5 Years

It’s a bit inconceivable to me that I’d be writing about the five year anniversary of my accident. I admit that I was never able to think this far ahead, and I didn’t really try to see around the corners as I went.

It’s pretty remarkable that it has actually been this long. It seems like yesterday, and yet, it seems like a lifetime ago. So much has changed in the meantime, but in some ways I feel like I haven’t progressed like I envisioned or desired.

The lack of progression is mostly in my wheelchair life. I blame the global pandemic. And stagnation. I didn’t leave home much, so I didn’t get the daily workout that I was used it. You can only keep your muscles so toned when you move from bedroom to office to kitchen throughout the day. I stopped going to PT for a variety of reasons. I tried to do things at home, but I wasn’t a gym rat before and that hasn’t changed - my intrinsic motivation for fitness didn’t suddenly materialize.

Progress, though. I feel so grateful for the progress that I’ve made.

I have so much to be thankful for and so many people for whom I am thankful. I’ve become close with therapists over time. I’ve encountered other wheelchair users or folks with paraplegia who have provided advice and insight. I’ve benefited from kind human beings who respond to bizarre requests for help from a random dude in a chair. I have the most amazing friends, spread across the country and world, who I’m so lucky to maintain strong connections with. I have another group of incredibly close friends - the pick up the phone at ungodly hours or show up in the middle of the night types of friends. And I have my family - my parents, my brother and sister-in-law, my nieces, and of course my incredible wife.

As I reflect on my growth over the last five years there has certainly been a great deal. Some is simply organic growth of a human being getting older with shifting priorities that require me to be different. Others are maybe more inorganic, born of a catastrophic accident and the changes that I have had to incorporate in my life and that others have graciously incorporated into their lives. I believe that I am today in a better position than I was five years ago, more able to be empathetic and more able to garner the trust of my patients. I like to think that I am more patient but that might be a stretch. I am more able to take situations as they come, believing that we can figure out an optimal outcome from a suboptimal situation. The truth is that I control for as many variables as I can in advance and also that I have become better at compromise. Patience and compromise are not my strong suits, but I hope I am growing in this area. I’ve also grown professionally - I’ve added another lens to my work, that of patient-navigator-of-a-complex-health-system. I thought I understood some of these things before as I’ve put on my business hat to try to influence change in the system, but as I’ve had to navigate it myself, I’ve found more of the nuance and specificity than I knew before. That, of course, informs how I think about change in the system.

Over the last several years Ashley and I have also traveled a lot more. As safety improved and borders re-opened, we took advantage of the opportunity to explore. We explored countries together that we had been to individually and visited countries that were new to both of us. There are always challenges, both logistical and emotional, in travel. These were no exception, but it was lovely doing it with my partner. I count myself as very lucky to be able to do what I love once again, though certainly quite differently.

Perhaps the most seismic change has come in the form of our brand-new daughter, born just 10 weeks ago. This, too, I suppose is an inorganic change. A decision Ashley and I made, recognizing (or perhaps not) the implications on our life. We are learning to parent just like all new parents. But we are also learning to parent with the added layer and complexity of disability. It’s not just a stroller and a car seat. It is a stroller and car seat and a wheelchair and all the things that every member of the family needs to be able to be out and about. It’s a crib and changing table that are accessible enough to allow me to do my part as a parent and don’t obligate Ashley to be the primary doer of whatever-the-job-is, but that also don’t look like the inside of a hospital room. (Big shout out to our contractor and master genius carpenter and dear friend, Chris Nelson, for figuring out how to make things that work for us!) And it will always be “easier” for Ashley to get out of bed to do a diaper change or soothe our daughter - but that’s not the parenting model that we aspire to.

I wrote up above about others graciously incorporating changes into their life. I recognized recently that others have a choice that they get to make. When I go to dinner at a friend’s house and there is a ramp, that is a choice that they made to welcome me into their home. When my brother and sister-in-law create an addition on their home with an accessible bedroom and bathroom, that is a choice that they have made to welcome me into their home. I recognize that is not a thing that people can universally do. (And, not having a ramp doesn’t imply that they aren’t welcoming me - but sometimes I get a bit verklempt when there’s a newly constructed ramp. A sense of adventure to “figuring it out” is all I can really ask for!) But the number of friends who have continued to show up over the last five years has been nothing short of incredible. They too had a choice to make. It is more difficult to have a friend in a wheelchair than it is to have a friend who is able-bodied. It is easier not to make accommodations than it is a figure out how to make things work. I recognize that people make a choice to have me in their lives as someone who lives with a disability. I recognize that Ashley has made a choice to be my partner in crime, to live her life with someone in a wheelchair, to have a child and parent with someone in a wheelchair, and to explore the world in a way that is more difficult than might have otherwise been had she made a different choice. I am extraordinarily grateful that people have chosen me, and I am extraordinarily grateful that Ashley chose me. My life is not without challenges, but it is my life, and I wake up every day with energy and positivity.

Making progress & trust in science

I’m currently in Week 44 of work-from-home for my non-clinical job. I’ve said it before, and will re-iterate it now — I’m in a position of privilege to be able to work from home. But as an extrovert, I miss seeing people at work, randomly bumping into colleagues and friends, meeting new people over coffee, or “running down stairs” to pop into someone’s office. I also miss seeing friends and family. And I miss hugging people. We’ve made the decision to be pretty conservative in our social distancing. So we don’t eat inside at restaurants and work hard to limit our interactions within closed spaces. We work hard to follow the science because, while we better understand it today than we did 50 weeks ago, the science has not changed. I also continue my clinical work, and I’m grateful that I can do that and that I feel safe while practicing medicine — and I get some social interactions with colleagues and friends while I’m in the hospital as well. Clearly, the disconnect between seeing friends at the hospital but choosing not to socialize with them outside of the hospital is a tough one and requires some cognitive dissonance.

I hope in the coming months that that will get easier. That there will be some reprieve. That “covid fatigue” will convert to “covid relief” and that we may choose to spend more time with friends and family again soon.

