MANILA, Philippines – Photojournalist Dante V. Diosina Jr was on his way with his brother, cousin and a group of friends to a small coastal town east of Manila to celebrate his 25th birthday.
The group was in a convoy he led riding his Yamaha NMAX scooter, recently purchased using money from a freelance photography assignment he did documenting agricultural and fisheries production in Southern Philippines for an international newswire.
Approaching an uphill curve in one of the roads notorious for vehicular collisions, he suffered a near-fatal crash.
He was overtaking some vehicles due to traffic when a jeepney and his scooter barreled head-to-head into each other.
Both his scooter and the private jeepney’s bumper were wrecked by the collision.
He had already pulled on the brake lever, but the jeepney was way too close and occupying most of the lane. He attempted to swerve to the other side, but knew it was a futile attempt.
Around a meter and a half in distance away from the incoming vehicle and amid the screeching sound of his two wheels decelerating, Diosina already closed his eyes knowing full well it would end in a crash.
Diosina ended up with a splintered hip, femur (thigh bone) and wrist, which all but looked like jigsaw puzzles in his X-ray slides. He did not suffer any head injury, with his US$100 helmet still intact on his head when his friends and some onlookers found him all broken on the road.
The 2004 World Report in Road Traffic Injury Prevention revealed that head trauma is said to be the main cause of road crash deaths, accounting to around 75% of the deaths.
Diosina regained consciousness as a crowd gathered around him.
“Nakita ko ‘yung kaliwa kong kamay. Bali ‘yung wrist. Nabali siya. Naka-letter S. Nag-curve… Pag tingin ko sa hita ko, ‘yung paa ko nasa bewang,” Diosina says in an interview with Workers of PH, explaining his recollection of the moment right after the crash.
[TRANSLATION: I saw my left hand. My wrist was broken. It was fractured. It was in the shape of the letter ‘S’. It was curved… When I looked at my thigh, my foot was already on my hip.]
His family would later on learn from the cops that, just a few weeks ago, a couple had died from another crash on that same spot.
In the days and months following the collision, Diosina was totally dependent on others for his basic movements.
He would be unable to move his body from the neck down, which meant he required assistance even just to eat and drink through a straw. He can only relieve himself from his hospital bed, with the help of adult diapers.
It took a year from the date of his crash before his movements went back to normal. Each day in the recovery process was a necessary step for him to return to doing what he loved. He is now back on the field as a photojournalist, just like he was before physically but much more stronger emotionally.
Following a successful six-hour-long operation that inserted titanium plates into the fractured areas of his body, Diosina had to undergo months-long physical therapy. Diosina’s doctor had recommended to his family the in-house physical therapist of a hospital near their home.
Mr. Lyle Patrick Tangcuangco, who runs a private physical therapy practice, explains that a motor vehicular crash patient and his or her family should seek a physical therapist or physiotherapist as soon as possible.
“This is to have the best recovery or to have the optimal recovery for the patient and also to prevent what we call secondary complications from the injury,” Tangcuangco told Workers of PH in an interview.
Tangcuangco received his Master’s Degree in Physical Therapy major in Orthopedics from the University of Santo Tomas, where he is currently a faculty member.
He explains that the process of physical recovery will be unique for every road crash patient.
“Recovery will never be the same for everybody even if two patients had the same demographics and type of injury. This is why we physical therapists or physiotherapists assess and create a personalized rehabilitation program for each patient,” he explained.
Tangcuangco added that recovery speed will “heavily depend on several factors” including the severity of the injury of the patient, his or her age and prior health conditions before the crash, the time or stage of injury during which the patient and his or her family sought a consultation, as well as the strict adherence of the patient and the support of his or her family to the rehabilitation program.
He says a patient’s injury could be as simple as a muscle strain or as complex as a traumatic brain injury.
Diosina admits there were several times especially in the beginning of his recovery period when he would compare himself to his peers, who were hard at work while he lay in bed all day.
“Noong una kasi maiingit ka, makakakita ka ng mga tumatakbo, naglalakad. Tapos makikita mo sa social media mga katrabaho mo dati, nagagawa pa rin ‘yung trabaho nila, ikaw hindi,” he said.
[TRANSLATION: At first, you’ll feel envy as you see others who are able to run, able to walk. Then you’ll see via social media your colleagues in the past who are still able to do their work while you can’t.]
He says it doesn’t always get to you. But on days when there is nothing else to think about, nothing else to talk about, and time seems slow, it does get to you.
You think of what life could be instead if things did not go wayward, if the lane was not too narrow, if the road was not curved, if the driver of the incoming jeepney only drove a little slower.
There are the days and the moments when the what if‘s are all that matters.
Ms. Kay Vardeleon, counseling psychologist at the Childfam-Possibilities Psychosocial Services, explains that “symptoms like mood changes, flashbacks of events, stress reactions when faced with any reminder of the event, sleep or eating pattern changes as well as fears to expose one’s self to related situations such as riding a vehicle are normal within the first couple of weeks after the critical incident.”
