Their bikes wheels were whistling, and Karen and Mark Tosh were humming in time and breathing in the crisp moonlit air as they glided home from the Zac Brown concert at Blackbaud Stadium on October 21. It had been one of those rare carefree date nights and they were in no big rush to relieve the babysitter watching their two young boys, Lawson and Huston, in their Smythe Park home. Still, they kept the pedals turning and chatted intermittently.
Then half of the whistling, humming, and chatting stopped. Karen had pulled just slightly ahead of Mark, and her cruiser got tripped by an unpainted speed bump as unexpectedly as meeting a prankster’s outstretched foot. The speed bump was invisible to Mark as well, and all he saw was his wife airborne, separated from her bike, then land headfirst on the unforgiving pavement. When he reached her, she was curled in a fetal position with blood seeping from her nose, ears, and the point of impact on her head. Neither had been wearing their helmets; it hadn’t even been a consideration to take such a precaution for an unhurried ride over familiar terrain of less than two miles.
Mark immediately dialed 911, but the dispatched medics had just responded to another incident in the area and were ten minutes away. Fortunately, the Toshes good friends had exited the stadium at about the same time, and Mark made a frantic call to them for help; they were there in a flash to lend support while awaiting the ambulance. Karen was unconscious during this period of panicked limbo. In fact, she recalls leaving the concert, but none of the ill-fated bike ride, a mental block for which she is thankful.
What happened next, the couple reports, was "straight out of an episode of ‘ER.’" As Karen joked days removed from those emergent first few hours, she bid a forced farewell to the beloved pair of jeans that came to know a distressing like no other denim. She spent the next two and a half days in the Surgery Trauma ICU at MUSC, followed by another day on the Surgery Trauma floor. CT scans indicated blood on her brain, both where her head struck the road and on the opposite side where her brain literally ricocheted off her skull. The scans also pointed to a fracture in the tympanic bone by her right ear and a hole in her right ear drum.
After days of thoughtful and thorough in-patient care, Karen’s medical team released her from the hospital with the assurance that she would make a full recovery, but that it would be an exercise in patience and physical fortitude. They weren’t kidding. The list of side effects from Karen’s trauma read like a hybrid of overt assault and slow-drip torture: near-constant migraines with limited medication, hypersensitivity to light and sound (necessitating the covering of her bedroom window with aluminum foil to block even the thinnest beam), vertigo, temporary narcolepsy, painstaking mobility, and the auditory sensation that her head was underwater. "It was like a prison, missing out on life with my kids and husband, hearing them play outside while I took another three hour nap," Karen describes. "I couldn’t even watch TV or read because my brain just couldn’t take it."
Friends, family, and DI neighbors mobilized quickly, bringing meals, flowers, and goodies for the boys. Visits, however, were a frustrating catch 22 for Karen; she craved company and distraction, but socializing proved painful and exhausting. Still, she and Mark are so grateful for the tremendous show of support, a recipient of which Karen is not wholly comfortable being. "I do much better as the helper than the helpee," Karen admits. "My husband had to carry the entire burden of taking care of the house and kids."
Karen’s recovery plods along slowly and painfully. Several weeks later, the blood in her brain continues to successfully reabsorb, the hole in her eardrum had repaired, and recent tests show that her hearing is back to normal. She remains besieged by excruciating migraines, regular bouts of vertigo, and frustrating lapses in vocabulary. But she is happy for every step in the right direction. In fact, she shudders with the realization of how much worse it could have been, and Mark is haunted by the recall of terror and helplessness of that October evening. Based on the basilar skull fracture she suffered, a friend of hers who is an ER doctor in Las Vegas (and presumably sees crazy head trauma on a regular basis), acknowledged that Karen "absorbed a massive amount of energy to the brain… dying or sustaining a paralyzing spinal cord injury were distinct possibilities in that scenario." He cautions her to be patient through her recovery, concurring with Karen’s outlook that she is extremely lucky.
