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Join us for an inspiring podcast episode as we delve into the world of trauma, resilience, and personal transformation. Our guest, Rebecca Fogg, consultant and author of Beautiful Trauma: An Explosion, an Obsession, and a New Lease on Life, shares her powerful journey of overcoming trauma and finding newfound strength.
Discover how trauma shapes our lives, identities, and perspectives, and explore Rebecca’s unique perspective on posttraumatic growth. Uncover the importance of integrating death into life and embracing the beauty that emerges from adversity.
Get ready for a thought-provoking conversation filled with insights and inspiration as we explore resilience and the transformative power of trauma.
Rebecca Fogg is a consultant.
She shares her story and discusses her book, Beautiful Trauma: An Explosion, an Obsession, and a New Lease on Life.
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Transcript
Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast and get CME for this episode by clicking on the CME link in the show notes. Today we welcome Rebecca Fogg. She’s a consultant, and her book is called Beautiful Trauma: An Explosion, an Obsession, and a New Lease on Life. Rebecca, welcome to the show.
Rebecca Fogg: Thank you so much, Kevin.
Kevin Pho: So we’ll talk about your book in a little bit, but first off, briefly share your story and journey to where you are today.
Rebecca Fogg: Sure. So back in 2006, I was living in Brooklyn and I was working in financial services. I stayed up really late one night working on a presentation, and as I finally stood in front of the bathroom sink brushing my teeth before bed, the toilet exploded. I will spare you the details of how we think that happened, but suffice to say, a shard of porcelain shot through the inside of my right wrist, partially amputating it. All in all, it was eight tendons, an artery, and the median nerve severed. I called 911, I stopped the bleeding, and the next day surgeons at Bellevue Hospital in Manhattan replanted the hand, or did extensive repair work.
Obviously, that was a very, very difficult experience, because so much could still go wrong in the recovery process. They couldn’t tell me whether I would have a useful hand again, and that was very distressing. Ultimately, it was three months out of work, about 300 hours of occupational therapy, and 45 visits to the hospital. But after all that, and you can see this, and maybe your listeners can’t, I have a hand that looks perfect. It’s very high-functioning, although it behaves and feels quite different than what I started out with.
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Kevin Pho: So that whole experience, how did that change you?
Rebecca Fogg: I’m still learning every day, and that’s a lot of the reason I wrote the book; we’ll get to that later. I think at the most fundamental level, it made me more empathetic. It made me more compassionate. There were lots of different ways that I needed help during the process, some of which I might have imagined, very practical things, and others of which I didn’t realize until it happened. And I think now I’m much better able to recognize need in other people. Because so many different people, not just friends and family but colleagues, neighbors, and even complete strangers, helped me so well, I think it just increased my toolkit for being able to assist, and also just to have the courage to step in when somebody else needs something.
Kevin Pho: All right, so let’s talk about your book. It’s titled Beautiful Trauma: An Explosion, an Obsession, and a New Lease on Life. So tell us, what gave you the idea to write a book, and how did it come together?
Rebecca Fogg: Initially, I was writing a journal while I was recovering, and that was with my left hand, so those are pretty illegible. But a really critical part of my recovery process was studying the science behind my injury and repair. That was a suggestion from an acquaintance, and I didn’t know how that was going to go, but it turned out to be absolutely crucial to my sense of purpose and my sense of progress. And I also fell in love with science. I found it incredibly inspiring and very hopeful. And so as I got more and more absorbed in that, I felt just a burning desire to spend more time with it, to learn more about it, to integrate it into my whole trauma experience.
Kevin Pho: And so tell us about that whole research process. What exactly did you do to research your condition?
Rebecca Fogg: I’m so glad you asked that question. No one has asked, and I’ve been waiting for it. It started out with left-handed Google searches for “spaghetti wrist,” which is the technical term for the injury online, and reading everything I could see there. Then it was sneaking into the medical school library at NYU, and then it was finding textbooks, and ultimately it just got more and more focused, really around the questions that I had during my recovery process. I wanted to know: Why didn’t I feel pain until I got to the hospital? Why didn’t I feel fear until the paramedics arrived? How is it that I escaped this without crippling PTSD? I had to know the answers to those questions. And so it went from the very surface level, the Google search, all the way to reading medical textbooks, to reading a lot of terrific science written by scientists for a lay audience, also journal articles. And then ultimately, I interviewed something like 25 scientists and physicians for the book.
Kevin Pho: It was fascinating, getting so granular into the science and the whole recovery process. It obviously influenced how you were coping with this trauma.
Rebecca Fogg: Absolutely. Well, one of the things is that understanding what my hand was trying to do in healing made me much more aware of small progress, and that was very heartening. But I was also well aware of the risks, and I could better understand that I was probably going to lose some functionality and what that might look like. Therefore, when progress was slow or I lost some functionality, I wasn’t as demoralized as I might have been.
Kevin Pho: All right, so go on with your story in terms of that journey toward writing a book and sharing your message.
