So many nights Dave Holland sits alone in his strip of concrete
back yard, counts the stars and thinks back to his escape.
Wondering if he ever really got away.
Three years on, sleep still comes uneasily. His head hits the
pillow and he flashes back: Caught up in the spinning and metallic
screaming and the wet cracklepop sound of tearing flesh. The
coppery tang of blood. The thing dragging him closer. The fear and
the pain.
When sleep does take him, so do the nightmares. His partner's
daughter, 11-year-old Xenia, getting trapped and torn. Or his
heeler-collie cross Pushkin being pulled apart.
He watches
helpless, heart racing, as the parts somehow reassemble and the
tortured dog sits there licking its terrible wounds.
And he shudders awake, grabs his smokes and goes back to the
night.
Daylight offers little rest. Too many sounds trigger the
flashbacks: Each March the angry, high-combustion howl of Grand
Prix cars circling the park a couple of blocks behind his home;
ambulance and police sirens along Kerferd Road; construction work;
the rattle and clatter of trains; a car revving too close.
He remembers the first time he got back in a tram. The doors
hissed shut and the tram jerked forward with the metal-on-metal
grinding of wheels on track and he began to hyperventilate. He was
sweating and pacing up and down the tram and people were staring.
Every whir and vibration was drilling through his feet, along his
spine and into his skull and he was back there again. Trapped in
the machine.
DAVE didn't like the thing from the start. It was an EVH 1750
Scout drill rig mounted in a tilt-frame on the tray of a green
Toyota. It used a 20HP petrol engine to drive its lengths of 75
millimetre auger. But already this morning, he'd decided it was
little better than a post-hole digger. It just wouldn't tell him
what he needed to know.
Dave understood soil. Since he was a little boy he'd absorbed it
from his father. Dr John Holland was a civil engineer, teacher,
geotechnical soil technician, specialist in "clay-heave" and one of
the originators of the floating slab technique of housing
foundation. By the time Dave was a teenager, his dad had him out
with a hand auger doing soil tests on subdivisions across
Melbourne.
Dave had studied commerce and accounting and worked for seven
years as an events manager and caterer, but kept up his "trade"
doing tests with his late father's company. The science of dirt was
almost imprinted in him. Show him a handful of clay, he reckoned,
and he could tell you where it came from, the depth you'd dug it
out and probably it's loading capacity.
He'd study the stuff by sight and smell. Roll a piece between
finger and thumb to gauge its elasticity. Mix it with a bit of spit
to determine its consistency. He'd even stick a chunk in his mouth
and chew to get a sense of its composition.
But that Friday morning, February 6, 2004, he was relying on the
truck-mounted rig on a site at the new Waterways Estate at
Braeside.
He was trying to find the depth at which the added fill met the
natural ground, but two pits he'd bored to five metres were
inconclusive. The ideal would be to take samples every 200mm, but
the rig was underpowered and the auger couldn't be withdrawn. So he
was depending on what was known as "spin test", watching the dirt
as it spewed out of the hole and looking for changes.
When that didn't work he tried a hand auger. He dug two metres
but still couldn't break through the fill, so returned to the rig
to bore a fourth hole. This time he felt he was getting somewhere.
The spin technique wasn't showing him enough, but there was one
more test he could try.
At the plane where fill sits on the natural soil, remnant
vegetable matter - grass, reeds or roots - slowly rots and decays.
Dave knew that when you broke into that level there was often a
pong of sulphur. He bent down beside the spinning auger and
sniffed.
He was two metres tall, lean, but with a powerful upper body
developed over two decades of digging. He wore his straight black
hair in a pony-tail that hung just below his shoulders, but at work
he folded and rolled it into a bun that sat on the back of his head
like a small fist.
It was just 9am, but already oven hot. He was bathed in sweat,
mixed with black, peaty dirt. The dessicating wind gusted and
skittered across the empty subdivision. It must have flicked a
little of his hair out of its bun and as he straightened he felt a
couple of tiny tugs as a few strands blew into the orbit of the
auger.
Then it grabbed the rest. Dave's head slammed sideways into the
unguarded drill. He felt it bounce once against the rotating auger
and his right ear began to rip away.
