Prior to the March 6th accident, my knowledge of brain injury was fairly limited. Yet, I suspect even my limited prior knowledge greatly exceeded the awareness of most of the public.

My core learning took place in British Columbia coastal waters when I served with the Canadian Coast Guard, Search and Rescue Division, Western region. The first classroom lesson took place on the waters of Queen Charlotte Sound. A fisherman had driven a metal bar through his skull. The metal was part of a seine drum, or a winch handle, I cannot be sure. I was the junior member of the crew and my chief memory is the shock of first seeing the victim, the dark stanchion embedded in his forehead, a pained and frightened human narwhal. I was stunned and inarticulate.

My reaction mattered little; my task was to roll ring bandages to place around the wound and stabilize the metal bar. I can still feel the ship rolling heavily in the swell, the slate Pacific waters bleeding into a dolphin coloured sky, the grey westerlies pushing chill moisture though my clothes and my fingers fumbling and numb in the frigid spring air. The wind sought to tear the bandage material from me, every surface was covered with a cold dew and I was being told “hurry up” while my fingers failed to respond to any command.

My second classroom was much warmer. It was situated in the Gulf Islands just off Porlier Pass. The classroom was reached by landing the work-boat in the small bay to the east of Race Point light. From there we walked a forest trail to a cabin planted in the pines a few metres back from a second bay which looked out on the bare expanse of Georgia Strait. Inside this cabin was the classroom. The only remembered object in the classroom was a large unmade bed. Upon the bed lay the nude form of a young woman.

She had been out walking across the rocks in the bay, had slipped on the kelp and fallen. That was the story I was told. I went out to inspect the accident site. There were rocks and kelp all about. And yes, kelp is slippery to a booted foot but much less so to the naked flesh of a bare foot. People who experience a fall will typically attempt to brace themselves with their arms. It is the arm that is used to break the force of the fall and it is the arm, or the wrist, that is fractured, lacerated, and contused. The young woman’s arms bore no marks. Her single wound was at the back of her skull which was fractured and stove in, a wet and pulpy mass.

Getting her to hospital required that we get her aboard our ship, the cutter Rider. Getting her out to the cutter required we transport her from the beach in our Canova work-boat. To move her to the work-boat she needed to be placed in a basket stretcher. Getting her into the basket stretcher without causing further injury was a significant challenge.

The mate was with me but he was incompetent so I will not mention his name. He hung back by the open door to the bedroom and refused to enter when he realized the victim was a naked woman. I had to order him in to help me. I do not remember much further detail apart from the fact I used her ears as handholds during the transfer, to support her head and avoid further compression of the fracture site. And I remember that as we made the lift she stirred in response to the pain she felt in her ears. I was glad to see her response to pain. It was a good sign, the first response she had made.

I wish I could tell you the outcome. We rarely heard what became of the people we helped. We stepped into their world when it fell into disorder. We plucked them from a dangerous place and transported them to another, better, world. But we never heard from them again.

I studied in other classrooms. I studied contusions, lacerations, green stick fractures, childbirth, toxic gases, hypothermia, traumatic amputations, death by fire, death by misadventure, death by bridge jump, death by flight into ground. Few drownings. The sea took care of those. And we never heard from them again.