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Injury Journal

Going Under the Knife: Managing My Fears

I have always been fascinated by the moment of awakening – that momentary chasm in which one emerges from the often fantastical world of the dream, prises open their eyes and becomes re-acquainted with the reality of their being. It is in this fleeting moment that the myriad fragments of our being, including the personal fears, challenges, opportunities and aspirations that define who we are come flooding back into our consciousness. And then there are those days that begin with an elevated sense of significance, of existential agony, and a genuine knowledge that ‘today is a big day’. As the morning light endeavoured to break through the sleepy residue in my eyes and I sought to strike that most cherished snooze button on my over-excited alarm clock, the magnitude of this day dawned on me. November 29th, 2011 was the day I would have reconstructive surgery on my ruptured anterior cruciate ligament and formally begin the long and arduous rehabilitative process. Boy was I ready for it. I had endured 5 weeks of grief, accepted copious amounts of sympathy but perhaps more fruitfully, acquired a keen sense of reflexivity about my own privilege.

As the immediate drama of my injury dissipated, I became acutely conscious of the human element which is at the very heart of our health systems, with doctors, nurses, therapists, hospital staff, colleagues and friends helping me to better understand the distinctively caring nature which is an inherent part of the human condition. As i crutched my way through the unmistakeable stench of bustling hospitals, through waiting rooms tense with personal concern, and through the rehabilitative energy of my therapy clinic, I learned much about the generosity and compassion that makes us distinctively human. However, it would be remiss of me not to admit that I witnessed a troubling degree of self-entitlement, of selfishness and of the sharp boundaries between privilege and poverty which permeates through our social world. Indeed, never was I more aware of my own privilege than the brief conversation I shared with an elderly Ukrainian gentleman as we both sat patiently awaiting our call for an MRI at Toronto’s Mount Sinai hospital.

As I nervously sat awaiting my first MRI, the only stimulus distracting me from my embarrassing attempt at putting on my scrubs was the almost comical stillness of the old guy directly across from me. Complete with a steely sense of focus and a remarkable fixation on what appeared to be my pale upper chest, this was a man overcome with anxiety I told myself confidently – a belief that was more about comforting me than a concern for my new friend. But seemingly without even twitching, he says, ‘Don’t worry son, this MRI business isn’t as bad as people make out. If you ask me, sitting in that chamber is no worse than that head-banging music you kids listen to these days’. As I broke into an appreciative laughter, he proceeded to ask me what the purpose of my visit was, a question to which I provided my now customary response about a torn ACL and a bruised ego. However, as he revealed the details of his continuing battle with testicular cancer and a 6 month wait for surgery on his troublesome hip, the comparatively trivial nature of my ailments suddenly became apparent to me. I had waited for nothing or nobody. I had received the very best in medical care, with x-rays, MRI scheduling and surgeon referrals organized on my behalf before the dust had even settled following the trauma of my injury. As my new friend had inadvertently shown me, I had relatively little to complain about.

However, as I tentatively donned my Varsity Blues tracksuit and made my way (accompanied by a much cherished friend) to the hospital, I could do little to disguise my fears. I was petrified about the thought of my impending surgical procedure, with memories of my squeamish reactions to hospital drama’s such as Casualty and Holby City now pulsating through my mind. I was going under the knife! My most serious injury previously was an ankle sprain and now here I was having the most integral ligament in my knee surgically reconstructed from a grafted piece of my own hamstring! As I sat patiently in the hospital waiting room clad in my now standard issue pale green scrubs, I struggled to engage with the supportive friends who had come to ‘see me off’. I found myself fixated on the automatic doors which opened onto the corridor towards the surgical chambers, eagerly waiting the announcement of my name. Clearly recognizing my distress, friends would seemingly take it in turns to re-assure me that all would be well come 5pm – the time I was scheduled to emerge from my post-anaesthesia slumber. They even achieved a momentary grin from my anxiety ridden face, a reaction to the suggestion that I might ‘enjoy the buzz of my heroine-derivative painkilling drugs!’

