were rolling down my cheeks.
I knew that something had to be done soon. We hailed a taxi and drove to the closest A&E service in Kreuzberg.
Hour 2: A&E
Medical emergencies in Kreuzberg are tough. The ward was full of homeless people swearing and screaming in all kinds of languages. The smell was unbearable. I could also see people who were terribly lonely, and just had nowhere else to go.
In slightly separated rooms, I saw people in much worse conditions, putting my shoulder and crashed Fontainebleau plans in perspective.
Hour 3-6: A&E still
As the hours went by, my expectations sank lower and lower. At first, I thought that my shoulder was simply dislocated. After a quick inspection, the nurse told me it was probably broken. The doctor then told me that the fracture was light. By the end of the night, I was told that I would have to go back to the hospital on Tuesday for a pre-surgery appointment.
Day 2: Looking back
This trip to the hospital put a lot of things in perspective.
Taking the future for granted
I was so busy thinking about a presentation I had to do for work in the following days, salary negotiations with my boss, a series of interviews with another company, my blog articles, heavy preparation for my Fontainebleau trip, etc… that I did not realise that I was taking all of this future for granted.
As it turned out, a lot if not all of these will not happen next week, or even the week after that. The future I had in mind simply does not exist. Tomorrow is never guaranteed.
Limited time before we get needles in our arms and wrists
Soon after I arrived, I was administered painkillers through a needle stuck into my arm. Looking at all the inventory of medical supplies in the room, including needles, syringes of all types, plasters, bandages… I realised that this is the last thing a lot of people see. Soon enough, you enter an A&E service and will get needles all around your arms and oxygen through your nose.
This was a vivid memento mori. I realised that getting out of this hospital was an opportunity not to be wasted. I was alive, I was conscious, and I was leaving the hospital on my own two feet.
Now, what was I going to do with this life? How do I use the time before I see these needles and syringes one last time?
Day 3 - Some time to think
More than a weekend
I am slowly realising that this is not just an Easter weekend thing and will change my life for the next few months at least.
I cannot wear t-shirts anymore as the pain of taking them off makes me sick. I am grateful to have enough oversized button-up shirts. I cannot lie down or stand up without terrible pain. The only way I can type is with my laptop on my knees. I feel every step in my broken collarbone. After having managed to lie down in my bed, I do not feel like I have the energy to keep going for another day of pain. I know that this will pass, but getting used to this new way of life is tough.
It helps to remember how lucky I am to have left the hospital on Sunday evening, as a few patients never did. I am sure that they would have given everything they had to take my place.
Bureaucracy
After A&E, I am now dealing with German bureaucracy. On Sunday evening, I was given a piece of paper to bring to my GP (Hausarzt) before another appointment at the hospital on Tuesday (today). I went to my GP early in the morning so that they could give me another piece of paper to bring to the hospital. At the hospital, I am meeting the doctor to finally book my surgery (hopefully soon). A piece of paper to get another piece of paper, to go to an appointment to book another appointment. In case you had not noticed, we are in Germany…
Update: I spent 5 hours at the hospital for two 5-minute appointments. I guess that this is the state of public health in this country.
Ups and downs
I keep going through many ups and downs. Yesterday night, I was in pain and did not want to go on. Today, I had two nervous breakdowns, one of them waiting for my anaesthetist appointment. The advantage of having to wait 4 hours to see an anaesthetist is that I had the time to have my nervous breakdown and calm down – I was perfectly fine by the time I saw her.
What happened to Stoicism?
Directly after the fall, I was surprised by the way in which I handled everything. I was relaxed, calm and had an unexpected control of my emotions. This was, I thought, years of meditation paying off. Maybe, but not sure. Looking back, this was probably my state of shock and a healthy dose of adrenaline.
I realised that the real stoicism was to settle into a routine of pain, disappointment, and embarrassment without complaining or giving up. I don’t have that yet. I am still sad and frustrated to have to cancel my plans, to be weak all of a sudden. I have not accepted this fate. This will come in due time.
Speaking with a friend on the phone when he talked about stoicism, I replied: “it’s not easy to be stoic, when putting on a t-shirt is so painful it makes you sick”. I still stand by this statement.
Day 4 - Last day before the hospital
On my last day before my operation, I decided to work a regular day to get everything in order before my hospital stay. This was not a bad idea, but it made me very tired.