AFTERWARDS, in hospital, he met so many people who told him they
remembered nothing of the events that put them there. The moment of
the car crash or fall; being trapped in wreckage; the ambulance and
emergency room; and, especially, the pain, fear and blood. None of
it. It was self-protection: their minds telling them there were
things they never needed to know.
Dave can't say how much he envies them. Because he has total
recall.
When it happened, it took seconds. But in his memory and
flashbacks it goes forever, like an interior movie run in surround
sound and cruel slow-motion so he doesn't miss a detail:
As his hair knotted tighter, he'd stretched for the controls.
The lever that controlled the auger did not operate as hold-to-run,
so the drill had kept rotating even while his hands were off it. He
couldn't reach the emergency stop button. "At that moment I
experienced total terror," he says. "I believed there was nothing I
could do and I was going to die.
"I'm slammed into the rig and it's turning full-pelt . . . I
don't know what was louder: the sound of the engine screaming or
the sound of flesh and tendons tearing.
"I knew my ear had just been torn off. At this stage it was
still connected at the base of the ear lobe and hanging down by a
thread of skin."
Dave was in a red haze of pain but knew he had to get some sort
of control. He twisted his body to bring himself face-on to the rig
as it dragged him upwards. A patch of skin between his right ear
and eye ripped away. He felt the auger catch a nerve - "this
gristly thing" - beside the ear and pluck it out.
His face was millimetres from the spinning metal and somehow he
noticed its edges were marred by sharp nicks and dents. "I
remember, in slow-motion, a splinter piece of metal protruding off
the auger and piercing into my right eye and slicing across the eye
ball."
All he could think to do was pull until his hair broke. He
lowered his head until it was banging into the auger and it was
gouging a crater the size of a 20-cent coin into his skull. He
braced himself: "I've got my palms on both edges of the staff, I've
got one foot up on the rig and I'm pushing off with every bit of
strength I had. I'm putting everything into it.
"In my mind's eye I'm trying to break the hair. But the first
thing that went was the back of the scalp. I felt it go. I heard a
tear and then felt this extraordinary cold chill and I started to
realise my scalp was coming off."
At that moment, Dave heard two short, sharp cracks from near the
base of his skull. They reverberated down his back and he knew he'd
just broken his neck.
For years one of the things he most feared was becoming
quadriplegic and now it seemed to be happening. But somehow he was
still standing.
"When I think back to it I recall the degrees of pain and wonder
why I was still functioning," he says. "I'm no special man: I pale
and run and hide from pain the same as anyone else. But I had no
choice. I guess I put the remaining fear away and kept
pulling."
It was either that or, as he says now, get turned into mashed
potato.
"I remember putting in a hell-mission of strength. I heard
another tear and my head could move a little. I was still pushing,
there was a loud tear and the whole scalp ripped from the back
forward and I was looking at the inside of my own face as it pulled
away from my skull to the end of my nose."
As he jerked free, Dave spun in a semi-circle. He was determined
to stay on his feet because if he went to ground, he suspected, he
wouldn't get up.
Blood was spurting from his skull and what was left of his face
seemed to droop loosely over his cheekbones. He pulled it up so he
could see. When he turned back, his scalp was flapping on the
rotating auger.
"Oh f---," he whispered. "Oh f---! Oh f---!"
TILER Osama Kerbej was on his mobile phone when he saw the
stranger coming. The man was very tall and he was holding his head
like he thought it was about to fall off. He was moving slowly,
moaning, weaving from side to side like a drunk and didn't seem to
know where he was going.
His head was a glistening red mess. Small fountains of arterial
blood were arcing from the top of his skull, running down his face
and onto his shirt.
To Dave it was like looking through heavy pink rain running down
a window. There would be moments of clarity then it would curtain
over again. He didn't know how long he'd been following the sound
of the tradesman talking on his phone, but when he got there, even
through his pain and confusion, he was struck by how calm the man
was.
"Gotta go," Kerbej said. "No. Gotta go now." Then he was at
Dave's side, saying "Y'right mate?"
For the first time in what seemed such a long time, Dave began
to believe he was going to make it. Kerbej was already back on his
phone, dialing 000. Dave dropped to one knee, so hard he cracked a
kneebone. Then slowly, carefully, he tipped on his side and lay
still.