Rebecca Fogg: Yeah, so initially I was just writing without the intent to make a book out of it. But over time, as I was recording my lived experience, that part of it, not the science, eventually an editor saw it and said, “This is a book, and it will be published. You just have to decide what kind of a book you want to write.” As soon as she said that, I knew that that was how I wanted to spend a significant chunk of my future. I was enjoying the writing process. I’ve always loved words and language.
But I also knew I did not want to write the book without the science. The science was an integral part of the experience, and also, it’s my body; it’s my science. When I was reading other books about people’s accident experiences and traumatic experiences, those stories were so important to me, and I felt that the science could add another dimension to it. So it was partly because I was intrigued myself and I was still understanding it, and partly because I just wanted other people to have that same joy of discovery that I did, and perhaps the benefits to healing, and maybe even to the patient-provider relationship, that happen when you have a science vocabulary and you have questions about your condition that you can ask and discuss.
Kevin Pho: So I want to ask you about some main messages from the book in just a little bit, but first off, just give us some time-frame context. When did this injury happen, and give us a sense of the time frame of your recovery.
Rebecca Fogg: So the injury happened in January 2006. I would say that the very practical recovery was about three months, as in, it was six weeks with my hand immobilized while the tendons healed. It was another six weeks or so of getting the hand mobile again, because everything is all gummed up and stiff after the tendons have healed. And then it was probably another couple of months before any nerve sensation started to return. So I think about it as a six-month process from injury to “I now have all the functionality and all of the sensation that I’m going to get.”
Today the hand is quite different. It has an impaired median nerve, and so I have what’s called protective sensibility. You can see I’m smiling, because I get myself into a fair amount of trouble, because I don’t have any surface sensation on my hands, and you have to watch it to see where it’s going and make sure you’re not touching anything hot. I have poor localization of stimuli, so you get a little pinprick in one part of your finger, but I feel it in 10 parts of my hand, etc. So it’s actually fascinating how the recovered nerve is very different. And so my hand behaves differently. I hold a pen differently. I hold utensils differently. There are certain tasks I do with my left hand now that I used to do with my right. And it’s essentially the hand that I had from six months after the accident.
Psychological recovery is a much longer process, and I am still learning about those impacts, and I think that’s something that has really surprised me. This is now an incredible 17 years ago. I did a lot of work in financial services and other jobs in between, and then I took some time off to write the book. In the course of researching and writing the book, a lot of which I did during the COVID-19 pandemic in lockdown, which was also a tough time, I learned a lot more about PTSD and a lot more about the psychological effects of trauma and resilience. Even at this late date, I was able to see impacts that I hadn’t really known were there, and I’m really grateful for that, because that’s also prompted me to seek out some EMDR, which your medical audience will know is one of the gold-standard trauma treatments.
So I would say it’s ongoing at this point. I wouldn’t consider myself in treatment, in a sense. It’s more that I think, like any really intense life experience, whether it’s positive or negative, it never entirely leaves you. You have to find a way to integrate it into your life. And particularly a traumatic experience, as the excerpt that you published on your site describes, is a tough integration process. If you’ve had a life-threatening experience, you have to learn how to live with energy and optimism, even knowing how fragile we are and that suffering or death could be around the corner. I think that there’s a great deal of meaning in that work of integration, but at times it can be difficult.
Kevin Pho: You use the term post-traumatic growth, so talk more about that as it relates to your psychological recovery.
Rebecca Fogg: Yeah, I talked about that in the book, because I absolutely feel that there are many, many positive things that happened to me as a result of the accident. That’s why it’s called Beautiful Trauma, because I was really surprised by the coexistence of awful things and amazing things: deepened relationships, my ability to be more compassionate and helpful, my love of science, my love of writing. All of these things are results of this trauma, but I’m not in any way saying that there’s a silver lining to every trauma.
And so my exploration of post-traumatic growth in that excerpt talks about my ambivalence toward that term. I think the subtleties of the theory are often misunderstood. The theory also is not saying that there’s an upside to every trauma, not at all. It talks about the growth that can happen as you learn to cope with a trauma. But from my perspective, I don’t like the term itself, because I think it’s too easily misunderstood. I think that people can take it as meaning that you have to experience that trauma to have that growth, or that if you don’t grow after a trauma, or if you find yourself really struggling with the psychological effects of it for a long time, well, then you haven’t stepped up to the occasion. So I prefer to think of it as an integration process, and one that we’re always going to be learning from and maybe working at.
Kevin Pho: So during this whole process, which spans more than a decade and a half, you’ve obviously had various touch points with the health care system, physicians, and rehabilitation therapists. Talk to us about your interactions with the health care system. What are some things that you think they did well, and what are some things that you think they could have improved on during this journey?