As the clock in the corner of the room settled into its groove on 1pm, I saw the doors open and with a relaxed precision, my name was announced. As I eagerly got to my feet, I could feel the nervous induced grip on my stomach tighten to breaking point. I became oblivious to the final well-wishes of friends as I walked assuredly through the double doors – a somewhat futile attempt at concealing the now carnal sense of trepidation that I was experiencing. In the following moments, I would be greeted by my surgeon – a supremely confident young man in whom I had amassed a great deal of respect. ‘You ready Darragh?’ he asked. Despite being cognisant of the fact my anxious smile spoke a thousand words about my state of mind, I nevertheless responded with a determined ‘Yes, Yes I am. Let’s get this knee back on the mend’. And with that, he began unravelling the intricacies of the procedure, before the no nonsense anaesthesiologist briefed me on his role in my surgery. Then it was time. As I walked in the surgical room, pacing proudly like a man facing the death penalty for a crime he didn’t commit, I climbed up onto the operating table and greeted the seemingly endless number of operating staff, surgical assistants, anesthesiologists and of course, my therapist who was granted access to observe the procedure. My final pre-surgery memories are of a Polish man administering the drip to my left arm as he locked both my arms in a crucifix like position while chattering about his admiration for George Best – a much celebrated Northern Irish footballer. This is where the lights started to dim and I gradually felt myself slip under, my mind finally halted from its unrelenting array of ‘what if’s’…

Fast forward a somewhat excessive sleep of five hours and I was repeatedly awoken by the indescript chattering of my nurses, both of whom were willing me to take deep breaths – a series of prompts which I comically failed to respond to. Following much laughter from my Romanian nurse and her assistant, as well as numerous cycles in which I would seemingly gain consciousness only to subsequently slip back under again, I eventually managed to regain my consciousness with the nurses celebrating my achievement by labeling me as their very own ‘Irish sleeping beauty’. ‘Well young man, you’ve had quite the sleep! Your surgeon had hoped to be here to tell you the good news himself but we couldn’t rouse you from your dreams and so he instructed me to let you know that everything went perfectly. The doctor said to inform you that his work is now done and it is your responsibility to continue on your ‘leg’ of the journey’. As her words resonated with my still muffled sense, I switched my attention to my bandaged left knee – briefly lamenting its dire complexion before quickly urging myself to think positively. It wasn’t long before a mini-legion of friends shuffled into the room one by one, all smiling tentatively as they assessed the visible evidence of my procedure and perhaps with more importance, my mental state. In typical fashion, I was immediately asked ‘how does it feel to be high for the first time?’, to which I responded by shrugging my relaxed shoulders and firing off a cheeky smile. It wouldn’t be long before I realized the value of my painkilling medication as the mind-numbing daily pain kicked in during my initial post-surgery period.

Despite the continuous onslaught of pain and application of ice and elevation, I was soon weaning myself off the medication and my crutches – a decision which was in keeping with my determination to begin rehabilitation immediately. In the weeks to follow, I would make great progress as I sought to negotiate the thin line between pushing myself to the limits and granting my knee the necessary time to recuperate and regain strength on its own. By the time I boarded a flight to Ireland for the Christmas Holidays, my crutches would be little more than a burden as I slowly regained my gait and perhaps more importantly, trust and confidence in my left knee. Things were looking up. Little did I know about the hard work that lay ahead…

