Maximizing Your Minimums (My philosophy about life).
Thirty years ago, I stood poised on the brink of my youth’s greatest dream: swimming in the Olympic Games. Getting to that point took years of training, focus, and dedication, and no small amount of stubbornness. At times it also demanded payment in the forms of pain, exhaustion, disappointment, and in the end, the loss of my dream. In 1980 as my teammates and I worked toward what we believed to be our destiny, President Carter made the decision to boycott the Olympic Games. Devastated, I then turned all that I had learned about achieving goals to my chosen career: medicine.
Fast forward 25 years. Living with my family in Austin, Texas, I was busy opening a new office for my thriving orthopedic practice and helping to found a new hospital. Life was good. Not without its struggles of course, but all in all, good. Then, on September 25th, 2005, l truly learned what it meant to have everything change in the blink of an eye. I made one decision that day— to go for my usual Sunday bike ride — that ultimately altered the course of my life and forced upon me a journey of personal transformation.
It was an ordinary decision made under not-so-ordinary circumstances. The thermometer was grasping for the 107-degree mark and the air was cloaked in a thick blanket of humidity. I remember clearly the voice in my head that said, “Not a good day to ride. Let it go.” But I couldn’t that compulsive streak overpowering reason once again. Dehydration hit fast and hard. By halfway through the ride, I was out of water with my mind as thick as the air and my body fighting the need to shut down. At the base of a hill, I glanced up and noticed briefly an SUV parked on the side of the highway near the crest. In what seemed the next instant, l was plowing into the back of the SUV, flying through the air and then landing, stripped of the ability to brace myself, on the hot sheet of road. All I could feel was my face burning against the asphalt; all I could move were my eyes. I have no idea how long I had lain there, facing the shoulder, helpless to the traffic speeding by behind me, waiting to be found. It felt like hours. My mind raced, trying as a physician to assess my condition, and trying as a man to fend off voices of panic, terror, and shame. I prayed and bargained with God. If I survived, I promised I’d do my best to make the very most of the rest of my life.
Like an answer to my prayer, the first two people on the scene of the accident were physicians, one the head of the emergency department at a local hospital. He knew what to do before the paramedics got there, how to assess me, and how to instruct the paramedics upon their arrival. After being transported to Breckenridge Hospital in Austin, I went through all the typical protocols: MRI, CT scan, drug injections, and physical assessments. For nearly two decades, I had been an orthopedic surgeon. On that day, I became the patient. Ultimately, my diagnosis was called incomplete quadriplegia, which basically meant that with surgery and physical therapy I may regain some movement and might even be able to walk again, but most likely only with the help of a walker or other aid. After two days of being on heavy drugs, steroids, and a ventilator, I was wheeled into surgery. There, bones and ligaments were taken from vertebrae in my neck, a hollow tube filled with bone was inserted, a plate and screws were put in place for stabilization, and bone from my hip was used to fuse the vertebrae together. All in all, it was a horrendous, violent surgery, for which no guarantees could be provided to me by my surgeons.
In the days following surgery, l was poked, prodded, and tested for signs of sensation. Within two days, my right arm showed slight improvement. There was no strength or motor control, but there was movement and, well, that was something. Little by little I gained small measures and soon began physical therapy. I don’t recall much from that early period because I was on so much medication, but one thing I do remember clearly is hearing the physicians, my wife Beth, and my best friend Kevin discussing the fact that I would never perform surgery again.
They say physicians make the worst patients, and though I’d love to differ, I can’t. From the start I did everything possible to direct the course of my own treatment. When, one week after surgery, plans were made to move me from the hospital to a rehabilitation center, I refused to go. Instead, I went home, deciding to take everything I had learned from years as an athlete and medical expert and applied it to my situation. A hospital bed was installed in my family’s exercise room. Physical therapists from my office came to the house to work with me, and in time I went to them. Robin, my lead therapist, was a blessing. She knew me well and worked me hard and got the distinct honor of being privy to some of my most difficult moments, including the day I broke down crying when I couldn’t lift the lightest of weights.
Though physical therapy was a key element of my rehabilitation, I knew in my heart that true recovery would require something more. The day after moving home, Beth drove me to the office of Debbie Tindle, a local occupational therapist referred to me by Dr. Charlotte Smith, head of rehabilitation for Seton Healthcare Networks in Texas. Debbie had years of experience working in pain management, first in the world of corporate healthcare and then in her own practice. Charlotte had told her of my case, and Debbie was planning to work with me when I got out of the rehabilitation center (the one I refused to go to), so she was no less than shocked when she found me standing with my walker (or something approximate to standing) in her front office. Two days later we got to work.
Debbie is no ordinary therapist. Her primary modalities — craniosacral and myofascial release therapy— are more often seen on spa menus than medical prescription forms. Considered “alternative” or “complementary” by most of conventional medicine, I was wholly unfamiliar with this type of work.
