I first published this piece on Medium in August 2012 and only moved it over to plasticbag.org in March 2013. If you’re interested in seeing it in its original context you can do so here: On Falling Over.

I’d moved over from the UK with some trepidation. I’d always wanted to spend some time living in America—I’d spent so much of my time online with SF natives in the nineties—but the mechanism I’d found to make the move was less than perfect. I’d found myself in a job that was relatively well-protected but working in an organisation that I couldn’t stand. I’d had some other—in retrospect rather better—opportunities, but I’d turned them down for a solid prospect. And then I’d delayed the move several times because of the scale of the commitment and my feelings towards it.

I’d have to work at this company for at least another two years in the US (potentially a lot longer), and I had absolutely no idea what the job would be like once I got here. It felt like the most grown-up thing I’d ever done. I was committing to do something I thought I’d hate, purely to be in the right situation a few years down the line.

Once I arrived though, things picked up pretty much immediately. The area I was working in was good and I got quite a lot of agency to improve and refine it. Within a few months, I was having a great time – working with clever, fun people in a familial, creative environment and on stuff that seemed actually important and interesting. I’d be working myself to death, of course – so much that I’d still not managed to get out of the corporate housing that I’d been placed in when I arrived in the country. Sixteen hour days were not uncommon. But honestly, it didn’t seem to matter.

One of the benefits of our particular relaxed environment and distance from the mothership was that we could turn our space into anything we liked. We had sofas and weird screens and neon signs and loads of space. We let dogs and children come in and play around us. We had people giving talks over the other side of the office. There were finger dart battles.

And we had a Balance Board.

The board was the property of our lead engineer and he used it to practice for snow-boarding. Very gradually all the rest of us started to play with it too. We’d stand on it and trying to stay upright and laugh at each other’s clumsiness. I started off worse than anyone else—I’d never had much sense of my body—but gradually started to improve. I mucked around on it every day. In the end something was bound to go wrong.

Picture the scene – I’m standing next to the lead engineer, looking at his screen. We’re talking about an element of the product we’re working on. We’re probably making some ridiculous joke or something. And I’m balancing on the balance board. And I fall off.

Everyone comes around and laughs at me lying on the floor, but I’m not laughing. I can tell something is wrong, but I don’t know what. I feel a bit irritated because they’re all having fun at my expense and honestly I’m not very good at being embarrassed. A co-worker makes a dumb joke and I say something like, “I think there’s something wrong with my arm” and then she looks and her eyes widen quickly and she shrieks and runs off. My arm is at a funny angle coming right out of my shoulder and it’s moving … strangely … I can’t seem to control it properly. And it hurts. Although not as much as it maybe ought to…

Ten minutes later I’m in a friend’s car driving to the hospital. I feel incredibly strange. I’m scared out of my mind. I’m in pain, but again, not as much as I ought to be, but every time we hit a pothole in the car it feels like something inside my arm is sawing through my shoulder muscle. My arm hangs off me strangely. It’s not moving properly. I have to hold it in mid air with my other arm or it feels … bad … Really bad. In the back of my mind I’m wondering whether it’ll be fixable. I’m trying to work out if I’m being melodramatic. Does this kind of thing happen to people all the time? My friend is being calm in that way that only someone who has had two children can be. She knows it’s a big deal, she’s not pretending it isn’t, but she knows that panicking won’t help. She’s awesome.

We get to SF General. I’m clearly not freaked out enough, because it takes me about ten seconds to notice that all the junior doctors and orderlies and people who are working there are absolutely stunning. It takes me about another five seconds to realise that I don’t like SF General. There’s a wide-eyed woman handcuffed to a railing who screams ‘Rape!’ whenever a doctor comes near her. There are two men who are mostly naked, covered in red scratches and dust, moaning like zombies and reaching out for one another with dirty, bloody hands. A woman runs in as the doctors start cutting off my t-shirt shouting, “Do you have insurance?” over and over. She’s shouting at me like I don’t have other things on my mind right at this moment. I don’t know what to say. I don’t know how this works. I have insurance in theory, but I haven’t looked into it at all since joining the company. I have no idea what one’s supposed to do. And also—by the way—my arm is hanging out of its socket…

