Mar 10, 2016

Resuming The Dangerous Dance With Traffic

Continued from A Typical Alice Springs Morning Ride and Dark and Hazy Days In Hospital

It has been over six months since I got knocked from my bike. I rode over 100km a weekend or two ago. I went in a triathlon and won. My right hip and gluteals are still limited in their range of movement but it doesn’t affect me too much. I get sore if I don’t rest and don’t stretch, but this is relatively normal for a man of my age.

The most significant problem that remains is the memory. I went for a ride this morning and pulled off the road twice as trucks went by. My anxiety rose every time a car went past. I pulled over at one point to take a photo of the sunrise and half-climbed over a fence to be as far away as possible as a sedan went speeding along the road.

The sun rises over the Telegraph Station near Alice Springs on the North Stuart Highway

More than one person has told me I am crazy for going cycling on the road again. But I don’t quite see it that way. I have been through the accident a million times in my mind and still think about what I could have done differently. Quite rationally I conclude I did all I could. The most likely scenario is that the truck driver fell asleep on the long road from Tennant Creek to Alice Springs and I was an innocent victim. No amount of light, no amount of reflective gear, no amount of armour is going to protect you from bad luck.

I called the police less than two weeks after the accident and was told the case had been closed. I asked a few questions of the responsible policeman and while he was amenable to my suggestions, I heard nothing further. I don’t resent this decision, as police in Alice Springs have much more pressing matters, but I do feel that more could have been done. That is a fact of life with an over-burdened public service.

I don’t retain any particular feelings for the driver. I would like to have a quick chat with him, just to show him my scar and explain the disturbance that it caused in our lives. I don’t think this would change anything.

A lone rider ascends a hill toward the Alice Springs Telegraph Station with Mt Gillen in the background

Certainly it wouldn’t change those first few weeks out of hospital. The two months on crutches were difficult to say the least. My head was constantly hazy with medication and I was unable to sleep soundly. I caught a virus which slowed me down for a few days. My wound leaked through its 52 staples into my clothes and bed sheets. I couldn’t walk, ride, or drive making appointments a logistical nightmare. I had to arrange time off work and accident compensation. And I had an active 2 year old to chase. A pregnant Mrs Bugler was magnificent.

I went to the gym on crutches and rolled weights to benches. I brought my array of thera-bands to add some resistance to the simple range of motion exercises set by the physio. I graduated to easy leg weights with as few kilograms as possible. I cannot emphasise enough how quickly I improved from going to the gym 2-3 times a week. I would see other rehab patients at my regular hospital appointments and feel guilty that they didn’t have the resources or wherewithal to visit the physio and the gym.

I was back on a stationary bike just over a month after the accident. Although horrendously boring, sitting still and spinning my legs over was another thing that accelerated my recovery. It gave me some strength without putting too much stress or impact on my leg. After I concluded the accident was not my fault, I returned to the road. My first forays onto the road were rather timid affairs. I avoided traffic like the plague, stuck to quiet roads and bike paths. I felt like I didn’t belong on the bike.

The cycling bunch descends toward Alice Springs on the North Stuart Highway

Inevitably, my story has become old. I listen to other people complain about their aches and pains, and no longer feel like I can trump them. I think I have almost showed everyone in Alice Springs my scar – the first time I had a couple of drinks it was on show most of the evening. I’m still happy to show anyone who cares to ask, but everyone has an horrific story to tell.

Other than the feeling of not being as fit as I was, the thing that continues to frustrate me most is the fatuous bickering regarding cyclists. The absurd arguments that categorise and pigeonhole cyclists as though they/we somehow don’t drive cars or walk on footpaths. The sense of superiority and self-importance that seem to take hold as people curse cyclists, motorcyclists, truck drivers, Volvo drivers, or some ‘other’ road user, questioning the validity of their reasons for using the road. How did public spaces become so exclusive?

