Bone by Bone: A Memoir of Trauma and Healing

Bone by Bone

A Memoir of Trauma and Healing

www.bonebybonebook.com

Copyright © 2022 by Geralyn S. Ritter

Published by The Core Media Group, Inc., www.thecoremediagroup.com.

The authors are represented by WordServe Literary Group, Ltd., www.wordserveliterary.com.

Cover & Interior Design: Nadia Guy

Print ISBN 978-1-950465-55-2

eBook ISBN 978-1-950465-63-7

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means—electronic, mechanical, photocopy, recording, scanning, or other—except for brief quotation in printed reviews, without the prior written permission of the publisher.

Scriptures are taken from the Holy Bible, New International Version®, NIV®. Copyright © 1973, 1978, 1984, 2011 by Biblica, Inc.™ Used by permission of Zondervan. All rights reserved worldwide. www.zondervan.com The NIV and New International Version are trademarks registered in the United States Patent and Trademark Office by Biblica, Inc.™

Printed in the United States of America.

Contents

Prologue

Chapter One

Chapter Two

Chapter Three

Chapter Four

Chapter Five

Chapter Six

Chapter Seven

Chapter Eight

Chapter Nine

Chapter Ten

Chapter Eleven

Chapter Twelve

Chapter Thirteen

Epilogue

Acknowledgments

Endnotes

For my family.

I am forever grateful.

Prologue

I ’m okay? These were the first words I tried to whisper when I woke up in the hospital—a statement posed as a question. In the years that followed, those uncertain words continued to ring in my mind: I’m okay? I had endured a dozen surgeries and counting; I had graduated from a hospital gurney to a wheelchair to a walker to crutches to standing on my own two feet; and I had weaned myself from the heaviest pain medications and pulled out of my depression, only to have new setbacks steal my progress. I’m okay. Period. Or question mark?

I was a passenger on Amtrak 188 on May 12, 2015, the day that train derailed outside Philadelphia in a massive accident that killed eight passengers and wounded more than 150. My chance of survival was slim. I was thrown from the train at such speed that my abdominal organs were rammed up into my chest, rupturing my diaphragm. Nearly all the ribs on my left side were crushed, my pelvis was broken in half, and multiple vertebrae in my neck and back were fractured. An object had penetrated my left hip, crushing my hip bone, and the wound was open and dirty. My spleen was destroyed, intestines badly lacerated, bladder ruptured, and my lungs collapsed. Later, my orthopedic surgeon said if someone had told him about a patient coming to the ER with my injuries, his next question would have been, When did they die? Given the force my body must have absorbed to produce those injuries, the doctors were stunned I was not paralyzed and did not sustain a major brain injury. Nearly every system in my body was severely affected, but over the course of the next few years, I recovered.

I recovered, but I’ll never be the same. My body is different, and I am different. Physically and emotionally, I have scars that won’t go away. But I am okay.

From the moment I returned to consciousness and found myself in the ICU, I had no idea what to expect—I had no idea what the process of healing would involve. Each time I was faced with a new hurdle or setback, I wished someone could have warned me and that I’d been better prepared.

At first, I assumed my bones would mend in a few weeks and I’d be back to normal with an incredible story to tell about how I’d spent my summer. As my pain and recovery wore on month after month, and my expectations were revealed to be wildly unrealistic, I searched for a book to help me understand the aftermath of what doctors call polytrauma and make sense of what I was experiencing. Most of the resources I found were dry accounts by doctors and psychiatrists. They didn’t tell me what it was actually like to try to get my life back. They didn’t describe how it felt to wake up every morning frozen in pain or to endure the suspicious glance of a pharmacist when I went to pick up my fentanyl prescription. They didn’t help me understand why my husband, Jonathan, and I were having the worst fights of our marriage. Albert Schweitzer, a famous German physician and philosopher, writes of the brotherhood of those who bear the marks of pain. I needed to connect to members of that brotherhood—people who had been there—who could help me deal with the present and the path ahead.

Recovery was like hiking a steep and tortuous mountain path, with little guidance on the distance to the top—a lot of effort for minor progress, a lot of doubts about the route chosen, but occasionally, a glimpse of a wondrous view over a valley that helps bring perspective. There were tremendously low moments, but the highs were equally high. I had so many laughs and intensely meaningful conversations with family and friends over those two years, and I have learned much about life I wouldn’t have learned otherwise.

To this day, I am frequently saddened by the senselessness of the accident. The names and faces of my fellow passengers who lost their lives are burned into my memory, and I have wept with some of their families. Against this background, it feels heartless to suggest that any kind of silver lining came as a bonus with survival. But it would also be wrong to avoid drawing something positive from the years of pain. There is a Tibetan saying: Wisdom is like rainwater—both gather in the low places.¹ Psychiatrists call the process post-traumatic growth. I am a stronger person after what I’ve been through. The experience has made me more aware of the joy in my life and the freedom and power to frame my own perspective.

