'A falling man broke my spine but didn’t break me' - Lives Less Ordinary podcast, BBC World Service

Key Concepts

• Spinal Cord Injury (SCI): Damage to the spinal cord that results in temporary or permanent changes in its function.
• Acute Care: The initial phase of medical treatment for a sudden, severe illness or injury.
• Spinal Rehab Unit: A specialized facility focused on helping individuals with spinal cord injuries regain function and learn to live with their condition.
• Internalized Ableism: The internalization of societal biases and prejudices against disabled people, leading to negative self-perceptions.
• Autonomy: The right or condition of self-government; independence.
• Dignity: The state or quality of being worthy of honor or respect.
• Restorative Justice: A philosophy of justice that emphasizes repairing the harm caused by criminal behavior.
• Ableism: Discrimination in favor of able-bodied people.

Summary

This transcript details the profound life-altering experience of Grace Spence Green, a medical student who sustained a spinal cord injury after a man jumped from the third floor of a shopping center and landed on her back. The narrative explores her journey from the immediate aftermath of the incident through her recovery, rehabilitation, and eventual return to her medical studies, highlighting the physical, emotional, and societal challenges she faced.

The Incident and Immediate Aftermath

On October 17, 2018, Grace, then a 22-year-old fourth-year medical student, was at a shopping center in East London. She recalls saying goodbye to a friend and then waking up on the floor, unable to feel her legs, with a crowd gathering around her. She learned that a man had jumped from the third floor and landed on her back. The surreal nature of the event, waking up in an "awake state," and the immediate sensation of paralysis were deeply disorienting.

Grace's initial memories are fragmented, a mix of her own recollections and what she was told. She vividly remembers the ambulance transfer, feeling "drunk" on morphine, exposed, and lying on a cold board. Her family and partner were already present, and friends were rushing to see her. She felt a profound sense of being out of control, not only of her situation but also of her own narrative, as the incident was already being reported in the media with her photos from old climbing competitions juxtaposed with the man who jumped.

Life Before the Injury: Climbing and Houseboat Living

Before the incident, Grace was a highly accomplished climber, having been the UK under-18 girls champion at age 12. Climbing was a sport that made her feel capable and strong, a contrast to her childhood experiences of being small and weak due to premature birth. She also lived an exciting period of her life at 22 on a houseboat on the Thames in London with her partner, while pursuing a Master's in Public Health. This time felt like she was "filling out the outlines of myself as a person," figuring out her interests and future aspirations.

Hospitalization and Early Recovery

Grace's experience as a patient was a stark contrast to her medical student perspective. She found hospitals humbling and often felt a lack of autonomy and dignity during invasive procedures. Healthcare professionals sometimes failed to introduce themselves or explain procedures, leading to her feeling outraged and demanding to know their names and roles. Her medical knowledge allowed her to advocate for herself, for instance, by correcting a staff member about her neck fracture. However, this also highlighted the vulnerability of patients who cannot advocate for themselves, making her acutely aware of her privilege as a medical student.

Despite her medical training, Grace experienced denial about the severity of her spinal injury for weeks. The lack of visible external signs like blood or bruising, apart from a bruise on her toe, made it difficult for her brain to bridge the gap between her appearance and the reality of her condition. She initially believed, "They've got it wrong. That's not me. I'm not disabled." A volunteer from a spinal injury charity's mention of wheelchair skiing was overwhelming, revealing her own internalized ableism and biases about disabled people.

Spinal Rehabilitation Unit

After two and a half weeks and spinal surgery, Grace was moved to a spinal rehab unit. This transition was a "shock to the system" as she was no longer in acute care with a clear recovery path but was now considered "disabled." The unit was regimented, focusing on getting patients out of bed and into wheelchairs. The overwhelming nature of learning to live as a wheelchair user was compounded by a giant folder of information about spinal cord injuries.

The realization of the permanence of her injury began to dawn as she was surrounded by other individuals with spinal injuries. Seeing her MRI scans, even as someone not adept at reading them, made the gravity of her situation undeniable. This marked the breaking of her denial and the beginning of understanding the true extent of her injury.

