Wouter Ramboer, a physiotherapist from Belgium and a good friend of noi, sent us this amazing, personal story.
Maybe its just me as a physiotherapist interested in pain, but lately I have experienced some pretty weird stuff – I lived through an experience that was like the educational stories I have told my patients for years, over and over again. I experienced firsthand how our brains can ignore nociception, how survival mode kicks in, how we can perform without feeling tired, and even, how we can create (and react to!) stuff that isn’t even there…
On the 8th of April I was working when all of a sudden my phone rang. Normally I don’t pick it up when dealing with a patient, but for some reason, I don’t know why, on this occasion I did. It was my girlfriend, she was crying and telling me something about a fire in the gym section of my practice. I was temporarily working in another location due to major construction works going on in our street, but my usual practice is attached to my house. I told her to leave the house with our child, to call the fire brigade and go to the neighbour’s.
This is where my journey starts. In a flash I jumped on my bike. I had to ride about 2 miles to get back home. I don’t t know where I got speed, I’ve never ridden so fast in my life, but I bet Mark Cavendish would have been in trouble trying to stay on my back wheel. When I arrived at the house I didn’t hesitate. I immediately went inside. I noticed my senses where sharp, very sharp, I was intensely focused.
Entering the fitness room I knew what to do- fire extinguisher, keep low, no oxygen, don’t mind the burning fridge, extinguish the roof.
My thinking was in very clear, short massages, as if my brain was giving me a staccato plan for acting, surviving and staying safe in Morse code.
If you had seen me at that point, you would have thought, “This guy means business.” Well I have to tell you, I heard a small cracking sound, I didn’t see anything, but I instinctively acted and got the hell out of there.
In seven minutes the whole house was up in flames. Due to the construction works going on in the street, the fire brigade couldn’t access the house – the rest is history. The house burnt down completely and nothing could be saved.
This all happened on a Thursday which didn’t give me long to do a lot of pretty important things; like find some clothes and find a place to sleep… there’s not much time for thinking about anything else in the first days after your home, and most of your possessions have burnt to the ground. Waking up two days later I felt my right wrist was kind of stiff, I hadn’t noticed it until then, but checking it out, it hurt to move in most directions. I went to see the doctor and have an x-ray. The verdict – a fractured scaphoid.
I was given a brace but the wrist has never really been that painful this whole time – maybe in the big scheme of things, whatever nociception that was coming from my wrist was just not that important.
An injury not hurting in times of crisis is not that surprising, but here is the really weird part. When we got our clothes back from the industrial cleaning firm, my checkered red lumberjack shirt (yeah I know, so 2010) and blue jeans that I was wearing at the time of my fireman antics smelled “peachy”. They smelled nice, really nice and much better than the smell of burning tar. A few days later, after taking a shower I put on my shirt and jeans and instantaneously I smelt fire again, I jumped down the stairs in the rental house where we are staying to see where the fire was. At the same time I experienced the same stress response again. My girlfriend was sitting at the breakfast table looking at me as if I had gone insane. Of course, you know there was no fire. I smelled my clothes and they really smelled awful to me. I asked my girlfriend to smell them and she said they smelt nice and peachy. I went upstairs and got on some other clothes. I smelled the jeans and shirt again as they were hanging over the chair and they smelled peachy again…
A couple of weeks after the incident we went to a restaurant to have a nice meal and to chat about the future, house plans and so on. Out of the corner of my eye I noticed two people coming in and being seated at the table behind us. In a flash I smelt burnt tar again. I quickly looked to the kitchen to see if everything was ok. The kitchen was fine – no fire. I checked behind me and realized what was going on – the guy that had just walked in with his wife was wearing a red lumberjack shirt and blue jeans. I was astounded. I had only just glimpsed the guy in the red shirt – a few seconds at most before he was out of sight again, but it was enough to create a powerful reaction. I didn’t dare to tell my girlfriend because she would have sent me to a psychiatrist….
I was determined to wear my jeans and shirt again. I started out wearing them separately, and now, months later, I can wear them together again with no problems. If I smell them now, they smell peachy.
-Wouter Ramboer
Physiotherapist, West Flanders, Belgium
Wouter is a very active Twitter user and can be found by his Twitter handle @neuromanter where he will be regularly posting links to some of the latest and most interesting articles related to pain and neuroscience, and discussing the future of the physiotherapy profession with others from around the globe.
Wow Wouter Glad to hear you are all safe……..what a powerful story and I’m going to steal it immediately for my patients 🙂 ……It literally sent shivers down my spine……work that one out….
DB
London
Hi david,
Thx for the reply… What struck me the most (knowing a little bit about perception and the NS) is that i could not cognitively shut it down, i could not reason around it… I knew the smell wasn’t in accordance with the reality and environment but i kept smelling it as long the clothes stayed on… What does this tell about pain in our patients? It must be very difficult for them, with no background in neuroscience, to see that pain does not always equal harm…. If i could not get my ‘head around it’, how can they?
Good story Wouter. All clients have experienced how smells such as food and perfume, and sounds such as music trigger can trigger powerful memories to be recalled. So we don’t need to be concerned about them not understanding the science of memory formation and chronic pain. ( I don’t understand it myself and it doesn’t seem to be a problem! )
If you’re a mad keen football fan, someone passing you on the street can trigger powerful memories in you by simply humming a few bars of your team’s theme song. It can even be done without you being consciously aware of the fact. Moments later you’re asking a client which team he follows, and you don’t know why!
I figure we must be associating and re-associating on a constant basis. Linking/un-linking/re-linking emotions with sensory inputs. Had your fear circuits been on hyper-drive when you arrived back at your home, I guess the association would have lasted a lot longer. I guess this is why fear reduction is the primo treatment for pain, acute or chronic.
Thanks,
EG
Reblogged this on Fit As A Physio – MOSMAN | BLOG.
Hi Wouter,
You’re welcome and I agree “How do we get it across” other than with beautiful stories like yours. I do think stories are the answer for us and our patients, underpinned by science for the inquisitive.
My, less dramatic story relates to Peanut Butter ! As a child I was traumatised by peanut butter. Let’s not go there on this delicate site !!! The end result is that even thinking about it now, whilst writting I begin to “Gag”. When in a shop if I know it’s on the shelf I’m walking past I have to look away to avoid this response !!!!!!
Maybe we can spoil Tims weekend again and put out a challenge for the “Best Story” in relation to your beautiful tale, a tale that will profit sooooooooo many sufferers. A tale that matches Lorimers snake bite adventure !!!
Not wanting to trash your experience, but they do say that everything happens for a reason……
DB
London