Of particular poignancy over the past few months is the victim blaming. I cannot countenance the idea that I was ‘asking for it’ by going for a ride on a road that also carries trucks. In much the same manner as rapists, the victim blaming somehow legitimises and excuses the truck driver. If the very same truck driver fell asleep and drifted into my path as I was driving my wife and kids on the same stretch of road what would be the reaction?

The bunch rides west away from Alice Springs on Larapinta Drive

I’ll get off my high horse but hopefully it is food for thought. Thanks for the messages of support – I’m happy to be alive, riding, running, and Bugling.

Feb 17, 2016

Dark and Hazy Days In Hospital

Continued from A Typical Alice Springs Morning Ride

It took about 15min before the reassuring sight of red and blue flashing lights appeared at the top of the overpass. My ability to endure pain was sorely tested when I realised it was the police. By this stage the pain in my hip was made worse by violent shivering from the cold and shock. The police were surprised to find only two cyclists. When Rod was requesting an ambulance, the 000 operator didn’t ask if the driver had stopped. Understandably, the police assumed the driver would be at the accident. The police most likely went past the truck as they were driving north and the truck was heading south on the same highway.

A diagram drawn in hospital explaining how to get hit by a truck

Another 5min elapsed before the ambulance finally arrived. By this point my reserves of pain tolerance and patience were nearing their end. I wanted to be warm and I wanted the ache in my hip gone. Neither happened quickly. The paramedics were more concerned with other injuries. I was sitting and they began asking questions to ascertain if I had a spinal injury. It didn’t help when I said I had numb hands and feet. I stood up to demonstrate I was OK. There was a pool of blood where I had been sitting. I had been trying to reassure people I was fine. That blood undermined my argument. I had been also trying to say I was lucid. My inability to recognise I was bleeding didn’t help this argument either.

Two fire trucks arrived on the scene and I was starting to get upset. I was shivering violently. I badly wanted to be in the ambulance with a blanket and some pain relief. I had created a minor traffic jam as the population of the vicinity swelled. One of the policemen began directing traffic. Mrs Bugler arrived shortly after I was loaded into the ambulance. We had a quick discussion with those around me. The blood pooling on the sheets of the stretcher was not reassuring to Mrs Bugler.

By the time we left the scene it was well after 7am. The police went to our house with my bike and other belongings. The fire engines had realised they weren’t much use and headed back to the station. Mrs Bugler set off for the hospital. The ambulance staff struggled to get an IV into my violently shaking limbs. They had also cut away some lycra and subsequently struggled to slow the flow of blood. Evidently lycra has excellent properties for slowing bleeding. Eventually we got on our way with me bleeding and in pain. I can only imagine how Rod must have felt as I was carted away with my entourage of emergency services. The ride back on the highway must have been a touch lonely and frightening.

Tegaderm holding my leg together and blood in


From the very first moment, I didn’t grasp the danger I was in. I was the only one. When I got to Alice Springs Hospital Emergency, I was only worried about getting more blankets so I could warm up. For 3 hours a single nurse put pressure on my wound to stem the flow. Each time she took her hand away, there was someone who would say something such as “oh no, it’s still going”. A variety of doctors – residents, registrars, consultants, surgeons, orthopaedic, emergency – asked me questions I felt were irrelevant. It was gradually made clear that the pain in my hip could likely be distracting from something much more sinister. Internal abdominal bleeding, a head injury or a spinal injury were very real possibilities.

I had been in hospital for around 4 hours before I felt something approximating comfortable. My limbs had gradually thawed thanks to heated blankets and the copious amounts of morphine turned the pain to a dull stiffness. The emergency consultant had given me an ultrasound to ascertain if I had internal bleeding. She also gave me an examination to discover the possibility of a spinal injury. Both gave her confidence. Nevertheless, successive general and orthopaedic surgeons requested x-rays. I was wheeled out of the resuscitation area of emergency by a clerk who called himself the “Cheeky Kiwi”.

