A Will of Iron

CYCLIST CRITICALLY INJURED AFTER COLLISION WITH GARBAGE TRUCK AT YONGE AND GERRARDToronto Star, Nov. 13, 2012

Margaret's legs are pumping in the cool air of the November morning as she cycles west on Gerrard Street in Downtown Toronto. She is on her way to meet her manager for their weekly meeting, short blocks away. The din of rush hour traffic in her ears, Margaret is heading through the Yonge Street intersection. She sees a garbage truck and realizes it’s turning into her path. She scrambles, trying to get out of the way.

With no where to go, no time to respond, Margaret is knocked down as the truck turns north. Then – complete unreality – she braces herself as she goes under the double back wheels once and then a second time. Oblivious, the truck continues. Now Margaret is in searing, all-encompassing pain, lying immobile on the road. But still clear-headed, with thoughts piling up in her head: “Don’t let me be paralyzed; why do they keep asking the same questions over and over; I’m too tired to talk; I want to shut my eyes but they won’t let me; and, my brand new jeans are wrecked.”

Margaret Harvey is rushed to St. Michael’s by ambulance. Orthopedic trauma surgeon Dr. Aaron Nauth receives an urgent page to come to the hospital: a severe trauma case requires his care. Margaret, 38, and the mother of two young children ages four and six, has an open-book pelvic fracture – the sturdy pelvic ring that protects her organs has been crushed open by the weight of the truck – but her bicycle frame has saved her from immediate death. Now she is suffering massive internal bleeding.

In the Emergency Department, Margaret feels compelled to put her affairs in order: she insists on calling her husband and her boss.

Dr. Nauth tells her husband, “I’m sorry to say Margaret has a 30% chance of survival: I have never seen a pelvic fracture that severe.”

“With new facilities made possible by Inspire 2018, St. Michael’s will become the premier critical care hospital in Canada. The new Slaight Family Emergency Department will be twice as large as our current space, with an expanded, state-of-the-art Trauma Suite with three modernized trauma bays rather than the current two – to save even more lives. With the new Peter Gilgan Patient Care Tower, we’ll open new hybrid operating rooms to offer the most precise surgeries possible, and new leading-edge intensive care units with all single-rooms for more privacy and better infection control. We have amazing people, and these new facilities will give us the tools to offer even better outcomes to trauma patients.”
— Dr. Andrew Baker, Chief, Department of Critical Care, St. Michael’s Hospital

Dr. Nauth and his team go rapidly to work putting Margaret back together. They use three internal screws and an external fixator to stabilize her pelvis and stop the internal bleeding that is threatening her life. She will require 38 blood transfusions over her first two days in hospital. She has multiple lacerations to her groin and has suffered what is known as a Morel-Lavallée lesion – essentially tissue sheared off and displaced below the skin by the force of the accident.

Margaret wakes up three days later but there is a tube down her throat so she cannot speak. Foggy and weak, she scrawls: “Paralyzed?” No. “Cane?” No. The pain is still severe from what turns out to be nerve damage to her right leg. Only slowly does she understand how close to death she came.

It will take more time to realize how life-altering the accident will prove to be. Her husband’s parents drop everything and fly in from Australia to help with the children. Margaret remains in hospital for three weeks following surgery and then transfers to Bridgepoint Hospital for three weeks of rehabilitation. That is followed by further rehab in a private retirement home, because her house is too small for her wheelchair and stairs are out of the question. She will not be able to walk or stand for three months. She does not go home for four months. Margaret dedicates herself to her recovery, completing an hour of physiotherapy every day as well as performing her own complicated wound care. She progresses from walker to cane to walking unaided. Her husband will establish his own company to devote more time to Margaret. Ten months later, in September, she manages a five kilometre charity walk.

MARGARET HAS A WILL OF IRON.

St. Michael’s is becoming the premier critical care hospital in Canada, and, through Inspire 2018, we are creating an expanded, state-of-the-art Trauma Suite with a third trauma bay to save even more lives. Some 700 trauma patients arrive each year from across the region, by ambulance and across the province by helicopter to our rooftop helipad, in order to receive expert, life-saving care as fast as possible. Six of 10 patients are brought directly from the scene, while the balance are transferred from community hospitals.

“Speed is of the essence: patients need to be diagnosed and begin treatment within the ‘Golden Hour,’ ideally the first 60 minutes following the trauma, in order to have the best chance at surviving and the best possible outcome.”
— Dr. Aaron Nauth, Orthopedic Trauma Surgeon, St. Michael’s

The experience leaves Margaret a passionate advocate for road safety and health-care equity. She is working with the hospital to establish a Toronto chapter of the American-based Trauma Survivors Network. Life posttrauma is challenging on many levels and Margaret believes that sharing that challenge with other survivors should be a part of the healing process. She is now actively fundraising for St. Michael’s through special events sponsorships such as Mudderella, an international series of cooperative obstacle courses designed by and for women. Visit Margaret’s fundraising page at stmichaelsfoundation.com/margaret.

Margaret has nothing but kind words for Dr. Nauth, who attended her 40th birthday party.

He came to see me every day, he answered every question patiently, and he has a marvellous bedside manner. I’m alive thanks to his surgical skills. Thank you, Dr. Nauth and St. Michael’s!
— Margaret Harvey, St. Michael's patient and donor

DID YOU KNOW?

  • Each year, approximately 15,000 Canadians die as a result of injury and over 225,000 are hospitalized
  • The economic burden to Canada is believed to be greater than $12.7 billion annually
  • In Ontario alone, representing almost 40% of Canada’s population, 65 people are injured every hour of every day; almost one quarter of these patients are hospitalized, and 11 patients die each day
  • Half of all injury-related deaths are potentially preventable through prompt access to appropriate medical care
  • Ideally, this care should be provided in a trauma centre, where there is a 25% lower risk of death