Rebecca Fogg: Yeah, I have such great warmth for the team that took care of me at Bellevue, everyone from the surgeons who did the repair to the residents who were following up. My occupational therapist was wonderful. And what they all did very, very well, from the ER to the OR to the OT room, was always looking me in the eye, taking the time with me, being very present, encouraging my questions, of which I had many, particularly as I started to learn more about the science, answering the questions, and really paying attention to whether I understood something or not. It was encouraging and answering questions and making sure that they didn’t leave until my questions were answered. It was looking me in the eye and listening. It was understanding what I was going through and recognizing that everything that they were asking me to do was difficult in that moment because of what I was going through.
I think what I would love for anyone at any part of the system to understand is that life demands the most from a trauma patient when they have the absolute least to deliver. I cannot overstate the sense of alienation and foreignness and disruption in the case of a traumatic injury. It is just incomprehensible. And your medical audience will be well aware of the fragmented system that we have and how the onus of a holistic view is all on the patient.
And so if there’s one thing that I could ask people to do when they are treating a trauma patient. If just one person, when I was leaving the hospital, had handed me a card that described some basic things about psychological trauma, what I might expect, a checklist of practical things that need to happen at home. Who’s going to count your pills? Who’s going to take out the garbage? Where are your meals coming from? How are you going to get to appointments? I am very lucky to be somebody who had family and friends who could be supportive, good health insurance, all of that. But first of all, everyone should have those things, and secondly, you still don’t know what to do next, and you are in no state of mind to figure it out for yourself. And by the way, none of your friends or family are either. And so I think that’s not something that you have to fix the whole siloed, fragmented system to do.
Kevin Pho: Tell us what your life is like now, before and after the trauma. How are you doing?
Rebecca Fogg: Yeah, I’m doing great. Thank you for asking. It’s a very different life. Once I’d gotten through that year after the accident, I really thought of it as, “This is my second life. This was not a given. Do I really want to continue exactly as I was before?” And it was a good life before, but when I looked at it hard, I realized that I wanted to make some changes. Very long story short, I ended up moving to London, leaving financial services, which had been a great career for a long time, but now I wanted to work in something that was more mission-based. And so I went on and had a wonderful time working at London’s Air Ambulance, co-founding their Institute of Pre-Hospital Care. I went on to do a lot of research on innovative care delivery models, and then went on to write the book. So it’s really been a big pivot. It’s also been a lot of work, but I feel that the life I’m living is much more closely aligned with my values now.
And I also recently picked up Scottish fiddle, which might seem like it comes out of nowhere, but I played violin very seriously as a young adult and into college, and gave it up for many years because there was no time, because of the way I was working and living in New York City. So I have a great family of friends over here, and I play fiddle a lot of days, and I’m just taking it as it comes.
Kevin Pho: What kind of pieces of advice can you share with those who also go through a trauma?
Rebecca Fogg: First, I would say do not be afraid to ask your health care providers questions, to rigorously question, even if they are very short of time. It’s really important that you understand what is happening to you and what your options are as well as you possibly can. That’s going to make you a better participant in decisions that affect your care. It’s going to make everybody’s jobs easier, and hopefully it also can relieve the suffering that comes from uncertainty.
Another thing I would suggest is don’t be afraid to ask for help. People really want to give it, and it’s not just your spouse or your family or your friends. Ask for help. Ask for practical help. There’s going to be a lot that you need, and they will be delighted to give it to you.
Another thing is, in any recovery period, there are going to be discouraging moments. There are going to be setbacks. There are going to be bad days. Something that helped me, that maybe will help you, is to find other sources of progress, and those could be super small things, like recording a little voice diary on your phone, or reading a few pages of a book, or doing some Duolingo questions every day, or even just buying a flowering plant and watching those buds slowly open. When life is feeling very small and very difficult, finding micro sources of encouragement and inspiration and progress can actually really help.
Kevin Pho: And my final question, Rebecca: Tell us some of your take-home messages from the book.
Rebecca Fogg: Coping can feel like falling apart, so if you feel like you’re falling apart, you might just be coping.
I was really impressed in the research by, and this will be very familiar to your medical audience, how our health status, and everything that we are and do, has biological, psychological, and social drivers to it. And so another takeaway is, try to recognize when you’re judging yourself or somebody else for how they are experiencing and responding to adversity. Everyone’s experience is going to be infinitely unique, so have some empathy for that.
Another takeaway from the book: Suffering and hardship are inevitable, and so is kindness. I was so struck by how much other people’s small acts of kindness made such a huge impression on me. I used to think, before the accident, that if someone was going through something big and terrible and unfamiliar to me, I couldn’t help them at all if I couldn’t solve the whole problem, that you have to solve the whole problem to be of any use. Through my own experience, I realized that sometimes, if all you can do is look them in the eye and tell them you care, that can sustain someone for a long time.
Kevin Pho: Yeah, the smallest kindness can sustain you for days. The book is Beautiful Trauma: An Explosion, an Obsession, and a New Lease on Life. Rebecca, thank you so much for sharing your story, time, and insight. Thanks again for being on the show.
Rebecca Fogg: Thank you so much. I really enjoyed it.
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