The vaccines will become more available. While the initial scientific data on the vaccines shows both their safety and the efficacy (how well they work), there is still more to be learned. We will learn how well the vaccines prevent the spread of COVID-19. We will learn how well they work for children. And we will learn how to distribute them around the world. We will also learn more about why certain groups or parts of the population are reticent to receive the vaccine.

In the meantime, I’m proud to say that I — along with many other healthcare workers — have chosen to trust science and to receive the vaccine. I’m anxiously awaiting the second dose, which will provide more protection.

Incredible Day - September 12, 2020

On September 12, I married my love, Ashley Wong. We had a COVID-appropriate wedding at the Walker Art Center in an outdoor wedding. We had six guests, and additional out-of-town family joined us remotely. While we were sad that more of our friends and family couldn’t be there in person, the intimate setting was lovely (though a bit chilly).

Photos by: Laura Rae Photography

It’s been a minute…

September 3rd. Sunday of Labor Day Weekend. Either way I look at it, it’s the same thing. A moment to pause and reflect, to be grateful for what and who I have in my life, and to acknowledge the loss that occurred — now, three years ago.

Since my last update in September 2019 the world has turned upside down. And mine has taken some interesting (and wonderful) turns along the way.

In October 2019, I started a new role as Chief Medical Officer at Best Buy, the consumer electronics retailer based in Minnesota. When I learned about the role, it was a no-brainer. Best Buy had recently launched Best Buy Health (largely through a series of acquisitions), and my role would be help lead strategy and corporate development for the group — essentially, helping to shape the future direction of Best Buy Health and how we add or create the building blocks to get there. Best Buy’s value proposition was compelling to me: change how healthcare is delivered - and received - by using the unique assets and DNA of a leading retailer to do it. Best Buy is trusted to come into people’s home, help people solve technology problems, and understand the needs of the customer with depth and nuance. Applying that to healthcare was appealing to me, not just as a patient, but as a physician as well. I’m passionate about changing how healthcare is delivered, and it was immediately relevant to me in my own life as a patient who relies on technology to enhance my life and as a physician who sees the transformational power of technology in healthcare. (I continue to work clinically at Mayo Clinic as well.)

As the novel coronavirus pandemic took shape early this year, I felt the impact in several different ways. My paraplegia has left with me an impaired cough — I don’t have the core muscles to cough as aggressively as I otherwise would, which places me at risk for pneumonia and other lung diseases. Additionally, hand hygiene becomes a challenge when you use your wheels to propel while touching doors and (if you’re lucky) push buttons for the doors. So, I did what many did, and sheltered in place to the best of my ability. I moved clinical shifts in the Emergency Department to telemedicine shifts (a whole new adventure - and the marvels of technology) that I could do from home, until we understood more about the virus and how to protect ourselves. (Thanks to my Mayo Clinic colleagues for their flexibility and understanding!) I avoided the grocery store and other public places. I relied on friends to help when possible. I also shifted some responsibility into thinking about how to keep our Best Buy employees, customers, and families safe, which was a whole new learning curve for me and a way to learn the nuances of our business.

Unfortunately, I also let my physical health slip. With physical therapy locations closed, staying home, working in front of a computer without propelling, and without the discipline to work out regularly, I lost significant muscle mass in my arms and shoulders. I’m disappointed in myself, and actively working to reverse it. I’d built up strength with 4+ months in the hospital and countless hours of rehab. I’m kicking myself for letting that go. I want to acknowledge, though, the privilege that is inherent in what I wrote above. I worked from home. I had groceries delivered. I had friends who helped me and loved ones who checked in on me. So many people were unable to do that. It placed them at risk for contracting coronavirus and getting COVID-19. It unmasked racial and socioeconomic disparities that are rampant in our society. It showed the haves and the have-nots. And that essential workers means essentially at risk. Working from home, with internet, with an office, is privilege. Yes, I struggled with social isolation, with loneliness, with the feeling of Groundhog’s Day. But I had the resources with which to fight those struggles. . So many people did not and do not. And so many people died or are left impaired as a result. Over the following months, I returned to working the ER. I developed a safety system for PPE, for cleaning my chair, for using video as an adjunct to see high-risk patients if I didn’t need to be in the room. I love being in the ER - it gives me purpose.

PPE in the Emergency Department

In other personal, more up-lifting news, I’m getting married. More specifically, I’m getting married to a fantastic and brilliant woman who puts up with me, who makes me a better person (and doctor), who is my partner, and with whom I love attacking life. She’s not my caregiver. She doesn’t do things for me. We do life together, with all its intricacies and inherent complexities. It occurred by happenstance - I ran across someone who I’d met a few years earlier. We’d worked together, and after I’d returned to work she heard about my accident. So she wasn’t shocked by this new wheelchair. And she knew me when I was standing up at 6’5”, instead of sitting at 6’5”. Ironically, we’d spent several months a few doors down - while I was in the hospital at Mayo, she was on an adjacent wing of the floor…but our paths didn’t cross then. Luckily, they did later, and I “jumped” at the chance to reconnect with someone special. Ashley, thank you for bringing out my joy and for being my partner. I love you.

As always, on the 3rd anniversary of my accident, I think about my dear friends, the Locksley family. On September 3, 2017 — a few hours after my accident — Mike and Kia Locksley’s son Meiko was murdered in Washington D.C. His murder remains unsolved. I’d known Meiko and his siblings for years. Mike and Kia are family. And it bears acknowledgment that while I’m able to tell my story, work, and get married, Meiko’s life was cut short. His siblings lost a brother. His parents lost a son. We miss you, Meiko. #LLMM

Missing a friend

This week we lost a wonderful human being and a dear friend to many — Robert Clifford Johnson (BJ or Beej).

