 Welcome to Much More On Medicine. I'm your host, Catherine Noor. Have you ever been injured in an accident or at work? Well, if you have, stay tuned to learn about how to reclaim your health and life after a serious injury. Much More On Medicine is an opportunity to learn about all aspects of healthcare. I talk with guests about medical and alternative care, treatment, insurance, medication, surgery, rehabilitation, prevention, and much more. Today, I'm talking with Dr. Christopher Brigham. Dr. Brigham is a thought leader on human potential and disability, whose goal is to have all of us, including those who are injured and ill, experienced joyful and productive lives. He is an author of many articles and books and a professional speaker, having spoken at over 350 events. Dr. Brigham earned his medical degree from Washington University School of Medicine and is a board certified in occupational medicine. Dr. Brigham, welcome. Catherine, it's great to be here with you today. And where are you today? Today, I'm in Hilton Head, Iowa in South Carolina. Oh, gosh, that's wonderful. A little bit east of you, but it's still in Iowa and still begins with H, but. Okay, fantastic. Well, I understand that you used to live and work in Kailua. And I miss it dearly for 13 years. We lived in Kailua and just love being out there, but grandchildren are here, so here we are. Okay, fantastic. And you actually were an expert witness on cases that I had and it's great to reconnect and have you as my guest. And what's interesting about today is we're gonna be talking about a bike accident in which you were injured. Is that right? That's correct. That's one of the things we'll be talking about. Well, you said it's really the platform to talk about how do we get well after injury and illness. Okay, and I'm particularly interested in this because I actually was in a very bad bike accident. I hit, I was on actually traveling from Kahalui to Hanna and actually hit a guardrail with my bike and my bike broken half went into a tree and I went over a 180 foot cliff and fell 30 feet in the air, landed and survived and thrived thereafter. So I'm very interested in your story. So how long have you been biking? Well, I've been biking since I was a young child. So that's been a few years, I guess six decades that I've been biking. And it's something that I really love doing. So, you know, go ahead. And what led to the accident that you had? Sure, and let me share that story and it's not quite as dramatic as yours are going off 180 foot bridge or cliff, but in November, 2018, I was on a bike ride from the Savannah, Georgia down to Titusville, Florida, about 400 miles. Fortunately, not all in one day. We'll have heard about five days. And this is something that I love. And you can see the smile on my face of how much joy you know, I had with that and just love being there with my friends and doing what really I was impassioned to do was bike riding like you had been, you know, before you faced that catastrophic accident. So I'm biking with my friends, having a great time and then suddenly things changed very quickly in front of the Ripley, believe it or not museum, which is kind of ironic that believe it or not, but what happened in front of that museum? So I'm biking early in the morning in a car in the opposite direction, suddenly in front of me, driven by a 16 year old who saw me, thought that she could turn right in front of me and obviously she did not have the time. So what happened with that is the car and I struck each other and I did significant damage to the car, as you can see, but more seriously, it was the damage to me because cars can be easily repaired. So I was thrown about 20 feet through the air. I found out I was not Superman. I did not fly, I crashed and people came over and they said, oh, is he dead? Is he dead? Which is really disconcerting when you're on the ground and you're just in agony of pain. So the ambulance came and they transported me to one hospital. However, it turned out that this was a large hospital about 400 beds, you know, not quite as large as Queens, but it's quite substantial hospital. And at that point, they said, you're too unstable to be here and you're in critical condition. You need to go to a level one trauma center. So they took me to a level one trauma center and I was brought into ICU, as you can see in the next image. And there I found out that I had fractured seven of my vertebrae and my spine, the bones that are in our spine. I had also the collapsed partially both lungs. I tore my spleen. I fractured all my ribs on the left-hand side and a bunch of other internal damage and bleeding into my gut and the like. So it certainly was not a good day to say the least. And the practice thing was one, I survived. And second is I did not have, well, three things, I survived. I did not have a brain injury. And the third is I did not have a spinal cord injury. So I felt at that point, that really the Lord was not done with me yet. I was still to be around for a while. But the challenging part of that was the, how do I get well? And it's very interesting because the focus of my work as a preventive medicine occupational medicine physician has been understanding how do we both prevent problems? But then when we are injured or ill, how