This perspective is also very much anecdotal-based. Since her own accident, Karen has learned of at least a half dozen other helmet-less incidents, some without the anticipated lesson-learned happy-ever-after outcome. A coworker shared with her the story of a dear friend who was out for a leisurely neighborhood bike ride with his kids, rolled into a patch of sand, and hit his head after being thrown from his bike. After weeks in a coma, the young father of three passed away.
Another accident happened at the exact same spot as Karen’s about six years ago. Steven Lopez, also a resident of Daniel Island, was returning on bike from a friend’s home in the early evening. "I never saw the speed bump, and went from riding to lying flat on my side," Steven remembers. "After going over the handlebars, I hit shoulder first into the curb." He was able to call his wife, and she rushed to pick up Steven and his twisted bicycle. Upon getting home, it became apparent that his right shoulder didn’t quite "match" the left. The couple went to an urgent care clinic for x-rays, which confirmed a separated shoulder. "A few weeks in a sling and another 6 months later, I had about 80% mobility back," says Steven. "It still bothers me some today and the bone shows itself as a little bump."
The scene of the mishaps is located on the service drive where Corn Planters Street ends just before Seven Farms Drive. There are actually two unmarked speed bumps on this drive. Karen takes full responsibility for the fact that she was not wearing a helmet, but expressed concern about the inconspicuous nature of the bump. Steven’s incident occurred just after the speed bump had been created, so he figured it would be painted or marked in fairly short order. Years later, however, it has not, and the bump has reportedly been problematic for golf carts as well. Gail Salomon of Cochran Park described for us a turbulent trip over the speed bump on the family golf cart. They were traveling along slowly, but the jolt nearly sent the kids riding in the back of the cart off the vehicle. It was this jarring episode that prompted the family to have seat belts installed on their golf cart.
A coat of paint in the road is secondary to Karen’s new personal crusade, however. Even in the throes of her recovery, she has squared her shoulders and put up her dukes against bare-noggined bike rides. Within days of returning home from MUSC, she had issued an email blast to everyone in her contacts list, detailing her ordeal and imploring anyone within shouting distance to buy a helmet and wear it every time they ride. It is of course commonplace for parents to make sure their children are protected, but adults are much less inclined to don the dome.
"Sure, I thought it didn’t look cool," Karen confesses, "Or that I could catch myself if I fell off my bike. But we wear seatbelts under the same logic that would apply to helmets; we could ‘catch’ ourselves in a car accident until it was too bad, and that’s when we’d really need it!"
Karen was not alone in her reluctance to take this simple safety measure. According to a 2009 study conducted by Consumer Reports, less than half of all adults regularly wear a helmet when riding a bicycle. Having children in the household does appear to influence whether or not an adult protects his or her head, but not by much: 43% of adults without children wear their helmets most of the time, while 49% of adults with children report the same habit. In the same poll, 82% of adults indicated that they felt it was "extremely" or "very" important to wear a bike helmet. Clearly, this is a do-as-I-say-(or-say-I-should)-not-as-I-do kind of guideline. And as the Insurance Institute for Highway Safety reported that 91% of bicyclists killed in 2009 reportedly were not wearing helmets, there is an undisputable need to start bridging that gap between attitude and action.
Understanding that a warning is often most heeded when there is a compelling (and sometimes gory) tale attached to it, Karen has even considered presenting hers to a more widespread audience, canvassing schools and local media and perhaps even taking it on the road. She is most immediately concerned with the hometown she loves so much, and has a dream to see a helmet on the head of every Daniel Islander. Those who know her would universally describe her as a charismatic person with a quick, easy wit and openness to candor. But it is her passion about the message that makes her best suited to deliver it. And she does not mince words for those who are concerned about compromising their dignity or, heaven forbid, their hairdo: "Take it from me, your dork quotient goes through the roof when you are in the ICU from a bike accident."
