Alan Madras – Our story is not all doom and gloom
Submitted by Ruth Howard
My husband, Alan Madras, was in a near-fatal accident on April 24, 2010. In so many regards, I am more familiar with his situation/case than Alan is, which is why he has asked me to write this on his behalf.
Alan was a pedestrian when, in a freak accident, he fell and the rear wheels of a truck drove over his midsection, missing his liver by less than an eighth of an inch and resulting in near-fatal multiple complex injuries, which included, but are not restricted to: a crushed pelvis, fourth degree friction burns (which destroyed his right gluteus maximus), a ruptured bladder, a severed urethra and traumatic brain damage. In total, Alan suffered 26 distinct injuries. Within two years, his condition was designated Catastrophic.
The severity of Alan’s trauma was such that he received 46 pints of blood within the first few hours that he was in Emerg, and several more in the following days. (Thank heavens for blood donors!)
It goes without saying that very, very special thanks are reserved for the entire Emergency staff at Hamilton Health Sciences for not giving up on Alan, not even when they came within a hair’s breadth of losing him several times the first night; and to the ICU staff, who worked tirelessly in keeping Alan as comfortable as possible. You saved Alan’s life. And in doing so, mine, too.
Alan’s medical care (including more than a dozen surgeries) and a whole host of therapies are legion. Endless thanks to orthopaedic surgeon Dr. Desmond Kwok and his team at Hamilton Health Sciences, who skillfully and creatively reassembled Alan’s crushed pelvis; to plastic surgeon Dr. Shar Shahrokhi at Sunnybrook’s Burn Unit, to whom Alan owes the healing of his grafts (which covered 30% of his body) and the relief of his debilitating pain that had been unabated; and to urologist Dr. Ron Kodama and team at Sunnybrook, whose expertise, Alan and I believe, is unparalleled. And to physiatrist Dr. Harpreet Sangha at TRI-MSK (Toronto Rehabilitation Institute-Muscular Skeletal), who continues to oversee Alan’s overall care, and without whose ongoing support, Alan would be lost.
Today, his daily schedule includes private therapies of one sort and another from a variety of health modalities in various healthcare settings. But ~ spoiler alert ~ our story is not all doom and gloom. It is because of all the wonderful people with whom we have come in contact over the past six years that our story has a much more uplifting outcome than one would have ever dared expect or even hope for.
It was while Alan was in an induced coma in ICU and while we (the medical team and I) faced the very real possibility that he might not survive that I was only surreptitiously given the name of the Thomson Rogers Law Firm by a hospital staff member who had observed their dealings with other patients over the years. (Sharing the names of outside professionals is contrary to hospital policy.) As I had had many past, unfortunate experiences with law firms in other matters, I was exceptionally cautious about whom I was going to hire when it came to getting the best possible insurance settlement for Alan’s future needs, should he survive. (It gives me the shivers to even think about this horrible time.)
I interviewed several different fine lawyers from several different law firms, but it did not take me more than a few minutes to realize that Len Kunka and his colleague Mike Holden would be those in whom I would put my trust and confidence. From the first day, they treated me with respect and dignity. Their concern for Alan’s health was obvious. Their professionalism, knowledge and expertise were immediately evident. As important as those qualifications are, it was their compassion that struck me. Anybody, almost anybody, can have paper qualifications and experience, though not necessarily to the high standards of the legal team at Thomson Rogers ~ the enormous and most important difference, though, is the human side of Len and Mike. They are fine lawyers and fine people, too.
Dealing with insurance companies is traumatic. In my experience, generally, they do not have a heart. They do not come across as being there for you. First and foremost, if it weren’t for Len and Mike, there is no doubt that in short order I, as Alan’s caregiver, would have fallen apart, which would have had a serious, negative impact on Alan’s recovery. He totally depended on me. Len and Mike were always there for us. Because of the severity of Alan’s physical and mental injuries, it was I on whom the preponderance of legal dealings fell. No matter how often I contacted Len or Mike with comments and questions, they always responded expeditiously and always did their best to relieve my anxieties about Alan’s well-being and the trajectory of his legal case.
Over the years, as Alan’s cognitive abilities improved, he was somewhat more involved in his insurance case; subsequently, he was equally impressed with Len and Mike. It was comforting knowing that of all our concerns about Alan and his possible health outcomes, the pending insurance matters were the purview of Thomson Rogers. They were competently navigating the unknown for Alan (and me). The stress reduction was a huge part of my being able to provide 24-hour care for Alan, for several years. And a huge relief for Alan, whose accident resulted in his being anxious and depressed.