do we get well? How do we reclaim our ability to function fully with our lives? And so I've spoken on this, I've written on this and now I had to apply that back to my life. Unfortunately that I had a wife who was a nurse, a rehabilitation nurse and was well aware of the books and the papers that I've published in this area and said, Chris, you now have to apply what you wrote about. And so it was very much of a learning experience in terms of my recovery process of starting with the walker. And as you can see, that was a great difficulty of ambulating and not only the impact to my body, but also to my mind and my spirit. In fact, while in the hospital, immediately the second day, I requested a psych console on myself and not that it was crazy, but because throughout the night, it was occurring over and over again, the accident, just many, many times. And I wanted to avoid getting to an issue with PTSD. So it impacted my body, my mind and certainly my spirit in terms of what my identity of who I was, but also in terms of spirit about me reflecting on my faith and how do I apply that to my healing process? So we could talk about Catherine, some of the lessons that I've learned and I think would be helpful to our listeners, our viewers about how do we recover from that type of process. But let me just share with you some of the highlights before we get into the specifics with that. Is I focused on function rather than pain. And there's an interesting way of how I dealt with pain. We could maybe talk about that later on because I didn't give pain any energy. I did need to give it a lot of energy the first two to three weeks because it was really excruciating pain, which I managed without oxycontin content. It's rather with Tylenol and ibuprofen, but it was miserable. But how I dealt with that, how I focused on resiliency, how I focused on what we call neuroplasticity, which we can discuss about. And then I got back into the process of doing what I loved doing. So I had a brace on from my neck down to my pelvis, keeping my whole body firm for two months. I had to wear that. I was not very happy in that. Two weeks after that was removed, a friend of mine who shared the group that's with East Coast Greenway Alliance, wonderful organization, ironically working on safe bike routes from Maine down to Florida, he came and joined me and said, Chris, let's go on a bicycle ride. And it really was not the time when the physicians wanted me to do that. But I said, well, let's try that. It was rather a daunting experience, but I went bike riding. And then as you can see, I went bike riding with three friends. Later in the summer decided I'm gonna get back into the bicycle that was so scary for me. And then I said, I'm going to do the other things that I love doing. I love to sail. So I would get on the helm and sail, bringing joy to my life because I wanted to focus not on the deficits that I had or focus on Catherine. When you and I work together, one of the things I would do is quantify the impact of an injury using a book called The AMA Guides, The Valuation of Permanent Paramount, where 0% is where perfect, 100% is where dead. And my impairment was 44% whole person, which meant I lost 44% of who I was. And that's probably, as you recall, that's a very, very substantial impairment. That is a higher impairment than if I had a leg chopped off. You know, I don't know that I've ever even seen that before. I don't think that I've ever seen a situation that I was dealing with that the impairment was that high. It's very, maybe the top 1%, but that's where I was. So that was my challenge. I had this incredible physical loss. And then how do I focus on the positives and how do I restore my function? Which is what we all walk when we're injured or ill. Well, before we go on the break, I just want to ask you one more question then we'll proceed. But my question is this. As a physician, was it, do you think that it was harder to be in the ICU and be dealing with that or knowing what was going on? Or do you think that it was probably easier? It was a little bit of each. And maybe after a break, we could talk about the parts that was harder and then the parts that were easier. Okay. How did your wife, was she able to assist a bit? Well, go ahead. Not a bit, a tremendous amount. It was really wonderful to have somebody there as a support and an ally to help me through that recovery process. Because that's one of the things we need is we really need an advocate and somebody who can help us maneuver through the processes of healthcare. And it's very difficult as not being a healthcare provider to make the numerous decisions that need to be made and to really advocate for that person who's injured or ill. Okay. And so when we, after our break, we can talk more about this difference between, you know, being a physician and being a non-physician in terms of how that helped. But at this time, we'll take a short break. I'm Catherine Norr. This is much more on medicine on the ThinkTech live streaming network series. We're talking with Dr. Christopher Brigham about how to reclaim your health and life after serious injury. Hi, I'm Rusty Kamori, host of Beyond the Lines on ThinkTech Hawaii. I was the head coach for the Punahou Boys varsity tennis team for 22 years and we