I was also getting more and more anxious about my first operation under general anaesthesia. This made me irritable. I was stressed and tired. Tired of the pain punishing any movement, tired of not having control over my own life, tired of not doing any physical activity. This manifested at lunch following a mild disagreement with my girlfriend about the menu (it doesn’t get more pointless than this).
This Wednesday was absurd. I can barely remember it.
In the evening, I went to a Charlie Cunningham concert at Admiralpalast. I really enjoyed it, though I prefer his older songs. His opening act was great, a performance by Cerys Hafana, a big recommendation. This was a nice last evening before the hospital.
Before the operation, I wrote one introduction article to Machine Learning. Just in case I did not wake up, I wanted my friends and family to know what I had been so passionate about.
Day 5 - The operation
I arrived at the hospital at 12:00. I was shown my room and introduced to my two roommates (more on them later). I was given a hospital robe and underwear (fishnets that could have got me into Berghain). I gave all of my valuables to the nurses, and started waiting until 14:00, time of my operation.
Waiting was long, I was in pain and getting anxious. To prepare for the operation, I had not eaten for the entire day, which made me tired. Thankfully, I had a really nice neighbour, who we will call David. He had shattered his leg bouldering. We started talking about everything and nothing: Germany, bouldering, hospital paperwork and tricks…
We also talked about our other neighbour, a strange anti-social man speaking neither German nor English. He kept listening to music and calling people on speaker, despite having noise-cancelling headphones; a piece of equipment that I had unfortunately forgotten.
At 14:00, I was wheeled into the central surgery ward. There, I was prepared for the operation and had a quick chat with the anaesthetists. They wired me to a machine checking heart rate, blood pressure and oxygen level. The device checked my blood pressure every five minutes. They gave me an IV of painkiller infusion, waiting for the operation.
I waited like this for two hours, with the machine taking my blood pressure every 5-10 minutes. Apart from a few visits from a student anaesthetist, I spent the two hours in the dark alone, hooked up to that machine. I had time to think about my life, though the drugs they injected me with started to cloud my ability to think clearly.
After these two hours, I finally met the anaesthetist in command, who proceeded to do his job of knocking me out in 5 minutes; making me breathe sleeping gas while one of the assistants was also injecting me with a tranquiliser. With my 60 kilograms, you can imagine that I did not resist very long.
I woke up by 19:30, feeling absolutely dosed, and with my left arm completely “asleep”. To limit the pain I would feel, the team complemented the general anaesthesia with a “regional” anaesthesia done through a nerve-block. This was great for the pain, but one of the risks is to damage the nerve permanently. I was quite happy to be able to move my left fingers when I woke up the next day. Joking aside, this nerve-blocking technology has been incredibly helpful.
Even though I was conscious, I have a memory gap in the hour following my waking. That stuff was strong.
The pain started coming back slowly through the night as I was regaining my capacity to move my fingers. I only managed to sleep between 4:00 and 7:00. The room was noisy, there was constant activity from doctors and nurses, punctuated by the screams of my slightly antisocial roommate. When everyone was silent, the birds outside sang throughout the night. I was really regretting forgetting my sleeping mask and my noise-cancelling headphones.
I had braced myself for terrible pain, as this operation is known to be tough. The idea is to consolidate the bone with screws and plates. The pain turned out to be ok thanks to the strong pain I had gotten used to living 4 days with a fractured collarbone, and the nerve block technique used by the surgeons. The pain only came back progressively, which made it very bearable.
Day 6 - Discharge
I woke up from my 3 hours of sleep surprisingly fresh. The pain was fine, I did not need any more drugs. The room had a large window, the sky was blue and the sun was shining. I was feeling a wind of optimism. Ups and downs, ups and downs.
I was getting very, very hungry. This is a tricky situation to be in. After a general anaesthesia and 36 hours without eating, the stomach is full of acids (i.e., it is busy digesting itself), one has to be careful with eating.
I also had to be careful with my movements as I could not use my left hand due to the operation, and my right hand still had a catheter (needle used to inject medicines) in my right arm.
Still, breakfast was a godsend. The saying “Hunger is the best sauce” was an understatement that morning. I had never enjoyed a slice of bread and cheese like this before. And I am French, so I know what I am talking about here.