During my recovery, I tried to learn as much as I could about how the body reacts to trauma and pain. Developing this understanding helped me control the self-loathing and hopelessness I felt when I simply couldn’t get out of bed in the mornings, and it helped me better understand the interdependence of the body and mind. Physical injury to the body can have a profound biochemical effect on our psychological well-being. Conversely, our state of mind can affect sensations of pain and the pace of physical recovery. Understanding this connection gave me back at least some sense of control over a body that I simultaneously hated and revered.

Trauma is a whole-body experience, regardless of which bones are broken. Recovery is similarly all-encompassing. One trauma expert describes three ways of dealing with trauma: top-down, bottom-up, and medication.² I used them all. Some of the tools that helped me, I never thought I’d consider—like yoga and breathing exercises. Others came easily, like making jokes and drinking wine with friends.

In the years since the accident, I’ve met a number of other miraculous trauma survivors. Everyone’s journey is different, but we all now identify as people with a before and an after in our lives. There is power in sharing our stories. My hope in writing this book is to offer a resource for fellow survivors, their caregivers, and anyone else who wants to understand the recovery experience and hear the story of someone who has been there—healing moment by moment, bone by bone.

One

I hate that I don’t remember. It is one of the most significant moments of my life, profoundly affecting my family and friends, yet I must rely on newspapers and other people’s stories. I hate that I don’t know who found me and can’t thank them for saving my life. People invariably tell me it’s probably better that way, but I’m not sure. One thing I know for certain, though, is that life can change in an instant—one perfectly ordinary instant on a perfectly ordinary day.

On the night of May 12, 2015, I rushed to 30th Street Station in Philadelphia. It was close to 9:00 p.m., and I was anxious that I might miss my train home. When I entered the main concourse, the station was nearly empty, making the sprawling marble floor seem even more expansive than usual. I hitched my briefcase over my shoulder and clutched my purse, racing toward my track. Within a few feet of it, I slowed my pace. I could see the long, winding line of passengers still waiting to board. I breathed a sigh of relief. I took my place in line and sensed someone joining behind me. I glanced back to see a confident-looking professional woman with shoulder-length dark, wavy hair.

My ticket was for the first car, business class. As I made my way onto the dimly lit train, I noticed it was rather empty. There were only a dozen or so other passengers spread throughout the car, including the dark-haired woman who took a seat near the back. I chose a pair of empty seats and slid my briefcase into the overhead rack. I settled in by the aisle since I’d be getting off at the first stop. I was heading home to New Jersey, where Jonathan and our three sons, Austin, Bradley, and Steven, were waiting for me. I traced the familiar route in my mind. Just a half-hour train ride to Trenton and then a forty-five-minute car ride home.

It had been a long day. When I got up at 4:30 that morning, I put on one of my favorite spring suits—light beige with clean lines. A zipper that went all the way up the back of the skirt made it more stylish than my usual conservative attire. I had caught the 6:30 a.m. train to Washington, DC, where I’d attended a board meeting of the US Global Leadership Coalition, a group of businesses and nonprofits that support the US government’s humanitarian programs around the world.

I loved this side of my job. I had been at Merck for seven years, primarily focusing on public policy, social responsibility, and charitable giving. My interest in politics and public policy had been sparked in college—so much was at stake, and shaping government policy seemed like one of the best ways to have a positive impact on the world. Early in my career, I had been an international trade lawyer working for the White House. I felt that the work we were doing to open new markets for US companies and improve access to American products for other countries really mattered in terms of making people’s lives better. Now at Merck, I once again felt that the health-care discoveries we were bringing to patients around the world truly made a difference.

The other plus was that my work allowed me (my husband would say required me) to travel often. A typical year would have me on the road every few weeks, and the destination was just as likely to be Uganda, India, or Ethiopia as the major capitals of Tokyo, Brussels, London, or Beijing. When giving career-day talks for my sons’ elementary school classes, I would play a geography game with the kids: whoever could name a country where I had not been would win a prize.

After the board meeting in Washington, I’d taken the train to Philadelphia. That evening, I spoke on a panel at a Duke University alumni forum for women in leadership. We talked about the central question that each of our careers was designed to answer. The question that had guided my work was, How can I have the biggest positive impact? I told the women assembled about one of my favorite projects: Merck for Mothers. I had led the creation of this $500 million program, which sought to make childbirth safer for women around the world. After the panel discussion, I stayed to chat with the other alums. I always find it interesting to hear other women’s insights on the defining choices they made in their careers.

