My narrow escape in the Italian Alps

This is my account of a near-fatal accident I had in the Italian Alps on New Year’s Day. The details are as I remember them, which may differ slightly from what actually happened. 

I just wanted to be in the mountains. On New Year’s Eve, I didn’t want to be anywhere near the parties in the city, the lights or the noise. I wanted to be on a mountainside, under the stars, amidst quiet. A big part of why I moved to Geneva after years of working in conflict areas was because I wanted to have easy and frequent access to the outdoors… I had so many plans for 2017 – skiing, ice climbing, hiking and more ultras than I could handle, including a coveted spot in Western States, thanks to Strava. And I wanted to start the year off right.

After a gentle hike across the Val Ferret outside of Courmayeur, Italy and a short climb, I reached Rifugio Bonatti on the afternoon of December 31st. I was meant to be on a snowshoeing tour, but there wasn’t really enough snow to warrant putting on the shoes, until perhaps the last couple hundred metres. Rifugio Bonatti is one that I know well as it is on the UTMB route and – until this past year – the Tor des Geants course as well. Many times during summer training I have stopped off at the rifugio for a coke or a chocolate bar en route to Col Malatra (2936m). I had so many good memories there, so it just felt right to be there at the turn of the year.  Before dinner, just as the sun set, I threw on my snowshoes and headed away from the rifugio towards Malatra to enjoy a few moments of peace and quiet, alone in the white valley of snow. I couldn’t have been happier.

The next morning, I got up early and wrote a note to my snowshoeing guide, thanking him and letting him know that I was going to head back to Courmayeur on my own. I had asked one of the younger guides the night before whether the route to Rifugio Bertone, which is just above Courmayeur and the last checkpoint on the Tor des Geants route, would be safe. He told me as long as I had crampons (microspikes) and snowshoes I would be fine. I was debating between heading up to Malatra and back down the way I came, or taking the route to Bertone instead. I initially decided to try Malatra and started off in the dark with my headtorch. Within the first 15-20 minutes, I started doubting my plan. Given the remoteness of the route and the height of the climb, I wasn’t sure it was the smartest idea. I decided to turn around and head towards Bertone, which I thought would be the ‘safer’ option as it was lower altitude and closer to the Val Ferret.

I became positively giddy as the sun rose. The tops of the mountains looked like they were on fire as the sun caught the snow, turning the peaks into orange and yellow flames. I tried to take some photos, but was disappointed to find that the cold completely drained the battery in my phone. I moved my iphone to the breast pocket in my patagonia hoodie in the hopes that my body warmth would revive the battery.

I was following ski and snowshoe tracks for over an hour when I reached a river. I recognized it from the summer, of course, but got a bit confused when I couldn’t find the bridge that was normally there (apparently it is taken away in the winter). I couldn’t tell exactly where to cross and couldn’t see where the trail picked up on the other side. The ski and snowshoe tracks stopped – and I should have as well. But it didn’t seem as if it would be that difficult to find the path again and continue along, so I forged ahead. I pulled my phone out again in the hopes of grabbing a few pics – the scenery was just too beautiful not to be shared, and I wanted my friends and family to see the start of 2017 through my eyes. After two tries about 20 min apart and further attempts to warm the phone, it turned on with 22% battery, allowing me to get a couple of shots.

I found the odd ski track on the other side of the river, which gave me comfort that I wasn’t too far off course, but I could tell that I wasn’t on the actual path. I figured I would make it to Bertone one way or another, and that it wasn’t crucial for me to be on the defined route… But I was completely wrong. Off the trail, you couldn’t really tell whether there were rocks or bushes under the snow, nor could you tell the depth, which made the footing trickier than I appreciated. As I worked my way across one particularly steep section, my right foot slipped. I lunged for a tree root with my right hand as I started to lose balance, but missed it by a few inches, and I started to slide down the mountainside.

I didn’t think anything of it at first – I didn’t think I was attempting anything particularly dangerous, so I just thought I would slip a bit, catch myself, and then continue trekking on as normal. But it only took a moment for me to realize how wrong I was. As I turned away from the mountain to look down the hillside in the direction I was moving, I immediately knew I was in trouble.