were fortunate to win 22 consecutive state championships. My show is based on my book, also titled Beyond the Lines, and it's about leadership, creating a superior culture of excellence and finding greatness. I feature a wide range of amazing guests who share valuable insights about how going beyond the lines leads to success in everything you do in life. I'm looking forward to you joining me every Monday at 11 a.m. Aloha. We're back, we're live. I'm Catherine Norr and this is much more on medicine on the ThinkTech live streaming network series. And we're talking with Dr. Christopher Brigham about how to reclaim your health and life after serious injury. Dr, so before the break, we talked a little bit about the fact that you felt there was a difference between being a doctor and if you weren't a doctor in how that experience was in the hospital or in ICU. You can expand on that, please. Sure, I'll be happy to. Catherine, there were pros and cons about being a physician. I think one is as a physician and then having a wife who is an advocate as a nurse is more attention was given to me. Although at other times I think they felt more of it could be self-contained and take care of things. I think I could certainly better understand what was occurring, which in a way was scary because I knew the significance of what was occurring. I also knew the other things that they had found in various studies that I was not concerned about. So there was a filtering of information. I knew what steps needed to be done. I was stronger about being an advocate and particularly my wife of being an advocate about what needed to be done in a timely way and also getting me out of the hospital so that I was in critical care for four days and was discharged from the hospital directly to home rather than going to rehab or a floor unit because I had the resources. So they sent me home with my walker and basically we continued what would have been hospital care at home. What I think is particularly impressive is the fact that you were able to get back on the bike and ride after this horrific accident. Can you tell us a little bit about that? I think it's important to return to function as quickly as you can. So even though I had marked difficulties and limitations I did return to the type of work that I do which is primarily sedentary at a desk and computer monitors a day later after I got home. And then with the bike accident once I had that this horrendous brace off me within two weeks I was encouraged and I knew it was the right thing to start to do what I had loved doing before. Not making a being very cautious about it. It was pretty scary to do that but by returning to what really brought joy and that I wanted to also we have changes to our brain that occur. And I wanted not to be reinforcing the negative but reinforcing the positive. So that's it was really important to me physically and certainly mentally to get back on the bicycle. Okay and then you actually there's a great picture of you holding bike. Can you tell us about that photo? Yes, one year later is I returned to where the bike accident occurred just close to that. And then I decided to join the rest of the group and I rode 435 miles down to Key West, Florida. And that was really challenging, Catherine. And I didn't know how challenging it would be because a lot of it was on highway with trucks going by at 60 miles an hour about a foot away. It was terrifying from one standpoint. And going through downtown Miami at rush hour was really difficult. But what happened is I got to the end and I realized I had done that. And I realized that during the event is that I would get discomfort which I never referred to as pain in my back. I'd say I'm aware of it, awareness in my back and I would get up and I would say awareness go away. I'd walk around and go back on the bicycle. And I realized if I got hit again I don't know what would happen to me but if I made it, it would all be behind me. My PTSD went away, my level of functioning increased. So I felt so blessed to be able to return with my friends and to ride safely and conclude at 435 miles and get to Key West. That's incredible. I'm really impressed by that. And what messages can you give to our viewers about how to reclaim their life after a serious injury or accident? There are many messages. First of all, in terms of our health we always have to deal with it from a standpoint of biopsychosocial that is our body, our mind and our spirit. Our typical medical system really just focuses on the body. We have to really understand and honor each of those areas. Resiliency is key. How we deal with challenges in our lives. And for those around us to really support resiliency and resiliency is also supported by compassion, by love and care. Also to be aware of what's called neuroplasticity which means that our brains are plastic, that they change, that if we reinforce negative things. If I focus on pain, if the doctor comes in and says how's your pain each time? I'm gonna focus on my pain. I had to have an attorney because of the complexity of the claim. But the attorney, I caution is not to focus on my pain. I didn't wanna talk in my pain, I was gonna talk about the function. And by focusing on function, it created positive changes in the brain as opposed