I first met BJ when I was in high school and my brother was at St. Olaf College and in the St. Olaf Choir. BJ (along with Dr. Anton Armstrong) recruited me to St. Olaf. From that time, he became an incredibly close friend. I worked for Beej during my entire time at St. Olaf, and learned innumerable life and business lessons from him. What always amazed me about Beej was his ability to connect with humans and to be his authentic self.

After my accident, and before his diagnosis with ALS, BJ visited frequently and at every hospital I was in. When we were on family vacation and he was nearby on his vacation, we found time to connect as a family. He and Sigrid, his wife, showed incredible love to me and to our entire family. After his diagnosis, we talked when we could — he was often fatigued and short of breath. But his joy of life and spirit were on display every time we spoke. My brother, Aaron, and I had an opportunity to share with BJ how much he meant to us (and to many others) at a celebration of his life in May 2019.

I’m reminded today that it is never too late to call someone you love - or someone who has made an impact on your life - and to tell them thank you. It is never too late to celebrate someone’s life while they are able to celebrate with you. Take the time to make the phone call you’ve been putting off making.

Thank you, Beej, for being an incredible friend for 20 years. I love you and I’ll miss you.

Always shocked by a three-year-old.

Over the last 20 months, I’ve often wondered about the impact that my accident and subsequent disability would have on those in my life. Some friends have told me that they haven’t had the courage to get back on a bike. Others have had a period of trepidation, but ultimately remembered that random events occur, and re-found the happiness they’ve experienced on a bike. Others have become more acutely aware of the limitations that exist for people with disabilities: how difficult it is to navigate Manhattan; how people park in parking spots reserved for those with a handicap (or wait in them), whip out their hang-tag, and then walk without difficulty into a store; or recognize that some stores or restaurants are not set up for success if you live your life in a wheelchair.

I’ve frequently pondered how my nieces, age three and almost-two, would process my disability. When would they start to ask questions? How would I answer those? How can I tell them about a bike accident, yet ensure that they’re not fearful of an activity in which they should take part without reservation (though with a helmet, obviously)? What I do know is that they’ll grow up never knowing that their uncle once walked, standing 6’5” and able to see above the crowd. They’ll see pictures, and they’ll have to process the dissonance. I wish I could carry them on my shoulders so they could see the world from greater heights. I’ll never have that joy.

I’m surprised, though, by the knowledge and empathy of my three-year-old niece. She asks why I’m in a wheelchair, though I know she actually knows. I understand she doesn’t want to have a conversation that is that straight-forward. Today, though, she surprised me. She pointed to a parking spot demarcated with the standard wheelchair paint-job and the blue wheelchair signage, and she said “Uncle Daniel, this is a parking spot for you. There’s one here that’s special for you - and there are other places too. So you can park there.” Now, the concept that a three-year-old understands a parking spot, or even a “reserved” parking spot, is pretty remarkable (I think). But that she recognizes that I’m in a wheelchair, and therefore need a special parking spot means that she has empathy.

If nothing else, I’m grateful that my nieces will grow up being more aware of people with differences, comfortable with people in wheelchairs, and empathetic human beings. That will be an amazing long-term win.

My brother, sister-in-law, and nieces

A long overdue update.

Since my last post in late August 2018, I’ve re-established a rhythm of day-to-day life. Unfortunately, that often doesn’t include adding to this blog. I’ll aim to change that. For now, this will be a hodge-podge of thoughts and experiences.

What I Miss

• I haven’t worked my way through the underlying reasons for this, but I miss being able to stand in community with people. And that’s probably what it is — the community aspect. But whether it’s standing for the National Anthem at a sporting event or standing as part of a standing ovation at a concert, it pains me not to be able to join in. I wish I could. [On the flip side, I’ve always thought that people are a bit quick to give standing ovations for some musical things … so my staying seated in protest lacks a bit of luster when it’s done in a wheelchair.] I first realized this during High Holidays in 2017 when the prayer book read All Rise. Every time the congregation stood, I would cry. In 2018 I told the Rabbi about this, and he actually said “Please rise if you are able” during the service. That doesn’t mean it doesn’t hurt. It does.

• I also really miss sitting at the bar at a restaurant. With all my travel, I could often eat at a restaurant bar by myself and I didn’t find it awkward. Even with friends, sitting at the bar takes a bit of the formality out of it and can be pretty comfortable if it’s designed for tall people. But bar height is well above my comfort zone, and so I can’t just go have a casual drink at the bar. “Bar top” seating in a most of restaurants also isn’t accessible — and those are often the ones the ones that are available on a “walk-in basis.” So if you didn’t make a reservation, there’s might be nowhere to sit. But not being able to sit at the bar — I miss that.

Travels

Over Thanksgiving 2018 (November), my parents I went to London. This was my first post-accident international trip. For context, I’d spent the prior 6 years traveling internationally about 50-75% of my time. So I had an itch to get back out there. London was incredibly accessible. It was easy to get around with the help of the SmartDrive to save my strength. All the London taxi cabs have built in ramps, so while the Tube isn’t the most accessible, it was still easy to get around. We ran into one small problem when we took a lift (elevator) up to cross a bridge over the River Thames and were met with a lift that was out of order on the other side. That was less fun. It should surprise nobody by now that we got in touch with the City of London and suggested an opportunity for improvement. The Mayor of London’s response is here.

But, London out-did itself on some other accessibility innovations. We went to the Bank of London for a quick visit. This is one of the most genius designs I’ve ever seen. Props, London.

London also has this incredible “National Disability” program. We were able to catch a few shows and had no difficulty with seating. It was really quite enjoyable, and I’m grateful to my parents for making it happen and helping me get back on the international road!

