Amtrak survivor returns to express thanks, share experience as a patient
By Michael Vitez
A day after he survived the Amtrak crash, because his injuries were so painful, Michael Walsh said doctors asked him if he wanted to be put in a coma.
He had one simple, overwhelming reaction.
“I don’t know how I got out of that train,” Walsh recalled. “By the grace of God. Maybe somebody pulled me out. Maybe I crawled out. I had dirt under my fingernails. That black fine stuff, that black dust. I felt as if I went through all that and I can’t let them put me in a coma. I’m so happy to be alive. That pain will make me recognize that I am alive.”
Michael Walsh, 60, was in the front car of the Amtrak train that crashed in Philadelphia three years ago this month.
He returned recently to Temple University Hospital to talk with anesthesiologists, to thank them but also to give them his perspective as a patient who went to the operating room 12 times in 22 days, who had 12 encounters with anesthesiologists, and who spent 28 days in total in the hospital.
“Michael is about as close as I could come to a professional patient,” Dr. Gordon Morewood, chair of the anesthesiology department, told his staff at morning faculty meeting as he introduced Walsh. “He has been through our operating room more times than almost anybody else currently living. I wanted him to tell us what it was like from his perspective.”
Today, Walsh is healthy, traveling the world for his job, forever grateful to Temple, and forever changed by the crash.
He was a former New York City cop, a former head of security for a New York hospital, working at the time for an anti-counterfeiting coalition, where he still works. He was attending a meeting in Washington, D.C. and heading back to New York. Because of a crazy cab driver who got lost, he missed the Acela train. Amtrak put him on the next regional train, and gave him business class — a seat in the first car.
It was May 12, 2015, a Tuesday, just after 9 p.m.
“I remember looking up,” he says, “and the train goes off the tracks, and I can’t believe this is happening, but I suppress that. You have to think about what is next. My life didn’t flash before me. I thought I have to survive this. If I can just survive this first few seconds, then I’ll be okay.”
Instincts told him to get out of his seat, to move into the aisle. “The train starts to buck, up and down, to bounce, and we start to slow down,” he continued, “and then the other six cars slammed into us. I was shot like a rocket. I was horizontal and flying through the car. I remember going into darkness.”
The first car was crushed like a beer can.
He doesn’t know how he survived or got out of the train. A police van brought him to Temple.
“I can remember flashes,” Walsh recalled of his arrival to the hospital. “People yelling at me. `Do you know what day it is?’ `Do you know who the president is?’ `Do you know why you’re here?’”
Dr. Morewood read out a long list of his injuries in medical terms, phrases like “left transverse process fracture at c6” and “right pneumothorax, with unstable right chest wall.”
Walsh used plain English: “I broke my neck and my back and 10 ribs. My lung was punctured and collapsed. My left hip socket was broken…” And for him the most enduring injury: “a void the size of a tennis ball where my right ankle was supposed to be.”
He has no recollection of surgery from the first night, when he believes doctors, among other things, tried to repair and rebuild his ankle.
But the ankle got infected. Walsh said so many of the passengers with open wounds, filled with dirt and debris from the crash, got infections.
He was heavily medicated. And his memory is foggy. But he remembers a doctor telling him a day or two later: “We’re going to have to go back in and take out the screws, and we’re going to have to go back in every other day to debride your wound.’’
Walsh continued: “I was brought downstairs to the prep area, transferred from the gurney. They put me on some table. I remember lying flat and it was extraordinarily painful to lie there. I didn’t think anybody knew what they were doing. I was hazy of course. I could hear in the distance them talking about me. `It looks like it’s too late. We might have to cancel this.’ “
He wasn’t sure what they meant or why they might cancel, but overhearing this caused him great anxiety. He knew from earlier conversations with doctors that he had a very long road ahead to get better, and he needed all these surgeries, and any delay was a setback. “I’m thinking to myself `Let’s get it done.’ Any stutter-step was devastating.”
Thankfully, the surgery proceeded as scheduled.
Next, he remembers “coming out of the OR. I was in a daze. And I was struggling to try to communicate. I was convinced they didn’t know what to do with me. It looked as if I was one patient in the midst of a thousand patients. I’m absolutely just beside myself. I have no control. I can’t communicate and I was really lost. It was great when I got back to my room.”
Walsh had been a New York City detective. He was not one prone to anxiety. But he felt enormous anxiety from this experience. He said he had no idea if this was from the medications, or the trauma he had just experienced, or a normal reaction.
He conveyed this apprehension to his doctors, and they immediately responded, he said. They agreed to let his best friend, Bob Barchiesi, his former detective partner, accompany him into pre-op for future surgeries and meet him in post op. “Having my buddy there put me at ease,” Walsh said.
He also got the same anesthesiologist every time, who made him laugh, who made him calm, and this was a huge comfort to him. When one of the doctors at the meeting asked him the name of this anesthesiologist, Walsh replied, “Dr. Ginsburg,” and everyone laughed.
“Dr. (Edo) Ginsburg was funny and entertaining and empathetic and he put me at ease,” Walsh continued. “And I was able to go back into the OR without any hesitation, without any anxiety.”
Walsh said from that point on, all his other experiences with anesthesiology, with surgery, were excellent. “As I came out of every one of those operations, I never had a headache, never nauseous, I never vomited. I never had any other side effect from it.”
One doctor in the audience asked him what could have been done to improve his experience. His reply was immediate: “Stool softener, double it.”
He lost 40 pounds in his four weeks at Temple Hospital because he didn’t eat. He knew what would happen if he did. “I had to go and I couldn’t go,” he said, and one night in particular the digestive distress was incredibly painful. On top of that, he had a broken hip and just maneuvering onto a bed pain was killer. So he chose not to eat.
“If I could sell that feeling,” he quipped, “that I just don’t want to eat, I’d make a lot of money.
Another doctor asked, “Have you overcome your mindset of being injured? Are you back to being yourself?”
“I would say that the only thoughts that I have that are negative is that I don’t see myself as getting back on a train. It’s a possibility, but not the Amtrak or the Acela. I couldn’t put myself in that situation.
“I’m more appreciative of life,” he added. “I’m more empathetic, even of strangers. Before I was like doctors, I suppose. (Laughter.) I was a cop in New York City. I saw crazy things as a detective. I read the paper now and I see somebody was killed by a car. I think that person had a mother and father. Probably 50 people are affected. Before I was never concerned about that. But now I am.
“I wish I had the names of all the people who took care of me,” Walsh concluded. “I was treated fantastically. Everyone here was wonderful. They treated my family beautifully. Anything they needed.”
Dr. Morewood ended the meeting by thanking Walsh and telling his staff: “This was important to remind everybody that we spend every minute of every day focusing on the technical details of what we do. The survival and good outcomes of the patients that we look after are critically dependent on us getting every single detail right. We have to do that. But it’s not what patients remember. So many patients pass through here and their memory of us is based on all these other things: the things you say at the foot of the bed when you think they are still asleep. The warm blankets.”
As the meeting broke up, Dr. Ginsburg approached Walsh and the men shook hands, exchanged knowing smiles and nodded.
“Thank you,” Walsh said.
Michael Vitez, winner of the 1997 Pulitzer Prize for Explanatory Journalism at The Philadelphia Inquirer, is the director of narrative medicine at the Lewis Katz School of Medicine at Temple University. Michael.firstname.lastname@example.org