Everything I’ve learned from cycling into a tree

Nikki Cunningham, MD at Curious London reflects on the accident that changed her life and what she’s learned from a serious head injury

I was lying flat on my back. Branches covered the sky in all directions. I figured I probably wasn’t on the road anymore. Beneath me felt cold and wet – most likely mud.

Somebody asked if it was alright for them to cut open my brand new cycling top. I declined but I was clearly outvoted because they went ahead and did it anyway. That was the first of many things that didn’t make much sense. As I’d later find out, I had a head injury.

Being involved in an accident isn’t what I thought it would be like. I wasn’t hysterically crying or calling for my mother, I don’t remember feeling any pain, I wasn’t particularly scared, and I didn’t think anything bad was going to happen.

Mainly, I just wanted to sleep. Which was quite difficult because I was constantly being asked to say where I was by the people in red jumpsuits – the air ambulance crew, it later transpired.

The crash happened 90km into a cycling trip in Wales. Going down a very steep hill I now know that I’d managed to cycle head first into a tree at enough speed to break my jaw, fracture my orbital bone, receive a severe concussion, and cause a small bleed in my brain. I also lost a tooth.

I’ve spent the past few months learning to chew again, getting less wobbly on my feet and above all, resting.

While the month of May and most of June is all a bit of a blur, the most recent weeks have allowed me to do a little bit of reflecting. As I begin to dip my toe back into the waters of work, I figured it might be a good idea to jot down a handful of things I’ve realised during this pretty strange situation I’ve found myself in. Partly in case it’s interesting for anyone else to read, but mostly because my memory is genuinely not what it used to be.

Lesson 1: Never underestimate the ability to chew

It turns out that breaking your jaw is quite possibly the most inconvenient bone to break, as it’s directly connected to one of life’s pleasures – eating.

With two metal plates holding my jaw together, I wasn’t able to chew for a month. And so for four weeks after my accident I existed on porridge and smoothies. Unfortunately I just craved a burger.

As frustrating as this was, surprisingly I wasn’t too bothered. That was interesting to me. I was totally content; everything was completely and utterly fine and I had no worries whatsoever.

This level of gratitude makes sense given what could have happened, but after doing a bit more research, I learned about a phenomenon in brain injuries known as “beginners’ mindset”, whereby patients report a sense of peace they didn’t have before.

Similar to the Buddhist practice of Shoshin, it refers to having an attitude of openness, eagerness, and a lack of preconceptions.

I look back on that time and despite the obvious physical limitations I had, part of me misses that sense of pure gratitude.

As I’ve healed and my ability to process things has come back, so too has my ability to overthink and question – something we can all suffer from at times. But then I remember there isn’t a need to forget that beginners’ mindset – yes, I’ve got a few more layers back to my thought process, but that doesn’t mean I can’t still choose to view challenging situations with a different take. One that’s a bit more open, a bit more measured and overall, just a bit more forgiving of myself.

Lesson 2: Brains take longer to heal than bones

A concussion is a type of traumatic brain injury caused by a hit to the head or body that forces the brain to move rapidly back and forth.

Sometimes, if the movement is hard enough – as in my case – it can lead to a bleed. I knew these types of injuries were often sustained in physical activity and I also knew they required a period of rest afterwards. What I hadn’t realised was the amount of time it can take to heal, nor did I understand the bucket load of complicated side effects I’d need to navigate.

Unlike my jaw which eventually sorted itself out on its own, the brain is a bit more of a slow burn. Despite asking in ten different ways how long it would take to heal I was always met with the same incredibly unsatisfactory reply: “It’s hard to say. You need to rest.”

Beyond the need to sleep a lot, I was faced with issues I’d never anticipated.

I got frustrated that I struggled to focus for any length of time – suddenly having an engaging conversation was far too tiring. My out of balance emotions meant mildly stressful situations made me incredibly anxious. Guilt followed me around as I insisted on viewing the time off work as holiday and couldn’t shake the feeling that I should just push through and stop fussing.

All these complicated emotions on top of the general situation I found myself in was slowly eating away at me. And I still couldn’t even enjoy a burger.

In time I accepted that I couldn’t keep beating my brain up about it all: it was going to take more than two metal plates to heal my head. The only thing that was going to help me get better was time.