Learning to Ski

I used to love to ski. Being in the mountains was one of my happy places. So, getting back out was something that was important to me (like biking). Adaptive skiing is definitely a thing. In fact, it’s a paralympic sport. I’ve chosen to pursue mono-skiing. Lots of innovation in the space with development of more and more complex ski rigs over time. I’m lucky to have access to one of the largest adaptive recreation and sports programs in the country at Courage Kenny Rehabilitation Institute. CKRI has an impressive array of programing, including a winter sport program. Along with the staff from CKRI, volunteers from across the region come out multiple times per week to help teach. Some have been teaching for 15 years. They teach people with a range of disabilities, not just those with spinal cord injuries. It’s incredible watching young and old learn, and awesome to watch a blind skier fly down the slope. Some folks have been doing this for years and years. I spent most of my first few lessons on the ground. Frustrating, of course, but it also just made me try harder and harder.

To accelerate my progress, a dear friend had organized a ski trip to Breckenridge, Colorado, where the Breckenridge Outdoor Education Center is location. BOEC is widely considered one of the top places to learn adaptive skiing. The team there was incredible. Patient, thoughtful, adaptive in their teaching style. They got me fitted in a mono-ski that works for my tall body. They realized quickly that I wanted to push and push, and they went with it. Sure, I spent a lot of time on the ground at Breck too, but the progress was exponential. (I also learned the hard way the benefit of winter tires/wheels for a wheelchair. While there was plenty of snow in Minnesota, I usually avoided wheeling through the snow. But there was no avoiding it in Colorado — and I ordered winter wheels upon my return.)

I made incredible progress. Here is a short video — the stopping part was definitely a work in progress.

Continuing PT

• I’ve also resumed PT at Courage Kenny. I’m lucky to have an excellent therapist who specializes in neuro. She pushes me hard. It’s clear that I have a ton of work to do. I’m nowhere near as strong as I need to be to safely navigate and also to get myself off the ground when I fall. Floor transfers - as I discuss at length below - are an incredibly important skill that I’ll need to perfect. To do that, I’ll need stronger triceps and scapular muscles. And, for the general long-term health of my shoulders (which are now basically my most important joints), I need strength and flexibility to maintain integrity and to ward off injury. We’ve continued to practice wheelchair skills as well — and sometimes my friends (like Ron!) get in on the action.

It’s spring in Minnesota. Time to emerge from hibernation. Back to biking season. The emotions won’t go away. But I’ll work more aggressively to get back on the handcycle this spring and summer.

Anniversaries

Anniversaries. To me they’ve always seemed a bit arbitrary, 365 days after the last time the same event was “celebrated.” Labor Day weekend had always had a positive connotation in my mind. Often a day or a weekend of celebration. The weekend to get away with family or friends, go on a quick trip somewhere, or just recuperate from the last several months. Also, the opening weekend of college football. (But we’ll get back to that.) Now, Labor Day weekend is an anniversary. On Sunday of every Labor Day weekend, I will wake up and realize that X number of years ago my life was inexorably changed in an instant. The life of everyone close to me was changed. This year, obviously, X = 1.

It’s been one year since my accident. I look fondly at pictures of that weekend and memories of biking with Ron and June, the little house on the lake that we rented, pour-over coffee, breakfast sandwiches, and killer manhattans. And the thrill of being on a mountain bike. Little did I know the year that I would have ahead. Nor did I know the incredible people who would enter my life in new ways. Or old friends with whom I would re-connect more intimately and with greater vulnerability. I didn’t know that I would have to learn how to ask for help from friends, family, and total strangers. The humility that I’ve learned and the gratitude I feel for the people in my life - especially my parents - is unmeasurable.

I don’t quite understand why people are making a big deal out of this being the one year anniversary. Every day I wake up wondering if I’m living a dream and if today will be the day that my legs start working. I don’t think Sunday of Labor Day weekend will be any different. Clinically, it moves me from the “acute” to the “chronic” category of spinal cord injuries. So there’s that. But yes, I realize the weight of the weekend on me and people in my life. I imagine my parents won’t tell me, but they will likely relive the worst phone call of their lives, received in the middle of the night while they were in Europe. (They’re not with me this weekend, so I can’t hug them and kiss them and look at them while I thank them for selflessly giving six months of their lives to sit at my bedside and care for me.)

Over time, I think that people will start to forget that Labor Day weekend has a very different connotation for me than it does for them. I imagine that I will never want to be alone on Labor Day weekend. (I half-jokingly say that my family coming to town is really a suicide prevention watch party.) But I guess I don’t yet fully know what set of emotions I will experience. I will surround myself with friends and family. We will “celebrate“ the “progress“ that I have made over the last year. Next year we will celebrate the progress I have made from this year. In general, I have not really paused to mourn the loss that I have also experienced. That shouldn’t surprise anyone who knows me well; they know that I am incredibly driven and goal oriented. So my mourning is replaced by drive. But, perhaps in addition to celebrating, I should allow myself time mourn a bit as well. We’ll see.

I’ve mentioned gratitude several times. I can’t properly describe how grateful I am for the people who visited me, donated, sent me a card or a text or an email, slept by my side, traveled across the country – or the ocean, sent food, books, flowers, fidget spinners, candy, played cribbage with me, held my hand, gave me a hug, a smile, made me laugh, told me they loved me. Please know that I’m grateful. I didn’t get where I am today alone. It was a team effort. I can’t express my gratitude. I’m too many thank you cards behind to count. But damn am I grateful. Thank you.

The other thing about the Sunday of Labor Day weekend (Sunday, September 3, 2017 to be specific) is that I didn’t suffer loss alone that day. My dear friends Mike and Kia Locksley lost their 25-year-old son, Meiko, to a senseless and as yet unsolved murder. Every Labor Day weekend I will call Mike and Kia and speak a language that only some people understand. To be clear, I will never understand what they’re going through. And they don’t quite know what I’m going through. But a shared anniversary of the craziest day of our lives means that it’s important to take a moment and be together. For Mike and his family, Labor Day weekend used to mean the joyous beginning of the football season. Now, it’s an “anniversary.”

An anniversary also means a time for people to call and ask how you’re doing, for them to send you text messages to let you know that they are thinking about you. I’ll be grateful that people care about me and I know people are well meaning. They understand the impact of the arbitrary year as well as I do. But I won’t quite know how to respond. Maybe I’ll have the emotional energy to respond “thank you” to each one. But I doubt it. There are still unanswered emails and text messages from a year ago.