As the train left the platform in Philadelphia, I pulled out my phone. I read a text Jonathan had sent earlier from our youngest son’s baseball game: Stevie led off the game with a legitimate base hit.

Awesome! I wrote back. Steven was eight, and let’s just say baseball didn’t come naturally for him. I wanted to congratulate him with a big hug and kiss when I got home, but I was sure he would already be fast asleep. I hoped I’d be home in time to say good night to my older sons—Brad who was twelve, and Austin, who was fifteen. Jonathan got to spend more time with the kids than I did since he’d left his job as a corporate lawyer a few years earlier to start his own business from home.

I texted Jonathan my ETA: 10:25 p.m.

See you then! he replied. I put my phone in my purse and got up to grab something to read from my briefcase.

It was then that I noticed the train seemed to be moving faster than usual. For a fleeting moment, I was pleased. Maybe we’ll arrive early. Those thirty minutes to my stop always seemed to take forever. The train began to sway, and I grew annoyed because I couldn’t let go of the luggage rack to reach into my briefcase. The rocking got more violent; now I was clutching the rail with both hands to keep from falling. Then the train tilted. I braced myself, both arms straining to hold onto the bar above my head. What the—? I yelled. I remember the overwhelming force pulling my body. I remember my confusion, trying to make sense of it. The whole train can’t actually be tipping over. In a flash, I realized it was true—we were crashing. The sound of my own scream is the last thing I remember.

Instead of slowing down at Frankford Junction, the sharpest curve on the Northeast Corridor, the engineer had sped up. It was later revealed that he was going more than twice the speed limit—106 miles per hour—on a curve designed for a maximum of 50 mph. When the engineer realized his mistake, he pulled the emergency brake. It was too late. Within seconds, the train broke free from the rails.

I don’t recall the feeling of the train hitting the ground sideways, twisting, splitting open, and filling with rocks and clouds of dirt. I don’t recall being thrown from the train as the car broke apart.

Other passengers later described the same sensation of the train moving too fast around the curve. Assistant conductor Thomas O’Brien was working in the back of the train and put it simply: Somewhere between Philly and Trenton, everything was fine—until it wasn’t… There was, like, two seconds of shake and two major impacts…then we hit, and I went flying.³ A man named Daniel Armyn, who was also seated in car one, said he grabbed his laptop and paperwork as they slid to the right. Then the car filled with angry, metallic screeching, and everything was shaking uncontrollably. He knew the train was going off the rails.⁴

At first, Michael Walsh had the uncomfortable feeling of being on a roller coaster—the force of speeding around the curve pressing him toward the windows. The train was turning so far out, he knew it was going to fall. As we hit the ground, Michael saw the front of the car bucking up and down, like it was tumbling down a staircase. Within seconds, he made the decision to get away from the window—he wanted to be in the aisle. He tried to rise and, as the car bucked upward, he was pushed to standing. His quick instinct may have saved his life. The fact that I was standing in the aisle with my hands above my head during the crash might have been what saved me as well. As the trailing cars plowed into car one, Michael went flying forward. In the back of the train, first, objects flew from the left side of the train to the right—laptops, purses, suitcases, shoes—followed by people being tossed through the air. Janna D’Ambrisi was thrown against the woman who was seated next to her, by the window. As the train tipped further, other passengers from across the aisle fell on top of them, one landing in the luggage rack above their heads.⁵

Eli Kulp, a thirty-seven-year-old chef whose wife and toddler were waiting at home, was thrown headfirst into the luggage rack. Buried beneath suitcases when the train came to a halt, he realized he couldn’t move. His single injury was simple, cruel, and devastating. He’d broken his C7 vertebra and was instantly paralyzed from the chest down.⁶

In the moments after the crash, passengers in car three who were able climbed out the emergency windows, which were now above them. One woman who made her way out the window was Seyward Darby, an editor at Foreign Policy magazine who was getting married the following month. She sustained minor injuries, while the twenty-year-old seated beside her, a naval midshipman in his dress whites named Justin Zemser, was thrown from the train and killed.⁷

One of the first responders, James Morace, a sergeant from the highway patrol, spoke to reporters about the way his group was briefed before arriving at the scene. They were told that if they’d been in combat before, what they would see might be familiar. Otherwise, they were instructed to steady themselves.⁸ The most prevalent word used to describe the accident, by first responders and passengers alike, was chaos.

Back in car seven, assistant conductor O’Brien pulled himself out from under the seat back he had crashed into and later described the scene to investigators:

As soon as I got up, I’m looking around and there’s immediately more blood than made sense for me to be able to see so fast. I just thought, ‘How are we all bleeding so much already?’ And I’m looking at the walls and I’m looking at the floor and there’s just blood and there’s stuff everywhere. The seats are all either disconnected and off or rotated out of place. And now people are like yelling about being trapped because they’re pinned with these seats. People are screaming that they think that the train’s on fire…

When Michael Walsh came to, he knew he was lying on his back in a confined place—an overhead bin? The lavatory? A doorway? It seemed strangely quiet. A uniformed police officer found him.