I’m put in a strange position and my arm starts to feel incredibly bad and painful. They inject me with something, but I don’t feel the pinprick. I start talking to my friend. “This isn’t doing anything…” I say. “It’s rubbish.” Then a few seconds later… “Shit, It had been doing something. Shit. Give me some more!” I’m in a room covered in tiles with equipment around me. I’m losing track a bit of who is in the room with me and who isn’t. They give me something stronger—something wonderful—and I start making jokes. Brilliant jokes. I’m the wittiest man alive. Also I’m English and that counts for something with these people. I’m dimly aware that I shouldn’t flirt with any of the doctors. I can sort of see them talking to my friend in the corner.

Time passes and honestly I don’t remember them setting my arm, but they clearly did. And next thing I know I’m lying exhausted and only semi-aware of what’s going on in a corridor on a gurney. One of the dirty blood-covered men is being wheeled past me on another gurney. He reaches out for me as he passes. My friend blocks him. I close my eyes and hear his groaning zombie-noise pass me by.

I’m sent home in pretty good order. Their suspicion is that the shoulder has just been dislocated. Now it’s been put back in place everything will sort of return to normal. I mention that I don’t seem to be able to move it that much and they say that’s common and that it’ll get better in a few days. I go home and collapse.

And time passes. The next day my arm doesn’t hurt that much at all. I can’t move it very much. I’m not that concerned. But the day after, it’s still not moving. It’s a long holiday weekend, but I stay at home trying to get better. The Monday comes and I’m starting to freak out. I’ve tried to work out what’s going on. A few things seem to be working. I can clench my fist. My bicep works. But I can’t straighten my arm, I can’t lift it up. I can’t straighten my fingers at all. And the outside of my arm from my shoulder to my finger tips feels cold and dead. My left arm can only really do one useful thing. I can hold out my arm like I’m begging. That’s the limit of what is practical. My arm has been replaced by a cup-holder.

Over the next few weeks I learn what’s going on. The brachial nerve in my shoulder has been ‘damaged’. No one knows how much. It could be bruised. It could be severed. If it’s bruised it will recover, at the rate of about a millimeter a week. If it has been severed, then it won’t recover at all. I’ll be stuck with a barely functioning arm for the rest of my life.

I visit a shoulder therapist who tries to calm me down about the whole thing. He’s a tall, tanned middle-aged man who looks like he surfs. He’s relatively positive, but says it’ll be a long wait to find out if I’ll heal. I want to know what happens if I don’t heal, but he doesn’t want to tell me. I have to force him to go into detail. He talks of opening up my arm and moving the muscles around so that they connect to the other side of my hand. He talks of fusing the bones in my wrist together so that my hand doesn’t flop down like a gay stereotype every time I move. He talks of braces and assistive devices. I sort of take some of it in. Knowing there are options—even weird cyborg, body-mutilating options—is weirdly comforting.

My friends try and help—some more than others. None of them really know what to do. None of them know how to react. They’re looking at me unclear as to how serious it is. At one level, I’m just a guy with his arm in a sling. At another level, I’m the guy whose arm doesn’t work and may never work again. They very graciously offer to help.

Very gradually a kind of black humour dredges itself across me, as I start to think about what my life could be like. You believe that you treat people with significant problems like this normally, but your illusions go away pretty quickly when you’re in the situation yourself. As the muscle starts to waste away on your arm, you start wondering what you’ll look like with one flaccid, scrawny arm, clawing upon itself. You wonder if you’ll be able to drive a car or ride a bike. What if you fall over on it? Would you be able to feel if you’d damaged it more? Will you be stuck looking after your arm like you would an insensate vegetative child?

