Learning by Accident: A Caregiver?s True Story of Fear, Family, and Hope

Learning by Accident: A Caregiver?s True Story of Fear, Family, and Hope

by Rosemary Rawlins


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On a sunny spring day, in an ordinary suburban kitchen, the phone rings. There’s been an accident. In one heartbeat, a family’s life is changed forever.

After her husband, Hugh, is hit by a car while riding his bicycle, Rosemary Rawlins is plunged into twelve months of marathon caregiving, without the promise of a positive outcome. She works herself to the point of exhaustion to bring her grievously injured husband—who suffered a traumatic brain injury, necessitating the removal of half his skull—back home and back to himself. Then, as he slowly begins to reclaim his life, Rosemary falls apart.

She can't sleep. Her heart pounds. Her joy and trust in the world dissolve into endless anxiety. She lays awake at night wondering how her marriage will survive. Will she ever be able to relate to Hugh again? What will become of their relationship? Their children? Do they recognize each other—literally—as the people they fell in love with and married decades ago? How can she let go of her fears? And what can she learn from them?

Learning by Accident is a caregiver's story of ambiguous loss, family love, and emotional healing. This compelling personal account demonstrates with heart and humor that what we fear can be more debilitating than any physical injury. And that sometimes starting over is exactly what we need.

Product Details

ISBN-13: 9781628737776
Publisher: Skyhorse
Publication date: 03/04/2014
Pages: 304
Product dimensions: 6.10(w) x 9.10(h) x 1.10(d)

About the Author

Rosemary Rawlins is a writer and speaker, currently blogging for BrainLine.org, an award-winning multimedia WETA site. She sits on the advisory board of the Virginia Commonwealth University’s TBI Model System of Care (TBIMS). She lives in Glen Allen, Virginia.

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April 13, 2002

Hugh's mind spins as quickly as the blurred spokes on the wheels of his bike. He pedals through a clear spring afternoon on the last leg of a twenty-mile route he has ridden for more than ten years: Springfield to Nuckols Road, right on Shady Grove, and into the Virginia countryside before winding around on Pouncy Tract by Rockville School. He's determined to get back in shape. Logging far too many hours in the office during winter has taken its toll. The burning in his quads reminds him to get out more so he can rejoin the rigorous Saturday morning group ride he enjoys. Vowing to whip himself into shape in two weeks, he smiles inwardly, his mood elevated by the wind cooling his face as he quickens his pace. Dressed in full gear, he glides along, feeling the stress of the workweek evaporate as quickly as the sweat pouring down his face.

He hears a car. Before he can glance over his shoulder, his head snaps back, and both hands fly off the handlebars as the bike is ripped out from under him. He feels his toe clips release, then he feels his body slide across the metal hood, smacking the windshield. Glass shatters into a million sparkling beads that bounce around him like a meteor shower. Tossed upward into an awkward flight, he shoots over the car roof, glimpsing blurred images of earth, sky, a truck, and treetops, until an earsplitting clunk sends blades of pain ripping across his forehead. His thick bike helmet cracks. Writhing in shock, he sprawls on the street, his skin scraped off in road-burned sections. His eyes close and open. One-word thoughts stab him into consciousness — blackness ... sunlight ... burning ... girls.

* * *

A young nurse is on her way home from Lowe's with her husband and son. Traffic stalls. Craning their necks, they notice a gathering crowd. "Must be an accident," her husband says, "I'll wait here. You go do what you do best." She pushes her long hair away from her face, throws off her flip-flops, and runs. Several distraught people surround the accident victim. As the nurse approaches, she says to two men, "Don't try to move him." A towel roll has been placed under his head. "Has anyone called an ambulance?" she asks.

"I think so," answers a tall young man, voice shaking.

"I'm an R.N.," she says, kneeling. "I'll stay with him." Swallowing hard, she naturally blocks out the sound of cars whizzing by to make her quick assessment: blood and gunk flooding his ears, pupils abnormally dilated. Head injury — acute. The man's eyes widen with unspeakable pain as he tries to talk while kicking his legs on the hard road.