No no no no no!! I shouted aloud, as if the repeated strength of my words could physically stop me from falling. I still assumed that I would come to a stop with a thumping heart and dilated pupils, shaking my head at how I had just scared myself. But the steepness of the slope only seemed to increase and I sped up. Soon I couldn’t control my body and I was turning head over feet, over and over, unable to see what was coming next. NO NO NO NO NO!! I’m not sure I can describe the disbelief and panic that took over my body… and the sense of dreaded anticipation. I kept waiting to hit something, but it seemed like I was falling forever…

…until my spinning world stopped with a thud that seemed to go straight through my body. After a 35m fall, I smashed into a tree with the trunk perfectly aligned with the right side of my body. I was so happy not to be falling anymore, but I had the wind completely knocked out of me. As I struggled to breathe in, I realized it was a lot more serious than that. I wheezed and gasped for air, hugging the tree, and unable to process or accept the seriousness of my injury. I was alone, in the middle of the woods on a mountainside, with no one expected to come my way. I looked down towards the Val Ferret and contemplated whether I could get there on my own, where surely someone would walk by and offer help. I tried to shift slightly on the tree trunk and my vision started to go. I realized I was completely incapable of moving and needed to just stay conscious.

I had tumbled down from 2041m to 2004m (according to my GPS track I retrieved later), but I was unable to do anything in the position I was in. I decided to keep sliding down the hill to get to a flatter part of the mountain. I was able to push myself off the tree and then continued falling another 10m to 1994m, where I finally came to a stop. There was a branch of a tree on the ground and I grabbed it with my left hand, thinking that it might help protect me from the cold. I rolled onto the branch on the snow on my left side, trying to stay awake and breathing, with my right arm glued to my side in an attempt to protect myself from the pain. I think I was in shock as I wasn’t really  believing what was happening. I kept thinking I would snap out of it and walk down the mountain under my own steam… but it was clearly impossible. I thought of the man who just the day before had been found by search and rescue after a day and a half – he had fallen 400-500m and had not survived. I thought about Adam Campbell, my Canadian ultrarunner friend, who suffered a horrendous fall in August 2016 while out in the mountains in Canada with Dakota Jones and Nick Elson, and who had to wait hours for rescue. And I thought about Dave Mackey, who recently decided to amputate his leg after his accident in May 2015 in the mountains. I’m not trying to compare my accident to theirs – their injuries proved to be much more serious than mine – but in that moment, those incidents flashed through my brain.

I was struggling to admit to myself that my situation was that serious. Actually, I don’t know how much I was really thinking as I’m sure I was in complete shock. I knew what I had to do, but it just didn’t seem real. It wasn’t happening to me. My brain went on autopilot and dictated the steps: Turn on my phone. Call Corrado and Jose, my friends who owned Hotel Croux in Courmayeur and who had crewed for me in Tor des Geants. Communicate my GPS coordinates. Wait for a rescue. I think I knew deep down that if my phone didn’t turn on – if my battery kicked out again or if it had been damaged in the fall – then that would be it for me. But I had to take it one step at a time. I just needed that phone to turn on.

As I continued to gasp for breath, I got out my phone and held the power button, trying not to panic as I waited to see the apple sign. It came on. My hands shook in the cold as I tried to find Corrado’s number as quickly as possible, not knowing how long my phone would last. At 9:34am, I rang through, relieved that Corrado picked up the call. “Corrado – I have had a fall and I need help. I need to give you my GPS coordinates.”

Corrado was amazingly calm. He asked me three crucial questions before passing the phone to Jose (or maybe she asked me some – my memory is fuzzy): are you alone? (yes) Are you injured? (yes) Do you have charge on your phone? (not much)

All I could think about was getting those GPS coordinates out. “45.82845N, 7.00334E”. Jose read them back to me. Yes. I took comfort in the fact that no matter what happened from then on, someone knew my location. I wasn’t alone – I wasn’t lost. I’m not going to say I relaxed, but gave myself permission to pass out if I needed to. I made it through the first and biggest challenge, and now I just needed to try to stay breathing until the helicopter made it to me.

At 9:41am, I got a call from the rescue dispatcher, who asked for my GPS coordinates. I started to panic. I tried to explain that I had already given them to Corrado and Jose, but it was getting harder to speak. While on the call, Corrado phoned back at 9:43am to reassure me that the GPS coordinates had been passed on and the emergency response had been activated. I was told to stay calm.

