It started like any other Sunday. The radio was on, Mardi and I were reading: I was lamenting another loss by the Rabbitohs while Mardi caught up on her X feed. I got up to make Mardi a cup of tea and some toast. That’s normal as well.
Tea made and delivered.
Toast made and almost delivered!
That’s when the day changed.
As I ascended the steps to our bedroom, I slipped. You know those moments in life when time seems to slow down? It is a fascinating interplay between biology, psychology, and neuroscience. When you, or in this case me, are crashing down towards a bookcase, a door, and the floor—otherwise known as a frightening situation—your brain undergoes a series of rapid responses. The amygdala, which is the brain’s emotional centre, gets activated. It triggers the release of stress hormones, including adrenaline and cortisol, preparing the body for a “fight-or-flight” response. This heightened state of arousal not only affects physical reactions—such as increased heart rate and heightened senses—but also has a profound impact on how time is perceived.
Under stress, the brain processes information more efficiently and quickly, allowing for a greater intake of sensory details. Studies have shown that during threatening encounters, individuals often recall more fine-grained information about their environment compared to non-threatening situations. This is believed to occur because the brain encodes memories differently during stress. Neurobiological mechanisms suggest that fear enhances memory formation and retrieval in a way that can lead to the illusion of time dilation. The increased detail in memory may cause individuals to feel as though time has slowed down, as they can vividly recall moments that seem to span a longer duration.
Research also supports the idea that time perception is closely tied to attention. Under duress, our focus narrows, creating the sensation of an extended timeframe. The brain prioritises important stimuli, leading to a slower subjective experience of time as it becomes acutely aware of surroundings. Consequently, the experience of fear can create an impression that time has expanded, allowing critical moments to be processed in more detail. In essence, while actual time does not change, our perception of it can be significantly altered by our psychological and physiological states. This complex interplay provides insight into how our mind and body work together to navigate perilous circumstances, thereby enhancing our chances of survival.
As I fell, this is exactly what I experienced. Immediately, I thought about my shoulder. I dislocated it—my right one—20 years ago (and the left one about ten years ago). But today, it was the right one’s turn again!
At the same time, I was aware of my head as the sharp corner of the bookcase loomed quickly. In my left hand, I was clutching a plate of toast, which I was trying to save, but I quickly let it go to try and stabilise my fall. My right hand took the brunt of the impact, allowing me to avoid my head being pierced by the bookcase. However, as I slid further down, my right hand hit the ground, and I heard that way too familiar “pop” as my shoulder was forced out of its joint. The shoulder joint allows for an extensive range of movements, which are crucial for various daily activities and athletic performance. It consists of the humerus (the upper arm bone), the scapula (shoulder blade), and the clavicle (collarbone), all of which work together with tendons, ligaments, and muscles. This intricate design provides unparalleled flexibility, but it does come at a cost: the joint is inherently susceptible to injury, particularly dislocation, where the humerus is forced out of its socket in the glenoid fossa of the scapula. Much like a golf ball on a tee, which is perfectly capable of sitting there, once under stress or hit with a club, the tee and ball quickly separate.
At the same time as the popping occurred on the right side, the toast and plate met the ground on the left, creating a tremendous noise. My head then collided with our bedroom door, making a third banging sound—the cacophony of sounds, almost rhythmic in nature, filled the house for what must have been only a second, though it felt like an hour-long performance.
The house fell silent as I slumped in the corner, broken china surrounding me, Vegemite and butter smeared across the wall and floor. The only sound, much like the beginning of Pink Floyd’s Dark Side of the Moon, was my heartbeat pulsating in my temples.
The silence was broken by me letting out a guttural “ouch,” as something in my brain triggered me to pop my shoulder back in. You see, I’ve been here before…
Twenty years ago, I tripped on a hose and fell outside, cracking three ribs and dislocating my right shoulder. Ten years ago, I fell off a ladder, dislocating my left shoulder. Neither time was I able to reposition my shoulder, so I sat in agony as, on the first occasion, Mardi drove me to hospital, and on the second, I called an ambulance. The pain was excruciating as my flaccid arm just swayed to its own tune.
This time, I was not going to endure that pain again; so, almost subconsciously, I grabbed my right elbow with my left hand and pulled my shoulder back into place.
Another guttural “ouch” escaped my clenched teeth.
Mardi had responded to the muffled sounds following the shattering of china and opened the bedroom door to see me hunched over, drenched in sweat and ready to vomit.
Sweating is a result of the activation of the sympathetic nervous system, part of the stress response. In stressful situations, the body prepares for potential physical exertion by increasing sweat production. I was bathed in sweat.
My head knock had caused a disturbance in my inner ear, which is crucial for balance and spatial orientation. This disruption triggered a sensation of dizziness that made me feel like vomiting. I sat hunched over for a while, waiting for the wave of nausea to pass, my shoulder cradled in my left hand. Mardi cleaned up the mess as best she could while I sat there.
All of the above took less than ten seconds.
A few minutes later, as the nausea passed, Mardi helped me back into bed. We discussed going to the emergency department, but as my shoulder was back in and my head was still sore, albeit starting to relax, we decided to wait and see.
Ten minutes later, my shoulder popped out again. The slightest movement and “pop.” Instinctively, I put it back in. That’s when we decided it was time for the hospital.