"Help me, help me," he grunts. She kneels beside him and takes his pulse. He jerks away. "Leave me alone!" he yells. The nurse's eyes travel up his arm where a chunk of torn flesh flaps on his elbow.

"You've been in an accident. Lie still. Help is coming," she says in the most even voice she can manage. Her face hovers directly over his as their eyes lock in the sunlight. "I can hear the fire trucks. They're coming to help you. Hang on." She can barely stand to look into his frenzied blue eyes. It's as if they are screaming — pleading with her to understand a message she should deliver. "What is it?" she asks. He turns to his right, screams again in pain, as she spots the gold wedding band on his left hand. She knows instantly that he has a wife who needs to know how badly he's hurt. What if she's at home planting flowers at this very moment? Does he have children? She grips his hand tightly, joined in the horror of his pain and his inability to communicate. She watches the sun reflect the shock in his eyes. "What is your name?" she asks.

He moans low and deep, as if he can't hear her. "Stay calm. Keep still," she soothes. "You'll be fine." Rubbing his arm in long slow strokes, she allows herself to take a deep breath. As an R.N. in the hospital, she has seen injury, but never the raw pain and panic of an accident scene. She knows that with every passing second, his life is ebbing away. She watches him grow weaker, more tired, but determined to live. "Stay with me," she says louder when his eyes close. He opens them again, piercing blue orbs reflecting the sky.

Traffic backs up despite the efforts of a twenty-year-old desperately directing cars. He checks in now and then with the nurse, his eyes glazed with tears. His tattooed arm directs bystanders to the roadside, forming an audience of paralyzed, whispering witnesses like a retaining wall around the scene.

The shrill siren grows louder and louder until, abruptly, it stops. The nurse hears doors crank open, hurried footsteps. Within seconds, paramedics arrive. As she steps aside to let others take over, the injured man curses and thrashes in a wild burst of energy. It takes nine firemen to strap him to a body board.

Running toward her van, bawling repressed tears, the nurse collapses into her husband's arms. She buries her face in his shirt to drown out the primal shriek of the cyclist as he's lifted onto the stretcher. Who is this man? How can she let go of him and leave him now? When she hears others scrambling in their search to locate some form of ID for the cyclist, she breaks away from her husband, runs over to the car that struck the bike, and sees a twisted knot of scrap metal wedged under the front fender. Peering under for clues, she finds none, so she continues to search for a wallet or saddlebag along the pavement. A few feet from the damaged car, she notices a policewoman speaking to a small group of people on the side of the road. An older woman glances over at her, oddly detached. A younger man is crying openly while gesturing to the officer.

Off in a patch of soft grass, someone yells, "Over here!" A cell phone is rushed to a rescue worker who presses Contacts, sees the word Home, and calls the nearest trauma hospital with the number as the doors to the ambulance slam shut.

The nurse feels a firm hand grip her shoulder. "Ready to go?" asks her husband. She lets her head fall on his shoulder. Minutes ago she was on a happy outing with her family. Now she hears only questions and the shrieks of a dying man in her head.


I fumble with overstuffed brown bags and keys, stumble in the front door, and hear the phone ring as I dump paper sacks on the kitchen table and answer the phone.

An urgent voice grabs my attention. "This is MCV Hospital — do you know a cyclist?" For a moment, I can't speak. Then the voice shatters my silence, "Hello? Are you there?"

"It's my husband. Is he okay?"

"No. A car hit him. He's in serious condition. You need to come down here."

"How serious? What happened?"

"It would be best if you could just get here right away."

"I'll be there." I hang up and stare at the phone, shaking. I have never been to MCV. I know it's downtown, but two other hospitals are closer. Why the Medical College of Virginia? Instinctively, I call a few friends who could take me there, but I get their answering machines. Just as I hang up on the third call, the phone vibrates and rings loudly in my hand, making me jump before I push the button to answer.

"Hello, this is MCV again. Can you give us his name? He had no ID on him."

"Hugh Rawlins, R-A-W-L-I-N-S. How did you know to call me?"

"We found your number on his cell phone. Is he diabetic? He may need blood."

It was Hugh. I was hoping they had the wrong person. Blood? "No, he's not diabetic. How do I get there? Give me directions from I-64 heading east."