How are you going to type? How are you going to do the work you’ve been doing for years? Within a few weeks I get my typing up to forty five words a minute one-handed. Everyone is very impressed, but what do they know? It’s half the speed I could type before. Am I going to be half as productive? My mother calls me and starts talking about assistive devices. Should I get a chording keyboard? It all feels like preparing for a life without a functioning arm. That’s not a view of the future that I’m capable of dealing with. I’m not able to think like that. It makes me angry that anyone would think that I should think like that. I will not think like that.

I find myself doing things in my home that I’d been meaning to do for years but never got around to, purely because doing them one-handed is borderline impossible. I refuse help from people. They mean well but they don’t understand. If I start taking people’s help now, then it’s accepting that I’m a broken person. It’s accepting that I’ll need some kind of assistance for the rest of my life. That I’ll always be dependent on other people. Fuck that. Fuck it so hard. I move every piece of furniture in my house. I rip up the carpet. I fold it up and drag it out into the shed. I’m swearing every step of the way. It’s a war between me and the carpet. It’s the most difficult thing I’ve ever done. It takes me four hours. At the end I’m victorious. I feel strong and angry and determined and relentless.

I don’t take a single day off work from the moment the fall happened. In retrospect this was one of the most stupid things I’ve ever done.

I wonder about sex. I wonder whether anyone would want to have sex with someone with a gimpy arm. I wonder whether or not I’d want to have sex with someone who wanted to have sex with someone with a gimpy arm. I try and imagine the mechanics. I visualize the look on their face as we go through the motions. I have fairly dark patches.

I go and see a neurologist who inserts long needles into my arms and asks me if I feel anything. He runs current through my body. He’s not impressed by the results. He tells me there’s a fifty percent chance of me getting something back, but that’s all. I leave composed and balanced. Sitting on a chair outside the surgery, I feel myself falling. I get a phone call from my boss. It’s the worst possible time and the poor man gets an earful of quite un-British set of emotion. I walk around for a bit. When I get back to the office, no one knows about my blip.

Months pass, and I start physiotherapy with two guys. One of whom is incredibly athletic and looks at me as if the arm is the least of my problems. Apparently working eighteen hour days and not getting any exercise is a bad thing. The other guy spends every minute manipulating my arm and asking about how to set up a tech start-up in San Francisco. I humour him. I wish he’d shut up.

I get an exciting new device that runs an electrical stimulus through my arm. When it’s on, every muscle clenches. All the muscles I can’t control. My fingers splay out like a maniac. It hurts a lot but it’s a pleasing kind of pain. It feels like I have some control over opening my fingers for the first time in months. I’m supposed to hold my arm out, trigger the device, watch my hand lift up and then turn off the device and try and keep my hand in the air. Every time I turn it off it flops down like a dead fish. Every time I’m a little more disappointed.

Friends are fascinated by this device. It gives them insight into how their bodies work; that you can route around the nervous system so easily. They sometimes want to try it on themselves. I’m eager to show them how it works. Partly that’s because I want them to understand the process, but there’s a part of me that also wants to hurt them for having working limbs. It’s not a feeling I’m proud of.

No one knows what to say, and I don’t know how to help them. After a while I start to wish they’d just pretend not to notice it. The following is the standard conversation that people had with me, borderline unedited:

“So what happened to your arm?”
“It doesn’t work”
“How did you do that?
“I fell over. I don’t really want to talk about it.”
“Oh well, I’m sure it’ll be better soon.”
“Well, actually, no. It’s paralysed and may never get better.”
“Seriously?”
“Yes.”
“Are you right-handed?”
“Yeah.”
“Ha! Well at least you can still masturbate, amiright?”
“…”

I have this conversation fifty times or more. I start to want to hide from people rather than have the conversation. I can sense when it’s about to start and try and steer the discussion in a different direction. It never works. I start to avoid talking to new people because I know they’ll do it. Every new time I have to explain myself forces me to go through the whole process in my head again. Yes, that’s right. My arm doesn’t work. It may never work again. Yeah, it’s a big deal. Thanks so much for asking.

Other concerned people ask me questions and sound so upset by the answers that I find myself having to make them feel better.