Are you in pain? the officer asked.

No, Michael replied.

The officer’s expression became more intense, and he asked about Michael’s shoulder, chest, and leg. No, Michael repeated.

Placing a hand on Michael’s shoulder, the officer tried to comfort him: You’re going to be okay.

Michael’s heart sank. He had heard this line before—as a retired New York City policeman, he’d uttered it himself many times as he’d watched injured victims slip away. He knew what it meant. The only response he could think of was, I don’t want to die. That’s when he blacked out. The policeman put a tourniquet on his leg before loading him and an injured woman into the back of a police wagon and rushing them to Temple Hospital.

Blair Berman, a woman in her mid-twenties, had moved up to the first car from farther back in the train. During the accident, she was knocked unconscious. Blair woke up in the woods with other passengers collapsed on top of her legs. She stood up, barefoot, and leaned against a tree, screaming in terror. Blair saw a man talking on a cell phone and asked to use it. No, he refused. It turned out he was Brandon Bostian, the train engineer. She badgered him until he gave in, and she called her father.⁹

Brandon Bostian walked away from the accident with a concussion and says he doesn’t remember why he pushed the throttle to speed up, when he should have been slowing down. The National Transportation Safety Board called it a loss of situational awareness.¹⁰ I think most people would call it distracted driving (of a 1,000-ton passenger train). It seems he got confused and thought he was on the straightaway after the curve. He may have been distracted by radio reports that were coming in of an emergency with another train. But the bottom line is that the deadliest crash in the Northeast Corridor since 1987 was a matter of human error.¹¹ Worst of all, it was completely preventable.

A technology called Positive Train Control (PTC) has been around for decades. It automatically slows a train that is moving too fast. Amtrak had installed PTC along most of the Northeast Corridor, but not at Frankford Junction, the sharpest curve on the route.¹²

In photographs of the aftermath, viewing the train from a great distance above, it is striking how haphazardly the cars are scattered. Car five, near the end, is perpendicular to the track. Cars two, three, and four are turned on their sides in an arc. The locomotive is many yards away, spun around, but still upright. Car one, where I was sitting, is a pile of crumpled metal surrounded by scattered debris and no longer resembles a section of train. I don’t know where I was found or who rescued me. From what I can tell, I was among the first to be saved.¹³

Two

It was around 9:30 p.m., and Jonathan was sitting in his usual chair in the corner of the living room, looking at his phone. He sent a few texts and then began to scroll through the news. He was scanning the headlines absently when a CNN news alert popped up on his screen: Amtrak 188 Derailed in Philadelphia.

Jonathan’s first thought was, That’s Geralyn’s train. He had no idea of my train number, but a gut feeling told him something was very wrong. The news report was brief—there wasn’t much information available. Jonathan called my cell. As the phone rang, he tried to reassure himself. Maybe the accident wasn’t serious. Maybe it wasn’t my train. Most likely, I’d be stuck in a frustrating delay. Maybe he’d have to come pick me up.

Meanwhile, my ringing phone, along with all my identification, was inside my purse, buried in the wreckage. I was lying on the ground unconscious, barely alive, nameless, and unknown.

When my voicemail picked up, Jonathan tried calling again. Nothing. He continued to weigh the possibilities—maybe I was on a different train and couldn’t hear the phone ring beneath the hum of the engine. Maybe I would walk through the front door in the next hour and everything would be fine.

Jonathan decided to contact my administrative assistant, Lisa. She would know what train I’d taken. He sent a terse email: Was Geralyn on that train?

Jonathan stared at the phone intensely. He needed to know where I was, and he needed to know immediately. He sent a desperate text to my phone: Are you all right?!! And another: Please call me. Then he thought to check Find My iPhone, an application that tracks the location of your phone when it’s lost or stolen. An image appeared. It was an icon of my phone over an aerial photo from Google Earth. The photo showed train tracks. Jonathan stared at the image, hit refresh, waited for the location to change. The image didn’t budge. A phone icon with an arrow pointed to a spot about twenty feet off the track.

That’s when Austin, our fifteen-year-old, arrived home. Hey, Dad, Duke game, fifteen minutes. Austin started toward the basement. Jonathan didn’t answer. He stayed hunched over the phone, anxiously running his fingers through his dark salt-and-pepper hair. Austin stopped at the top of the steps and frowned. You hear me?

Jonathan clicked refresh a few more times, but the location of the phone icon didn’t change. Panic seized him. Staring at the image of the tracks, new possibilities started to race through his