An photocopy of my x-ray with gauze in situ

My x-rays delivered a classic scenario of good and bad news. First the bad. The truck had smashed the top corner of my femur, a part called the greater trochanter. This had likely torn a number of muscle attachments off too. The fragments of my femur were floating throughout my general hip area and there was concern some of these fragments may have been gravel from the road. The open wound and shattered bone made concerns for infection with long-term consequences very real. And the good? Despite some initial concerns about a hairline fracture of my pelvis, I was given the all-clear for other injuries. No fractured skull. No spinal injury. A lucky Bugler.

Upon my return to ED, I was admitted under General Surgery but my surgery was to be done by the orthopaedic team. I was booked in for exploratory surgery that afternoon. This was to clean out the wound and to discover the extent of the damage.

A drawing of the anchors re-attaching my gluteals

The six days I spent in hospital following my initial surgery tend to blur together. A combination of drugs no doubt contributed to this. The effects of the surgery also made me feel much worse than the initial accident. A few key moments stand out.

Mini-Bugler fell sick adding to the extraordinary stress on a pregnant Mrs Bugler and each time they visited I felt a flood of emotions, love and guilt primary among them. I was greatly relieved that Mum and Dad decided to drop everything and fly up.

I was scheduled in for further surgery two days following the accident. My surgical team explained that this was to repair the damage to my greater trochanter, and to re-affix and repair my gluteus maximus, gluteus medius and gluteus minimus. The day of fasting waiting for the surgery was extraordinary. I kept getting bumped to later and later in the day. By 9pm my patience was wearing thin and I was hungry. After I was wheeled into the surgical suite, I spoke to my surgeon and questioned his ability to perform the surgery expertly at the end of a 15 hour day. Apparently his team was chuckling as they overheard the exchange in an adjoining room.

An exchange with a surgical nurse was particularly memorable. She recalled me from my surgery two days prior. She said something along the lines of “I remember you, I could fit my fist through the hole in your bum” and proceeded to motion with her clenched fist. I asked how the damage to my femur was done. She explained using her fist that the blunt edge of the truck had punched through my sufficiently hefty bum cheek and slammed into my femur, shattering the corner of it. This rather vivid image made it quite clear that I was in a bit more trouble than I had initially thought.

Centralian Advocate understating my injuries

My surgery went as planned and over the next few days we discussed my health with a myriad of doctors and nurses. I was grateful to have a doctor as a wife to help interpret what was being discussed. Not for the first time I felt concerned for the many other patients without the resources available to me. A discussion of my blood was particularly enlightening. My initial blood test indicated a haemoglobin of 144g/L and an haematocrit of 0.43, both comfortably in the reference range despite an hour of bleeding. During my second surgery, these had dropped below 50g/L and 0.20 respectively, about a third. I was given two blood transfusions of packed red blood cells which restored my blood to 103g/L and 0.31 – still significantly below the reference range.

By this point, I absolutely understood that I was not in good shape and that the rehabilitation was going to take a long while.

Feb 4, 2016

A Typical Alice Springs Morning Ride

We had just returned from a mid-year escape to Indonesia. The footy club I had been playing for, Federal, were sitting atop the Central Australian Football League ladder. We had four games remaining before finals and I hoped I would be an important part of the team. Prior to the season I had ridden a lot of kilometres and it had proven to be an excellent way to improve endurance without exhausting my legs. With a bye on Saturday, there was a good chance to get some extra fitness in. I got up at 5:30am on Tuesday to ride a quick 40km before Mrs Bugler had to go to work.

Alice Springs is cold in winter. Very cold. The lack of humidity means that the temperature drops below 0°C more often than cities further south. The cold wind seems to rip right to your core. I layered up with tights, woolen socks, shoe covers, base layers, a footy jumper, thick gloves, a skull cap as well as the normal cycling gear. I rolled off in the darkness hoping that the effort would at least partially warm me.