As for whom Alan and I credit with his remarkable journey ~ ﬁrst, his survival was in question; then he suffered almost unimaginable skin infections; next, he faced the possibility of amputation; eventually, he was told he might never walk again; and so on and so on and so on ~ well, through the grace of the many, many superb health providers he met, starting with those in Hamilton Health Sciences Emerg, he deﬁed the odds and despite his severe injuries and despite the recurrence of limb and life-threatening skin infections while he was hospitalized and despite his tremendously dangerous weight-loss (he was nearing 100 pounds, a loss of 65 pounds) and despite his diminished executive functioning, he has come such a long way that to this day, his contingent of medical support continue to refer to him as a “miracle”.
I spent at least ten to twelve hours a day with Alan every single day for the entire seven months of his hospitalization, both advocating on his behalf and providing hands-on care. I am witness to the superior quality of Ontario’s spectacular healthcare providers, to whom I give my utmost admiration. I would be remiss in not pointing out the important role that our knowing that OHIP was behind us right from the start of this story played. What a HUGE relief it was not having to worry about the mind-boggling expense of Alan’s in-hospital care and well beyond! How fortunate we are in this province!
Alan spent a total of 12 weeks in two different hospitals before arriving at TRI Hillcrest, at Bathurst and Davenport. (TRI is now part of UNH and is located in state-of-the-art new facilities on University Avenue). The ﬁrst hospital, the one where his life was saved by a team of amazing surgeons, nurses and support workers was Hamilton Health Sciences. When, after ﬁve weeks and multiple surgeries, Alan left ICU, he was transferred to the Burn Unit in the same hospital. Still sporting an external ﬁxator and a super-pubic catheter, immobile, conﬁned to bed and in need of intensive wound care and further surgeries, he was repatriated to Sunnybrook Hospital and later on, in a similar condition (minus the NG), he was transferred to TRI, where he spent four months as an inpatient, followed by a year as an outpatient. Throughout, Alan had to visit different surgeons and clinics at several different hospitals.
The “miracle” of it all, apart from Alan’s courage, determination and compliance, is all those who made the journey considerably easier than it might have been. I’ve already extolled, in all sincerity, our delight in Len and Mike. However, I haven’t mentioned their excellent team of contacts and resources. Knowing that they’d be there for Alan at least as long as his case continued, was such a relief to both of us.
Above and beyond the professionals, who else supported us throughout and over the long haul? Family and friends. I’d certainly put Alan’s brother Neal at the top of the list, and their mom, Sylvia.
Sylvia, elderly as she is, and as reluctant as she had been to leave her home for any reason when no other transportation was available, gathered her inner strength and took public transport all the way from North York to Hamilton. Thank you, dear Diane, for all the times you brought Sylvia., on your way from Aurora. And thank you for your laughter. Our devoted friend Gil held my hand every step of the way, acting as my designated “communication ofﬁcer”. Having understanding family and friends visit Alan when he was up to company was welcome. (Sometimes, it was I alone whom they ended up visiting.) All those who responded with encouragement to my twelve months of nightly email updates lightened our burden. Cards, email, photos, visits. Such support and contact with the outside world were vital for Alan. (As for me, how amazing it was to ﬁnd a hamper of pre-packed meals, prepared by my niece Jordan, waiting for me on my front porch on my arrival home from the hospital in the middle of the night!) And there were so many more people outside of the health system who were godsends.
But ﬁrst . . . the names of all the health providers who made life easier are far too long to list here. All the nurses at the various institutions who took hours to dress Alan’s wounds twice a day for months are tops!A special “thank” you goes to wound specialist and nurse Lourine Smith at TRI, who went out of her way to formally increase her knowledge speciﬁcally in order to help control Alan’s skin infections when they suddenly and uncontrollably ﬂared up. And a special thank you to nurse Beverly at TRI, who Alan and I think had the worst of all worst jobs. We don’t know how you did what you did, Beverly, but we’re sure glad that you did. A super loud shout-out goes to the night nurses, who ~ mostly unseen by the public at large ~ never get credit for their awesome work. I know about them only because insomniac Alan was so impressed by their kindness and patience.
I give my heartfelt recognition to the team of three nurses at Sunnybrook who followed a surgeon’s orders to debride and cleanse Alan’s injured skin by submerging him in a bathing “table” and“scrubbing” him. I know that everyone involved was traumatized by the horriﬁc ordeal. I am so sorry for what you were put through. I can’t help crying when I think about this particular, gut-wrenching incident. Your caring touched my soul.
