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Knocking on the Door of Rose Cottage - Recovering from a Mountaineering Accident Article

© Chris Shirley

Former Royal Marines Officer Chris Shirley was seriously injured in an accident on the Matterhorn last September. Although his cognitive recovery post-coma surpassed doctors' expectations, Chris remains in an external metal leg frame, which he will have on for a year in total. In this article, Chris describes his ongoing road to recovery.


Surprisingly, writing this doesn't bring back terrible memories – they were wiped clean in the accident.

My pain instead comes from hearing loved one's recount when they were told that I'd die or spend the rest of my days with life-changing injuries. When combined with pained expressions, those words hit me harder than anything else I've ever had to deal with.

Chris in his mountaineering element pre-accident.  © Chris Shirley
Chris in his mountaineering element pre-accident.
© Chris Shirley

After more than a decade in the British military, I was used to a lifestyle that embraces personal risks. I'd survived mortar bombs flying through the air in Baghdad, Iraq or the Taliban suicide attacks in Afghanistan's capital, Kabul. Transitioning to a civilian career was a slow process whereby I learned that I was incompatible with a large corporate building of an international media organisation in central London, choosing instead to freelance for better work-life balance.

In a single 12-month period, I'd usually spend a month mountaineering, visit 3-4 active or post-conflict zones, spend hundreds of hours developing my Brazilian Jiujitsu skills and then many more trail running, open-water swimming or looking for new outdoor experiences. In the months before the injury, I'd completed the Marathon des Sables desert race, and spent a fortnight summitting unclimbed peaks in Kyrgyzstan.

However, in September 2019, my tiptoeing along the tightrope between life and death went the wrong way. After trying to summit the Matterhorn in Italy, I slipped and tumbled a long way down.

When it all goes incredibly wrong

In her book 'Breaking and Mending', Joanna Cannon describes a situation wherein she's a junior doctor on shift in hospital and a porter notifies her about a delivery for 'Rose Cottage'.

Unbeknown to her, Rose Cottage is a metaphor for the morgue and the porter has a deceased patient who needs to be taken there. However, it requires Dr Cannon to complete a death certificate before the delivery can be fulfilled.

After slipping or being hit by rockfall (I'm not entirely sure what happened), I fell 50-60 metres in 5 metre intervals, hitting my head several times until I came to rest: bloodied; unconscious and barely breathing.

The friends that I was climbing with heard rockfall and saw me mid-fall, thankfully calling the rescue helicopter immediately and giving me first aid when it was clear that I wasn't okay. They found me unconscious and I had sustained a number of traumatic injuries all over. Thankfully, my climbing helmet – although battered and littered with cracks – had kept me alive. When I checked it a few weeks after the fall, it was covered in my own blood and looked like it had been hit by a car. Bizarrely, I still choose to keep it as a reminder that one day, my number may come up again.

Based on what my friends told me in the weeks after, the helicopter flew me to an Italian hospital in Aosta – some thirty miles away - whereby a trauma team started to assess and treat me. The paramedics told my friends they didn't think I'd make it to hospital. However, the doctors' prognosis was bad. The MRI scans revealed a large number of challenging injuries: shattered bones and bleeds on the brain.

Chris post-coma in Italy.  © Chris Shirley
Chris post-coma in Italy.
© Chris Shirley

Upon hearing the news, my loved ones immediately flew to Italy to be by my bedside. Whilst my temperature fluctuated as my body fought a fever, Anna-Liisa - my girlfriend - set up communication groups and a social media page to update friends and get information out about my situation.

The Italian doctors, accomplished in dealing with mountain trauma due to their proximity to the mountains, nervously told them that I may die from the fall or spend my days suffering the consequences of a life-changing injury. Frustratingly, it was hard to predict how bad the damage would be until I came out of the coma, which was showing no signs of letting up to my family and devastated partner.

Although the worst-looking physical injury was a lower leg with multiple fractures (I'd badly broken the tibia and fibula and both had been poking through the skin when I came to stop tumbling), I also had severe lesions (blood clots) in different parts of my brain. This was terrible as I could be left in a bad mental place from these – if I woke up at all. The medical staff and my family shared the same perspective: I'd find it hard to make a full recovery from this.