Lesson 3: The world isn’t designed for brain injuries

People fear anything happening to the brain. After all, it’s where our personality lives, our decision processes, our ability to exercise empathy, compassion, reason, judgement. Our moral compass and our sense of self. So, when something happens to threaten this we strive to seek reassurance.

This became apparent as I went through my healing process. As well as a TBI, I had a very swollen face, a particularly unattractive black eye and a mouth that opened approximately 2mm wide. But these physical injuries soon subsided, my face returned to a normal dimension and people were quick to tell me how much better I looked. Which was absolutely true but was something I struggled to hear.

Although my exterior had successfully rebooted, my internal set up was still buffering.

I’ve now progressed in leaps and bounds to the point that I find it hard to remember what it felt like to struggle. But I won’t forget the need to be kind to myself and not let external pressures or stigma get in the way of being open about how hard the brain injury was to deal with. Because it was bloody hard. And that’s ok to admit.

Lesson 4: Control only what you can

Telling me to rest was unhelpful. I’m impatient. I’m a fixer. I like a series of steps to help sort something. So, when it came to fixing myself, I began to explore a number of different activities that I hoped would help.

The first was writing. Given how confusing it was to make sense of what was going on in my head, the physical act of extracting the words that were floating aimlessly around up there and writing them down was incredibly therapeutic.

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I started to understand things a little better. And I began to solve things. Little by little I was able to start processing my thoughts again. And, despite it being nearly impossible to distinguish what I wrote about in those early days, it proved incredibly helpful with my memory and general cognitive skills.

Mindfulness is something to which I’ve never given enough time, but given the difficulties I found in processing emotions following my head injury, it’s proved invaluable to finally have a routine that gives this practice the attention it deserves.

At the moment I’m focusing on simple meditation techniques and a very beginner’s approach to yoga. Thankfully no one is around to judge my awful form and, the truth is, I don’t really give a hoot about how I look – I just care about showing up each day to do it.

But the most valuable thing I’ve done since my accident is to just speak about it. Openly, unashamedly, confidently.

Initially I wasn’t sure about sharing – I didn’t want to be treated differently, or to feel like a victim, because I didn’t see myself that way. I also worried about how it might impact my career. The nature of my job means I need to be able to converse freely, with different people across a host of scenarios to solve problems or devise solutions. It’s what I thrive on. My injury meant it was difficult to imagine doing that again.

But I realised there’s nothing to be gained from continuing the cycle of not speaking about head injuries, because that won’t stop them from happening.

They aren’t as scary as they sound. The more people understand about them, the easier it will become to live with them.

Lesson 5: Sometimes it takes a tree to remind you why you’re here

Imagine sitting in a room, minding your own business, and suddenly the lights are turned off. You don’t know why, nor who did it, and you’ve not got a clue when they’ll be turned on again.

That’s pretty much how it felt for me following the accident.

One minute I was busy trying to navigate our agency out of the never-ending tunnel that is this pandemic, the next there was silence.

I couldn’t think about the issues that used to occupy my brain before. The various projects we had going through the studio, how our team were doing, how our clients were doing, the different ideas I had for the coming months… Suddenly I was floating around without the usual sense of direction I’m accustomed to.

But my brain didn’t stop working, even after the whack I gave it. Sooner or later the cogs started to slowly click together, and I was trying to grab hold of what made me tick again.

Stepping back into our new office in Soho recently was so powerful. It gave me a rush of energy that I hadn’t felt in a long time.

Flicking through the pages of my notebook I saw the last scribbled thoughts, dated 29 April, and was reminded of the fire that was in my belly. The reason I got out of bed in the morning. What used to make me, me.

After a couple of months sitting on the sofa learning how to chew again, I was transported back to what I love to do, to my sense of purpose. The light was switched back on.

Lesson 6: The lessons continue

Recovering from a brain injury has been one of the most bizarre, confusing, and difficult experiences I’ve ever had to face. The reality is I’m not there yet – I still struggle with certain tasks, I still get frustrated and I still get bloody tired.

I’ve finally accepted that this probably will last for a good few months yet. But as difficult as it’s been, this period of time has taught me so much.

The need for patience, the need to be kind to yourself, the ability to train your brain into a positive mindset and, above all else, the realisation that you’re not here forever.

That last statement is thrown around a lot these days but as someone who picked a fight with a tree and somehow lived to pedal another day, it’s certainly not something I’ll forget any time soon.

So, in possibly the longest shot for a silver lining ever, I’m almost grateful for it. Almost.