Transcript of The Bike Crash which made me Forget English as first broadcast on 27 July as presented by Beth Rose with Hannah Jenkins.
BETH - Hello and welcome to the latest BBC Ouch podcast with me Beth Rose. Have you ever woken up in hospital disorientated and confused about why you're even there as things slowly come into focus? What about if you've had the misfortune of waking up in a foreign hospital unable to speak the language? For Hannah Jenkins from Kent a bicycle crash turned into a complete puzzle for everyone involved when she woke up in an English hospital but had lost the ability to speak the language she had grown up with, and could only speak German.
HANNAH - What I remember is obviously taking my dog for a walk and then taking a client's dog for a walk, unlocking my bike outside his house and that's as far as I can remember. What I apparently did after that was cycle into town and go to the gym and cycle home, and it was on the way home in the park 100 yards from my own front door, while I was going uphill and round a bit of a blind bend along a sort of shared cycle path and footpath, when I got knocked off my bike by another cyclist. It was around 2:15 in the afternoon, and the chap who hit me was the one who phoned the ambulance and was there when the paramedics arrived, but he didn't give his details. He did say that he had been going about 20 miles an hour around that bend; a little quick when you can't quite see where you're going that time of day when there are children and animals around as well.
BETH - I'm guessing you'd cycle around this bend countless times?
HANNAH - Yes, whenever I go in and out of town, so three or four times a week. And it's a rat run for picking up children. There are a lot of primary schools and they all tend to go along that main little thoroughfare through the park.
So, I was probably a bit distracted in my head thinking about what I needed to do for the rest of the day, as we all do. But I don't remember the accident at all. It was only once my partner was back that he was able to start phoning around and finding out from the paramedics what had happened and where it had happened that we kind of had a bit more of a picture as to what was going on.
BETH - And what picture was built up? So, you came off your bike and the paramedics were called. And then did they drive you to hospital?
HANNAH - Basically my GCS, Glasgow Coma Scale was very low, I only registered four on that which three being the lowest.
BETH - What does that mean?
HANNAH - It's a scale that works from three to 15: 15 being as we are now, talking quite happily; three is basically unconscious, unreactive, no reaction at all. I don't know if I was talking, responding in any way, shape or form. I was obviously bleeding quite profusely from the head. And I didn't remember anything of it but apparently an air ambulance was called. It happened to have a doctor on board who was a trauma surgeon from Royal Berkshire Hospital, he ended up getting me stable and they transferred me by road ambulance and he came with us to Royal Berks where I spent the next four days in the hospital bed trying to work out desperately what had happened and what was going on.
BETH - And when you came around in hospital, when you woke up, did you know what had happened?
HANNAH - I didn't have a clue what was going on. My main issue that I had was that I couldn't understand anything. I was brought up bilingual German and English, and German was my first oral language and that was still as sharp as anything. Unfortunately my English comprehension had gone completely, so I couldn't speak or understand English. So, I felt as though I'd woken up in a foreign country and I couldn't understand why people weren't speaking to me in a way that I could understand. The only thing I could say at that point was my name and date of birth, which I said quite happily to anybody who approached.
BETH - That's amazing. Was German something you spoke a lot still at that point or was it something from your younger days?
HANNAH - No, it's something that I've always spoken with my family. It was a rule we had in my house, because my mum is Austrian and my dad was a language teacher and they're both multi-linguists, and they were aware of how important it was for a child to learn a second language at a young age. So, my sister and I were both brought up speaking German and learnt English when we went to preschool. And then it's been a rule ever since that when we speak to my family it's always in German just to keep the language fresh in our heads.
BETH - And at this point in hospital you couldn't comprehend that what the people around you were talking was English? It had been knocked out of your mind completely?
HANNAH - Yes. It could have been Arabic for all I knew. It was just completely frustrating.
BETH - Were you scared to be there?
HANNAH - I think it probably was scary because I was still, I don't know if was dropping in and out of consciousness but I really have very, very vague recollections of my time in hospital there.
One thing I remember quite vividly is when my sister phoned and spoke to me on my mobile, then I was chatting quite happily, which made the doctors walk past staring at me and staring at my notes and trying to work out what was going on, because obviously they were confused; they didn't know that I spoke German before the accident.