Sunday of Labor Day weekend.

Sharing My Story... Additional Media

Over the last several months I've been lucky to be able to share my story with a broad audience. Some people have (appropriately) asked me what the goals are in sharing my story. The truth is that I don't have a structured set of goals that I'm trying to achieve. I'm uncomfortable with my role as an "inspiration," but I recognize that my story can serve as a source of hope for some or be motivating for others. My goal isn't to inspire. More likely, my goal is to show people that setting aggressive goals and working your butt off to meet them can yield real returns. And that showing vulnerability and being transparent about my own challenges can help others feel less alone, more connected, and more understood in what is - in reality - a very lonely world. I'm not yet comfortable assuming a formal role in the disability community or being a spokesperson for others with disabilities. But I recognize that at some point I will have that responsibility. I've always been outspoken (shocking); I've always advocated for what I believe in and for those who can't advocate for themselves; I've always used my platform as a physician and business-leader to be a passionate leader and storyteller to inspire and inspire/motivate others. So I suspect that all of these things I've done naturally over time will intersect around my own disability. Honestly, if I can't talk openly about the challenges I'm experiencing, how can I expect others to do that same? Perhaps telling my story is simply a way to force myself out of my own comfort zone.

My goals were reinforced a few weeks ago on my way into the hospital when a young family stopped me to thank me for telling my story. This husband and wife had their young child with them -- she has a rare congenital/genetic disorder. They explained to me how motivating it was to them that I was able to share my story and how it kept them driven and motivated for their own daughter. I think them stopping me meant just as much to me as reading my story may have meant to them.  

In addition to the things I've already shared (my own writing at: https://www.linkedin.com/in/dbgrossman/detail/recent-activity/posts/) and Mayo's article (https://intheloop.mayoclinic.org/2018/04/24/emergency-medicine-physician-back-to-work-after-accident-that-left-him-paralyzed/) I did two other major pieces.

My friend from high school, Jeremy Hobson, is a host on WBUR's Here & Now, picked up by NPR.  Jeremy and and Chris Bentley from WBUR did a fantastic job telling my story --- there is a written narrative here http://www.wbur.org/hereandnow/2018/06/06/doctor-paralyzed-mayo-clinic ... but please, take time to listen to the story they tell. They did an amazing job. It's only 21 minutes long. But you have to push this big red button on the upper left:

 I also did a piece for NBC Nightly News with Lester Holt. I'm really grateful to the NBC team for being so gracious in their story telling.  https://www.nbcnews.com/health/health-news/paralyzed-er-doctor-returns-work-just-don-t-call-him-n882911  -- I'm also glad that Ron could be part of the story. I don't know where I'd be without Ron and my other incredible friends who have been by my side over the last 11 months. 

[Also, they tell you never to read the comments on things ... that's probably a good idea, but it was nice to see the impact some of these stories have on people. And to the folks out there who wonder how I can be a doctor and not perform CPR because the beds don't go low enough ... I don't know what to tell you. I haven't done CPR in probably 10 years -- when there's CPR in progress I'm essentially the traffic director, keeping my eye on the big picture and directing care. Also, contrary to the reporting on Here & Now, we didn't really take one last run of the day ... we consciously decided against it and instead took the (now ironically) named "Easy Street" out of the mountain biking terrain. My Strava still shows where I stopped.]

Some behind the scenes photos:

It even made it onto those little TVs in the back of taxis in NYC and Chicago:

This didn't make the final cut, but was awesome nonetheless:

I didn't think spring would be this painful

I grew up off-and-on in the Netherlands from age 5 until 18. If you know anything about the Netherlands, you likely know that bike culture is huge -- it's the primary mode of transportation. So I grew up biking to school, the grocery store, to friends' houses, the restaurants, to the Saturday market ... you get the point.  I used to watch the Tour de France in the summers, watching all these incredible athletes race through time-trials, climb enormous mountains, and sprint to fantastic finished. (Ignore the part where they fall from grace. I was hooked.) I went and saw the Tour twice live in France. I still have one of the drink bottles that a rider threw onto the side of the road as he flew by. 

While I was still living in the Bay Area, before I moved to Minnesota, I finally invested in a nice road bike. Biking in the Bay Area is a big deal ... I was clearly a novice. When I moved to Minneapolis, I explored the bike paths and used road biking as a source of exercise and mental health. I'd go on solo rides, group rides, and most often, rides with my friend Ron. I was never particularly good -- I think my longest ride was around 57, and I think I stopped about 12 times near the end. I added a gravel bike to my stable over the summer, and found the flexibility to off-road onto trails awesome. Then I bought a mountain bike to open even more new experiences, and I looooved it. Exhilarating, different terrain, different skill requirements. Obviously.

I live right on one of the most popular bike routes in Minneapolis. The snow melted in the last two weeks, and bikers are out in force. And I'll admit, it's really really difficult. I never thought I'd be jealous of seeing someone else decked out head-to-toe in spandex. But it's hard knowing that I can't get out there and ride -- yet. I miss the physical activity and the mental health. And I miss riding with Ron and having philosophical discussions about life, death, and career. Additionally, one of my favorite summer activities was biking from brewery to brewery. Safely, of course. I need to figure the logistics of that out, as well. 

The good news: this week at Courage Kenny I have a fitting for a handcycle that I can rent over the summer. At some point, if I figure it out, I'll probably buy one. And, of course, I'll get a new helmet, because mine got pretty messed up in the fall. (Thanks for saving my life, Giro.) I'll have one of those orange flags and nerdy review-mirrors as well. I doubt that I'll get to France to bike through wine country or to follow the Tour....that seems like a stretch goal.  But, if I've figured anything out, it's how to make stretch goals.

Next Steps ... recently published pieces

Over the last week we did some writing.

