How to spoil your whole day
by Adrian Pullin
The Middle Guil starts as a grade 3 run. The put in at la Chapelue is just down stream of the road bridge. A short scramble down the bank and get on at a small wave, ideal for settling in. On July 24th 2001, the river is fairly low but certainly goes. We've been in France since the previous Saturday, starting on the Isere at Bourg St. Maurice then moving down to the Guillestra area. On the water today are Ray Goodwin, Dave Wilkinson, Bertie, Ross Tutton and me. On the road on his bike is Slime, taking photos for the update to his Southern Alps guide book.
It would be safe to say that I am not having a good week so far. It is some time since I paddled anything this fast and I am finding some of the rapids a little daunting. I made a complete prat of myself the previous day bottling out of playing the Rabioux. However, the Guil is more to my liking. Not so much water and lots of rocks with big eddies behind them. I take the lead as we move off and am happy with the river, the group and my leadership. More to the point, Ray is happy with my leadership. All I have to do now is paddle and lead like that on grade 4! So, a lot of the (self imposed) pressure comes off and I start to relax a bit. After some time, Ross takes leadership and I am at the back. A further change around puts me in the middle of the group, so I relax even more.
I don't know if the drop has a name. I doubt it, because it isn't significant compared with others in this section of the river. By now, all coaches should have alarm bells ringing. A paddler within the comfort zone, relaxed. The drop is straight forward, but I don't attack it properly. I'm already leaning back as I go through the slot. The pour over catches the back of my kayak and kicks it right and down. I support high and back. The support fails and I capsize. As I go for a roll, the set-up seems fine but the roll doesn't work at all. Not even head up. I pull the deck and swim.
Bertie carrying me, Ross about to chase the boat.
Bertie is on the scene and I reach up to get a ride on the front of his boat but only my right hand comes up. The left arm feels stiff and I think I've pulled something. Bertie lands me in an eddy and whilst he is getting out of the boat, I do my own first aid check. Anyone who has first aid training will recognise the position instantly. Head down and to the left. Right hand holding left arm just below the shoulder. Left arm held bent at the elbow across the chest. I feel my left shoulder and think that it is the wrong shape but I can't get my left hand up to my right shoulder to compare. As Bertie arrives, I ask him to check to see if my shoulder is ok. As he gets within three feet, I yell at him not to touch it. The diagnosis is obvious. The shoulder is dislocated.
The first thought is that it has ruined my holiday. I had another three days of paddling to do. By now, the brain is starting to go a bit odd. There are two completely separate screens showing different movies. One is me in considerable pain. The other is me watching the whole scene from an outsider's perspective. Ross and Dave have chased and recovered my boat. My paddle is long gone but eventually recovered further down stream. Ray is out of his boat and with Slime on the river right bank, where the road is. I am on the left bank with Bertie. It is obvious that I need to cross the river. At this point, the hours of white water safety and rescue courses spent swimming on the upper Tryweryn come in to play. The half of the brain that is watching from the outside sees a rope thrown across the river and a vector pull set up. The rope is clipped to my chest harness and I start wading out through the eddy. Ray is giving clear instructions but suddenly he changes from calm advice to giving orders: "Go NOW!". The ride across is actually not that bad. The river is not too fast or wide and I am pulled into a big eddy easily. Standing up is not so easy. I won't let anyone near my left hand side and I shout and swear at anyone who tries. (Sorry about the language, boys!) I tell Ray, in a very matter of fact fashion, "I'm going into shock". He tries very hard not to laugh.
Recovering the paddle...
...and the boat.
The reason for Ray hurrying me up is that another group of kayaks coming down the river are about to run into our rope. They stop to offer assistance and it turns out that they are German and one of them is a surgeon. He offers to try to put my shoulder back. A brief discussion concludes that the sooner it is back in place the better and that he does know what he is doing. He has done them before. Unfortunately, in the time it has been out, the muscles have gone into spasm and no amount of pulling (and screaming) will get it back. A final attempt with three people pulling on my arm doesn't work and we give up.
Ray Goodwin attempting to reduce the shoulder...don't try this at home, children.
The road is about 6 metres above us, requiring a scramble up a steep shingle bank. This would be easy with two arms but looks rather more tricky with a shoulder out. Ray sets up a rope to the top of the bank and comes up behind me, either supporting the middle of my back or holding my feet in very loose footholds. Meanwhile, Bertie has borrowed Slime's bike and cycled to the get in, where he left his van.