Riding on the road to Simpsons Gap near Alice Springs

The Stuart Highway wends its way through the hills north of town. From the last buildings in Alice, the blacktop gradually climbs to the high point marker – the highest altitude on the highway between Adelaide and Darwin. The route is popular with cyclists because there are hills and because the road has a wide shoulder giving a buffer between you and the road trains.

I overtook another cyclist on a short pinch, but didn’t recognise him so said hello and quickly rode on. The aim was to get to the high point marker about 20km north of town, before turning back and meeting others at the Bond Springs turn-off at 6:30am. If I was too slow, I either wouldn’t get as far as I wanted or the bunch would leave without me.

After the railway overpass, the road north flattens out and the shoulder disappears. In the last 4km before the high point marker I passed a couple of other cyclists heading south. It was still as black as pitch, but undoubtedly they were my cycling friends I was meeting at the Bond Springs turnoff. I put my head down to ensure I didn’t make them wait long.

At the high point marker, I could see the lights of a vehicle in the distance a long way further north. I turned around knowing that at some point that vehicle would catch me on the road. With numb feet and hands, I again upped the ante not wanting fellow Alice Springs Cycling Club members to wait in the cold. To this point, there was little to distinguish this ride from many others I had done.

I rounded a slight bend and rose out of my saddle to push up a short climb. I estimated I was less than 2km or 4min from Bond Springs. It was almost exactly 6:30am so I was running a couple of minutes late. The road in front of me lit up as the vehicle rounded the corner. I could hear the sound of the engine change as it too climbed the hill. The deep pulse of the engine clearly indicated a truck. I kept my eyes on the white line that delineated the side of the road and focused on keeping as far left as possible without riding on the gravel.

What happened next I have only pieced together retrospectively. I remember seeing the side of the truck out of the corner of my eye. It was only a flash. It was a white truck but appeared yellowy-orange from the glow of the lights and the red dust that commonly stains in these parts. I thought I felt a thump on the back of my helmet, as though someone had reached out the window and slapped me while driving past. But in rapid succession, I felt an almighty hit in my right bum cheek. It was a feeling that went beyond pain.

I was lifted clean off my bike. Despite being clipped in, the force broke a cleat from the base of my shoe and threw me over the handle bars. As I was flying I recall the fear of thinking it was a road train and thinking there could be a lot more hits to come. That fear, like the initial pain, is indescribable. I hit the road and rolled. I scrabbled on the asphalt, trying to find grip and get away from the huge tyres on the four trailers to come.

Shoes destroyed in a crash

My next memory is of standing beside the road with one shoe off and the other on watching the red tail lights already 50m down the road. A truck travelling at 110km/h disappears quickly and with little fanfare. My leg and hip were aching but adrenaline was pulsing through me. That it was but a small delivery truck, not a road train, was of only small mercy at the time.

I sat down to relieve the pain in my hip. The pain didn’t relent. I felt my pockets for my phone but my belongings were strewn everywhere and I was in no state to stand and walk. About 1km away I could see a solitary light atop the overpass. A cyclist was coming toward me. I just had to sit and wait.

I’m not bad with pain. I can manage to avert my attention for a finite period of time. The light was getting closer giving me something to focus on. A car went past and I didn’t bother waving them down because the cyclist was still coming. When he arrived, he asked if I was OK. I said no. He asked if I needed an ambulance. I said yes.

My knight in lycra took an amount of time to dismount, lean his bike against a rock, sift through his pocket for a phone, and switch off his tracking app before he called 000. I didn’t think I was bleeding and I didn’t have a head injury. I honestly thought that I might have just fractured a bone. A couple of rudimentary questions from the operator and the ambulance was on its way.

The sun was slowly shedding light on the scene. My new friend Rod chatted to me as he picked up my belongings. He found my phone and I thought I should call Mrs Bugler to let her know that I was going to hospital. The screen was shattered. I called her from Rod’s phone and told her not to worry, I was OK, I had just been knocked off my bike by a truck and I was waiting for an ambulance. To my mind, this was supposed to set her mind at ease. It wasn’t the first thing I under-estimated about the situation.

To be continued…