First, Mayo Clinic graciously featured me in their patient stories section, In the Loop. Thank you to my colleagues at my clinical home for the beautiful piece, and for all of their support -- they helped to get me going again and to achieve my goals. On my shift today I wheeled into a patient room and the patient's mom looked at me and said: "I just read all about you." Wow...not quite sure where to go with that one.[https://intheloop.mayoclinic.org/2018/04/24/emergency-medicine-physician-back-to-work-after-accident-that-left-him-paralyzed/]

Second, I wrote about part of my journey and a new job I've recently started (in addition to my work in clinical medicine as an emergency medicine physician). [https://www.linkedin.com/pulse/embracing-new-beginnings-normal-daniel-grossman/]

Thanks to all of you for your continued support. I know I wouldn't be where I am without a network of incredible humans. Words can't accurately express my gratitude

We all fall down.

I knew it would happen at some point.

You can't take a two-year-old out on a Puky bike for the first time and not expect her to fall. And fall she did, four or five times. But each time she high-fived everyone around, brushed off her hands, we kissed her hands (and then she kissed her own hands), and then when we asked "what do you do next?" she said "I get up." Each time.

But there's more to the story.  As we were headed outside to try the bike, I had to navigate a few steps. We made it down the first one, and then on the second I took a tumble. Nothing too bad, but I landed on the ground. I knew this was going to happen at some point. It turns out, we all fall down. Of course, this is why we practiced all those floor transfers in PT. In fact, I'd fallen the weekend before as well -- I was alone in the bathroom at the hotel before working an ER shift when I missed my transfer from the toilet to the wheelchair and landed on the ground. Luckily, I'd left my hotel room unlocked and unlatched, just in case something happened (a welcome gift for all you would-be thieves following my hotel travels); I called one of my former nurses who is now a good friend and she came over to help me off the ground. I'll admit, I was pretty shaken. I was pretty sure I wasn't injured, though my pride and confidence certainly took a hit. It was the first time -- sitting there on the floor of a bathroom by myself -- that I had one of those "this really really sucks" moments.  After I got off the ground in the bathroom, one of my friends who is an occupational therapist came over -- and we practiced the transfer I had just missed. Over and over and over again.  And then the next night we did the same thing. Because when you screw something up, you need to do a root cause analysis and try again. So, when I fell going down the stairs my confidence wasn't hurt. My niece didn't see it, but she saw me right after, sitting on the ground. Between my dad and Heidi, we got me back up. I high-fived everyone, brushed my hands off, gave my niece a kiss, and told her that when you fall down, you just get back up. And then off we went  to try the Puky bike for the first time where she was able to put theory into practice. The lesson stuck. With her and with me. It's going to happen again. Get up.

Uploaded by Aaron Grossman on 2018-04-03.

First Flight!

Over the past four years, before the accident, I flew over a million miles with Delta and its partner airlines (and some others...so I guess well more than a million miles). Flying was second nature. It was seamless and easy. I learned that I could only control what I could control, and that to stress out in the face of weather or mechanical issues was a lot of wasted energy. To be honest, it's not glamorous, though it sounds like it would be ... it's actually pretty unhealthy. But, I loved to travel, to see new places, or to hop on a quick flight and to see my nieces or visit my parents. I realized pretty quickly after the accident that that would be more challenging now.  Not to mention that I wouldn't get exit rows anymore...I'm 6'5", so you can imagine I like my exit rows! 

I knew another of my hurdles would be flying again, and this weekend I tackled this challenge. I flew to Cincinnati to visit family, to celebrate both Passover and Easter, and my niece's 2nd birthday! 

Of course, I was nervous, and I invited my friend Heidi to accompany me on the trip. I did a whole bunch of research before hand and heard all the horror stories. But the Delta team was awesome -- they met us at the airport, helped me to get through security, and then met us at the gate again when it was time to board.  The wheelchair and boarding management is outsourced to a third party vendor, but they too were awesome. A few lessons: I brought an extra cushion for the seat, to provide a bit more protection for my skin; when you land, without trunk support, you need to brace yourself so you don't get thrown forward; and make sure you take all the removable parts of your wheelchair off so nothing gets lost! 

All in all, it was a seamless experience. First on, last off. Be patient, and remember that everything takes longer -- be safe, take your time, and be gracious to those who are helping you. 

Had a whole crew to help me get comfortable with the boarding process -- using that little aisle chair there.

Shocking how this is a happy place for me! … But always got work to do.

After transfer back from the aisle chair in Cincinnati

Back with Aaron, Charnella .... and thanks to Heidi for being my wonderful travel companion … and, the birthday girl!

Graduation Day

Today had to come at some point. After 190 days of being by my side, my parents went back to Illinois. Over the last months, people have commented on how lucky I am to have great parents. They don't even know the half of it. My parents are incredible. Selfless. Thoughtful. Caring. I could go on. All they've done for months is think about ways to make my life better. Re-organize my closet, my pantry, my kitchen. A 3M hook here. A floor-protecting felt pad there. Countless trips to the container store to optimize the re-organization. Practice getting in and out of the car. Trips to Mayo to get me back into the zone. I mean, it's incredible. I can't begin to describe how grateful I am, because it wont do it justice. But they've sacrificed for 190 days. Now it's time for them to get back to the normalcy of their lives, their friendships, and their routine at home in Illinois. I'm happy for them. And thankful for all they've done to get me to where I am today.

There's no doubt this is scary. (For all of us.) If I forgot something and was in bed, I could ask them to get it for me. Dinner was easily solved for me (thanks mom!). The coffee was made in the morning (thanks, dad...though I wish you'd learn how to make pour-over). I probably don't even know half of what they did. But I'll figure it out quickly when I try this whole complete independence thing.

I'm also grateful for the opportunity to have some alone time. I've spent one night alone in 192 days. One night. I'm pretty extroverted ... but this has been a challenge for everyone. I'm excited, but I'm nervous about doing some things that I haven't frequently done. And I have no doubt that I will fall. I also know that I have incredible friends who are near by and who will be here in a heartbeat. Tonight I'm full of gratitude.

