Some of you have noticed that I’ve been off blogging for months. This post is about the grueling details of why. If you make it through, I promise this read can change the way you approach leadership. It certainly did for me.
My Accident and Aftermath
I had a horrific car accident in November. I wrote a blog about it, and then went silent, until now.
Yesterday, while a makeup artist got me ready for a Linkage Thought Leader video shoot in Boston, she asked me what had happened. I’d warned the Linkage staff about my accident and that more than the usual makeup and time would be necessary. She was surprised I didn’t look as bad as she expected. She laughed and said: “You look like Brian Williams, and he wasn’t in an accident.”
I told her the story of what happened, and she sat down and listened. After hearing the details, and then having to sit through the 90-minute video shoot (touching up the makeup at breaks), she made me promise to tell this story. So here it is.
How Bad Was It?
If the impact of the crash had been a few inches higher, I would have died, or suffered brain damage. A few inches lower and I’d be paralyzed. I don’t recall the crash itself—a Prius taxi versus a Mercedes SUV—and I was unconscious for about 90 minutes. The doctors feared brain damage, and perhaps a spinal cord injury. As I slowly came to at the UCLA Medical Center, I knew my mouth was a mess. I was missing two teeth, and much of the jawbone that used to support them felt like it was gone. My bottom two front teeth were knocked so badly that they pointed toward my tongue, which was so swollen that I couldn’t keep it all in my mouth—the result, I assume, of biting it during the car crash. Other teeth were scrambled so badly the surgeon wasn’t sure how to put everything back together again. Several teeth were fractured, with only small pieces remaining. My right ear was shredded. The impact of the collision had mostly hit the front of my jaw, and my broken bone was almost visible through the gash in my chin. I was throwing up blood.
The trauma team decided they couldn’t wait for plastic surgery, and so they sutured the wound in my chin, saying they were afraid I’d lost some vital tissue there. I imagined a lifelong horrific scar, and from the looks on their faces, so did they.
A CT scan showed that my jaw had been shattered. The surgeon, who was trying to be optimistic, said: “it’s in hundreds of pieces, at least it’s not thousands… and most are still there, just in the wrong place.”
Six hours of plastic surgery consisted of reassembling my jaw and remaining teeth, repairing my ear, and then reopening and closing the wound on my chin. When I came to, my chin was probably triple the size it normally was. My two remaining teeth, which were now pointing up again, were swaying like tree branches in a storm. The new CT scan showed two titanium plates, several wires, and many screws, holding everything together.
As soon as my IV antibiotics were in my system, I decided to leave the hospital—about a day after the surgery.
Then the big decisions started. How much would I rely on what was easy, versus what would make me fully functional again?
My wife had to step back from her role at CultureSync and her full time job, along with taking care of our kids, became keeping me fed. She’d make stews with lots of protein and vegetables, and then puree them. They resembled dog food, but they slowed my weight loss. This was far better than drinking high-calorie shakes, which are mostly sugar and fat. Still, I lost 10 pounds almost immediately, and then another five.
At first, all I was able to do was use my computer. I scoured the medical literature for what to do to stop or slow my muscle loss, because I couldn’t walk more than a few feet, much less do any kind of resistance training. I found a couple of studies that indicates that creatine supplements had helped muscular dystrophy patients keep their muscle mass, so I added that to my daily dose of steroids for the inflammation, antibiotics for infection, pain killers, mouth rinses, and several things I can’t even remember.
Two days after the surgery, I went to my regular dentist, who performed three root canals on my remaining teeth, to try to save them. He left them “open” for six weeks, while the bone healed. He also created an Invisiline to hold my teeth together while the underlying bone decided whether it would fail or try to survive. That device—or one like it—was in my mouth every minute of every day until April.
My surgeon was pessimistic about whether much of my jawbone would make it. At one point, he said the odds were 20%. My wife negotiated with him on the night of the surgery to try everything, noting that I was a nonsmoker, in very good physical shape, and would do everything he asked to increase the chances of success. She also talked him out of wiring my jaw shut. He said that without her appeal, he probably would have removed a big chunk of jaw, and the two teeth on it. (If you are a smoker, please think about this: if I had been a smoker at the time of my accident, the surgeon wouldn’t have attempted to save my jaw. Something about reduced circulation.)