BETH - And none of them could kind of work it out or pick up words from you?
HANNAH - Not really.
BETH - What about your partner, does he speak German? Was he there?
HANNAH - He doesn't speak German. He did a little bit of GCSE. He was actually out of the country at the time; he was up a mountain in America when he got my text message. And from that all he could understand was dog and hospital. And that was my one and only thought as I was coming round was I need to make sure the dog's okay. Luckily, although I couldn't speak English and I couldn't understand English, I was still able to read and write in English, although very badly, so I was able to text people. But yeah, my partner wasn't able to drop everything and come flying back because obviously he had to get off the mountain first.
BETH - It must be very disorientating if your partner's had this accident, which is traumatic enough, and then to find that they're suddenly speaking a language that you don't understand and they don't understand you anymore. What was that like?
HANNAH - I think he found that very normal in a way because he knew that obviously whenever my parents phone I just switch to German, and whenever we go and visit them I'll be chatting English whenever he's in the room, as soon as he leaves the room we all switch to German without thinking about it. He doesn't really speak very much. He understands more than he can speak. But with a little bit of sort of sign language and hand signals we got through that first few months.
BETH - Months! Wow, so this went on for a long time?
HANNAH - It went on for quite a while. It did come back fairly quickly, but the nuances and the intonation and the subtleties of the language took a lot longer; that took over a year. I think for him, and this is where Headway, the brain injury charity were so helpful because they were able to provide both of us, mainly him at that point, with a lot of information about what brain injuries are all about, how the brain works, which part of the brain affects which element of behaviour. And in a way it's quite lucky because he's a mechanical engineer, so for him he needs to know this is a brain, this is a tool, what does it do, how does it work, what can best be done in order to get those parts of the brain working again. So, he looked at it almost like a project.
But recovery wise right from the start we were told years rather than months for recovery.
BETH - Is it something with language did you have to relearn it or did it re-emerge as you began to recover?
HANNAH - A bit of both really. When the communication really broke down between my partner and I we did resort to writing stuff down and texting or emailing each other, even though we were in the same room. But luckily, because my dad's a language teacher and my mum was a trained social worker, between the two of them they're very up on social skills and language as a whole and were able to help get me into the right direction. And talking to friends helped as well; they were incredibly understanding and supportive.
Yeah, it was a difficult time but it came back a lot quicker than if you have to learn a language from scratch. And I started understanding a lot more. Usually with languages what you understand you learn a lot quicker than actually speaking it, and that was very much the case with me where I could understand a lot more, and if was asked yes/no questions that made a big difference. But I would say it was a good sort of three or four months before I was able to go to the shops and buy some food without somebody having to come with me. But it was over a year before I was able to work because the language skills were certainly not up to that level.
BETH - And this happened, when did it happen, which year?
HANNAH - 1st October 2015.
BETH - Brain injuries take a long, long time to recover from. What's it like today, do you still have German moments or is German your preferred language?
HANNAH - German is definitely what I tend to think in when the fatigue hits. And I'm fine in the mornings, but by about two or three in the afternoon the fatigue really kicks in and then I switch in my mind to thinking in German. I'll write little notes to myself in German, and I just sort of almost power down that part of my brain that deals with communication and go into practical things like cleaning and ironing and all the boring household chores just to sort of try and relax that part of my brain a little bit so that in the evening when my partner's back I can communicate again a little bit better. Just little things like what's for dinner, and being able to cook and talk at the same time is a problem if I don't have that time during the day to power down.
Luckily my dog, I've trained her to be bilingual, so she ignores me just as well whether it's in German or in English.
BETH - Did the doctors explain to you or understand what had happened? You hear stories where people wake up from a coma and it's almost as though they've suddenly picked up a French accent overnight. It's called foreign accent syndrome where you just kind of lose the fluency of your own accent and it sounds like you speak with someone else's accent. Were they able to work out what had happened to you?
HANNAH - I think that's what they probably had in their minds. It wasn't until they spoke to my sister that they realised that actually technically I guess German is my first language. So, I think that's why I got some very strange looks to start with from the doctors, until my sister was able to talk to them and explain that in our house this is normal. And the doctors did say that getting the English back it would come but it might take a little bit of time and a little bit of work to get to that point where it comes back and it's fluent.