The drive to Embrun, the nearest hospital, takes about half an hour. Bertie quite rightly decided to ignore my yelling and get us there as fast as he could. Those French roads are rough! Slime asks if we know where the hospital is. We don't. OK, lets look in the guidebook. The guidebook says, "See map of Lower Durance". The map shows where Embrun is but not the hospital. For future reference, follow the main road through town and turn left at a strange roundabout. Then down some very narrow roads. Slime says, "Must fix that in the new edition".
The hospital is wonderful. A E is on the first floor. You press the bell for the lift and a nurse arrives with a wheelchair. I am wheeled straight through the waiting room and into a consulting room. The only people in the waiting room are those waiting for casualties. My French is ok in restaurants (laughter from the rest of the group) but I struggle after that, so communication is tricky to start with. It is obvious what is wrong. They find a nurse who speaks enough English to take a case history. They say this is the second dislocated should they've seen this week. I was wearing a dry cag and Extreme River Vest, which comes off over the head. Not this time it doesn't. The only way to get the kit off is to cut it. (I hope the insurance will cover this.) So, kit off, drip in (morphine is the same in French as English) and over to X-Ray. The want to check the extent of the damage and make sure nothing is fractured. (Bit late now, after our German friend's efforts!) Getting to lie on the left side so the shoulder is near enough the X-Ray plate is not fun. I hear them say it's just a dislocation. The next thing I know, I wake up in recovery, with my shoulder back in place. They rig a temporary support out of Tubagrip and prescribe a fancy support, which goes round the body and has Velcro to hold the arm in position.
The shoulder before reduction in hospital...and after
Once back at camp, I have to sort some things out. First, what do I say to Wendy (my wife) who is at home in England? Once that is done, practicalities need sorting out. I can't drive, so I get Dave (who travelled with me) added to my insurance for the trip home. (It costs 72! I have to add him as a named driver for the duration of the policy.) I also check with my holiday insurance (Snowcard) who say they will pay for the motor insurance, damaged kit and medical expenses. With an E111, the hospital only charged about 12.00 but the fancy support cost 57.00 and is not covered by the E111 at all. The rest of my holiday is spent sunbathing and getting some very silly tan lines with the sling.
Once at home, I see my friendly physio and am told to keep the shoulder immobilised for eight weeks! I will then start rehabilitation exercises to regain movement and then build strength. The doctor says there is a 10% chance of doing it again! All my paddling friends ask "how long before you're back in a boat?" All my non-paddling friends say, "I suppose you'll be giving up paddling, now". Different perspectives on life.
Sitting round the campsite afterwards, Ray and I discuss the incident. There are always lessons to learn. Undoubtedly my mistake caused it. I have a habit of leaning back as I go through waves. Ray had already pointed this out when I ran the Rabioux. I also have a habit of leaning back and supporting too high. This is common and it is something we have been trying hard to coach out of people at Peninsula Canoe Club. So, the lessons are to attack the wave ("eat the wave" as one American on the camp site put it) and to support low (even on a "high" recovery) and forward, in front of the hip line.
My thanks must go to the people on the water with me: Ray, Berite, Dave and Ross, and to Slime on the bank. I would rate the rescue as "text book".
It is now just over a year on. My shoulder is almost right. I can feel it sometimes, when tired, when it is very cold or when I've been carrying one of the kids for too long. I haven't been able to paddle much due to the arrival of twins last January, but when I do get out, my left shoulder seems to be fine. My confidence (never a strong point) is somewhat dented and I think it will take a long time and lots of paddling to get back. As for the people who asked if I'm giving up paddling, I don't need to tell anyone reading this the answer!
All photos by Slime, except me in the tubagrip sling by Nigel Garratt and the X-Rays by Embrun hospital.
By Adrian Pullin.
Postscript, from Graham Beckram...'Adrian 'forgot' to mention one or two things in his article about his shoulder dislocation. Firstly, Adrian is quite happy with his religious beliefs, however I suspect that had his church heard some of the language his mouth uttered on that day he might have been asked to leave it by now! Secondly, he's forgotten when trying to find the hospital in Embrun, we pulled up next to a pedestrian, wound down the window and whilst Adrian's screaming continued unabated I asked the pedestrian, in not so good pigeon Franglais, where the hospital was only to discover he was Italian and had no idea what I was on about - I personally blame it all on Slime and him forgetting to put the hospital in the bl**dy guidebook!'