As I thought that my day could not get any better, the nurse removed the needle I had in my arm. At that point, despite the pain, I felt free and healthy.
Throughout the day, nurses kept bringing me loads of pills and painkillers; 4 at 8:00 and another 3 at 12:00. I asked them if they were necessary as I did not feel pain; they replied that it was doctor prescribed. I did not object, this is their job not mine. My bias against medication was overcome by my respect for science and medicine.
I spent the day waiting for an X-ray of my shoulder, the last step before my discharge. I waited 6 hours on my hospital bed. Thankfully, David and I had a really nice chat about life, work, weekend plans and visits, languages, more administrative tips (we are in Germany after all)… I am not sure what my hospital stay would have looked like without him.
Making sense of randomness
When the physiotherapist arrived in our room, she started doing some arm exercises with David. After the exercises, we all started talking about ways to keep strong bones. David mentioned collagen, I was talking about eating more protein.
The interesting thing is that we had both experienced “freak” accidents, very unlikely events. I fell on my collarbone while playing Spikeball and he shattered his leg falling from 1 metre while bouldering.
And yet, we were still trying to make sense of the event, to find ways in which it could have been avoided. It is just so hard to realise that our lives are fragile and sometimes absurd. We can certainly put the odds on our side, but there is no way to prevent these unlucky accidents. We could all die anytime from a ridiculous fall or something that has nothing to do with our free will and ability to plan.
I still find this illusion of control useful. It pushes us to make sensible decisions and allows us to live without bearing the weight of the absurdity of luck. It is also much easier to wake up in the morning and do stuff when I think that I am the master of my fate.
Going forward, I will get back to this illusion of control. I will eat more protein, do less risky sports, wake up in the morning and work for future gratification. In the process, the scar on my chest is a reminder to enjoy the present moment, and that we are a Spikeball game away from disaster.
Waiting for discharge
My hospital lunch was thoroughly disappointing: pasta in a watered-down tomato sauce and an industrial chocolate cream/pudding. I cannot believe they give that stuff to people who actually need to recover. As my stomach is still in a tough state, I have to eat slowly to avoid nausea. To my surprise, I still enjoyed the food; I was desperately hungry.
After lunch, I started being worried that my X-ray would be delayed and that I would have to stay another night, and this was not an option. I started mentioning this to every nurse I could see. This strategy worked and 4 hours later, I was finally discharged.
As I was getting dressed, I could not help but think about David and his crushed leg full of screws. His recovery would take more than a year. I had to be happy to be out, but at this point, it felt unfair to leave him there. We exchanged contact details; I hope that I will be able to help him through this process.
It was a very sunny day. I hailed a taxi and told my girlfriend to meet me outside her flat with a picnic blanket. I just wanted to be outside in nature for a bit. I felt alive. My girlfriend had also prepared her incredible tiramisu; I was a happy man.
The only issue is that the medications I had taken during the day were starting to have an effect on my brain. I was unable to think straight and had lost a lot of my short-term memory. I kept forgetting what I was saying, or the questions I was asked. I was numb.
Day 7 - Back to Normal Life
On this first night back, I slept well from 21:00 to 5:00. At 5:00, I had some kind of panic or anxiety attack. I was convinced that the moment I would fall back to sleep, people would come back to operate on me again. Another nightmare/thought that I had was that there was a black spot on my shoulder (where my scar is) that was growing onto my whole body, until I was completely covered in dead tissue and died.
This was rough. I do not know why it happened, probably the trauma of the operation or the after-effect of the medication. It could also be just a plain nightmare. Anyway, not an easy way to wake up.
Generally, I feel much better. The pain is much lower than before the operation, when my fractured collarbone was moving. I have used only two painkillers since my discharge and everything is fine.
Filled with optimism, I decided to take care of lunch. The trip to the supermarket made me very tired. This is when I realised that recovery would be long. Ups and downs, ups and downs. When I got home, my girlfriend thankfully helped me cook.
I spent the afternoon in the park with a friend who came all the way there. We talked under a tree. Life was good, I felt at peace. Friends, nature, time. I definitely want more of that in my life now.
Day 8 - Getting into the rhythm
I woke up after a good night of sleep. I took off my t-shirt (a victory, though still painful), showered and washed my hair; all on my own. I felt free and powerful.