But I didn't talk with a strange accent when I did start speaking English again. And my German accent was as it's always been: with an Austrian twang, as is always the case in our house. I'm pretty sure that's what the doctors were thinking judging by their expressions in hindsight.
BETH - You said that the doctors warned you it could take years to recover. What was that like to be given that news and how did it change your life?
HANNAH - It was a bit strange knowing that it was going to take years rather than months. The news that affected us a lot more was that I might not be the same person post-accident as I was before the accident. And having spoken to several others who have had brain injuries as well I think that's the hardest part to get your head around because you've spent however many years of your life getting to know yourself, and to suddenly have that taken away it's almost like you have to go through a bereavement process to say goodbye to the old you before you can get to know the new you. But there is that level of resentment there to start with. I was fighting that quite a lot and saying, no, I'm still me, don't be silly, this is who I always am.
But I have noticed a few little subtle changes where I'm certainly not as patient as I used to be. I'm nowhere near as diplomatic as I used to be; I say what I think a lot more now. That could be age as well!
BETH - It's not always a bad thing doing that.
HANNAH - It's not, it's not. I certainly don't suffer fools gladly. But from the work that I was doing before where I was running my own dog training business and specialising in rehabilitation of rescue dogs that certainly I couldn't do anymore. I don't have the patience, and the subtlety of language that you need when you're doing a job like that where you sometimes have to tell people that this isn't the right dog for them, they have to change their whole lifestyle in order to incorporate this dog into their lives, that's incredibly difficult to do on the best of days, but when you're lacking that sort of diplomacy and almost that sort of empathy that makes it impossible in my mind.
That was an element that I don't think either myself or my partner, Andrew, were prepared for. We were going to be the experts in my brain injury, and it was to go at my pace and do what we felt was best for me.
BETH - Did it impact on your relationship with Andrew, with the friends you'd built up and the sort of business interactions you had, did that change?
HANNAH - Not as much with my friends and my family because you can dip in and out of those relationships. You can sort of go I'm not going to meet anybody today because I'm too tired, fatigue is through the roof or my communication skills are down so you can lock yourself away on days where you're not fully compos mentis, shall we say.
But when it comes down to my relationship with Andrew yes, it has affected it because you can't not talk to each other just because you're tired or under pressure. And having that patience for the situation and the patience in each other is always a little bit of a struggle. But I certainly couldn't have done it without him and his support and his help. He said, you're definitely going to have to go out and volunteer somewhere because I don't want you learning my diplomacy skills - which is entirely fair; it's not his strong point. So, we kind of use the sense of humour to get through it a little bit.
We know each other very well. We'd been together for about seven or eight years before the accident and that helped. But I think in the back of our minds both of us had that, are we going to go back to where we were before the accident; has this changed our relationship for the better or for the worst. So, you always have to have that little niggling doubt in the back of your head. But we're still as strong as ever.
BETH - The fatigue is a big longstanding effect of the accident. Were there any other injuries that you had to overcome?
HANNAH - Not physically, no. Physically I only had one bruise on my leg and that was it, and a bit of a stiff shoulder where it had jarred as I hit the floor.
BETH - Wow.
HANNAH - But my head took the full impact of the fall, so I've got a little bit of a dent on the side of my head just on the hairline.
Mentally what I struggled with most actually was things like anxiety and panic attacks, which I'd never had before. I'd always been a fairly independent, stubborn minded person, and to be in a situation where you're not able to get back on a pushbike again for several months, I pulled the bike out of the garage and I just froze and couldn't get myself to get back on it again, not even not going anywhere but just in the garage with the door shut, I couldn't just sit back on the bike again. And that took a good few months and a change of bike before I was able to go out cycling again.
BETH - And have you got back into riding?
HANNAH - Yes. I have the slight disadvantage where I'm partially sighted, so I have to either walk, cycle or get public transport everywhere, and buses and trains don't always go where you need them to go, so I kind of had to get back onto the bike and carry on with my life again. And I knew that without the bike my life would be so different. I didn't want this one accident, this one occasion to spoil and affect my life so much.