“It would be helpful to remember that traumatic events are abnormal situations in a person’s life — that is, they are events that don’t usually happen everyday. Thus, if you are experiencing these symptoms, it doesn’t mean that you’re weak or mentally ill. Give yourself time,” she explained in an interview with Workers Of PH.
Vardeleon says that finding a way to express your feelings, surrounding yourself with supportive loved ones, and engaging in relaxing activities such as breathing exercises or mindful meditation can be done while at this stage.
“Family members should normalize these responses and offer support or understanding, instead of judgment or impatience,” she added.
Emotional support along with opportunities to process the event is very much needed in most cases, according to Vardeleon.
“When memories of the event become recurrent and excessively intrusive, you can employ what is called grounding techniques which means using your five senses—sound, touch, smell, taste, and sight—to immediately connect you with the here and now,” Vardeleon explained.
“Examples of grounding can be stopping to notice colors and patterns in the objects around you, singing a song, biting a lemon, or smelling pleasant aromas like lavender or peppermint,” she added.
When you notice that symptoms may be prolonged, intense or difficult to manage, Vardeleon says professional mental health support can also be considered.
“Post-Traumatic Stress Disorder or PTSD is the diagnosis given to a person who has been exposed to a traumatic event and presents with stress symptoms for more than one month,” she explains.
Vardeleon says PTSD symptoms include re-experiencing flashbacks, nightmares or involuntary intrusive thoughts related to the event, persistent avoidance of trauma-related thoughts or feelings or trauma-related external reminders such as people, places or activities, avoidance of anything that will remind one’s self of the traumatic incident, feeling keyed up — what is called hyperarousal — or being excessively alert in case a new traumatic event happens, having difficulty sleeping, and having alternations in mood such as being sad or depressed or being angry or irritable.
“PTSD symptoms can happen immediately after the traumatic incident, or even after some time has passed,” she explained.
Vardeleon adds it is best to contact a mental health professional such as a clinical psychologist or a psychiatrist for proper assessment and therapy if you suspect that you may have PTSD.
“With the right diagnosis and treatment, a person suffering PTSD can make a full recovery,” she says.
Diosina said even the physical recovery process entailed emotional resilience, as one could sometimes be impatient with the results.
“Noong mga first month noong kalalagay pa lang ’yung bakal kasi, as in hindi ko magalaw ‘yung paa ko. Wala siyang pakiramdam. So parang although sinasabi naman ng doktor na makakalakad, pero kasi hangang hindi ko nakikita na gumagalaw ‘yung paa ko hindi ako naniniwala,” he said.
[TRANSLATION: During the first month of my recovery, when the titanium plates were just placed in the fractured areas, I couldn’t move my leg yet. I couldn’t feel it. Although the doctor was saying I can walk again, it was difficult for me to take the doctor at his word until I could see my leg move.]
“Pero ang ginawa ko noon, lahat ng therapy noon ginawa ko, sunod sunod, hangang sa naramdaman ko na lahat ‘yung buong paa ko gumagalaw,” he said of the year-long process.
[TRANSLATION: But what I did then, I did all the therapy exercises, one after another, until I could feel my whole leg moving again.]
Physical therapist Tangcuangco explains that a physical therapist or physiotherapist also provides patients with home programs that they can easily apply on their own, on top of the patient’s treatment with the professional.
“We usually see and treat the patients two to three times a week. In between those days, the patient with his or her family should adhere to the home therapy or program that the physical therapist or physiotherapist instructed. This will significantly help and hasten the recovery of the patient,” he said.
Diosina also advises those still undergoing recovery to trust the process.
“Huwag na huwag kang titigil sa therapy, sa exercise kasi iyon talaga ‘yung makakapagpabalik ng lakas ng katawan mo,” he encouraged, despite being in pain during some of these exercises.
[TRANSLATION: Don’t stop with your therapy and exercise because that is really what will bring back your body’s strength.]
Mr. Tangcuangco said that aside from adherence to the physical therapy or physiotherapy program, family support is also an important factor in the “fast and optimum recovery of the patient.”
Counseling psychologist Vardeleon also explains that events that are potentially traumatic can significantly impact a person’s psychological well-being, not just his or her physical well-being.
“Remember that you’re resilient; tapping into your reservoir of coping skills will greatly help,” she advised.
Diosina encourages those undergoing recovery from a road crash injury to not be weighed down by negative thoughts for too long.
“Makinig ka sa doktor at saka tatatagan mo sarili mo,” he said. [TRANSLATION: Listen to the doctor, and be strong.]
“Higit sa lahat, doon sa mga pamilya, sa mga ka-partner… huwag na huwag sila papabayaan kasi iyon ‘yung time na kailangan talaga nila kayo,” he said.
[TRANSLATION: Most of all, to the family members, to the partners of road crash survivors, don’t ever neglect them during their recovery because that is the time when they need you the most.] (END) – WorkersOfPH.com
This story was produced under the Bloomberg Initiative Global Road Safety Media Fellowship implemented by the World Health Organization, the Department of Transportation in the Philippines and Vera Files. The author is closely related to the article’s primary subject and served as his caregiver in the recovery process.