The ‘Rock’ hitting bottom: Coping with Injury

As I eventually came within sight of the stadium, I could see the explosion of light radiate into the crisp cold of the night sky, its beauty bettered only by the familiar echos of our pre-game warm up as the almost ritualistic sounds of ‘Shipping up to Boston‘ pierced the quiet of the evening air. The assent of the Dropkick Murphy’s to the top of our pre-game routine said much about the influence I had on the team since assuming captain’s duties two years earlier. As I slowly made my way through the automatic doors to the stadium, the receptionist greeted me with a warm compassionate smile as she clamored to grant me access through the wheelchair specific gateway, an area which I had previously been oblivious to. Smiling to acknowledge her kind assistance, I maneuvered my crutches in the desired direction, and quickly engaged my already fatigued upper body to propel myself into the stadium and the beginning of an evening which I would later realize was the lowest point in my recovery. In the days immediately before, I had come to accept that I would play no further part in the quest to retain our OUA title and perhaps more poignantly, that I was to undergo a career-saving surgical procedure and a long journey back if I was to reach the height of my athletic powers again.

That very afternoon, I had sat quietly on a hospital bed flexing my traumatized left quadriceps as I pondered the onset of muscle atrophy and the words of my newly acquired surgeon. ‘Would you like to see the internal imaging of your knee, Darragh?’, he asked sensitively as I feared the arrival of further bad news. Momentarily finding a fragment of courage, I replied ‘Yeah why not… I guess I should really understand what I’m up against here’. However, as he maneuvered the MRI image of my left knee on the large screen, pointing out the ligament damage on my medial side and the potential tear in my lateral meniscus, I curiously asked what had been of my anterior cruciate ligament. Pivoting his head in my direction, a wry smile extended across his surprisingly youthful face as he delivered one of the few comical moments I would experience in those early weeks. ‘Almost breaking into laughter as I attempted to decipher what was funny, he pointed to a little stub on the screen, ‘That’s what remains of your ACL my friend! Think of it as happily blowing in the wind at this point’. Before I could get time to really process the image of my devastated ACL, he quickly began uttering comforting words in my direction, assuring me that ‘when he’s done, it will be as strong as an oak tree again!’. I have always been a very independent person, struggling to trust others in times of need and always the first one to volunteer to take on the difficult decisions during times of pressure – a fact which was testament to my leadership instincts. But as I grappled with the challenging techniques of crutching as I entered the stadium to watch my teammates, my strength of character and personal resolve was about to tested beyond its limits.

I have always found it difficult to observe the wonders of a football match in its live form. I become agitated, too eager to criticize those players who are seemingly too lazy to truly realize the full extent of their talents, and frequently descend into my own world as I analyze the performances of players that I can learn from. But, watching my own team – the guys I have played with through success and failure for 3 years now – would prove to be a more troubling experience that anything I knew previously. Knowing that the guys would be eager to welcome me and pay their sympathies about my injury, I decided to make my way straight out onto the field as they went through their final preparations for the potentially tricky challenge ahead. Varsity Stadium is a majestic place at night, with its blinding floodlights providing a fitting accompaniment to the myriad skyscrapers which paint a dreamy cityscape reminiscent of images of the New York skyline which I had grown up watching on television. Down at field level, the guys were ready to go, with a heated fury of steam rising above them as they stroked the ball around the park in a manner so fitting of our team’s style of play. With the improvised whistling of our assistant coach, the guys casually made their way off the field and in my direction, a moment at which I found myself becoming embarrassed – uncomfortable at the impending chorus of sympathy about to come my way.

As I began explaining the seriousness of my injury, the guys remained as silent as I’ve ever seen them, each one’s attention to the uttering’s of my mouth broken only by a momentary glance at the state of my left knee as it hovered helplessly above the ground. As the guys gradually filed towards the changing room – their pace seemingly rapid in my new sense of perspective – I lagged behind with one or two of the guys who understood the limitations of my crutching abilities. Entering the changing room, the feeling of embarrassment refused to subside as I received a round of applause for my decision honour my captaincy duties. One by one, the coaches and players would slide towards my customary position in the corner of the room, offering words of encouragement and assuring me that I was much too strong to let a setback like this beat me. I would routinely offer the same contrived smile to acknowledge their kindness, while simultaneously sinking deeper into my own world of private depression. The truth is that there were no words that could lift me from my sense of woe as I sat quietly in the corner of the room, elbows languishing tiredly on my thighs as I watched the other guys put the final touches to the preparations – slipping on their many different styles of boots, pulling their socks into position and chattering with anticipation about the game ahead. As I lowered my head towards my knees, I suddenly noticed the presence of my previously cherished Nike boots, still glossed by the sweaty residue of that tragic game a few days before.