Chris in hospital in Italy.  © Chris Shirley
Chris in hospital in Italy.
© Chris Shirley

Start of the recovery

After eight days, I was finally stable enough to be woken up from the coma – but I wasn't the same person. My head was full of haze, only exacerbating everyone's worst fears.

For the first twenty-four hours, I didn't speak. By the second and third days, I was talking in gibberish - not making any sense and using the wrong words in sentences. But as I started to regain basic cognitive, mental and physical skills, I started to ask what had happened to me and wanted to understand what I'd been through.

Another week later and I was deemed stable enough to be repatriated back to the UK. And so, escorted by an English doctor and nurse – I was loaded into a Beech 99 – an aircraft I knew well from skydiving in my earlier years – and taken to a hospital in East London to continue my recovery.

Weeks passed by and the medical staff monitored my injuries. After two months in hospital, I was ready to be back at home and yearned for my former life. During the weeks of living in a small shared ward in a three metre by three metre box only segregated by curtains, I slowly realised that my life had become something resembling a waking nightmare: frustratingly predictable, almost completely reliant on other people and not physical enough.

And then, complications

The doctors had suspected something was going on when some minor stitches were taken out and the wounds hadn't healed. My shin bone had a long metal rod inserted and bolted into it when I was in the coma and was now starting to affect my leg. The skin wasn't receiving a good blood supply and was starting to show signs of decay, rather than the positive signs that it should've been demonstrating.

This was worrying to the team managing my care, so I was referred to a plastic surgeon (one who deals with skin) and a trauma and orthopaedic surgeon (one who deals with bones) to check out the wound site. Both took a look at the leg and decided another look would be required in a week's time to assess it again. The next appointment was conclusive: that the metal pin holding my tibia together was probably infected and would have to come out and either be replaced with another one or an external frame depending on how it looked under the skin. X-ray would give them a reasonable idea of what was happening, but for certainty – I'd need to go back under general anaesthetic so they could take a look.

An X-ray featuring metalwork.  © Chris Shirley
An X-ray featuring metalwork.
© Chris Shirley

Days later, I went in for my fourth operation and woke up with a large external metal frame fitted to my leg. I looked like some kind of cyborg from a sci-fi film!

The surgeons removed six centimetres of fragmented and infected shin bone to allow my body to heal. Five days later, I'd go back into the operating theatre for my fifth operation under general anaesthetic and the temporary frame would be replaced with a Taylor Spatial Frame (TSF). The TSF was something I instantly recognised from friends in the military who had been blown up by IEDs whilst serving overseas. I recalled one particular friend in the Marines who'd had one on for three years. The thoughts of a long, protracted recovery made me feel sick.

The change of narrative

Thankfully, I'd insured the trip. Normal cognitive function was coming back and with it, concerns about how financially secure I'd be. After a 12-year career in the military, I found the transition into a normal office job in central London too much and so had decided to become a freelance consultant.

However, with my injury - my narrative had changed beyond my control. It was now: 'Chris had a bad injury whilst on a mountain recently and is currently recovering in hospital', which was not helping me feel as though I was moving forward or giving clients reassurance that I could continue to consult for them.

Chris serving in the Royal Marines.  © Chris Shirley
Chris serving in the Royal Marines.
© Chris Shirley

Ownership of my recovery

Watching TV felt like a mini-holiday at first, however I felt that my rapid recovery depended on feeling like I was moving forward – even with small victories.

I didn't need forlorn people visiting me with grapes. I needed tasks to get my teeth into, to feel like I had ownership over my time again. Suddenly, I had many free hours on my hands and no immediate sources of inspiration beyond the hospital's magnolia walls. I knew I had a great team of doctors and nurses looking after me and was lucky to have them, however, I was yearning to feel less like a victim and more in control of my day-to-day life again.