After he'd pulled away from the drill he'd been lost in
confusion. He'd gone to the rig controls to turn it off, but
couldn't remember how. "For months afterward I was heartbroken
about that," he remembers, "because someone else could have got
hurt."
He opened the truck door and grabbed his mobile then stood
staring at it: "I've got it in my hand but I don't know how to use
it . . . I can't function, I don't know where I am or what I
am."
But he knew he had to get help before he bled to death. His neck
was swelling and he was scared that if pressed against his spine he
would be paralysed. And he knew that something had snapped high up
in his neck: "We all got told at school that if you break your back
or your neck, you don't walk. But here I am still standing, all
alone in the middle of a paddock, blood spraying out of my head . .
. and if I don't walk, I don't live."
In the distance he could hear a radio and someone talking on a
phone. He remembered there were tradies working on a new house
nearby. "So I walked," he says.
Dave was frightened that a sudden jerk could snap his spine so
he focused on keeping his head balanced squarely over his
shoulders. Later he would compare it to balancing a basketball on a
finger, but says now it was more like a deportment school model
learning posture with a book balanced on her head.
He had help. As he carefully stepped out, he felt a hand come
down on his shoulder. Afterwards, a priest suggested it was the
hand of God, but Dave thought that too easy an explanation: "Then I
remembered my father having hands that were bigger than life. That
hand on my shoulder could have been nobody else's but his.
"I know it sounds funny. The mind plays games with you and maybe
that was my way of getting through that 50 metres. But I felt I was
being assisted, I felt at last someone was helping me."
SO much blood and so many flies. That's the image MICA paramedic
Barry Bates keeps from that morning.
The call came about 9.15am, the first job of the shift. Both
Bates and his partner Andrew Black had just returned from leave and
when they pulled up Dave was lying on his back, ambulance officers
David Jones and Elizabeth Pisasale already working on him.
"He was lying on the ground and there were flies hovering over
his face," he recalls. "He was covered in blood, it was sprayed all
over his shirt. He had very graphic, horrific injuries, like
something you'd see in a cowboys and indians western movie, but
worse."
For a moment, Bates feared Dave was beyond saving: "You could
see the beads of white in his eyes - the stare someone gets when
they're facing death. And we pretty much knew from then on that it
was going to be a hard run.
"David was in so much pain that he couldn't talk, didn't scream.
He just didn't have the energy. He was moaning but was almost
beyond that. You can be here one second and gone the next and I
think David, at that point, was probably thinking 'This is
it'."
The way Dave remembers it, he'd already gone. "I don't know that
I died and they brought me back," he says. "But I found out what
life was that day . . . I lost a bit of time and in that time
something happened.
"What I saw that day was very, very beautiful. I guess from the
moment I hit that bitumen I couldn't tell you what my name was. I
felt what it is to be me peel off like an orange skin."
He had an image of a cloud, slightly grey, and he was becoming
part of it. After studying Buddhism for 10 years, he finds that
perplexing: In the Tibetan Book of the Dead, a grey cloud
symbolises hell, but there was no way in this world - or the next -
that he was in hell.
"I was surrounded by people who cared and I could feel it. I
knew what each of them was thinking," he says.
Then he gives a self-deprecating smile and adds: "Bear in mind
that by this time they'd given me the absolute maximum dose of
morphine possible. So near-death experience, morphine-induced,
shock - God knows what it was. But whatever it was, it came to me
at the moment it was required, because it took away my fear."
In fact, says Bates, they'd given him enough morphine "to drop a
horse". An intravenous line was put into his arm and he was given
Hartmann's Fluid, a solution similar to human plasma. The gaping
wound over his skull was washed with saline and moist dressings
applied. Because of the likelihood of spinal injuries, they put him
in a Vertabrace cervical collar then strapped him to a hard board
for full spinal immobilisation.
Matt de Graves, a senior inspector with WorkSafe Victoria,
pulled up just as Dave was being loaded in the ambulance. He
introduced himself to Senior Constable Duncan McKenzie, from
Mordialloc Police, and his partner Constable Greg Pajor. They'd
arrived not long after the first ambulance and were appalled at his
injuries. His skull was exposed, like a bright red egg in an
eggcup.
"We see a lot," says McKenzie. "But you don't see something like
that every day. You remember it, is the best way to describe it.
You remember it and you never forget it."