As the swelling went down, and the bone healed, I had lost 15 pounds of mostly muscle. I was too weak to stand. I couldn’t speak.
I created a workout regimen to get me back involving first walking, then jogging, and then running. As soon as the surgeon cleared me to start lifting weights, I did—and found my upper body was half as strong as it was before the accident. When my blood pressure would rise, I would feel a throbbing in my mouth, which I felt was a good sign—at least my circulation was still working, and my cut nerves were beginning to mend. Any muscle connected to my jaw or neck hurt. Bench presses were like medieval torture sessions, even without weight on the bar. Shoulder presses sent pain up my neck. If I would do a little more than I should, the next day I’d be unable to move at all.
Every day was a balance. Too much exercise and the next day I’d be disabled. Too little and the next day I’d be weaker. A breakthrough moment came when Rich Callahan, my long time friend and academic colleague, called. When I bragged about my recovery plan, he yelled at me for doing too much. At his suggestion, I used my FitBit, which during better times motivated me to walk more, to limit my steps every day. Following his advice, I limited myself to 2000 steps per day.
By far the biggest problem was learning to speak again. Every day, I’d record myself for 20 minutes, and later an hour, reading a book out loud. Between nerve damage in my lip, my swollen tongue, the fact that my teeth had all moved (and some were gone), and the bulky Invisiline, it was like I was starting over. I lisped. “Th” sounds were impossible. My voice was raspy and hoarse. I couldn’t get enough breath support.
After 20-minute sessions of reading out loud, with my MacBook Pro recording every nanosecond of audio, sweat and tears would pour down my face, from the work and pain. Listening to the recordings was even worse. I sounded like, well, like my jaw was shattered and reassembled, with some pieces missing. I’d make a list of the sounds I couldn’t pronounce and then find tongue twisters to emphasize those over and over.
Every minute of every day was about being able to give speeches again. After a couple of weeks, I started laser treatments on my scar at the USC Keck Academic Medical Center, which felt like razor blades in the portion of my face that still had feeling. I also used a silicone-based gel that my dermatologist recommended.
For the first two months, my lower lip was completely numb, as were much of my mouth. I used a prescription antiseptic rinse that kept my mouth free of infection, but also turned my teeth a brown-green that doesn’t exist in nature.
My target was January 8. I had a speech scheduled at California State University, Fullerton, to my friend Ed Hart’s Center for Family Business. I always take speeches seriously, but for that one, I practiced every word, over and over. At first I did this from bed, and then sitting in a chair. I wasn’t able to stand for more than 10 minutes until the day before.
Still unable to drive long distances, my CultureSync colleague Carrie Kish drove me to that event. Looking in the mirror at the university, I had a Jay Leno chin, which was an improvement from what it had been—something resembling a curse in Once Upon a Time. My chin had a second smile scar in it, and it was bright red. The scar was ironic, because I couldn’t smile. And my brain was flighty, and I had a hard time keeping a single thought in my head.
Thanks to Ed’s understanding, Carrie’s help in the presentation, all those meals and care from my wife, and a very supportive audience, I made it through. It was the hardest presentation I’ve ever given—worse even that the first speech I gave in Toastmasters as a high school student. I was drenched in sweat.
Three days later, I started a two-day leadership training session—six weeks to the day after my surgery—with about 55 leaders at HealthCare Partners. Jack Bennett, COO of CultureSync, helped me make it through, as did some wonderful friends at that great company. As someone who never needed a microphone, I now had to hold it an inch from my mouth or people in the back couldn’t hear me. A few days later, I was in Pennsylvania training a group of medical doctors, again, with a microphone an inch from my mouth.
The speeches took absolutely everything I had. At an airport in Pennsylvania after the speech there, I almost missed a flight because I wasn’t strong enough to walk down the jet way.
I would categorize every day as either a “deposit”—working out, eating just right, and practicing learning to talk again—or a “withdrawal,” which was a speech, or client work.
As the swelling went down, I had several more Invisilines made, with fake teeth in them so that, to quote one of my three dentists, I didn’t look like should be playing the banjo.