I tried to focus on breathing. I could only take shallow breaths, but panicking made it harder, so I just kept telling myself help was coming. I couldn’t move by this point – I was curled up in the fetal position with my snowshoes on, facing down the mountain and on my left side on the branch. My warm mitt had fallen off my left hand – or maybe I took it off to call – and was just a few inches away, but I couldn’t navigate my limbs to be able to put it back on. It was cold and I was freezing, but there wasn’t anything I could do about it. I was prepared – I had extra clothes with me, but there was no way that I would be able to reach them. They were in my backpack, which was still strapped to my back. I told myself the cold would be reversible. I wasn’t in danger of frostbite. The breathing was my main concern.

After what felt like forever, I called Jose back at 9:51am. “Jose, tell them to hurry. I can’t breathe.” Jose spoke to me calmly and said they were on their way and she could hear the helicopter. I just needed to relax and not panic – help was coming. At 9:54am the dispatcher called and said the helicopter was close (I think). But I couldn’t hear it.

At 9:58, they called back just as the helicopter flew into view. It was right in front of me. I could see them so plainly, so I couldn’t figure out why they weren’t coming for me. The dispatcher asked if I could see it. “Yes. Yes!” I said as loudly as I could, although it was getting more and more difficult to speak. “I’m further up the mountain,” I told him. “I’m in an open area wearing an orange jacket.” The helicopter went a bit back and forth and I tried to explain to the dispatcher where I was in relation to the helicopter, but we weren’t getting very far. “Tell them to look out of their right window. Right window! No, now the left! Left window!” I said into the phone as the helicopter moved. The man on the other end of the phone told me to describe in detail where the helicopter was and to speak loudly and clearly, which I thought I was… As the helicopter moved out of view, I began to get frustrated and panicky.

“Can you raise your hands up and wave?” he asked. “No, I can’t move. I can’t breathe,” I said. I could hear the helicopter coming closer and disappearing away from me, but I couldn’t see it. My field of vision was limited to the window created by the hood from my waterproof shell, so if the helicopter went too far to the right or left, or above or behind me, I lost it. The dispatcher pleaded with me to tell him where it was in relation to me, and I couldn’t. I could only tell him where I heard it.

We continued on like this for nine minutes – I thought I might not get rescued after all… until finally the helicopter was pointed right at me. I struggled to free my left arm, which I was lying on, to try to make some motion. I thought that I would have been easy to spot as is, but I realized that my orange jacket may have been somewhat hidden given that I was in the fetal position. The dispatcher confirmed they had spotted me, and the helicopter briefly touched down to let three emergency workers – two men and one woman – on to the ground below me. They climbed up the hill towards me carrying a stretcher as I lay still.

I cannot remember if any of them spoke English or not. Even if they did, I’m not sure I would have followed. The woman shoved what seemed like a lollipop in my mouth, which I understood was for the pain, and I concentrated on sucking every ounce of relief out of that candy (turns out it was probably a fentanyl lollipop, which is a strong opioid). They rushed to put on my left glove and I believe they may have covered me in an emergency blanket, but I can’t be sure. They took off my snowshoes and my backpack, and put the stretcher together. I remember saying over and over, “I can’t breathe, I can’t breathe,” which I knew they wouldn’t believe because I had enough breath to speak. I knew myself that I could breathe, but I was having significant trouble because of the injury to my right side, and it would have been way too much effort to say all of those words. I stuck with the most simple plea for help, rather than the most accurate one. I was terrified that I would lose the ability to breathe entirely.

When they tried to strap me down to stretcher I cried out in pain. They thought I was just panicking and told me to be calm (in Italian? In English? I don’t know). I just kept repeating “I can’t breathe! I can’t breathe!” I needed to be sitting up – lying down seemed to close off my ability to draw in air and the pain was immense, so they had to strap down only my legs.

The rescue crew had to carry me down over a small avalanche of snow boulders to a space further down the mountain where the helicopter could land. Because I wasn’t strapped down flat, I was fairly unstable and I remember more than a few painful tips of the stretcher, which caused me to yelp out. When we stopped, the crew covered my face to protect it from the debris that the wind from the helicopter blades whipped through the air. Finally, I was on board.

About 20 minutes later, we landed in Aosta and I was transferred to an ambulance, which took me to the emergency room (ER) of the hospital. I had an oxygen mask on to help me breathe, but I don’t remember any other interventions at that point. I do remember a tv camera in the entrance of the hospital, filming me being rolled into the ER. I wondered who they were waiting for and why they couldn’t turn their cameras off when I was coming through. It never occurred to me that they were there to film me.

