Like I need a Hole in the Head Article

© Toby Dunn

Toby Dunn is a talented climber from Newton Abbot. Having moved north and worked his way through the grades on Yorkshire limestone in recent years, an accident last summer on familiar territory changed his life dramatically. Toby has bravely shared his story in the interest of helping others to avoid the same fate.

Please note: This article contains photos of wounds and surgery, which some readers may find disturbing.

In June 2016, my right foot slipped off whilst I was clipping the first bolt of Appetite 7a at Malham Cove in the Yorkshire Dales. This is the story of my experience. You need to read it so that you reduce the chances of anything similar happening to you, to a minimum.

Toby in Costa Blanca, Spain  © Toby Dunn
Toby in Costa Blanca, Spain
© Toby Dunn

The thing that no one tells you about really hurting yourself is how strangely fascinating it is. I’m lying on the ground on the catwalk at Malham with a splintered skull and wrist. I can remember the pain and the fear, but the thing that really sticks is the unique way that colours and shapes ebbed and flowed on the edges of my vision. I could see the worry fretted in my climbing partner’s face, but he was so hard to focus on as he kept dissolving into a polychromatic fractal in front of me.

I think I asked to be moved, as I thought I was being rained on. In reality, I think it was a mixture of a thin evening drizzl, and the steady shower of blood from my head; warm and sticky on my neck, back and shoulders. I desperately needed to empty my bowels, but felt like I couldn’t move or do anything about it. All I wanted was to see my family again; guilt overwhelmed me as I was pretty certain at that moment that I’d never get to speak to them again.

Toby in hospital following his accident
© Toby Dunn

The local rescue team stretchered me off the catwalk down to a flat field below the crag, where I was picked up by the Yorkshire air ambulance and taken to Leeds General Infirmary. I was rushed into theatre for an emergency craniotomy. I had fractured two lobes of my skull, and my right wrist in the fall. I had bled into my head; the operation involves removing a large section of skull to relieve the pressure of the blood on the brain, and bolting the section back in place when the clotted blood has been cleaned out.

I was in hospital for over a week, initially unable to swallow and with what seemed like dozens of lines running into arteries and veins as well as a tube to drain blood from the wound site on the back of my head. Things which might normally seem like a humiliating trauma like having to poo in a bedpan, or having pureed hospital food became, thankfully briefly, the pleasures of life. It was about a week before I was stable enough to go in for another operation to pin my right wrist back together. I walked out of hospital, wobbly as a toddler, clutching a huge bag of medication.

I lived temporarily with my parents again, struggling with the intermittent unpredictable fatigue which affects most people with head injuries for months and sometimes years after the initial injury. After three months, including another brief hospital admission, and intermittent leaks of pus-like goo from my head when I lay down, my head wound still hadn’t healed.

Titanium head plate (my one is under the bandages, this is an example model!)
© Toby Dunn

The bolted-in bone flap (which becomes essentially a foreign body with no blood supply) was rejected by my body, and it was infected. I had another emergency head operation to remove the bone flap, which has left me with a gap in my skull the size of an orange where my brain is covered only with skin and dura (an additional fleshy layer of protection on your head). Six months or so after that, I managed to get yet another operation to place a purpose-made thin titanium plate in the hole. I’m currently back on the rehab routine, praying my body accepts the metal better than the bone.

I’m longing for the time I can wash my hair without being really careful in one area, or can have it cut short without worrying about people asking questions about the big dent. I’ve not climbed outside since June 28th 2016, certainly the longest break I’ve had since I started rock climbing on New Year’s Day 1997. I pine to feel the warm rasp of sunlit stone on the pads of my fingers; but at the moment I can only hope for these things, sit tight and try to get another grisly wound healed first.

I procrastinated for a long time about speaking about this experience, and I can only try to convey the utter gratitude I feel for the friends, hospital staff and family who have given me their advice, help and support. Eventually I posted publicly on social media about this, and was touched by 98% of people’s reactions. Only a couple of comments seemed to me to be deeply unhelpful. I have not reacted to these in any way, and will not. My attitude towards sport climbing is that I am doing it for the difficulty, for the joy in moving over the stone. I’m not advocating endlessly ‘clipstick top roping’, or trying to climb without ever having to run it out at all; just doing enough to stay as safe as the situation allows.

I love traditional climbing, which I’ve always found more deeply fulfilling ultimately, but none of us are always mentally in the right place to push ourselves on adventurous, difficult climbs. Climbers, in my experience, all climb for subtly different reasons, and to my mind, those who sneer at the practice of others do nothing but display their own weakness. I fell off a route eight grades easier than my best effort at the same crag. I had done Appetite at an educated guess more than 200 times, and never fallen off it. Keefe and I had a clipstick at the crag, and I didn’t even think to use it to clip the first bolt.

A helmet would likely have reduced the severity of my head injury, but a broken wrist, and serious concussion still would have been a best case scenario in the same fall.

My advice, whether you want it or not, is to remember that your wife, husband, kids, or parents are somewhere waiting for you. Ask how can you approach any climbing scenario in order to reduce risk to an acceptable minimum for you, and as long as you can do enough, commit and revel in the joy of this activity.

Toby's scarred head
© Toby Dunn

“Only those who will risk going too far can possibly find out how far one can go”. (TS Elliot). Just make sure you get home in one piece afterwards, because however bad a cook you might be, it is not as bad as NHS beef goulash on a pureed diet. However nasty your student shared bathroom, it’s not a bedpan or a nappy-like pad, nor is it having to empty your bowels in your own bed and ringing a buzzer to ask a nurse to clean you up.

If UKC will indulge me briefly, I’d love to thank all at Malham on 28th June last year, the MRT, Yorkshire Air Ambulance, and all staff at Leeds and Plymouth hospitals.

Especially, but not only, Keefe Murphy, Stu and Jules Littlefair, John Dudley, my family, Caedmon and Catherine Mullin, and for every little caring gesture from anyone who’s seen me. The single thing which most sticks with me, though: a nurse called Zoe in Leeds brushed my teeth for me without me even having thought about needing it. Her ordinary, tiny act made a willful, stupid man in his thirties feel human by doing something which could have been a grim humiliation. Zoe will probably never read this, but at that moment she did more good for one stupid selfish man than she will ever know.

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8 May, 2017
Inspiring, thought provoking and brilliantly written Toby. So good to hear you're on the mend. Hope to see you out and about before too long.
8 May, 2017
Thanks for taking the time to write what I'm sure was a difficult piece Toby. Best wishes for a full recovery and I hope you can get your hands on sun warmed rock again sooner rather than later.
8 May, 2017
Totally agree Toby. And coincidentally this happened to a couple of really nice lads who were trying Yosemite Wall yesterday (same start as Appetite). I didn't hear the full conversation, but somebody was criticising their use of a clip-stick. Really stupid, macho nonsense. And potentially putting pressure on others to take risks they don't want to.
8 May, 2017
Wow. Get as well as you can soon, Toby, and thanks for sharing.
8 May, 2017
Brilliant article, best wishes for your recovery. And thanks for writing it.
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