Adopting a routine felt like the best way to get through a sudden, life-changing accident as its stabilising effects enabled me to work through the difficulties.

Becoming a vampire

The fitness industry has a well-used saying: 'If you put rubbish in, you get rubbish out'. After 2 months, I was closely managing my mood and realised I was feeding off other people's positive energy. I'd become selective of who I wanted to hang out with, as I was absorbing their positivity as fuel to keep me going.

Developing the tact of asking people to leave if they are having a negative effect on my mood – especially at difficult times – became a challenge, because I didn't want to let people down. But it's not something you can share with others very easily, as they assume that you're being rude or not coping with the injury very well. So, I learned to keep it to myself, compartmentalise and find excuses as to why I couldn't always talk to them and reschedule for a time when I was feeling in a much lighter mood.

The most difficult visitors are the ones that come and visit you and look forlorn or glum the entire time. In my darkest hours, I had to resist the urge to tell people directly that I needed their warmth instead of them bringing their own hard times to me in the hospital. I still felt emotionally numb after the accident and not my usual upbeat self.

My closest friends were able to become my collective social intelligence when my own started to run out. I'd write my unedited thoughts down and share with a select group who had spare capacity to soften my words and add eloquence. In my history of visiting friends in hospital, this was never something I'd been asked to do, yet I resolved to offer it in the future.

Another hurdle to seemingly positive recovery was people visiting unannounced. While it was nice to have people drop in on me unexpectedly – especially those from quiet corners of my life – visits can start conflicting with each other. Some people will try and visit you whenever they're able to; these visitors are difficult as they arrive according to their schedule and not necessarily at a convenient time for the patient, who wants to give their sole attention to one person or a small group as more can be mentally tiring.

While there is a lot of responsibility on the patient, visitors also need to spot the signs when the patient is getting agitated and wants to be on their own. Remembering that a bedbound person has very little privacy and that they may need to go to the toilet, but might be too embarrassed to say, or to do it in front of visitors – is something that doesn't immediately occur to us. They might be tired and in pain, and want to take some medication and sleep, but feel like they must stay awake for the visitor. Ultimately, as a patient, you don't always want to feel like you're contributing to your loved ones' sadness – as it robs you of your limited morale reserve.

Chris and his external fixation frame.  © Chris Shirley
Chris and his external fixation frame.
© Chris Shirley

The 'down days'

A key tactic I found for helping with the dreaded 'down days' was to warn a list of friends that I'd need help from them in the future, albeit some days with little notice. This may be something small like keeping some chocolate or films you've been given to pick up your mood. I found that friends sending me funny memes was one of the best because it became like a game of who could find the funniest for something occurring in global affairs.

Depending on how regularly you want and like contact, this is something which you can clarify with your support network. Being disciplined with how often you use it is a gentle art which will take time to cultivate.

The dreaded question: 'How are you?'

It seems counter-intuitive, but understand that if your friend or loved one is in hospital, they're probably having a bad day already!

Being constantly asked how I was would often force me into packaging the difficult times into a grammatical sentence structure - meaning I'd partly relive the experience. My high-EQ friends on the other hand, used indirect methods of asking me, which naturally led to me sharing how I was getting on in a more cathartic method. By making conversation about other things which weren't going to constantly demand I recount the details again and again (as they might have done with other visitors that day), the world seemed like a less dark place.

Good quality and pacey conversation not only became a source of energy for me, but also got rid of some of the hard times through osmosis.

I also found that my relationship with social media changed whilst I was recovering: longer, deeper and more-nuanced messages from close friends helped; whilst I barely read (and often ignored) generic ones such as "how are you doing mate?" or "chin up buddy" as they were difficult to know how to respond to without appearing insensitive or ungrateful.

It slowly dawned on me that my mobile phone could've either been my my best friend for connection to the outside world, or my worst enemy for acquaintances asking how I was doing in a seemingly over-simplistic method.