I went out on a morning walk, taking the bins down. I am keeping this one short as I am meeting friends tonight for a longer walk at 16:00. I need to be in shape for that. I feel like an old man these days. Taking public transport or walking for more than 30 minutes feels exhausting.
Walking for a few hours in the evening was a tiring achievement. It is by now the only sport I can do, and I am enjoying it. My friend Eliot and I walked along the Spree in Rummelsburg. The weather and sunset colours were incredible. Friends and nature again, simple pleasures.
My girlfriend helps me so much with everything. She takes care of most of the cooking and cleaning, with my help where I can. My recovery would certainly not be as smooth without her. I am also rediscovering the warmth of a shared bed, watching movies together, or just sharing a space with someone you know and love.
Day 9 - Slowly back to work
Officially, I am off sick for the entire week. The issue is that as a Team Lead, one rarely gets time off. I am taking it easier today, just an hour in the morning; but will have a few meetings tomorrow.
I am still walking in parks, alone this time, as most of my friends are working. I spent some of this morning reading a book on Mathematical Analysis. I am still fascinated by the beautiful and rigorous simplicity of mathematical reasoning.
This afternoon, I will spend some time writing – passive knowledge consumption can only take you so far. After writing this paragraph, I will probably go back to my article list and drafts. Time to move forward with my blog.
Day 10 - Settling into a new normal
My days are now becoming more regular. I am still off work but will have a few meetings today.
I walk a lot, and will keep doing it over the next few weeks. This has a very positive impact on my mental health. I keep writing, both for my blog and this collarbone journal. This is helping me make sense of the reality around me and what I want to do next. I am enjoying this life of walking and writing. I may want to investigate this further in the future.
This evening, I will probably go to my GP practice to pick up some documents: a Krankschreibung (sick note) and a prescription for physiotherapy. My first appointment will be on the 9th of May. I am excited to get back to physical activity.
I am thinking of running a 10K on the 26th of July to mark recovery. That could be a good idea, but let’s make sure this is not too risky.
Moving forward, I will decrease the frequency of these entries, as recovery is not that interesting.
One month after the operation
I am reviewing this one month later as I am thinking of publishing this article. A lot has changed since.
Thanks to daily physio exercises, I have recovered most of my mobility. For 2 more weeks, I am limited to an angle of 90 degrees with my left arm. After that, I should be close to normal. I feel some pain once in a while, but it is getting rarer. I am not sure I will be able to run 10K in July; I will ask my physio’s opinion next Friday.
My scar is requiring some extra care. A few days after I removed the steristrips, the bottom part started splitting. I am making sure not to move too much.
Buying bandages in Germany
For some unknown reason, the plasters I need (9x15 cm) cost 2€ per piece in Germany. With the number of plasters I needed, this would have represented a substantial cost. Following a tip from David, my hospital neighbour, I was able to buy some online for a tenth of the price. After an operation or hospital stay, it is a good idea to ask the hospital for a few spare bandages, to have some while waiting for the bandages to be delivered. I still cannot believe that plasters could be that expensive.
A slower life
Throughout my recovery process, I have had a lot of time to think, walk and write. I walked more than 10,000 steps every day. I am embracing a much slower life. I got back to my daily meditation practice, even starting a 30-day guided meditation programme.
Instead of spending a whole week bouldering in Fontainebleau like every year, I spent this time with my family and walking around Paris. I feel much more at peace. I am writing this from the countryside in Normandy, where I am spending the weekend with my family. I am walking every day.
I still cannot carry anything too heavy or open a bottle of wine, but life is good. I am as happy as I was before the accident. Maybe more aware of my surroundings and more relaxed.
What to do now?
Rereading this, I may have found some answers to the question: What to do with my life until I see these hospital rooms and syringes one last time?
For some reason, it was important to me to have my article on Machine Learning live on my site before my operation. It is important to me to share the science of mathematical prediction with others, through my work, teaching, and article writing. This is definitely something I want to focus on now.
This feels like my life’s calling, or at least one of them. I will soon embark on a project to teach Machine Learning from the ground up, starting with the nature of numbers and functions. If that sounds interesting, subscribe to my newsletter to hear more about it in the following weeks!