Cradling my shoulder, we drove the ten minutes to Canberra North Hospital (Calvary). We parked and went to emergency. It was quiet, it was Sunday morning around 11:30 am. A man was in front of me, hobbling; he had ruptured his Achilles. There were three or four other folks in the waiting room. The ACT Health app suggested a two-hour wait for non-emergency cases. I was one of those.
We went through the admission process. I received a temporary sling, which felt so good, and I was asked to wait for the doctor to perform an initial assessment. During my wait, the triage nurses were great, taking vital signs and checking on everyone in the waiting area. I was keen for some painkillers, which came only after I had seen the doctor, but sitting quietly was all I could do to dull the pain.
I took in my surroundings. The waiting room could easily seat 100 people. It was divided into several smaller areas, perhaps a COVID measure to keep people a little farther apart. Mardi read a sign on the wall stating that the COVID status of the hospital was amber—whatever that meant. There was a drink machine, a snack machine, and various brochures on health services in the ACT. The patients waiting formed a mix of our society. There was the young guy with his Achilles and his girlfriend/wife, an older Asian lady reading quietly, an older Caucasian man coughing up a lung, a European family with a screaming child, and a pair of very old ladies holding onto each other for dear life.
Other people joined those of us already waiting. People weren’t seen in the order of arrival, but in the order of the severity of their ailments. An older gentleman arrived complaining of chest pain, and he was ushered through the waiting room immediately. Another family arrived with a screaming child; I could hear the screams slowly die down as they were led away down a hallway, each scream growing quieter as the family passed through doors away from the waiting area. The Achilles bloke was whisked away in a wheelchair, his female companion trailing behind with bags, jackets, and drinks filling her arms as she rushed to join him.
The TV was on, the Paris Olympics, the volume at that annoying level: just loud enough to hear it, but not enough to understand it. Replays of so-called heroic events unfolded on screen as Australian athletes were showcased with medals of varying colours. Commentators routinely using terms like “Australian hero”, “heroic act” and “super-human effort”. I love sport, and I enjoy watching Australian athletes perform at their best on the world stage, but they are not heroes.
They do what they love and sure give up a lot for it, but it is a choice, a passion, a desire.
We certainly excel at this level, and each athlete deserves applause for their achievements. For us, their success is but a moment in time; for them, it is a four, eight, or even twelve-year journey to reach that moment. Many watching, including myself, will never really grasp the effort they put in to achieve “their” pinnacle, so we should cheer for them. However, their acts are not heroic. They train for this moment, they choose this moment, they aspire to this moment.
The smell of bleach wafted in waves, accompanied by hordes of staff as the shift changed at 1:00 pm. The smell of bleach mixed with the scent of alcoholic vomit as a man sitting three metres from us leaned into a bin and heaved up last night’s dinner—the thirty beers he had. He slumped back in his chair before heading in for round two.
The Achilles dude returned on crutches, his leg swathed in bandages as he departed.
At around 2:20 pm, I heard my name called. Dr. Abby greeted us. She was British and in her 30s. She escorted Mardi and me to a room, flattering Mardi by assuming she was my daughter. Mardi exclaimed that she was only two years younger than me! The doctor chuckled.
Dr. Abby turned to me and asked what had happened. I recounted my woes from earlier in the day. She examined my shoulder and asked about my head injury. Satisfied that there were no ongoing neurological issues, she mentioned that she had ordered an X-ray to further investigate my shoulder before proceeding with any treatment. She promised me some painkillers.
We headed back to the waiting room. It felt a bit busier now, with a line of people waiting to see the triage team.
A few minutes later, I was called for an X-ray. Dr. Abby saw me again about an hour later and informed me that there was some serious damage, but it could be from my initial shoulder injury 20 years ago, or something new. She ordered a CT scan and fitted me with a proper sling.
A few minutes later, I headed off for the CT scan. Another hour or so passed as the ever-changing crowd of people needing help evolved—sporting injuries, household accidents, and kids getting sick from swallowing something odd.
As 6:00 pm rolled around, another change of shift saw staff weaving in and out as they finished, started, or shifted their tasks.
Dr. Abby saw me again at around 6:30 pm. The scan indicated a fracture, some loose bone, and potential soft tissue damage. She recommended seeing a surgeon and getting an MRI privately, as it would be quicker than the public system. We sometimes lament our health system, but from what I witnessed today, we are all in very good hands. Dr. Abby, despite being seemingly the only doctor on duty, had done an excellent job managing the crowd and attending to each patient with the same level of care and attention. She was supported by a very caring and engaged team of health professionals. The triage nurses, along with those who checked on me every hour to take my vital signs and chat about the footy and Olympics, were all pleasant and friendly.
And just like our Olympians, they all trained for this, they all aspired to do their best at this. Similarly, for me I am a moment in their day, I am my own single Olympic event.
I can almost hear the commentator: “Here is Dr Abby in the dislocated shoulder event.”
I didn’t see the four or eight or twelve years that Dr Abby and her colleagues invested. The early mornings, the training, the tough times.
The unknown nature of what our medical professionals see or have to do can be scary. I was just a simple older bloke with what was, in the scheme of things, a fairly routine shoulder injury. I could understand what I was being told and comprehend what I needed to do next. Not everyone who presented that day could do that. The parents with fear in their eyes as their newborn baby turned blue and was whisked away, the pair of old ladies not understanding a word about one of their husbands who had just had an aneurism and was most likely going to die.
The doctors and nurses need to be at the top of their game. They need to perform at gold medal level every day.
Where are the gold medals for this group of people?
They are the true heroes.