Measuring success

My loved ones found ways to help me ward off a low mood with some simple exercises. Initially, I had no appetite for them at the start, however I eventually found that they were innovative ways of measuring success to ensure I was on an upwards trajectory. When I first started using crutches, my body had burned kilogrammes of muscle and so I'd get tired out early on - progress was measured by how many metres I could get (childishly marked by my hand print on a window).

It was December before I was finally ready to go home. I'd been in hospital for two and half months and was highly-dependent on other people. The trouble with being reliant on others all the time, is that it undermines your self-confidence and makes you feel even more like a victim.

I had to get realistic with my new life; the things that made me happy weren't accessible. Before the accident, when life became too much for me, I'd remedy it with a good, fast trail run, an hour-long Brazilian Jiu Jitsu session or a swim in the sea. But the external frame needed to be kept as clean as possible, so these weren't options available for at least another 12 months.

Despite a ruptured anterior cruciate ligament (ACL) in my mid-twenties, I'd never broken a bone before – let alone spent any more than a few days on crutches. This kind of immobility was a new kind of challenge for me to face; to stay emotionally strong and mentally active when it felt like the injury had become my master.

Now feeling somewhat devoid of a morale reserve, my media consumption habits changed almost overnight. I no longer had appetite for watching sad programmes but only wanted to watch inspiring and positive documentaries. I had to seek people's recommendations for rooting through the junk to get to positivity-rich viewing.

Getting mobile

Recovering from muscle atrophy in the coma and antibiotics had presented a new kind of problem: getting upstairs now required more dynamic strength than I currently had readily available.

With my body still fighting the bone infection, a community nurse would come to my house every day and administer IV antibiotics - leaving me feeling exhausted. Getting up a set of stairs would take all my focus and power, sometimes leaving me out of breath. Some days it hardened my resolve, other days it exacerbated my mental anguish.

On a blustery Saturday morning in December almost 3 months after the accident, I set myself the goal of getting to my favourite café for my first cooked breakfast in a quarter of a year! A task requiring me to self-propel four hundred metres of uneven pavement in my wheelchair and then crossing the road on crutches, made even harder by inconsistent gusty wind and rain to quickly chill me. But having something seemingly difficult gave me passion. I grabbed it with both hands and refused to let it beat me.

Chris taking part in the Marathon des Sables.  © Chris Shirley
Chris taking part in the Marathon des Sables.
© Chris Shirley

Negotiating the uneven London streets became a new challenge, and one that I didn't want to let get the better of me. Despite the street rising and dropping for a few metres and using the crutches to cross a road, I put all my energy and focus into it, which at times manifested in me focusing my frustration on the very thing that was helping me regain my independence: the wheelchair.

One of the front wheels had become bent and this meant that steering was much more difficult. However, it would allow me to focus my frustration and personalise the pain I was going through into something that I could seemingly control.

Holidays

Christmas came and went in the same way it does every year: stress; family, friends, mince pies, stress, but no alcohol this time.

It had now been four months since the accident, and I'd been out of hospital for a few weeks. Christmas would usually be spent driving hundreds of miles north to see my family, however, I wasn't ready to struggle with the rail service. The effort it would take to get across London from the south coast (itself already experiencing difficulties from flooding) and then many more hours on the trains just seemed beyond me at this stage – so my Anna-Liisa and I settled for a relaxed one at home watching Netflix and drinking too much tea. The feeling of letting people down stayed with me for days afterwards despite being reassured that I wasn't.

Physical reminders and life changes

It's not just the broken leg and fractured skull that would remind me of the fall: my left ear would take months before it was back to normal hearing. The heel of my hands tingle as though I've got some kind of cold injury, and then, bizzarely, I'd also get hiccups after every meal - apparently from where the oxygen tube was fed down my throat whilst I was in a coma.

Far more irritating was my sense of smell still not coming back. Phantom feelings of smell would pass through me inconsistently, leading me to suspect my brain was engaged in some kind of internal rewiring - almost like someone was working in my head to remind me how the sense works!

Understanding that I couldn't really move anywhere fast yet was a challenge. It would take me an hour to get out of bed, get washed, dressed, negotiate the stairs and make breakfast before I was ready to start working.