Honestly, before I found myself lying on her table at the mercy of her hands I would have called what she did “woo-woo.” But I was, at that moment, willing to try anything and everything to recover. Very quickly it became apparent that these therapies would be absolutely integral to my recovery. For the next approximately six months, I worked four to six hours a day, combining physical therapy and Debbie’s modalities. Debbie’s goal was to get my fascial and energy systems to release and begin flowing smoothly again. The fascial system is a web of fibrous tissue that interconnects all structures of the body. When healthy, the fascia is supple, allowing the body to move and bend fluidly, but when damaged, it can become rigid and tense, inhibiting movement. In Debbie’s words, my fascia began “shrink-wrapping” upon impact with the SUV and was going to continue doing so unless she got in the way and stopped the process. Though I have learned that myofascial release is considered by many a form of massage, there was nothing relaxing about the work we did in those sessions. It was excruciatingly painful. Debbie had to literally wrestle my body out of spastic postures, her strength and ability to do so was astounding.
Craniosacral therapy, on the other hand, was in many ways the exact opposite. Energetic rather than physical, it required subtle placement of the hands on various parts of my body, especially the base of my skull. It is much more difficult to explain craniosacral work, but I can tell you I could feel its effects.
The moment Debbie’s hands would slip under my head and find particular points on my skull, my entire body would relax. Her goal, as she explained it, was to activate and strengthen my parasympathetic nervous system — which controls the functions associated with rest and repose — to counterbalance the chaos of my sympathetic nervous system, which was firing with a mind of its own.
According to Debbie, I absorbed an exorbitant amount of energy during the accident and most of it was still locked in my neck and head; she could actually feel it. Her job was to simply allow the energy to release, so my nervous system could begin finding its own balance.
Besides physical and occupational therapy, invaluable aspects of my recovery process were the incredible support of family, friends, and community, and I dare say my own nature. Perseverance, focus, and singularity of mind proved crucial. I had learned and honed these traits as a competitive swimmer 25 years before; along with another fundamental concept I now call “maximizing my minimums.”
At the time of the accident, I had a lot of minimums, or what might be commonly referred to as “weaknesses.” I had little to no muscle control, took over two hours to dress myself, and more than likely had lost my livelihood, not to mention my sense of selfhood. It would have been more than easy to give up, to let my “minimums” consume me, body and mind, and resign myself to a life lived within narrow walls built by self-pity, remorse, and rigid thinking. There were days when I seriously contemplated doing just that, but the competitor in me wouldn’t allow it. Instead, it demanded that I take all I knew of my strengths and put them to use, and even more importantly to take my weaknesses and find ways to lift them up—to maximize my minimums. Only then would I have even the slightest chance of standing once more at the brink of any dreams.
My recovery process was long, intense, and exhausting. At the end of every day, I felt wrung out and pushed to the limit, physically, emotionally, and spiritually. But in the end, it was worth every tear and drop of sweat. Within one year from my accident I donned scrubs, walked into the operating room, took up scalpel, and began again.
Today, I maintain a full surgery schedule and am able to use my hands with great precision and dexterity. I walk on my own, though I do have a slight limp and when tired, a foot that drags. Those who see me and don’t know about the accident might notice the limp, but many don’t. I do experience pain and have difficulty regulating body temperature at times, but have no remaining deficits that severely limit my activities. I swim and bike and in the summer of 2010, to commemorate the five-year anniversary of my accident, I completed my first sprint triathlon. Though I broke no records, I did finish (and in swimming was the 8th fastest out of 56 in my age group, which I felt pretty darn good about).
As I’ve said, significant credit for my recovery goes to my incredible therapists, physicians, and personal support systems, as well as to specific medical interventions and certain states of mind. Beyond all of these, however, still floats a very large question mark: one I live with everyday. With these various elements taken into account, I cannot answer with certainty why or how I recovered as fully as I did. “Why me?” It buzzes through my head all the time. I don’t really know the answer. But what matters is that if such a thing can happen to and for me, it’s a possibility available to anyone. I’m not “special” in some extraordinary sort of way, any more than any of us is special and unique. l have had gifts that I’ve used in this life, hopefully in ways that have helped others, but I have also made many mistakes. I’m not perfect; I’m not chosen. I’m a man who had an unfortunate accident and experienced an extraordinary recovery. My greatest lesson to share is one of hope and faith, about the inherent power of possibility, and the importance of breaking down the walls of limitations set by our thinking. it is that simple question, “Why me?” that catalyzed the path that ultimately led to this workbook.
We hope you enjoy our thoughts and discoveries, and even more so, that you find in it kindling for your own journey toward maximizing your minimums and reaching your utmost potential.
For more information, and the full workbook please read, Maximize Your Minimums: A Workbook For Reaching Your Utmost Potential.
Authors: Scott Spann, MD, Joanna Cain BSN, RN and Tracy Carreon.