IJE Advance Access originally published online on December 14, 2006
International Journal of Epidemiology 2007 36(1):47-49; doi:10.1093/ije/dyl264
Published by Oxford University Press on behalf of the International Epidemiological Association. © The Author 2006; all rights reserved.
Acts of God
David Graham
Corresponding author. E-mail: david{at}photograhams.com www.photograhams.com
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Ali, tetraplegic. He had a motorbike accident in India.
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In August 2003, I took my 23-year-old son to St Tropez in the South of France for the bank holiday weekend. After lunch we went for a swim and had a couple of races, which he won. As I went to change, I saw him floating in the sea near the pier. I remember thinking he was fooling around trying to see how long he could hold his breath. The following events play forever in my mind, over and over, in slow motion: realizing he was in trouble, reaching him, the empty look in his eye, his lolling head, screaming for help, kiss of life, consciousness, helicopter, hospital, waiting rooms.
The doctors told me that night it was unlikely that he would walk again, but I did not believe them then. All that had happened was that my son had dived from a pier and hit his head on a sandbank. I did not understand, perhaps I did not want to. Not only had he broken his neck but he had also nearly drowned and he developed pneumonia within a couple of days. I remember counting the tubes, as he lay unconscious for nine days in intensive care. They reduced from 15 to none as he slowly recovered but he remained paralysed from the neck down, unable to speak until the tracheotomy was removed and his lung function improved.
He stayed in intensive care in Toulon for 7 weeks until he was strong enough to be flown back in an ambulance plane to the national spinal unit at Stoke Mandeville Hospital. It was there that the reality hit home. I had never given a thought to who was in a wheelchair, and how they might have got there, and I used to avert my eyes in the street as if they could be contagious. I had no comprehension of a life without limbs, incontinent, with little independence.
I was humbled by the resilience and the public faces of all the patients I saw. And Nick was still Nick—thinner, but with the same sense of humour. He just could not move. In the end you just get on with it: help with pressure relief, give injections, hoist in and out of cars, cut his food, give a drink, light a cigarette. The list is endless but eventually it all becomes second nature and you no longer notice.
Meanwhile, I changed. I had always been selfish. I still am, but I started to think about others and appreciate the small things in life. I started taking photographs. I found that being behind a lens was a great way to hide my tears and avoid conversations and thoughts about my son. I always had an enquiring mind and photography enabled me to see the world in a different way. It was my way to answer questions.
I never photographed Nick during his rehabilitation. I wanted to but he did not. So after he came out, I went back to Stoke Mandeville and started taking photographs. Stoke Mandeville, near Aylesbury, is the largest spinal unit in the UK. It accommodates 120 patients. The degree of paralysis depends upon the level and severity of damage to the spinal cord. A paraplegic has partial or full paralysis to their lower body whereas a tetraplegic is without use of their hands and arms. The higher the injury the more serious the condition. At Stoke, about half the patients are going through rehab following their accidents and the remainder are readmittances with various problems, frequently urinary. Typically a new admission will stay for about 8 months learning to cope with their disability and re-learning so many everyday functions. The progress from bed to wheelchair is slow, learning to feed themselves again and overcome the many adversities whilst having to face the indignity of incontinence and being washed like a baby.
Slowly my pictures evolved. I wanted to show how in an instant through a simple accident one's life can be transformed and accidents happen in such innocent and unexpected ways. Falling upstairs, slipping in the bathroom, tripping on the pavement, airline turbulence. The list is endless and it is so easy to become paralysed. I wanted the viewer to feel the pain I felt as a father. I wanted to see the operations my son had and understand more about a disabled life. Some of my questions were too personal to ask and the camera provided the answers.
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Francis, putting on a wrist strap. He fell while placing a hat on a Christmas tree.
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Linda, paraplegic. She slipped while out shopping.
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Robert, tetraplegic. He fell into a paddling pool.
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Linda, tetraplegic. A stranger fell on top of her in a London nightclub.
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And Nick now lives in a flat with a carer. There has been no improvement in his mobility since the moment of his accident 2 years ago and the likelihood of any recovery remains remote. Our relationship has changed as he recovers and adapts. Time together is more precious for both of us and although lacking in spontaneity is also unpredictable. We see each other when we want to—not out of duty. We enjoy each other's company and although he is my son he is also now my best friend.
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Matt, tetraplegic. A rugby scrum collapsed on him during training.
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Linda, tetraplegic.
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