To compensate for the time it'd take me to get breakfast, I'd resorted to keeping snacks in my room. The coma had stripped sixteen kilograms of fat and muscle off me, so to remedy it I'd snack on crisps, chocolate and nuts. Meaning that it wasn't long before I started to generate excessive belly fat.

After a few days of being at home, I realise that I can't move hot drinks without spilling them and find myself wearing half of it. I scour my outdoor gear and find an insulated mug and a bum bag to help me move hot things back into my living room where I can lay out horizontally and drink them. It's a silly look; however, if it's making life slightly more manageable for the next ten months, I don't really care.

Long nights awake

Some days, the 'contraption' (the external frame on my lower leg) aches all day and worse at night.

It wakes me up every few hours when I inevitably roll onto it. I don't believe in taking pain killers so generally wait until it's keeping me awake for long periods before I take a paracetamol. Or when it's really bad, a codeine tablet. Other days, it just aches intermittently. I joke with friends that it feels like I'm babysitting an irritating pet some days – but I think they see that my joking covers up genuine frustration.

As expected, it's made me nervous about going to sleep in case I end up lying awake for hours – so I find more work to do or distractions to keep me awake. I spent years growing up in the creative sector before joining the military, so I redevelop my love for art and design. I also start to indulge a nascent interest in medicine by reading A-level biology and chemistry textbooks.

When your leg becomes three times its normal width overnight, it's inevitable that you're going to bump it from time to time. Each time I do, I'm swiftly reminded that it's connected to my shin bone via fourteen steel rods. Each knock sends vibrations through my skeleton, making me shudder and curse myself. After a month of wearing it, I'd assumed that I'd be more careful with it – but each knock confirms that's not the case.

Chris abseiling in the Alps pre-accident.  © Chris Shirley
Chris abseiling in the Alps pre-accident.
© Chris Shirley

Getting back on the horse

My housemates, friends and girlfriend cook for me until I figure out how best to use the supermarket's home delivery service and not tire myself out standing around in the kitchen. When they're not around to cook for me, I make frozen pre-cooked or dehydrated meals mixed with humus and pesto sauce to sustain me when I can't stand up for long enough to cook anything healthy.

But sadly, it's not always good as easy to live with the frame attached to me for so long. Even after I've left hospital, my career as a media consultant has not picked up and has slowly died a death. I presume it's because my clients need someone who can travel overseas, which I'm not able to do yet as my mobility hasn't come back and deep vein thrombosis from a flight could be a threat to me. As my lifestyle and choice of profession is clearly going to be affected by the injury, I have to change my habits to save money as the timeframe for recovery isn't clear.

Epilogue

I often get asked if this is the end of my mountaineering exploits.

In truth, I don't know. The sight of my loved ones' pained expressions is burned deep into my conscious mind by guilt. Finding the form and the voice to tell people that I so lust to get back into 'the arena' and duel with those lumps of rock and ice, puts me in a difficult predicament. I want to see the beauty of high peaks with my own eyes, experience the thrill of the summit and the complexity of the challenge so that I still feel like I'm alive and not just simply breathing.

But if I do, will I become just another waiting delivery for Rose Cottage?



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Chris, I wish you all the best for your recovery, I am sure you will get back to an active life, you are young and have a positive attitude . Although my accident was nowhere near as bad as yours maybe I can offer you some hope regarding your leg.

I had a climbing accident in May 2018 and suffered a compound open fracture of the tibia and fibula and also the talus. I had a Taylor Spatial Frame fitted (and a large section of fibula removed) and at the time the doctor said forget about ever running or climbing again. My recovery went quicker than expected and I was only in the frame for 6 months, followed by a cast then crutches. I was climbing within 12 months( the difficult bit was trying to walk to the crag). Now even 2 years on I continue to see further improvement. I'm back to the same strength as before but not the same grade on trad, and I can complete at 10 mile run.

I pushed my recovery as hard as I could, sometimes too hard. One thing that helped early on was swimming. I had a dry suit material cover custom made to fit over my frame and seal on my thigh so I could swim several times a week, it was a physicological life saver. Let me know if you want any details.

