Favorite Mayo Clinic Stories of 2018: Emergency Medicine Physician Back to Work after Accident That Left Him Paralyzed #ThrowbackThursday
Each year, Mayo Clinic's In the Loop blog looks back and shares some favorite stories of the year gone by. Be sure to check back each week for the next story.
Emergency Medicine Physician Back to Work after Accident That Left Him Paralyzed
Daniel Grossman, M.D., was in command and control mode, assessing a 36-year-old who'd fallen off his mountain bike on the Cuyuna Trail in northern Minnesota. No one had seen the fall, which cracked the man's helmet and left him unable to feel or move his legs.
Having worked for a decade as an emergency medicine physician, Dr. Grossman understood the gravity of the situation. But it was also completely new to him. Because this time, Dr. Grossman wasn't only the physician. He was also the patient.
"I knew enough to know it was bad," Dr. Grossman says of those initial moments after his fall. He gave his phone to a friend and started directing calls. First paramedics, then family, friends, and the colleague who was expecting him to show up for a shift in the Emergency Department at Mayo Clinic's Rochester campus the next day.
He didn't make that shift. But less than five months later, Dr. Grossman would return to his role in the Emergency Department, reclaiming an important piece of his identity.
"Ultimately, this is a story about getting back to doing things," he tells us. And focusing on those things—work, independence, making a difference—has propelled Dr. Grossman forward in an extraordinary journey marked by hard work, determination and a willingness to accept a radically new normal.
A devastating diagnosis
Dr. Grossman was taken to North Memorial Medical Center, where imaging exams revealed a grim prognosis. He'd fractured a vertebra in his spine, resulting in a devastating spinal cord injury. An emergency surgery performed that night wouldn't change what Dr. Grossman had recognized at some level while lying on the bike trail. And by the day after the accident, he says, "I knew I wasn't going to walk again."
As Dr. Grossman began adjusting to this reality, a steady stream of visitors made their way to his side. His brother Aaron, a neuro-interventionalist practicing in Cincinnati, was at his bedside by the time he came out of surgery. His parents, who had been traveling in Europe, flew to Minnesota—and stayed for six months. Friends and colleagues came, too, from Mayo Clinic; St. Olaf College, his undergraduate alma mater; and Medtronic, where he'd led efforts to improve health care for underserved patients around the world.
Dr. Grossman was buoyed by their support and discovered one of the most important lessons he's learned on the other side of the bedside. "As a physician, I had underestimated the importance of a patient's support network," he says. Now, surrounded by love and encouragement, he understood its significance.
Days after surgery, his condition stabilized and it was time to start rehabilitation. Dr. Grossman chose to begin the next phase of his journey at Mayo Clinic. "My brother and parents considered rehabilitation options around the country and we ultimately chose Mayo for many reasons, not the least of which is that it's a place of comfort," he says. "It's family. It's home."
Dr. Grossman's homecoming put him in an unfamiliar position. He was returning to Mayo Clinic not as a physician, but as a patient. He recognized that accepting this new role would be essential to his recovery—both for himself and those caring for him. So he insisted that his care team call him Daniel, not Dr. Grossman, to emphasize that when it came to his recovery, they were the experts.
"Being a physician patient, people are going to expect that you know more than you do about your injury," Dr. Grossman says. "But I'm an ER doc, not a spinal cord doc. It was important to be humble about that."
At Mayo, Dr. Grossman began the difficult work of learning to navigate the world in a new way. He needed to learn how to move through life in a wheelchair, and how to master the many "transfers" that would be essential to his independence—bed to chair, chair to car, and floor to chair after the inevitable fall. It was demanding and draining work, physically and mentally. But Dr. Grossman tells us that every day he "showed up and worked hard and said thank you to the people who were helping me get to where I wanted to be." There was no self-pity, no time wasted wishing things were other than they were. There was simply radical acceptance, a concept Dr. Grossman discovered and embraced early in his journey.
"That doesn't mean I haven't set my sights on walking again or hope for a miracle of science," he tells us. "It means that I recognize where I am and what it means for me and my loved ones and friends. It means I embrace where I am and what I have to do to move forward."
After 64 days of working with the physical medicine and rehabilitation physicians, nursing staff, and therapists of Mayo Clinic's Spinal Cord Injury Rehabilitation Program, Dr. Grossman was ready to take the next step in his rehabilitation. He transferred to Courage Kenny Rehabilitation Institute's Transitional Rehabilitation Program in the Twin Cities, which offered a longer-term, high-intensity inpatient rehabilitation program. There, he continued to hone the skills he'd need to get back home, back to work, back to the life waiting outside of the hospital. "My goal was to return to independence as quickly as possible," says Dr. Grossman. That included learning to drive an adapted vehicle and passing a driver's test, milestones he achieved during his stay at Courage Kenny.
After more than four months of therapy, Dr. Grossman was nearly ready to return to work in the Emergency Department. But first, he'd need to learn to perform physical exams and procedures from a seated position. He'd reached out for tips from other emergency medicine physicians who use wheelchairs and watched videos to see how they adapted their practice.
But preparing to go back to work would require much more than watching videos. Dr. Grossman would need to learn to do familiar things in different ways. And he'd need his colleagues' help. This presented another lesson for someone accustomed to doing things for and by himself. "I'm learning that people are willing to help and actually really want to help," Dr. Grossman says. That included several of his colleagues, who volunteered to practice exams and procedures with him in the Emergency Department with equipment from the Mayo Clinic Multidisciplinary Simulation Center. Not long afterward, some of those same colleagues would partner with him during his first shifts back in the Emergency Department.
"I had to begin that practice with humility, recognizing that things were not going to work perfectly right away," Dr. Grossman says. "My colleagues have been incredibly supportive."
So have some of his patients. While many react with surprise or confusion when Dr. Grossman wheels into an exam room, others seem relieved, as though they're comforted by being cared for by a provider who has clearly faced his own health hurdles. "One patient said she thought you have to go through something yourself to be a good doctor," Dr. Grossman says. "I don't believe that, but I do agree that having a personal experience gives you a perspective that others might lack."
For Dr. Grossman, that new perspective is a gift that has transformed the way he cares for patients. "There's no question that this accident will have a long-term impact on my ability to be a better physician," he says. "It's made me more empathetic and compassionate and made me much more aware of my patients' needs."
It's also made him more aware of the challenges within the health care system and more committed to finding a way to address them. "It's a difficult system to navigate," Dr. Grossman says. "I now have a unique voice. I want to use it to help humanize the system."
We have no doubt that he will.