Missoula Notebook

How I Cracked My Skull

By Sutton Stokes, 11-02-08

	For some reason, my black eyes weirded my doctor out.

Apologies if this column turns out a little disjointed. It’s only been two weeks since I fractured my skull, you see, and the list of traumatic-brain-injury side effects they gave me in the emergency room lists “poor attention and concentration”, “difficulty reading”, “memory problems”, and “low frustration tolerance”.

I suppose it’s a wonder I’m already on the third sentence, although frankly that list doesn’t sound too different from a normal day for me.

Amy was away for the weekend, and I was out with friends on a Friday night. I was standing at the bar of the Top Hat, only a few sips into my first beer, when the room started to go a little swimmy and my face turned prickly and hot. I remember saying something about going outside for some air, and then the next thing I knew I was being helped to sit down on the sidewalk.

In the meantime, I’d apparently made it from the bar to just past the pool table before falling over backwards, straight as a board the whole way down.

“Like a cartoon character,” one friend later told me. “I expected to see a pool of blood.”

As I gathered my wits out on the sidewalk, I had no memory of this fall — I still don’t — and so I was confused to hear someone talking about calling an ambulance. What on earth for? I remember thinking. I don’t need an ambulance.

No one asked me what I wanted, however, and soon not only an ambulance but a fire truck were stopped on the street in front of me, their whirling red lights looping and crawling across the darkened storefronts and not exactly helping me feel normal again. Men and women in blue shirts crouched on the sidewalk around me, hooking me up to a portable EKG, taking my pulse, pricking my finger for a blood-sugar test, and posing existential questions about what day it was and what city I was in.

After about 15 minutes, though, the medics admitted they were unable to find anything acutely wrong with me, other than the fact that I’d just fallen down and bashed my head for no good reason, of course. But I still only vaguely understood that I had fallen down, and my head didn’t hurt particularly, so — when asked if I wanted to go to the hospital — I declined.

At this, someone shoved a clipboard at me and asked for my signature under a statement indicating that I was “refusing” care. I remember hesitating at this, thinking that it didn’t quite describe the situation as I saw it. I wasn’t refusing care, I was just pretty sure I didn’t need any, and no one had really explained to me why I should think otherwise. Besides, I felt like the medics and I had grown pretty close over the last quarter hour, and I didn’t want to seem ungrateful.

“Next call is a CPR!” someone yelled from the fire truck.

I signed the form, and some friends called a cab and took me home.

For the rest of the weekend, I had a noticeable headache, and the room spun a little if I stood up too quickly. There was a sore spot at the back of my head; when I rubbed it, I found that pressure on this spot made me woozy and caused my peripheral vision to sort of blank out.

Usually a somewhat sensible fellow, I can offer no good explanation why none of these signs inspired me to seek any medical attention, beyond what I’d received under a streetlight on that first night. But when, on Monday morning, I noticed a sort of black-eye effect above both my eyelids, I did finally find myself wondering what a doctor might think of all this.

One and a half hours later, I was departing the Northgate First Care clinic with written orders to proceed directly to the emergency room for a CT scan. The reason for concern was not the fact that I’d fallen down — a simple “vasovagal episode”, the doctor told me, which apparently can happen to anyone at just about any time — but that I’d hit my head hard enough to cause whatever internal bleeding had resulted in my raccoon eyes.

On the way to the ER, I took a detour to the airport to meet Amy’s plane.

“How was your weekend?” she asked, as we ambled past the baggage-claim area.

“Well, actually…” I began.

I hate the thought of wasting the time of important people like emergency-room doctors, so I was almost relieved to hear mine announce that I had, in fact, fractured my skull.

This announcement came after I’d spent about two and a half hours lying on a gurney in the St. Patrick’s ER, with Amy patiently sitting by my side. In that time, I’d undergone an exact reprisal of the diagnostic tests performed on me the previous Friday outside the Top Hat — blood tests, EKG, existential questions — in addition to being wheeled down to the CAT-scan room by a soft-spoken young woman in flowered scrubs. (“We can’t let someone in your condition walk around,” she told me.)

It’s never good news to learn that you’ve cracked your skull, but my injury was a pretty safe one, all things considered. The only detectable fracture was on the back of my head, at the point of impact. This is a much better outcome than if I’d fractured the delicate sheet of bone at the base of the skull — the floor that the brain sits on — a type of fracture that can also cause blood to pool in the eyelids or behind the earlobes.

The doctor explained that the weird vision effect I noticed when I touched the injured spot was probably due to swelling at the back of my brain, where our eyesight is controlled. This would go away soon, he promised; the only long-term effect from my injury, apparently, is a slightly increased risk of seizures, which doesn’t sound like such a bad thing since I could probably get a column out of one of those, too.

He concluded with some advice I think we’d all do well to follow.

“Don’t do anything else to bust your head for a while.”

For more like this, read the rest of the Missoula Notebook.

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