In late January, I started teaching in the USC Executive MBA program—a month later than originally planned. The students were understanding of my initial incompetence, and during the six weeks of that program, I noticed a startling change.
While speaking still hurt, and my endurance was limited, people stopped noticing that I had been in an accident. The swelling was down. The laser treatments were blending and lightening my scar. My practice sessions of reading out loud were teaching me to use my new jaw. Chiropractic visits were realigning my neck, which had been crooked for the first few weeks. The meals my wife made had enough protein and nutrition in them that I was building muscle. My daily torture sessions at the gym were bringing me back to my old strength.
One of my EMBA students is the Dean of the USC Dental School. He pulled me aside after my first day of teaching, and referred me to an oral surgeon and a restorative dentist, both top in their field. The surgeon removed some bone fragments that my body had rejected, and the restorative dentist started work on a plan with several surgeries to replace my missing teeth and allow me to get rid of the Invisiline.
I decided to start work on the mental recovery. Another of my students, Mike Grice, is a retired Lt Col in the Marines. He wrote me every week about my low morale, and what I could do to improve it. I saw a hypnotherapist (who wrote a great book I recommend – Your Survivial Instinct is Killing You). He recorded the session and asked me listen to it once a day. For the next week, I began talking in my sleep. According to my wife, it was as though I was arguing with myself. I’m still not sure what’s in that recording—when I listen to it, it hypnotizes me—but it seems to have brought mental balance and confidence back. I began to sleep better, and then, for long stretches. As someone who used to sneak by on five hours a night, I was now often sleeping 10 or more hours.
On April 9th, I gave my last speech—a keynote and a follow up workshop in Las Vegas—with the Invisiline in my mouth. It was just in time. No matter how many times I had it adjusted or replaced, to speak properly I had to force my tongue against it, and that created a sore that often bled. I had to take frequent breaks to spit out blood.
On April 10th, I had my first restorative dental surgery. For the first time since November, I was able to speak with out pain. My nerves had regenerated enough that I could smile, although it’s still a little crooked.
The New Normal
I’m writing this on April 26th, on a plane from New York to Denver. Yesterday, one of the restored teeth (that the surgeon had moved back into place and that the restorative dentist had made into a crown), began to hurt, and then throb. It may a sign of “reabsorption,” which would mean I’d lose the tooth and perhaps some bone. Or it might be a temporary infection. Or maybe it’s nothing. And this will be my life for the next few years. I have four teeth that probably will eventually fail, as may the jawbone underneath. That could be happening now, or not for a decade. When it does, I’ll need more surgery, more restorative dentistry, and more time off work.
Why I’m Writing This
As leaders, or leaders-in-the-making, our biggest challenge is in dealing with crucible experiences—set backs, disappointments, or a sudden flood of self-doubt. All of those happened to me, starting with the accident on November 28.
For those that have been through something like this, you’ll understand this next line. Others will think they get it, but won’t. I wouldn’t have gotten it even two months ago.
The harder you work at making it through a crucible, the easier it appears to have been, and the less people learn from your experience.
Because leaders don’t talk about our crucibles in detail, we limit others’ ability to get through them. We also minimize the learning, because to wallow in it feels off purpose. Leaders look forward, not back. They talk about what will be, not what was.
And this situation presents leaders with a dilemma. Leaders are authentic and focused on others—so going through the steps of what happened to us feels self-indulgent and irrelevant. But to not talk about it feels like an ethical omission.
Crucibles are the most demanding teachers of all, and their gifts are life-changing. So that you can learn what an experience like this can teach you, here’s an email from my friend Ivory Madison, the CEO of Red Room, who saw me last week for the first time since the accident: “Dave, you look younger and healthier than ever, just the hell-and-back thing gleam in your eyes gives it away. That gleam reminds me of the stage at the end of the Hero's Journey where the hero becomes the ‘Master of Two Worlds.’ Having stared down death and now back in the Ordinary World, he is a master of both.”
The best advice is to listen to your tribe. They know better than you what to do, how to do it, when to push and when to rest, and when it’s time to come clean about just how bad things have been, and the amazing gifts the crucible has given.