30 Apr
Hi Chris, I hope your recovery continues.

I too had a nasty lower limb fracture and an external fixator for a year afterwards after a climbing accident. It did at times look like I’d be lucky to keep the leg let alone walk. In the end, I made a partial recovery and never returned to climbing. I still very much enjoy the hills and they remain a big and satisfying part of my life but as a walker and cyclist, I’ve accepted the change in circumstances finally and not climbing was a small price to pay if it meant my family and loved ones no longer had to worry. There’s singleminded ambition to succeed and then there’s selfishness, try and decide where you want to be on that spectrum. There are other ways to enjoy mountains and still feel fulfilled.

Best wishes for the future.

30 Apr

Chris, that is a great primer on how to behave as a visitor to someone who is not in the best of shape. Being all maudlin and glum is no help at all. Neither is dwelling on the cause/past (although entertaining past events are fair game).

Great article and very thought provoking.

30 Apr

That's quite a read. What was worth taking from it is how to treat friends with life changing things that happen. We've got a mate with MS, the worst kind that's gradually shutting him down and it's very hard to know what to say and when to push. The article did give an excellent insight into the headspace we perhaps need to understand, thanks for posting.

30 Apr

Hi Chris, sounds like you've been through the mill there and I'm sure you've been given lots of "advice" by lots of people. Everyone is different, everyone responds differently and every injury is different so no one can get inside your head and your recovery but I thought I'd share a few things from my own.

I had a serious accident in the Himalaya in 1992. Some Swiss climbers made a film about it and the mountain that was shown at the KMF in 2016 and you can watch it here: https://www.dropbox.com/s/0isgb2y1tfuukgi/Tupendeo_EN_H264.mp4?dl=0. A lot of people seem to have found the story and message uplifting and positive so may be you will too. It's meant to be upbeat....

A rockfall removed the front of my leg and severed my tib and fib halfway between my knee and ankle. It took just under a week to get my off the mountain and to a hospital in Jammu by which time I had pretty bad gangrene, frostbite and blood poisoning. It was all a bit touch and go. I spent 4 years on crutches. That's 4 years not able to walk. I had nine operations, an ex-fix, infection in the bone and so on. I was at Headley Court for a while which I'm sure you know. The docs told me I'd be doing well if I was able to walk to the shops and back. My leg is 2 cm shorter, my ankle partially fused and have frostbite damage all over the foot. They were not overly optimistic. I can remember seeing the last orthopeadic consultant who treated me and the first thing he said was "hmm, well that's a pretty nasty fracture" with several intakes of breath. Not exactly encouraging. There's a short article about the accident and my recovery here https://www.theguardian.com/lifeandstyle/2007/jul/07/familyandrelationships.features.

That was a long time ago but I can remember all of it. Four months is really nothing in a lifetime and its not long in terms of recovery. The body is an amazing thing and so is the mind. Sure you have to work within the limits of your injuries but you'd be surprised at how wide those limits can be. It took me years to gain strength in my leg again but after about 5 years I was walking well on it and gradually, ever so gradually I was able to do more and more. You have to be patient and that was not always so easy. I don't think it's easy for anyone when you're used to being active, fit and healthy. I used to be a keen distance runner.

Cycling really helped because it's non-load bearing and got the circulation going in the lower leg and helped regain some muscle. It really was a long game though. Ten years after my accident I won a half marathon in Somerset. That's ten years later, after a few set backs for sure, but really it was beyond my expectation and that of all the consultants. That was back in 2002.

There are things I still can't do but there is so much that I can, but never thought I would. I did climb again although the love affair was not quite what it was. I switched to other ways of enjoying and exploring the mountains. Last year I ran the TransAlpineRun which was a 270 km race across the Eastern Alps. Fantastic in its own way. So be patient, be positive, don't get down about short term set backs, know that time really does heal and that a positive mindset will make so much difference to the healing, the recovery and outlook. I hope it works out for you. Jonathan

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