to the negative changes that occur when we focus on pain itself. So mind, body, spirit, resiliency, neuroplasticity, it just returned to what you love doing. Right, right. You know, I think that that is an excellent message. And it was interesting to me when you said about how you were aware of what was going on in your body. Would you call the way you were using your brain, would you call that mindfulness? It is mindfulness. And mindfulness is so important that that's something I've applied mindfulness, meditation. And then probably from a physical standpoint, yoga and Pilates were really key to my recovery process. And you know, it's interesting that we have all sorts of interventions in medicine and we have drugs and surgery and often doing more harm than good. But we get back to some of the basics about mindfulness, being attentive to the moment, meditation. And then simple physical techniques like yoga and Pilates, we can get tremendous gains for those. And those really cost essentially nothing. What I've found is that it seems to me that in order to, or maybe the psychology of a lot of patients is that they need to get a pill or they need to have someone do something to them, like surgery or actually inpatient physical therapy or massage, do you believe that these tools that you're talking about are available and free to people that as long as they take action and do them themselves that they can recover maybe faster or more fully? Yes, many times. I mean, there is a place for medicines, is a place for surgery, but I think so often we've looked at these other things that have caused us to have problems. So the problems we have with opioids or unnecessary surgeries or unnecessary like spinal fusions that we have not been discerning. And there's also the, we have to consider the behavior of other stakeholders that when surgeons are paid to do surgery and that's what they know. So it's not surprising that they do that. That we as patients need to take control of our lives. When we're working with a healthcare provider, that is a person who's working as a member of our team. They're our consultant, they're helping us through the process but ultimately the responsibility of our recovery is our own. And that was very clear in my personal experience. It's interesting over many years of clinical practice and exploring and researching and writing on these topics. To then to have to deal with this myself was an incredible eye opener. So in a lot of ways, you apply these principles on your own. Do you feel that you're in a better position now that you've actually been able to apply those principles than you were before? I do feel that I'm in a whole different place of understanding and being able to better articulate what needs to be done and more dedicated to what needs to be done. So it was a tremendous learning experience. So I think back is, would I choose to have this learning experience again? Because certainly it's been enriching. No, I wouldn't choose to have it again but I learned a lot from it. So I understand that you are trying to get this message out in certain ways. Why don't you tell us about that? I'm trying to get it out for getting the message out to a whole array of stakeholders through social media, through the writing that I do, through presentations and that we really need to apply these principles back to our own health. And we also need to deal with the health and standpoint of our body, our minds and our spirit, our faith. Do you feel that insurance carriers and actually premium people who buy insurance would benefit financially if people did what you did and took control of their health? Absolutely, is I think a big failing of the insurance industry is a failure to empower, engage, to educate those who are injured or ill. So used to just paying bills and trying to control that process that we need to be much more visionary than what we've been before in that arena. So I think there's a real need for a change and not only in the insurance but from the area that we had to interface before the workers compensation arena, which was supposed to be a grand bargain with the injured worker, has been a system that has been so incredibly flawed that it's unfortunately benefited various stakeholders but not the person who we should be most concerned about that is the injured or ill worker. Because really what we're trying to do is get these people back to function, right? Absolutely, that's what we should be focusing on function and reclaiming our lives. That we all can experience joyful and productive lives. It may be different. My life is different than it was before but it's still a life that I cherish. Well, Dr. Brigham, it's been wonderful having you as a guest today and we've learned so much and you have been a terrific example of how we can proceed if we're injured or have an accident but we're out of time and we'll have to wrap it up. I'm Katharine Norr. This is much more on medicine on the ThinkTech live streaming network series. We've been talking with Dr. Christopher Brigham about how to reclaim your health and life after serious injury. Thank you for joining us today. Thanks for our broadcast engineer and to Jay Fidel, our executive producer who puts it all together. Please join us for future ThinkTech productions.