As I picked the left boot up for closer reflection, I heard a gentle piece of advice coming from my immediate right, ‘Don’t do it to yourself man… It’s a little too soon to be torturing yourself don’t you think. You’ll be back in them before you know it’. I quickly let the boot slip from my grasp, again feeling uncomfortable with the inevitable interrogation of my every expression and gesture. With the sound of our Head Coaches voice, the boys quickly ended their chattering, got to their feet and locked arms in the middle of our team room, a ritual in which I had always delivered the final words as we awaited the knock of the referee on the door. As I gingerly got to my feet and grasped helplessly to my crutches, I could feel myself becoming overwhelmed by the possibility of having to address the boys. Looking back I was petrified of having to look them all deep in the eyes and attempt to articulate my demands on them for the game ahead. As their arms locked around my shoulder, I exchanged a momentary glance with my close friend and assistant captain, Geoff – a guy who I was delighted to see have the cherished opportunity to walk the team out wearing the armband. Before I could even attempt to clear my throat, Geoff had recognized my suffering and launched himself into a powerful speech before delivering the words that would break my already ailing pokerface. Looking me with a steely determination and a genuine respect, Geoff said ‘this one’s for you skip’.

Already feeling a growing sense of disconnection from the inner sanctum of the team, I decided to politely refuse the offer of a place on the bench alongside the coaching staff, instead deciding to watch from the lofty heights of the press box. As I sat snuggled into my oversized team coat, left leg elevated on a nearby chair, the full consequence of my decision not to walk away from the program descended upon me. Having to watch the guys play was already excruciating and I had yet to make it through the first half. It didn’t help that the guys were not performing, their first half characterized by sluggish possession play and a lack of impetus which seemed to extend itself through the entire line up. Going in at half with a 0-0 scoreline, I endeavored to lift myself of the chair to make my way towards the changeroom and help light a fire under a few guys for the second half. However, as I grimaced in anticipation of moving my left leg, I had completely stiffened up – the already cement like settling of scar tissue in my knee joint making it difficult to bend my knee. Realizing that I wasn’t capable of making it down to the room in time for the team talk, I sunk deeper into my chair and awaited the emergence of the boys.

The second half would legitimate that most overused expression in every commentators repertoire – a ‘game of two halves’ – as the guys began asserting their obvious technical dominance on a labouring opponent who looked on the verge of caving in at any moment. With a piece of sublime skill, we would take the lead – a goal which I greeted with a muted arm in the air as I sought to avoid disturbing my now settled left leg. Running away with a 4-0 win in the end, I slowly labored my way down to the field for the final whistle to congratulate the boys – a decision which was as much about keeping up appearances as it was a genuine desire to do so. I was already struggling to keep myself connected to the team, to the program as I tried to deal with the fact that I was no longer the one everyone looked to in times of need, and no longer capable of leading by example as we swept aside anything that stood in our way.

With as many as 5 games to go in the season and the thought of my impending surgery pertinent in my mind, I was deeply pensive as I hobbled out of the stadium on that chilly October night. As would prove only too accurate, the weeks ahead would be supremely painful as I came to terms with my rehabilitation timeline, watching the boys initially prosper without me on the field and slip deeper into an unpredictable and damaging emotional volatility that would threaten the relationships that were most dear to me. I was becoming depressed and I knew it. I just didn’t know how to stop it. Looking back, I didn’t know that this was the toughest point in my recovery and things would slowly get better as I prepared to go ‘under the knife’ and begin rebuilding the structural integrity of my knee.

‘I have a torn Anterior Cruciate Ligament… Repeat!’