After a while I find a new script to stop things spiraling out of my control – a better script, a script that scares people. A script that stops their homilies dead in their tracks.

“So what happened to your arm?”
“Horrific fisting accident.”
“I’m sorry. What?”
“Horrific fisting accident. I hurt myself fisting someone.”
“Holy shit.”
“This is nothing. You should see the other guy…”

That shuts them up.

Four months after I fell over, I started noticing that I could lift my left hand up a couple of millimeters. I didn’t want to get my hopes up – maybe I’d always been able to do that, but the swelling from the injury had just masked it. But then a week later, it was getting stronger. I could move it half an inch. And then stronger and stronger. A couple of months later, with regular physiotherapy, I had a fully functioning left arm again. It was weak, certainly and it took a long time before it felt the same as my right arm. And there are still moments where the joint hurts a bit. But every day throughout all of the healing, while working hard to make things better, I’d say to myself, “This is fine. If it never gets any better than this, I’ll still be grateful.”

Today it’s back to normal, and it’s so easy to forget how hard it was and how I felt during the process. During the time it happened, I never once wanted to go onto my blog and write up what was going on. It was too big, too hard, too upsetting. All it would be was spreading my black mood around the internet.

The first thing I learned when this happened to me was the difference between something that will heal and something that may not. People break their arms every day. They know it’ll get better. They’re in pain and sad and limited, but they’ll almost certainly get better. So they can take help, lean on their friends and family. Accept a short burst of incapacity, then get back to normal.

But if it might not heal—if it’s something that you could have to live with for forty or fifty or sixty years—then it’s very different. We don’t tend to think about disease or illness in that way. We have very few mental tools to help us understand that kind of shift of life-expectations – that deformation of your future. You may not get better. You may not heal. You may be like this forever. Are you going to be a burden to everyone around you? Are people going to treat you like a child or look at you with ‘profound sympathy’ until the day you drop dead? Are you always going to be unable to carry your own weight? Are you always going to rely on others?

People always say, “What doesn’t kill you makes you stronger…”, but I’ve come to ruefully add in my head every time I hear that, unless it maims you. Unless it maims you.

So I’ve got a newfound respect for all the people who have had these experiences. My experience was thankfully brief but I feel I have a little more understanding of what it means to fall over and feel that you have to get up, no matter what you have to leave behind in the process. No one wants to have their independence and sense of self diminished by some trivial and stupid accident. I now understand a little more the absolute determination of people who live with a condition that won’t go away – the guts it takes to get through fear and self-doubt and the need to demonstrate that you’re not a wasted person, a mutilation, a wreck. Looking that battle in the face, however briefly, made me admire people who fight through it every day all the more. They don’t need our sympathy. They need our admiration and our respect. My arm healed. I was lucky. Many other people are not.

I have no moral from this story. I wish I could say it changed my life dramatically, or that I brought something back from the abyss that I can share and we can all learn from. But really, all I have is that you should appreciate what you’ve got. Very few people whose bodies get broken were injured rescuing children from ships or fighting against dangerous psychopaths. Most accidents are in the home or in a car, doing something normal and stupid. Falling from a ladder. Tripping on a curb. Trivial, embarrassing things. And they can happen at any time. There’s little you can do to avoid all risk in life, and it would be a pretty dull life if you did. So just be careful. Be decent. Be nice to each other. Because it could happen to you.

Update: I’ve received a number of comments from people about this piece who have said that it’s given them some extra perspective or helped them through tricky situations, and obviously that makes me feel quite good. However, I’ve also had a couple of people who have experienced much worse situations respond to it very badly indeed. Absolutely the last thing I would ever want would be to piss these people off – my goal, if anything, was to try and share with able-bodied people some small amount of the change in perspective I went through. Nonetheless, I’ve pissed them off, and I have to accept that. Rather than change my piece above, I’ve decided to link instead to this response: Alexander Williams on Google Plus. It’s far from flattering about me, but if you want a different perspective, there it is.