I scribble the directions, stop for a minute, and take a deep breath. After pulling a list of phone numbers out of the junk drawer, I grab my car keys and run out the door. "Just drive. 64 East to Exit 74C, 74C ..." I repeat to myself.

At a red light, I call a cycling friend of Hugh's and reach his voicemail. "Kevin, it's Rosemary. I'm on my way to MCV. Hugh has been in an accident. I think it's bad. I don't know if I can do this alone." My voice breaks up. "Please come."

Stuck behind a slow truck, I want to jump out of the car and run the rest of the way. My litany continues in a strained whisper, "Right on Eleventh Street. Right on Clay."

I find a space in the parking deck, jump out of the car, and race to the emergency room, where the full force of dread hits. A security guard steers me to a policewoman in the hall. "Your husband has been hit by a car," she says quietly. "He's in critical condition. He needs surgery. They are x-raying him now. I'm sorry, but can I get some information? I need his full name and a number where I can reach you later."

Bile rises in my throat as I answer her questions. A young woman in a white coat hurries over. "Mrs. Rawlins?" she asks. I nod.

"My name is Karen. I'm here to help you. I'm sorry about your husband." The two escort me to a small, narrow, whitewashed room with a few chairs, a box of tissues, and no windows. "Can I get some information? Correct spelling of your name? Your husband's social security, insurance?" she asks.

I numbly take out my ID cards and hand them over, "Can I see him?"

"Yes, in just a moment, before he goes up for surgery." Why, if this is so urgent, does everything feel like slow motion?

I look at the police officer. "Who hit him? Was that person hurt too?"

"No, he was the only one hurt. I'll be going now. Is it okay if I call you later for more information?"

I nod.

Karen takes over, "Would you like to call someone?" she asks.

"No. Not now." I say it slowly as though trying to stop time. My mind is as blank as the bare walls of the room.

A woman comes in and introduces herself as the hospital chaplain. "I'm sorry about your husband, Mrs. Rawlins," she says. "It looks very serious. What religion are you?" Her voice sounds overly calm.


"Can I help in any way? You will be able to see him, but I must tell you, it's a massive head injury. You may want to say goodbye. Be prepared for the worst."

"No. I won't ..."

Karen hands me a tissue. Her voice is sweet, like a family member. "Is there anyone nearby who can come here to help you? You should have someone with you."

"No," I repeat. "I won't say goodbye."

"Can I get you a drink of water?"

I shake my head no.

"Your husband has multiple injuries. But the most serious one is his head injury. He needs surgery now; we will bring him up soon. We'll certainly do everything we can. Come and see him." She gently takes my hand.

"I can't believe this," I whisper as she guides me like a child across the hall. Hugh is lying flat and still on a gurney, the light over him casting a garish glow. People mill around him, but I'm unaware of what they're doing. He looks dead. No, I tell myself, he's just asleep. I walk over to him and lay my hand on his chest in disbelief. He is real — lying on a gurney — about to have surgery. I'm transfixed. Through hot tears, I see his solid frame dressed in colorful cycling clothes as he walked out the door just a few hours ago. We had said the most casual of goodbyes, no kiss, no hug ...


A whiff of alcohol startles me back to the present. Still in disbelief, I lift Hugh's hand, bruised and swollen at the knuckles. His black cycling shorts are torn and his jersey has been removed. His tan, muscular thighs are streaked with lines of blood now drying to a dark crust. Gazing at his unconscious face, I lean close to his ear, "Please don't leave me, Hugh Rawlins, don't let go — I don't want you to go. Mary and Anna need you. I love you." Sensing someone nearby, I look up. An orderly nods sympathetically as Hugh is rolled away for surgery. A gentle tug from Karen tells me to follow.

I'm across the hall in the white room again. "Sit here," Karen says. I register short phrases floating off the cloud that cushions my mind against the onslaught of bad news: "Brain surgery ... very serious ... long operation." My mind and heart bounce racquetballs off each other, the logical and the hysterical colliding.

"Mrs. Rawlins, is there anyone you can call to sit with you?"