Whether it’s a routine Sunday afternoon kick-about with friends, or the dying embers of a Manchester Derby, the inherently dramatic nature of sport is ever-present. It engulfs all those who embrace it, with players, coaches and fans investing their very sense of being in the ‘game’, putting their bodies on the line, and pushing the boundaries of what is physiologically possible in the quest for achievement, success and personal fulfillment. However, as with all dramatic performances, the delicate balance between triumph and tragedy is constantly in flux, with moments of elation carefully counter-acted by those of despair, failure and in the moment in which I felt my knee twist, genuine devastation. The moments immediately following the injury have now been resigned to the deepest corners of my memory, but the palpable sensation of shock that accompanies a season ending injury will forever remain with me. Spiked from copious amounts of adrenaline pulsing through my body, I initially refused to accept the reality of my ruptured anterior cruciate ligament, actively resisting the therapists (who would become such cherished and trusted friends in the coming months) as they sought to test the structural integrity of my left knee.

Indeed, my stubborn refusal to accept the extent of my injury even led to me performing an unaided squat in the immediate moments following the trauma of my ligament damage. With the invaluable aid of retrospective, I was clinging desperately to any fragment of hope that was left, that maybe I had only suffered a minor tweak and would be fit to captain the program I cherished so deeply to its second consecutive championship. Our program is unlike any other, founded as it is upon an incredible group of young men whose drive to succeed is much greater than any individual craving for achievement. Here, the collective is stronger than the sum of its parts, with a group of selfless individuals mobilizing around a greater cause and giving everything they have to achieve success – for our program, for the guy sat beside you and only then, for yourself. As I hobbled out of the stadium fearing the worst for my traumatized left knee, I knew that I would soon be presented with a tough choice – to either pledge my continued support and leadership to the team and continue to honour my captaincy despite being reduced to a mere spectator or to walk away from the program and begin the long road back to fitness free from the sinking feeling of ‘what if’ on a daily basis. As I reached home and finally came down from the adrenaline driving me on, I soon fell asleep with my knee elevated – a position that would soon become ritualistic. Barely a few hours later, any simmering hope of avoiding serious injury would evaporate in a split second as I opened my eyes only to experience the kind of excruciating pain that had been unknown to me previously. Overwhelmed by my inability to engage my heavily swollen left leg, I broke-down in tears as I stared helplessly at it, hoping, wishing and praying that this wasn’t really happening.

My worst fears would be confirmed the following morning as I became acquainted with crutches and slowly made my way to the Sports Medicine clinic for the dreaded diagnosis. As I sat waiting to be called, I began thinking about how I would react when I received the verdict – would I break down in tears? Looking back, it was one of the toughest moments of my career, and when that doctor lifted and manipulated my left knee, it was all confirmed by my tearful shriek and soon I heard those dreaded words. ‘I’m sorry son, you’ve torn your anterior cruciate ligament with 100% certainty. You’re varsity season is over’. Lying on the treatment table as his words penetrated the inner sanctum of my being, I halfheartedly sat head in hands quietly grieving until he began outlining the details of my proposed surgery and planning for the road back. As he left the tiny treatment room, I felt empty, unable to think, unable to feel and unable to fathom what this all meant for the coming months. so many questions raced through my mind, not least of which was what would now happen to my doctoral research. Would I be able to make it to Ghana as scheduled in January? Where would I stay after surgery and who would look after me given that my family and home comforts where all the way back home in Ireland.

Picking myself up off the table, I slowly managed to dress myself, slipping my sock on to my left foot while battling the grueling pain coming from the micro-bend in my knee. Grasping tightly to my crutches upon standing up as the blood plummeted to my already swollen left knee, I emerged from the room to break the news to my therapists and friends. This would come to characterize the next few weeks as I routinely went through the almost ritualistic description of my injury, the surgery and what it all meant. But as I made my way out of the clinic that day, I knew that I was ready for the challenge – although little did I know that the dark days were yet to come as I grappled with my place on the margins, my depressive demons, and the quest to trust my knee again.

