Crush Injuries

Some months ago I attended a friend’s yoga class and helped sign in his students.  One was a friendly and fit looking male, maybe in his late 30’s, with a raised multi textured wide scar running down each side of his right calf.  Being naturally curious, extroverted, and a little lacking in social restraint, I asked what had caused such extreme scarring.  He wanted me to guess.  My initial thought was a car or motor bike accident.  But, “No,” he said, “This was the treatment for a crush injury.  The doctors had to cut the fascia to relieve the pressure…”  I recalled the life threatening nature of a crush injury.  My head was buzzing with, “Wow, like, that’s life or death treatment then!  Well worth the scarring.”  I would have liked to have had the chance to ask what had crushed his leg but the class was under way by now and I waved him in.

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My natural curiosity later send me to google.  I knew a little of crush syndrome, but had never heard of this treatment.  What I did know was that if large muscles are crushed under a heavy weight for some hours or more, muscle breakdown causes build-up of life threatening toxins.  When the crushing object is released these toxins pour into the blood stream and cause a range of issues including kidney failure or cardiac arrest.   This is a huge danger during rescue efforts at the site of earthquakes, or other such disasters.  People may be found seemingly miraculously, days later, still alive and conscious, just to die soon after being released from the weight pinning them down.  It is sometimes called the smiling death due to the demeanor of those who think that, at last, they have been saved.  But I couldn’t see how this flesh cutting technique, graphically illustrated in Joe’s gaping scars, would prevent such deaths.

My instinct was correct.   In Joe’s case, his immediate risk was amputation, not death.  He had suffered compartment syndrome.  This is excessive pressure from swelling or internal bleeding, whether from fractures, crush injuries or other causes.  Eventually blood circulation is blocked and lack of blood supply then kills off cells.  It is a medical emergency and if not successfully dealt with can lead to amputation, and a standard treatment is fasciotomy, a gory practice where huge cuts are made up and down the area affected, then stitched loosely back together with the flesh gaping apart between stitches, like a latter day Frankenstein.  I dare you to google image it.  Pressure is released by this cutting of the fascia, that tough glad wrap like material encasing every body part, from the smallest muscle fiber, to the largest organ, and which ties each to the other, holding the body together.

I never did get a chance to check my conclusions with Joe, who as it turns out would have been well placed to answer me.  He was not just the patient, but one of the doctors on his case, although strictly speaking doctors don’t treat themselves.  As you may note, I am writing in the past tense here, and this is because I have just had a phone call from my friend the yoga teacher.

We chatted a little and he asked me if I remembered meeting Joe* that day at his class.  I immediately guessed the reason… “Good Lord, you’re going to tell me he’s dead?  I can’t believe it!  I can’t believe it!”   But as my friend pointed out, it’s not so strange.  Everyone dies eventually, and someone dies every day.  None the less, we both agreed it was shocking, on account of his youth and apparent fitness.   He had had a heart attack while kite surfing.  My friend’s main thought was, “The waste, the waste!”  Here was an intelligent man, who had spent his life, his relatively short life, striving for a high level education, gotten a PhD, then a medical degree, and all that work just disappeared in the click of finger.  One doesn’t retain academic knowledge beyond the grave.

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This is not to denigrate education.  One must make one’s way through this impermanent, transitory life in whatever way one can, to paraphrase the instructions of a great teacher, and for some people, working as a doctor is that way.  But the second part of that instruction is to keep the ultimate goal of spiritual life foremost in your mind.  This should be foremost because spiritual development can be taken beyond the grave.  It is an eternal asset and you get to take off again in your next life wherever you left off in your last.  This does  not mean you remember your activities from the previous life, but you will find at some point a natural interest in the journey is reignited, and there is a the blooming of an ability to almost instinctively recognize and understand the truths of spiritual life, up to the point you had advanced previously.

We made the point that Joe had begun on a spiritual journey, so all was not lost, only the effort for his material education was top heavy, and useless at death.

Our thoughts were in alignment, as we both then also remembered another acquaintance, busy studying medicine at an even more rarefied level.  This person has been questioning the worth of his studies.  He asks why he should put all this effort into gaining his long term dream when he can see that that alone will not lead to ultimate happiness.  He wonders if he should give it all up and live a “yogic lifestyle”.  See some profound answers to most of the important questions of life and our ultimate goal given by Chris Butler here.  And the answer he is given is that spiritual life is a bit like homeopathic theory, in that the very same thing that can cause the pain and upset of a disease state, can also be used as the cure.  A traditional cure for diarrhea caused by overindulgence in dairy products is yogurt mixed with rice.  Similarly, action, often seen by neophyte spiritualists as bad, can be used to release one from the bindings of material life.

This is the meaning of karma yoga.  Karma means action.  The popular western idea that karma is that which comes to you, the good or bad reactions to your previous actions is slightly skewed.  Rather, karma, or action, is what you do.  You act and that causes karmic reaction, an automatic reaction, whether immediate or delayed: as you sow so shall you reap.  So in karma yoga one learns to dovetail one’s activities with one’s spiritual pursuits, rather than running away and living in cave, or whatever might be considered a yogic lifestyle.

Joe had not gotten to the point of asking this question, or having it answered, but he had, almost inadvertently, begun the process of meditation.  Because of his interest in health and his active nature, he had taken up yoga asana practice, and the classes he went to included mantra yoga, the taking of a transcendental sound and the absorption of one’s mind and heart in that sound.

This is an unbelievably powerful spiritual process and propels one forward like a rocket blast, even if the progress, being an inward journey, is not clearly apparent.  So Joe, who we began by considering to be “poor” Joe, is actually most fortunate Joe.  May the whole world be so lucky?

 

(*Joe is not his real name).