BETH - Do you think that reliance on it made you face your fears and do it? Because I guess if you could drive or if the buses and trains took you exactly where you wanted to go it would be very easy never to get your bike out of the garage again.
HANNAH - Yeah, I think the reliance certainly helped. I think the fact that I am stubborn and independent, and that hasn't waned. I certainly didn't want to start being reliant on other people to take me around. And I think I've had that since a child, a partially sighted child. That could go one of two ways: you could either be mollycoddled and not be allowed to do anything or, like my parents did, which was the, you know what you can and can't see, if you want to go and do that, and if you can't do it and you hurt yourself then you'll learn not to do it again. And that was much more attitude to the bike.
Certainly the first few times I got back on it again my partner had to come with me; I couldn't just cycle off on my own. And I did go round the houses a bit because I couldn't go down that same path where the accident had happened. That affected me quite a lot, and I was only sticking to routes that I knew very well; as soon as I was off on a road that I didn't know so well I would start feeling the panic rise. On more than one occasion I went to turn right and ended up on the wrong side of the road and just pulled over and just tried to get my breath back and just focus the mind and go, don't be so silly, come on, you can do this.
BETH - Have you been on that bike path again in the park?
HANNAH - Yes.
BETH - And what was that like?
HANNAH - Another regular thing. It was a bit strange the first few times and I would find myself wanting to touch the brakes and just stop and push it just round that bend. So, it was a real sort of mental fight to go no, don't be so silly. But it was one I knew I needed to overcome, it was time to start. And now when I go round that corner I don't think about it at all; the accident doesn't cross my mind.
BETH - And do you feel your recovery is ongoing? Do you see little improvements or has it slowed and this is kind of it?
HANNAH - It's slowed down a lot. I think it's that last 10% of improvement that you don't see so much, it goes at such a slow pace that you're not sure if you are still improving or whether this is the way it is. And weirdly enough the sports I do are also helping in that respect.
But I also do a real mental sport which is shooting, and that has been described as skilled meditation, and I think that is very, very true because you have to focus completely on what you're doing. If your brain goes off and ruminates or meanders then your bullets do the same; they don't hit the targets, they go where your mind goes. So, you have to completely focus on that one instant. And to start with I could only do it for about 20 minutes, and now I'm up to about an hour and a half of that sort of level of focus. So, that's been a big, big help.
There's a sports centre in Maidenhead which is for particularly disabled people and there are a lot of others there who have had brain injuries in the past as well. So, it's a good little group of people where we're constantly comparing notes and saying, oh do you do that, because I do that and it's really annoying. But you can help each other through it and you can help keep that focus and keep that motivation when you're on the firing point as well, which has been a big help.
BETH - Had you tried other forms of meditation or mindfulness before and then used the shooting as an alternative?
HANNAH - I was introduced to the idea of mindfulness by the neuropsychology team who also helped a huge amount after the accident. And I think because I've got an arts degree and we were brought up in the countryside playing with insects and identifying birds and things I've always just been a lot more aware of my surroundings and able to just take time out of the rat race of life and sit in a wood and just listen to birds. I've always had that element to me. I've done a lot more of that obviously since the accident because it really just calms me down and helps me to switch off a little bit.
And the shooting has worked alongside that because it's a lot more intense, you can't have distractions, and you have to completely focus on what you're doing. And you can see how good you're getting because you can score it as well so then you're aware of yeah, I'm not just focusing on this for a lot longer but actually I'm maintaining the level of focus because I am still performing to my abilities.
But I've also started painting and drawing again and doing a lot more photography and just generally playing to that creative side of my brain, and that's all been a huge help.
Mentally I have to see it that this is me now. If I improve as such then great, but if not I'm happy in my own skin again. Improvement for me now is about managing the fatigue and extending my concentration span and getting back into a bit more work. So, those are battles that other people deal with every day so there's no reason why I can't just run with life as I am now. I've learnt how to deal with those issues. I can carry on with that. If those issues go away then great, but life is what it is and I'm sure there will be other challenges along the way.
BETH - Thanks so much to Hannah for chatting to us about her extraordinary experience.
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