Crossing the White Line: My Journey Back

On October 16th 2011, I gained what many of us know only as ‘perspective’ – that all too elusive intrinsic capacity to take a momentary step back from the here and now in such a way that allows one to understand their individual positioning relative to all that which they have known previously. At few points in life do we truly acquire perspective, at least the kind that allows you to radically contextualize all that you are, all that you can become and perhaps more commonly, all that stands in your way. As I stared blankly into the distance, pale faced and overcome with a sense of shock, I knew I had acquired mine. I was in the midst of a title deciding game at the business end of a season in which I knew I was destined to achieve, playing with a level of confidence that athlete’s know only at special moments in their careers. But, in the cruel, and dramatic manner that is so deeply woven into the very fabric of competitive sport, my ‘special’ season was about to be curtailed in that most heartbreaking of ways as I tragically twisted my left knee in a seemingly innocuous challenge. And in that moment, all that seemed routine in my world was quite literally dislodged at it’s very foundations.

As any athlete will tell you, injuries are simply a frustrating dimension of the game, with hamstring niggles, quad strains or groin tweaks often restricting one to an observational position on the sidelines or even a weekly slot on the physio table. However, few will tell the tale of those injuries that put your very presence on the field in permanent doubt – the kind that catapults you from the light into the darkness, from dancing under the Friday night lights to the solitary confinement of rehabilitation, coping mechanisms, and the deep search for the vast quantities of self-belief required for the long journey ahead. As I lay rigid on the damp turf, adrenaline pulsing through my veins and eyes bulging from the trauma, I knew my season had just ended and my greatest challenge only begun. As team-mates and physios hurriedly shuffled in my direction, I felt a sense of disconnect – not only within my now ruptured anterior cruciate ligament but from my immediate surroundings as time slowly ground to halt around me.

‘Get me off! Just get me off’ I agitatedly replied to the concerned inquiries of the physio’s. As I slowly got to my feet, the realization sunk deeper – my season was over. In the surreal manner that is so often tangible in the most tragic moments, I briefly flirted with the idea that this wasn’t really happening – a feeling that was soon extinguished by the resigned look of sympathy etched on the face of our Head Coach. Knowing he had suffered a similar fate some ten years before, I will always remember the moment we exchanged eye contact as I was carried from the field. If everything up to this moment was a muted blur – the sounds of the stadium, the supportive words of team-mates and the calming examinations of the physios – it was about to violently change as I became excruciatingly conscious of my surroundings, my pain and within seconds, the challenges that lay ahead.

Immobilized on the table as the physios manipulated, examined and tested the structural integrity of my traumatized left knee, the feeling of disconnection transitioned to one of genuine anguish – the ‘what if’s’ now stimulating teary emotions as I lay yards from that white line. In the weeks and months to follow, it would be the burning desire to get myself back across that line that would dominate my thoughts, quench my fears and support me through my darkest moments. Owing much to my love for the game and a stubborn determination to command my own destiny, the word ‘recovery’ would quickly engulf my very sense of being, whether first thing in the morning or at my lowest ebbs of despair as I lay awake in the cold dark of night. Indeed, it was these very nights that are the catalyst behind my decision to share my experiences, struggles and victories as I navigate my journey back across that white line. Many of the fragmentary personal narratives that will be presented here have been penciled in the midst of sleepless nights in which I failed to keep my left knee motionless and elevated. I hope that my stories will be of as much interest to friends, family and colleagues as the process of writing them has been for me.

With that said, I invite you to engage with the stories, experiences and challenges that have characterized my daily existence as I continue my journey along the long road to recovery. In granting that most precious of insights, my renewed sense of ‘perspective’ has allowed me greater clarity in understanding that football simply isn’t ‘just a game’ in my world, but rather it is the platform through which I feel ready to take on the world.

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