Both de Graves and McKenzie suspected this would probably be a
case for the coroner. De Graves paced out the distance to the drill
rig, following the bloodstains in the dust. Somehow, almost blind
and probably with a fractured neck, Dave had walked 51 metres.
There were hanks of hair all round the rig and a thick loop
still knotted on the auger. Blood was splashed on the ground and
spattered over the rear of the truck. "What machinery can do to the
human body," he says, "there's no other word for it but evil."
He noticed Pisasale and Jones were sifting for something in the
dust. They told him that a call had just come through from the MICA
van: they'd driven off without Dave's right ear. De Graves called
McKenzie and they organised a line search.
After about 10 minutes another call came through. Dave had told
Bates where to find it. After he'd pulled free from the auger, the
ear had been hanging by a strip of skin and gristle. He pulled it
off and tucked it in the breast pocket of his shirt.
De Graves shakes his head: "That was when we began to get the
idea that David was a very different, unique individual."
IN 20 years of medicine, half of that in reconstructive and
plastic surgery, Richard Bloom had seen some confronting things.
But he admits to a sort of double-take at what was on a small table
in the Alfred Hospital trauma bay. It was like a raggedy black wig
- but with a forehead and eyebrows attached.
"That," he says now, "was pretty spectacular."
Pisasale had been sent to retrieve Dave's scalp from the auger.
She'd only been with the ambulance service four months and it was a
confronting task: "It was still fully attached, tightly wound
around the auger and embedded in mud. I couldn't pull it free so I
had to get surgical shears and cut the hair away." She put it in a
plastic bag with ice, and sent it with him in the MICA van. But
successfully putting it back would be difficult.
In 30 years there have been only 35 successful replantations of
a totally avulsed scalp. Avulse means "tear away" and the savagery
of such an injury often inflicts massive vascular damage. In Dave's
case, as the auger pulled, his blood vessels stretched until they
couldn't stretch any more, then snapped, popped and split. Bloom
could see a section - running roughly from ear to ear - where they
were irreparably mangled.
There was another, more dangerous obstacle. A barrage of x-rays
showed Dave had indeed broken his neck. The two uppermost cervical
vertebrae in his neck had fractured. He had also snapped his
occipital condyle, two small oval nubs of bone under the skull that
connect to the spinal column.
They were cracks a hangman could be proud of. A neurosurgeon
later told Dave that it was only the third time he had seen such
fractures - and the other two victims had been dead.
"A break at that level, you don't become a paraplegic or
quadraplegic, you die," explains Bloom. "That's where the
respiratory centre is and if you sever the spinal cord at that
level you just can't breathe."
Successful replant surgery relies on reconnecting as much blood
supply as possible. Bloom needed access to as many veins and
arteries as he could reach and to be able to position a microscope
to do microsurgery. But Dave had to be totally immobilised.
"Imagine the dilemma," says Bloom. "You want to do as many of these
vessels as you can, but if you move his neck, even to have a look,
you could sever his spinal cord and he doesn't wake up."
In theatre the neurosurgeons would put his head in a Mayfield
frame, screwing it into his skull and fixing it to the operating
table. Bloom would only be able to replace his forehead and
eyebrows, the arc of flesh over his right cheekbone, a crescent
under his right eye, and a 5-8 cm strip of his frontal hairline. He
could access just two major vessels, the right superficial temporal
artery and vein. At best, he had a 50-50 chance of success.
He said as much to Dave, who was awake, lucid and alert.
"Incredibly composed," says Bloom. "In fact he was pretty cool
about the whole thing . . . Essentially he said to give it our best
shot and that he had faith that we would do the right thing."
The operation began around midday. After the forehead and his
right ear were reattached, ribbons of tissue-thin skin were shaved
from his thigh and grafted across the rear half of his skull. It
finished after midnight.
Dave's partner, Louise Taunt, had spent those 12 hours waiting.
A teacher at Gilmore Girls College in Footscray, she had been
called to the hospital that morning. When she arrived, she was
shown to a small waiting room near the trauma centre. A box of
tissues was on a table. "So I knew it was something really bad,"
she says.
She had only seen Dave for a few minutes before he went to
theatre. When he returned he was wrapped in bandages and his neck
was in a cervical collar. She couldn't see the line of stitches or
the staples holding his bruised half-scalp in place, but he looked
terrible.