On to the next phase....

Its been a few weeks

The first Sunday of every month is significant to me. Today, even more so. It marks the six-month “anniversary” since my accident. I never knew life could change so dramatically or so quickly. I’ve talked a lot about the “new normal” and “radical acceptance,” and I believe that both of these concepts have helped get me to where I am today.

I’ve worked eight shifts in the emergency department at Mayo Clinic, each less fumbly and awkward than the last. I’ve made the hour-and-a-half drive down and back to Mayo, survived nights in hotel rooms, driven independently and picked up friends on my way to dim sum, and gone to the movies. I’ve also become more comfortable with myself in a wheelchair. I still wonder if everyone is staring at me when I go into a restaurant or into the cafeteria at Mayo (or whether they’re annoyed that I’m slow in the salad line which is clearly not designed for people in wheelchairs…thank god I have go-go-gadget arms), but I care less that people might stare. Let them. I realize that seeing a guy in scrubs in a wheelchair is an anomaly. Or that watching someone hop into his wheelchair from a parking space is worth a gander. Oh well.

My time in the emergency department is particularly rewarding. When I wheel into the room, I think I’ve seen every reaction you can imagine – surprise, confusion, bewilderment, bemusement, and even relief. Each reaction looks different. But when I introduce myself as the supervising doctor, it feels pretty damn good. Sometimes I ask patients to bear with me as I figure out the mechanics of doing an examination or sewing them up, requiring an explanation that I’m new to the wheelchair. Sometimes I use wheelchair-related humor to relate to a patient or to defuse a testy situation. I’ve talked with young patients about the importance of having their parents with them on difficult medical journeys. When the patient looks at me, looks at the chair, back at me, and back at the chair I pre-empt it … “The answer to the question that you want to ask is that I fell off my mountain bike.”  “Yeah, thanks, it sucks – it was five months ago, so I’m still learning how to do something I’ve been doing for 10 years.” But it feels good, and my colleagues and our nurses and support staff have been incredibly supportive.

I’ve even been asked to talk with another physician with a recent spinal cord injury. By no means am I an expert – but it felt good to help someone navigate the system, understand some of the nuances, and identify a few things to advocate for when the time comes. We talked about aggressive goal-setting with respect to getting back to work as a physician – obviously something that motivated me over the preceding months. I remember in the first week after my injury a former patient (10 years out from injurye) stopped by my room to offer encouragement that I could resume my life, and another physician at Mayo in a wheelchair did the same on multiple occasions. And, as I’ve mentioned, I frequently text a friend I haven’t yet met who is an emergency physician with a similar injury to ask him for advice. The network and encouragement are important.

My parents head home in a week and a half. That will naturally trigger some anxiety. But I think we’ve figured out a routine. And, honestly, it’ll be nice to have a bit of alone time again. I’m pretty extroverted, but I definitely need alone time to process my thoughts and to recharge. They’ve been insanely wonderful, and I can’t imagine this process without them. We’ve reorganized my home so that everything I need is accessible to me. They’ve taken me to doctors appointments, therapy sessions, and have run every errand imaginable. To say I’m grateful doesn’t begin to describe it. But after six months of sacrifice, they too need to resume their lives and to return to the routine they’ve established at home in Illinois.

In other news, I start a new non-clinical job tomorrow. I’ll continue to work part-time clinically, as I did while I was at Medtronic. I’m excited for a new challenge at an early-stage company in an industry for which my learning curve will be quite steep. But I know that my experience as a physician, a business executive, and now as patient, will be important components of my role there. The real challenge may be continuing/resuming my fitness/strength/therapy program and integrating all of the new things I need to do in my life (and how long it takes to get ready in the morning!) into this new job.  More on that in the future …

Back at it (for real!)

This week I returned to the emergency department and worked two shifts at Mayo Clinic! I can't explain how great it felt to get back "home" and work with my team. The nurses, techs, physicians, unit coordinators, everyone has been so gracious during my time away. It was incredible to come back to them.  I made a goal while I was in the hospital to get back to the Emergency Department in January -- and I achieved that goal on 30 January, almost 4 1/2 months after the injury. It'll take me a bit to work up to full time, and for now I'm partnered with one of my colleagues ... but soon I'll learn how to do this without running over people's feet. I truly believe that my experience over the last months -- and my "new normal" in a wheelchair -- will make me a more compassionate and empathetic physician.  

I will also likely join a healthcare-focused business in the near future. I strongly believe in the role of business to transform healthcare, and my passion extends beyond the practice of medicine to working through markets to impact patient care.

Good Corporate Citizens Give me Hope

The last four 1/2 months have been full of uncertainty and surprises.  That much is obvious. When you have traumatic life events, you discover silly little things that worked well in your life, but that suddenly don't work anymore. Some are big things, some are small. You also realize that you're largely at the mercy of others, and some people can make choices that are positive for your life and others make choices that negatively impact your life. During construction, I had a neighbor who made a series of choices that I wish had represented the best that humanity had to offer, but this neighbor made choices that negatively impacted my life.

On the other hand, far more people and organizations made surprising decisions that, in the midst of uncertainty and chaos, gave me hope and provided joy. 

Let me tell you about two of these organizations: Delta and Restoration Hardware (RH)

I've been a loyal Delta customer for the last 4+ years, since I moved to Minneapolis and traveled over a million miles in four years for Medtronic. (It seems glamorous...trust me, it's not.) Delta took good care of me, and that circle of great customer service and loyalty is a circle for a reason. I had an international trip scheduled to visit my parents for mid-September, which was just after the accident; we called Delta from the ICU and explained the situation. They asked for my hospital phone number, called to confirm I was in the hospital, and immediately refunded my tickets and sent me a gigantic gift basket full of goodies to the hospital. (Counterpoint provided by an alternative airline that made me jump through hoops, supervisors, letters, and more for a 1/2 hour domestic flight worth $118.) When I realized that I wouldn't fly enough to maintain my loyalty level with Delta, I decided to tell them the whole story and ask for help ... their response was, once again, impressive. They told me they would maintain my status for the year. For those who don't fly, that seems like a silly thing to get excited about, but for frequent fliers, it's a big deal. Thank you, Delta Airline, for showing there is good in humanity.