"Not really. My children are at a party. I have no family here. Hugh's parents are in Florida and mine live in New York." Tears stream down my face. I rub them off and wipe my hands on my jeans. "All my brothers and sisters live out of state."

"Don't you have any friends?"

"Yes, but they're out. I already called some on the way over. I'll be alright." I feel small, curled up like a bug against a huge foot pressing down on me.

"Let me give you a moment. I'll be right outside," she says and leaves me to gather myself. I hear faint murmuring as she consults someone.

My mind drifts back to the day and night before it all happened, wondering if I could have changed the course of events by stalling, lingering, or making love to Hugh when he sent me all the right signals. I resurrect and relive every second, every word, impression, and look he gave me in the twenty-four hours before he was hurt. "Stop it!" I tell myself. "What does it matter anyway? It happened. It's done." Still, like a winding newsreel, it replays in my head.

The night before he crashed, all four of us were home. Hugh and I heard the slamming of a door and the muffled stampeding of a carpeted race downstairs before watching Anna half slide and nearly fall into the hallway with her sister in full pursuit. They had spotted their ride to the eighth-grade dance from the upstairs window. "How can two tiny dancers sound like such a herd of elephants?" I whispered to Hugh, making him smile.

Anna skidded by us first, clad in a tight little skirt and fitted shirt, perfect for her thin, straight frame. She brushed soft kisses on our cheeks, turned dramatically, opened the front door, and strutted across the green lawn in mock sophistication. Glancing over her shoulder with a wide smile, her blonde curls bouncing, she waved one last time. "We are in big trouble," Hugh whispered to me.

After hopping on one leg to adjust a flapping shoe strap, Mary followed with a hurried hug. Even while sprinting to catch up to her sister, she moved gracefully in a swirling skirt of violet flowers, her long brown hair cascading down her back.

"Stay away from the boys!" Hugh shouted to them, only half joking.

"Sure, Dad!" Mary called back, her eyes rolling with innocence and mischief.

"Those girls are growing up way too fast. Too many guys are calling them. Do you know all these kids?" he asked with a serious look, hesitating to close the front door.

"Well I know that one of them said he had a dream that you were chasing him with a chainsaw, so I guess they all know you are an over-protective father!" This brought a sinister smile to Hugh's face. "They're fourteen-year-old boys, hon. How bad can they be?" I said with a shrug. His eyebrows shot up as if to say, "Pretty bad!"

Hugh stared at the empty spot where the car had turned the corner. "It sure is strange to think of them going to a dance," he mumbled.

"C'mon. Let's go around the block and eat at that little place by Michael's. I don't feel like cooking," I said, nudging him in the waist.

At the restaurant, we talked over drinks.

"Do you have any townhouse work to do with Lee this weekend?" I asked.

"No painting or anything, but he called me today to say he saw a few new condos on the market. Trouble is, both of us are too busy with our day jobs to look into new rentals." He wiped buffalo sauce off the corner of his mouth and asked me about the girls' plans.

"A few friends are throwing a surprise birthday party for them at the ice skating rink. They really have no idea, especially since they already celebrated with us. They won't want me to hang around."

Hugh's eyes creased sympathetically. Our knees touched under the table in the cramped booth. "Any new clients this week?" he asked.

"Two: a Capital One analyst and a store manager who works at Talbot's. Her résumé will write itself. I hate to say this, but I'm getting tired of writing résumés. There are only so many ways to say the same thing."

"Hire people, grow the business, or go back to school. You always planned on finishing your degree," Hugh said.

"Oh, I don't know — it's so time-consuming and expensive. When are you and Anna going to start surfing again?"

"Soon, I hope. I need a wetsuit that fits, though." He tapped his stomach and smirked.

"Think Mary will go?" I asked. Hugh finished his Jack Daniels. I savored my red wine. My salad and his burger were plunked down in front of us.

"She'll go if Amanda goes; those two are joined at the hip. It's weird, but she does look more like Mary than Anna does; people have mistaken them for twins instead of best friends. Anyway, I hope Mary tries it again. She's such a great swimmer."


Excerpted from "Learning by Accident"
by .
Copyright © 2014 Rosemary Rawlins.
Excerpted by permission of Skyhorse Publishing.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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