"On the way home from the hospital I remember I was making
sounds, not crying, just making these animal sounds. I don't think
I was able to process it," she says.
But she realised she had a daughter to look after and a VCE
class to care for. "Everything had to keep going. So I very
deliberately compartmentalised and said to myself 'He just had 10
bad minutes'. From the accident to getting help was 10 very bad
minutes and then he had morphine - God bless morphine - and then he
moved on."
But it was never going to be as simple as that.
DAVE was sick of the smell. It was like someone had left a plate
of rotting meat sitting in the corner of the room. But he knew it
was him.
For nearly four weeks the nurses and doctors kept coming in and
picking at his forehead, looking for signs of re-established blood
supply. He didn't understand their optimism, you only had to look
at the thing to see it was dying.
"I knew it wasn't going to take to begin with, but now it was
black. There were stretches of skin that just looked like a
criss-cross of fibreglass, the actual skin was starting to break
down. It had the texture of a pig's ear, only darker. They were
doing their best to save it and I'm in the background going 'Jesus,
look at me. Just get rid of it'."
Dave had oscillated between elation, acceptance and depression
since the operation. He'd fixated on the neurosurgeon's observation
about the gravity of his neck fractures and convinced himself that
any movement could paralyse him. (For three months he would be
scared to sleep, fearful that he would wake trapped in a useless
body. "Richard set me straight. He said: 'Forget about that. If
something goes wrong you'll be dead. But it's not going to
happen!"')
Initially the fractures meant he had to stay in a brace and lie
flat on his back. Louise put together a montage of photos and hung
them over the bed. Nurse Johnny di Nunzio liked one in particular:
"It was him and Louise and I think it was in Nepal. He had this
long, flowing hair, a free, happy expression but I couldn't help
thinking 'That's gone'. That expression's gone."
They hadn't shown him a mirror for three weeks. When they did,
he had to fight back tears. The grafts were red raw, there were
staples everywhere and he had picked up a staph infection. Then
Louise walked in. It was the first time she had seen him without
his dressings. "She got it right in the face," he says. "I really
hurt Louise that day. I told her she should leave me. 'You don't
want to stay with me, just look at me. Get out while you can'."
Louise remembers him standing naked in the bathroom. "I'm
hideous," he told her, and began to cry. "I just remember hugging
him. I felt bewildered and wasn't sure how I felt but I wasn't
going to turn my back on him or run away. I can't remember what I
said but I wasn't going anywhere."
On Friday, March 5, Dave went back to theatre. The replant had
failed, so Bloom replaced it with a 10-by-15 centimetre oval of
full-thickness skin from his groin. He was happy with that, but the
infection was playing havoc with the grafts over the rest of his
skull.
"After they tried every drug they could to kill the infection,
Richard decided they were going to physically remove it and were
going to do it four times a day," he says. "And there began the
part I'll never forget - medieval torture."
The medical term is mechanical debridement. The grafts are
treated with silver sulphide diozene and covered with a wet
dressing which, as it dries, absorbs wound material, infected
tissue and exuded fluids. When the dressing is removed, such
material is pulled away with it. What's left gets plucked away with
surgical forceps. It can be very painful.
Dave was debrided "QID", that is, four times each waking day.
"My head was mostly flesh and bone and they were scraping the
infection directly off the nerves. I was trying to cut down on the
painkillers so tried to meditate throughout the process, but it was
horrifying. I would swear and scream. There are bed heads in there
that I bent and I would cry like a baby."
He insists that there are nurses who abandoned the profession
after experiencing such episodes. Johnny di Nunzio, who dislikes
even giving injections but had a rapport with Dave, volunteered to
do as many as possible: "I'm flinching and pulling this stuff off
and thinking 'You poor bastard'. It must have been hell."
After a week, says Dave, "my mind turned to mush. I didn't know
who I was, I just knew nobody was going to touch me. I'd overdosed
with pain and I couldn't take any more and I went into a full
pain-induced psychosis. I'm convinced it was one of the catalysts
for my post-traumatic stress disorder.
"I'd had my scalp ripped off once. Then every day they seemed to
do it all over again."