RH (previously Restoration Hardware) also showed me great faith in corporate citizenship and humanity. I had a beautiful, wonderful, comfortable, plush, and luxurious leather sofa that I've loved for several years. It was perfect for my gigantic body. The problem, after the accident, was that it was so plush that while I could get myself in, I couldn't get out of the sofa without two people helping. Clearly, this was not going to work for the future. I also had a beautiful California King bed...but this too wouldn't work with my new life, which requires me to get wheelchairs around the bed in a relatively small bedroom. I called RH Corporate and explained that my "new normal" meant that I couldn't love my RH furniture like I used to, and that I needed to make some changes. To my amazement, RH agreed to pick up and return my furniture. Thank you, RH, for your compassion and for looking long term to win a customer for life.

There are other examples, and I suspect there will be more. But these will stand out. At the end of the day, these last months have taught me that there is far more good in this world than there are negative forces -- sometimes you need to call, tell your story, and ask for help. I never liked asking for help before, and I don't quite like it now, but almost every time I have, people and companies have shown their humanity. Thank you.

Home

September 3 - January 19  (and really, a few days before September 3rd, cause we were biking up North and having fun!)

After a week at North Memorial Medical Center, 65 days at Mayo Clinic, and 66 days at Courage Kenny, I was discharged home on Friday, 19 January 2018.

The transition was less anxiety-provoking than the move from Mayo to Kenny. My contractor had done an incredible job getting my home (particularly my bathroom) ready for me come home. My parents did more than I'll ever even be aware of, and lived at a hotel for the 2 months at Mayo and in my cramped condo loft full of my crap and clothes for 2 months while I was at Kenny. 

We had new furniture delivered Friday afternoon (a bed that fit the room and a couch I could get into and out of). And then had a few friends over for a drink. 

There's a long way to go. We need to reorganize my home so I can get to dishes. I need to learn to navigate safely from the shower to the bed. And figure out how to cook again. Oh, and I need to return to work. This is a major milestone, to be sure, but it's one more step in a long process. 

Back in the Emergency Department (for simulation work)

I'm starting to think about what's next.  Rehab is wrapping up. I've developed a good base of skills to live life in the wheelchair. Strength and fitness are there, though always in need of improvement. Home is almost ready for me to come back, adapted (at least to some degree) for what we call the "new normal." 

Before the accident, I was both practicing emergency medicine at Mayo and working at Medtronic, the leading medical technology firm.  I left Medtronic after 4 1/2 awesome years and something like 60-75% international travel to explore some other things. (By the way, I'm incredibly proud of my team and of what we built at Medtronic: a new business focused on developed products and services for underserved patients in emerging markets called Medtronic Labs.) I'd been looking at some other business roles, both in Minneapolis and elsewhere. In the meantime, I was enjoying picking up shifts and working at Mayo Clinic in Rochester and also at some of the other emergency departments in the health system ... I'd missed just practicing medicine. I was scheduled for a pediatric emergency shift the day after the accident. I remember laying on the trail and, after figuring out that I couldn't move my legs, asking Ron to please call my colleague to tell her that I wouldn't be able to work, and that I was sorry. So, yeah, the practice of medicine is important to me -- as is balancing it with entrepreneurship and being a business leader. 

Yesterday I went down to Mayo Clinic and did some simulation work -- we often practice procedures on mannequins. We practiced intubation (putting in a breathing tube), central lines (large IVs often placed under ultrasound-guidance in the neck or other strategic locations  to allow administration of life-saving medications), and general positioning in the room for physical exams. Two of my colleagues helped to set it up and then offered pointers or suggestions or how to position better. I also got advice and some helpful videos from Francisco Sanchez, an ER doctor at Harvard who had a similar spinal cord injury during his intern year of residency ... he's had some time to figure it out and knows the tricks. That blue strap I'm wearing? It helps to hold me against the back of the chair because, no matter how much core strength I have, I'll always find it difficult to work with two hands out in space and to maintain my balance as I'll need to do to safely perform procedures.  

Overall, it was pretty awesome. It felt great to get back into the ER, to experiment and find positions that work, and to know that I'll be able to safely return to the ER and get back to something about which I'm passionate. I still have some work to do before I can return to work, but each small step is one more step closer to doing what I love.

Practicing intubations -- tried a few different positions, but straight on to the head of the bed worked best with my go-go-gadget arms!

Checking out some ears--- two hands out in space means lack of balance.

Central Line placement with an ultrasound on hand

Back on a bike & some odds and ends

So if it wasn't clear before, biking is pretty important to me.  It was my main form of exercise over the last several years. Also how I would unwind and think through important things in my life. I think part of my love of biking comes from growing up in the Netherlands, where biking is the primary form of daily transport for most people. 

We've also recently practiced some more floor transfers -- this wasn't the prettiest of the day, but making some progress and feel more stable doing this at home if necessary. 

Today, I got my first shot at trying a hand cycle.  Ron was there, naturally. As was my physical therapist. Courage Kenny has a really great sports and recreation program, including adaptive cycling.  There are different types of hand cycles, but we tried a pretty sleek one that is low to the ground. As you can see from the video, I didn't fit perfectly, but it felt pretty great to get back in the saddle and cruise the halls (it was -10 degrees F today here in Minnesota).  

Uploaded by None on 2018-01-13.

Finally, some very thoughtful friends sent me some boxing gloves while I was still in the ICU. They thought I needed a little more fight in me so they sent me these to "FIGHT ON." (Definitely not a USC reference..notice the Stanford logo.) We use these in therapy to build core strength and balance. (Also, YES, I'm fully aware that I need a haircut!)