What else helped Alan and me through those difficult times? That would be the generous visiting hours at the various institutions, the respect given by so many of the staff (my being kept apprised of developments and not being talked down to ~ my being treated as integral to Alan’s recovery), the knowledge that we had a dedicated team of health care providers, the fact that we had a reliable, responsive legal team. . . and access to all of the following people, each of whom gave Alan their undivided attention and met his special needs (some, even after his homecoming), listed here in no particular order because each and everyone is equally responsible for Alan’s survival and his many successes: all the kind, caring and competent doctors and nurses and physio and occupational therapists in Ontario’s ﬁrst-rate hospitals and institutions, the kitchen workers (who worked diligently to fatten up Alan), the cleaners and porters (you have no idea how observant they are and how willing they are to cheer on the patient and his family), the ambulance drivers (a huge thank you to the guys who ever so sweetly gave Alan a few extra moments in the sunshine in the parking lot before wheeling him into Sunnybrook for the ﬁrst time), the receptionists (who always took the time to enquire about both Alan and me), the different drivers (a compassionate and optimistic bunch!) at Dignity Transportation, TTC’s Wheel-Trans (such pleasant drivers), the maintenance people (who did their best to keep Alan’s special pressure relieving mattresses pumped up) . . . here’s to all of you . . .
Thank you to Chaplain Claire at HHS, whose patience, gentleness and support are exemplary; to a very special social worker, Gabriele, also at HHS, who spent time doing relaxation exercises with Alan when he was in the Burn Unit; to fab OT Kristina Ellis, psychologist Dr. Loren Bush and speech/language pathologist Michelle Cohen (the preceding three directed to us by Len and Mike). And thank you to Recovery Garment’s Roberta Harris (what amazing success with scar reduction!), dietician Alexandra Anca, LifeMark Physiotherapy Clinic, Satori Wellness Clinic, kinesiologist Manesha Khazanchi (whom we ﬁrst met at TRI), therapist Susan Wood (whose innovative suggestions helped to decrease Alan’s PTSD) and to to respirologist Dr. Clodagh Ryan at Toronto General Hospital (who continues to help Alan control his ongoing sleep problems). And thank you so much to osteopath/acupuncturist Justine Vo, who, bearing (healthy) goodies, frequently made the trek back and forth from Oakville to our home to treat Alan. And the list goes on . . . The interns, the student nurses, the volunteers . . .
Not to be forgotten are the myriad of other specialists at Mount Sinai Hospital, London’s St. Joseph’s Health Center, North York General Hospital, Hamilton Health Sciences, Sunnybrook Hospital, TRI, Holland Orthopaedic Centre, Toronto General Hospital, Toronto Western Hospital ~ whew! that’s some list! ~ all of whom have had a hand in putting Alan back together again. Grace under ﬁre. Alan and I owe all of you our eternal gratitude for your skill and dedication.
Credit is deﬁnitely due to those “ordinary” ~ we prefer to think of them as “extraordinary” ~ godsends whose thoughtfulness went a long way to brightening our darkest days: hairdresser Evana, who, despite her dread of VRE, came to Toronto all the way from Richmond Hill to give Alan a four month-overdue shave and a haircut while he was bedridden at TRI; Michael at Sun Milk & Variety who always kept a generous supply of black cherry jelly powder on hand for me to disguise the hospital-issued protein powder that Alan otherwise rejected; Angelo, our mail deliverer at the time, who surprised me one morning by his having planted a garden for us in the dark of night; the woman (sorry, I can’t spell her Chinese name) at the local fruit store who put aside the best mangoes for me to pick up for Alan on my daily hike to TRI Hillcrest; Ray who lovingly volunteers so much time to the Health Recovery class at Fung Loy Kok Taoist Tai Chi (a registered charity) on Bathurst Street; our fabulous tenant, Drew, who willingly took on responsibilities to help us get through . . . All of you are part of Alan’s recovery team!
Once he was aware enough to have hopes, any hopes, Alan’s prime goal was to walk again, using just a single cane. I had my doubts. (Of course, I humoured him.) Physiotherapists Chris and Rhonda and OTs Joanne and Nancy ~ I watched you while you were hard at work with Alan, when he was “living” at TR Iand then when he came to you as an outpatient.
Disbelieving, I watched as you ﬁrst slid his then useless legs back and forth over plastic garbage bags while he was still ﬂat on his back where he had lain immobile for months. Eventually, you had him sitting ~initially, torture for him (and torture to witness) ~ then, achingly slow step by achingly slow step, little by little, you had him using a high walker, then a Zimmer frame, then two canes . . . and now, ONE cane!
While our reality can never be the same as it was prior to Alan’s accident, we are so thankful for all those whose combined efforts saved his life and then rebuilt it. Though not every person who assisted in Alan’s recovery and general well-being is named here, please know that I do remember each and every one of you. “Thank you” hardly seems sufﬁcient. Alan and I are blessed to have been surrounded by angels when we needed you so desperately. We are privileged and honoured to have met you, despite the circumstances.
A ﬁnal thank you goes to Steff, a then stranger who happened on the scene of Alan’s accident. After making sure that onlookers kept their distance, Steff sat on the road where Alan had been left, ostensibly dying, holding his head in his lap, comforting him and encouraging him not to fall asleep while waiting for the ambulance.
This is one story that could have had a dreadful ending, but we are, indeed, blessed.