My list of non-fiction recommendations for 2019 will include two biographical books about women who sustained life-changing injuries in middle age. By coincidence, both books arrived together from my local library last week, and I noticed several similarities between their subjects: both were born in the late 1950s, grew exceptionally tall and athletic, worked as journalists for the Times newspaper group, and were injured as a result of their chosen activities. But the nature of their traumas, and their ways of coping, were very different.

My former medical career brought me into contact with many people recovering from serious illness or injury. Emotional responses varied tremendously. Initial distress usually resolved, being replaced by the capacity to accept and cope even with longterm impairment, often including some positive changes in attitudes, beliefs, relationships or way of life. But not everyone was able to adjust, and some were left with ongoing psychiatric symptoms. Given the complex interplay of biological, psychological and social factors unique to each case it is unwise to generalise or to predict individual responses, and blanket advice to “think positive” or show a “fighting spirit” can be unhelpful. The stories of the women in these two books illustrate this diversity. 

Melanie Reid (1957 – ) was thrown from her horse in 2010 when he refused a cross-country jump. She sustained spinal fractures which rendered her tetraplegic apart from having limited function in her right hand. Her memoir The World I Fell Out Of describes the months she spent in hospital, and subsequent years back at home with her husband. The practical limitations of being largely confined to a wheelchair mean that the mundane essentials of living – washing, dressing, toileting, eating and drinking – require assistance, and occupy a large part of each day. The inability to move, the bodily disfigurement, the loss of sexual attractiveness, being deprived of the sense of touch, have a huge emotional impact for patients themselves and for those close to them. To a healthy person all this might sound so horrific that it would inevitably lead to deep despair and the desire to end it all. Spinal cord injury is in fact one of the few medical disorders shown to be associated with a raised suicide rate (Harris and Barraclough 1994). Melanie Reid does make brief reference to considering a one-way trip to Switzerland, and to taking antidepressants, but on the whole her mood stays upbeat. With tenacious determination to work on rehabilitation, her physical function improved much more than her doctors predicted. She was eventually able to drive a car, and even return ride a horse until she was thrown off again and suffered further injuries. She has overcome this setback, and continues to channel her mental energy into writing. This book, and her “Spinal Column” in The Times, contain frank and often darkly humorous accounts of life following her accident.

Marie Colvin (1956-2012) lost the sight of one eye after being shot in the face and chest by snipers in Sri Lanka in 2001. In Extremis: the life of war correspondent Marie Colvin, written by her friend and colleague Lindsey Hilsum, gives a comprehensive account of her life and complex character. Described as brave, passionate, driven, intellectually outstanding, beautiful, glamorous and generous, she has been hailed as the greatest war correspondent of her generation. Yet quotations from her diaries reveal an inner insecurity and her personal life was tumultuous, marked by heavy drinking and smoking and a succession of doomed love affairs. The optic nerve injury, though not the main focus of the book, was a watershed. Her blind eye had been preserved and looked normal from outside, but she always covered it with a large black patch: “part of me in a way, something that would make a clear division between life before and after”. She also replaced all her clothes with those of a more “architectural” cut than her previous “lacy or flowing styles”. As soon as she was physically fit she resumed assignments in the Middle East but worsening nightmares, panic attacks, anxiety and depression eventually forced her to take leave and undergo psychiatric treatment for post traumatic stress disorder. Over the next few years, while her intrepid forays into war zones and graphic dispatches brought international acclaim, her private life became increasingly miserable and chaotic. She was killed by a rocket attack in Syria in 2012.  

Inevitably, reading such stories makes me wonder how I would cope with a life-changing injury myself. And it could happen to anyone, even someone like me who is neither athletic nor adventurous and is not attracted to extreme sports or situations. My most demanding activity is dog-walking and even this can be hazardous – I have already had two bony fractures due to being knocked or pulled over by excited canines. Both injuries have healed perfectly but I know they could have been much worse, in which case I very much doubt that I would have been able to marshal such courage and determination as that shown by Marie Colvin or Melanie Reid. But none of us can predict how we will respond if faced with a health challenge of such magnitude as theirs.