THE GIRL wasn't paying attention when she sat next to him on the
tram last year. Then, out of the corner of his eye, Dave saw her
suddenly take notice.
Just for a moment she stared at the brownish patch of his
forehead; at the deep scar that runs up from his left eye then
veers sideways to circumnavigate his skull; the small crater
quarried by the auger; the valleys and ridges around his right eye
and ear; and the shiny, uneven, pink-spotted dome of his bare
cranium. Then she stood up and changed seats.
"And that hurt me," he says.
At the next stop, a trio of unwashed vagrants got on. They sat
down and wedged her in, mumbling inanities over the top of her. "I
got up enough courage to look across at her. She was looking back
and the look on her face was somewhere between compassion and
apology, like: 'And look what happened to me now'.
"Karma."
It used to happen all the time. People would stare, avoid or
patronise him. He'd suffer petty discrimination. So many times he'd
line up in the supermarket queue, wait his turn, and suddenly
they're serving the shopper behind, as if he was invisible. "I
think it's fear," he says.
"I think they look at me - and, until recently the colour was
all pink and grey - and it looks like I've had a frontal
lobotomy."
He smiles: "They don't know whether I'm going to dribble or yell
at them or go mad and tell them about the weather in China. They're
scared of me."
But if they want to be really frightened, they should step
inside that head. Experience one of his flashbacks, getting dragged
into the spinning machine, the sound of his hair ripping off, the
whiplash as he tore free. Or join him in his nightly
nightmares.
Those began with a panic attack about three weeks after he left
hospital. "Everything's going wrong, you can't breathe, or you're
breathing too fast to take in oxygen," he says. "You start to get
pins and needles, an edgy sensation. I probably lived in that panic
attack for the next four days."
He has learned to control the attacks, but the night terrors
sneak up and drag him back. His heart's jumping out of his chest;
he feels the pain, the heat, the smell. It's worse when the
nightmare takes Louise's daughter Xenia or his dog Pushkin. That
shames him. "And you are full-on frightened, with as much fear as
in the real world. You are in the real world."
Dave had read the stories about damaged soldiers returning from
World War I and Vietnam and knew he needed help. He was referred to
psychiatrist Dr John Webber and trauma counsellor Louise Bailey.
His intrusive flashbacks, nightmares, teariness, hypervigilance,
sleeplessness and avoidance were all symptoms of chronic
post-traumatic stress disorder. The drill had scarred his psyche as
horribly as his body.
After three years of weekly visits, he and Bailey have dimmed
the flashbacks and begun work on his nightmares. Bailey uses a
technique called eye movement desensitisation and reprocessing: In
essence they replay Dave's internal video of the incident.
"We run the movie through on fast forward then pause it at a
crucial point and do a little talking, work it through," she
explains. "We have to be very careful because each time I take him
through he's living it. But the next time you come back to the
scene, it's that little bit less intense."
Often he made it hard for her. After months of morphine, he was
determined to minimise medication, but that meant he was
continually sleep-deprived and exhausted.
"David is a gentle, very beautiful man with an esoteric belief
system about the world, God and Buddha," says Bailey.
"There's a real kindness about him, but there's an amazing
stubbornness and determination. That's what helped him survive, he
was determined he wasn't going to die. That he can be so strong and
stubborn is what's healing him."
In February Dave saw the company he'd been working for, Chadwick
Group Holdings Pty Ltd, fined $30,000 after pleading guilty to
failing to provide a safe workplace. Last month he agreed to a
compensation settlement. Apart from some volunteer work at the
Sacred Heart Mission in St Kilda, he hasn't worked since the
incident, but with Matt de Grave's help and inspiration, he is
studying for a diploma in Occupational Health and Safety.
"The day I got squashed I changed," says Dave. "I was just a
quiet Australian who went out to work one morning and got turned
into a different person.
"But it made me better in some ways too. I have a psychological
awareness I never had before, I perceive and care about other
people's feelings more than I ever did, I don't let the little
things bother me. I might be a victim, but I don't want to have a
victim mentality.
"On my best days I've come to terms with the way I look. I have
no hair, no eyebrows and there's visible scarring over my face and
head. But at heart I'm a Buddhist - I understand all things
change."
And so, he says, there are many nights when he sits out in his
backyard and watches the stars just to enjoy their beauty.
No comments:
Post a Comment