Camaraderie and the "Holy Grail" of Walking

The rehab unit fostered a unique camaraderie among patients, many of whom were older. Grace formed close friendships, notably with Vince, a scaffolder in his late 40s, with whom she developed a deep connection forged through their shared experience. These relationships were unexpected but profoundly valuable.

The "holy grail" of recovery for most patients was walking. Grace initially fell into this narrative, driven by media portrayals of recovery. However, she later realized her desire to walk was partly to "look less disabled" to others, a reflection of her internalized ableism. This realization led her to question who she was doing this for, especially as the physical exertion for minimal gains continued, while other permanent issues like continence, skin, and neuropathic pain remained.

Challenging Preconceptions and Finding New Role Models

Grace confronted her own preconceptions about disability, realizing she had previously thought disabled people had a lower quality of life. Her life felt smaller until she began following disabled people on social media and connecting with others, like a wheelchair-using doctor in Scotland, who normalized disabled lives and demonstrated that fulfilling careers and lives were possible.

Returning to Medical School

Ten months after her injury, Grace returned to medical school. While excited to reclaim a part of her identity, it was challenging. She felt isolated from her year group and like everyone was moving ahead of her. The sensational nature of her story meant she felt like "a story" rather than an individual, especially to those who only knew her through media reports. She struggled with the attention, exemplified by an incident where she dropped a pen and was too anxious to pick it up, leaving it on the floor until the end of the lecture.

The Patient's Perspective: A Better Doctor

Grace believes her time as a patient has made her a better doctor. She calls it "the best placement I could have had," teaching her invaluable lessons about dignity, autonomy, and the fluidity of care. Concrete takeaways include her commitment to introducing herself, explaining procedures thoroughly, and recognizing the bewilderment patients may feel. Her visible scar also creates an immediate openness and understanding with patients.

Navigating an Inaccessible World

Grace highlights the everyday challenges faced by wheelchair users due to an inaccessible world. Basic issues like the lack of accessible toilets, steps without ramps, and the absence of curb cuts are constant reminders that the world is not designed for them. She finds it frustrating when establishments claim they don't get many disabled people, when the lack of accessibility is the very reason.

Dealing with Misconceptions and Hurtful Comments

The most difficult aspect after her injury was the shift in people's reactions towards her. She recounts instances of strangers making hurtful comments, which she initially felt obliged to endure. This felt like a stranger "spitting on" her world. She has since learned to set boundaries, often deflecting intrusive questions by referring people to her book, hoping to educate them about asking such questions. She shares an empowering anecdote of confronting a drunk man who made a "vroom vroom" comment, leading to his shame and her satisfaction.

The Man Who Jumped

Grace knows very little about the man who jumped. She has intentionally kept her distance, stating there was no anger to begin with, so no forgiveness was needed. She was told he was charged, served two years of a four-year sentence for grievous bodily harm, and was deported. She felt upset by further ramifications, wanting the event to simply stop. She views them as strangers who collided and are now strangers again, the randomness of the event preventing her from feeling anger towards him. She contrasts this with targeted attacks, which would be a different experience to navigate.

Personal Transformation and Relationships

The injury, and the subsequent years of adaptation, have profoundly shaped Grace into a more confident and anchored person. Her relationships with friends and family have deepened, fostering a closeness that might not have existed otherwise. She learned to have difficult conversations about her needs and was more honest in her relationships, strengthening them. Her relationship with her partner has become even closer due to the care he provides.

Kenwood Ladies Pond: A Place of Belonging

Grace finds solace and belonging at the Kenwood Ladies Pond in Hampstead Heath. The pond's accessibility, with a mechanical lift and accessible changing facilities, allows her to cycle there independently, swim, and return on her own. This connection with nature, with herons and birds swimming at eye level, is particularly meaningful as a wheelchair user. It's a safe and supportive place where she feels she truly belongs.

Conclusion

Grace Spence Green's story is a testament to resilience, adaptation, and the transformative power of lived experience. Her journey from a shocking accident to becoming a doctor and disability activist underscores the importance of challenging societal ableism, advocating for accessibility, and finding strength and purpose in the face of adversity. Her perspective as a former patient offers invaluable insights into the healthcare system and the human experience of living with a disability.