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January 14, 2022 – Bruce BJ Miller Jr., a 19-year-old sophomore at Princeton University, was traveling with friends near a railroad in 1990 when they spotted a parked train. They decided to climb over the train, and Miller was first on the ladder.
Suddenly, electricity from nearby power lines struck his metal watch, firing 11,000 volts through his body.
An explosion exploded in the air, and Miller was thrown onto the train, his body smoking. His terrified friends called an ambulance.
Clinging to life, he was airlifted to the incineration unit at St. Barnabas Medical Center in Livingston, New Jersey.
Doctors saved Miller’s life, but had to amputate both his legs below the knees and his left arm below the elbow.
“Electricity burns from the inside out,” says Miller, now 50. The tension enters your body – in my case, the wrist – and moves inward until it finds a way out.
With him, the current tried to escape through his chest, causing more burns, but did not spare his legs.
“I think I had about half a dozen surgeries in the first month or two at the hospital,” he said.
Awakening to a new body
Miller doesn’t remember much about the incident, but he does wake up a few days later in the intensive care unit and feel the need to use the bathroom. Disoriented, he pulled out his fan, got out of bed, and tried to move forward, unaware of his injuries. His feet and legs have not yet been amputated. When the catheter line ended, it collapsed.
“Eventually, a nurse rushed in, responding to the fan’s alarm bell,” he said. “My father was not far behind. Then it became clear to me that this was not a dream [I realized] what happened and why I was in the hospital. “
For months, Miller lived in the burn ward, receiving countless skin grafts and surgeries. His feet were amputated first, and later his legs.
“In those early days of the hospital bed, my mind turned to identity issues,” he said. “What should I do with myself? What is the meaning of my life now? I was challenged this way. I had to think about who I was and who I wanted to be.”
Miller eventually moved to the Rehabilitation Institute in Chicago (now called Shirley Ryan AbilityLab), where he began the grueling process of regaining his strength and learning to walk on prostheses.
“Every day was filled with a mixture of optimism and good struggle and 5 minutes later with irritation, frustration, tons of pain and insecurity for my body,” he said.
His family and friends offered him support, “but much of the work was up to me. I had to believe that I deserved this love, that I wanted to be alive and that there was still something here for me. “
Miller didn’t have to look far for inspiration. His mother has lived with polio for most of her life and acquired post-polio syndrome when she grew up, he said. When Miller was a child, his mother walked on crutches and she had to use a wheelchair when he was a teenager.
After the first leg amputation operation, Miller and his mother shared an in-depth discussion about joining the ranks of the disabled and how their relationship is now even stronger.
“In this way, the injuries triggered even more experiences to share between us and more love to feel, and therefore some early sense of gain to make up for any losses that occur,” he said. “She had taught me so much about living with disabilities and given me all the tools I needed to reshape my sense of self.
From a burnt patient to a medical student
After returning to Princeton University and completing his bachelor’s degree, Miller decided to go into medicine. He wanted to use his experience to help patients and find ways to improve weaknesses in the health system, he said. But he agreed with himself that he would not become a doctor in order to become one. He would enter the world of medicine only if he could do the work and enjoy the work.
“I wasn’t sure if I could do it,” he said. “There weren’t many triple amputees to point out to say if it’s even possible mechanically to go through the training. The medical institutions I spoke to knew that they had some legal obligation to protect me, but there was also an obligation that I should be able to fulfill my competencies. It was unexplored water. “
Because his biggest physical challenge was standing for a long time, instructors at the University of California, San Francisco, made changes to ease the tension. His clinical rotations, for example, were organized near his home to limit the need to travel. During surgical rotations, he was allowed to sit on a chair.
Medical training progressed smoothly until Miller completed a rotation in his chosen specialty, rehabilitation medicine. He didn’t like it. The passion and meaning he hoped to find was missing. Disappointed and with the end of his last year of medical school, Miller dropped out of the program. At about the same time, his sister Lisa died of suicide.
“My whole family life was in ruins,” he said. I felt, “I can’t even help my sister, how will I help other people?”
Miller received a medical degree and moved to his parents’ home in Milwaukee after the death of his sister. He was close to giving up medicine, but his deans persuaded him to do an internship after his doctorate. It was as an intern at Wisconsin Medical College that he completed an elective course in palliative care.
“I fell in love with him right away the first day,” he says. “It was a field dedicated to working with things you can’t change and dealing with the lack of control of what it’s like to live with these diagnoses. It was a place where I could dig into my experience and share it with patients and families. It was a place where my life story had something to offer. “
Creating a new form of palliative care
Miller continued to complete a scholarship to Harvard Medical School in hospice and palliative medicine. He became a palliative care physician at UCSF Health in San Francisco and later led the Zen Hospice project, a non-profit organization dedicated to teaching care-based care to professionals, family members, and others who care for them.
Gail Kojimoto, a program manager who worked with Miller at the UCSF outpatient palliative care clinic for cancer patients, said he was preferred by patients because of his authenticity and ability to make them feel understood.
“Patients love him because he’s 100% present with them,” Kojimoto said. “They feel that he can understand their suffering better than other documents. He is open to hearing about their suffering when others may not be, and does not judge them.
In 2020, Miller co-founded Mettle Health, the first company of its kind to rethink the way people think about their well-being, as it is linked to chronic and serious illnesses. The team provides advice on a range of topics, including practical, emotional and existential issues. No recommendations needed.
When the pandemic began, Miller said he and his colleagues felt it was time to introduce palliative care online to increase access while reducing burnout for caregivers and clinicians.
“We created Mettle Health as an online palliative care consultation and training business and removed it from the health care system, so whether you’re a patient or a caregiver, you don’t have to meet any insurance needs to get that kind of care,” he said. .
“We are a social service, not a medical service, and this allows us to complement existing care structures instead of competing with them.
Miller’s presence as a leader in Mettle Health is a huge driver of why people are looking for the company, said Sonia Dolan, chief operating officer and co-founder.
“His approach to working with patients, carers and clinicians is something that I think sets us apart and makes us special,” she said. “His way of thinking about serious illness and death and dying is incredibly unique, and he has a way of speaking and humanizing something that is scary for many of us.
“Surprised how much I can do”
After the incident, Miller has come a long way in overcoming his physical boundaries. In the early years, he said he was determined to do as many activities as possible. He skied, rode a bicycle, and was forced to stand on his prosthetic legs for long periods.
“For years, I would be forced to do these things just to prove I can, but not to enjoy them,” he said. “I went out on the dance floor or exposed myself to vulnerable social situations where I could fall. It was kind of brutal and difficult. But around the age of 5, I became much calmer with myself and more at peace with myself. “
Today, Miller’s prosthetics make almost all activities possible, but he focuses on activities that bring him joy.
“Probably the thing I can still do that surprises most people, including me, is ride a motorcycle,” he said. “As for my upper body, I’m used to living with just one arm and I’m still amazed at how much I can do.
It took a while, he says, “to figure out how to applaud! Now I’m just hitting my chest for the same effect! “
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