In the ER, there were about ten female medical professionals running around speaking loudly to each other in Italian as they started to work on me. Once again they tried to have me lie down, which I protested in a panicked state. One woman started cutting off my clothes, exposing my breasts, legs, stomach and back in this cold, large room. I remember telling the woman that she didn’t have to do that – that I was capable of removing my clothes myself (amazing to think that I was concerned about preserving my patagonia top and new salomon pants with everything else going on, but I guess that is what shock does). She shook her head and exclaimed that we were in the midst of an emergency, and there was no time.

I don’t remember much after that. Over the next two hours, I know I got some CT scans done, which revealed four broken ribs, a punctured/collapsed lung and a moderate-severe liver laceration. Later scans revealed that I had actually broken six ribs, not just four. The doctors inserted a chest tube in my right side to help drain the blood and fluid around my lung, which thankfully I don’t remember. I was never put out – I think I have just blocked it out as being too painful to recall. The tube remained in my side for the next five days.

The next thing I remember is seeing Jose and Corrado around 12:30pm. I must have been loaded up on a ton of morphine, and in shock, as I really didn’t think things were that bad at that point. I knew I needed to call my parents, but I didn’t want them to worry, so I told my dad over the phone about the accident in a very light-hearted kind of way. I must have downplayed it a bit too much, as the reality of what was going on didn’t sink in until he hung up and replayed the conversation for my mom. They were on a flight to Europe just a few hours later.

I spent the next three days in intensive care, being poked, prodded and monitored. There was a worry that if my liver didn’t stop bleeding into my abdomen, I would have to have surgery, which would have carried risk and was ‘fairly major’. Every two hours, the doctors checked my blood to see if my hemoglobin dropped. I was insanely thirsty – lips sticking to my teeth, crawling through the desert thirsty – and all I could think about was drinking water (apparently extreme thirst is a side effect of internal bleeding). However, I was not supposed to have any food or liquid in case I needed surgery. I knew I was being hydrated by IV, but it didn’t help. I begged for water and got wet gauze pads to suck on instead, which was more disgusting than satisfying. I could think of nothing else than getting a sip of water.

The doctor finally agreed to the equivalent of about 50ml of water once an hour. She drew a redline on a plastic cup for the nurses, and I would stare at the clock, waiting for my little reward. Sometimes I would drift off in a morphine-induced haze and wake up just a few minutes later, thinking it was hours. Amidst the needles, catheters, bedpans, and other sources of indignity, that water was the only thing over which I felt I had a modicum of control. When the doctors changed shift and the night doctor put me back on the soggy wet gauze pad routine, I completely broke down emotionally. I know that it wasn’t really about the water. It just felt like everything had been taken away: my ability to move, to laugh, to cry, to pee, to sleep and to drink…I felt like a mass of cells with bones and organs in the wrong place. I looked remarkably fine from the outside – barely a scratch on me – but my insides were a mess. And all I could do was lie there and wait.

After three days, I was moved out of intensive care into the surgical ward for further monitoring. I avoided surgery, but 1.5+L of blood had accumulated in my abdomen, which was more than uncomfortable. I was nauseous and could barely eat a thing. The next day I was able to have my chest tube removed and I practiced sitting up in bed for the first time (quite a dizzy experience). Slowly but surely, the needles were removed and my catheter was taken out, and I was allowed to be escorted to the bathroom with just one IV drip of morphine and fluid.

As the dosage of drugs was reduced, reality started to set in… I think in those first few days in the hospital, I really had no idea how close I was to not making it. Maybe I wasn’t willing to admit it. Maybe I was in shock. Or maybe it was the high levels of morphine. I was giving updates on facebook, whatsapping with my friends and telling jokes to make light of some of the more difficult aspects of being in the hospital (mostly bathroom-related). I can remember being surprised that the doctors wanted to keep me in the hospital for five days (which was later extended to two weeks, although I ended up leaving on the ninth day). But when I started to come out of the morphine haze, I became a bit depressed… I wanted to stop the beeping machines and shut off the fluorescent lights. I wanted to erase the hurt I had caused my family. I wanted to stop the  nightmares – always about falling – and the ridiculous night sweats, which would invariably leave my bed soaked by 2am. I wanted to be able to lie down flat and close my eyes without feeling pain.  I just wanted to be normal again.

But I would also experience moments of great relief and gratitude that I had made it through this accident. My legs could work. My head was fine. And I would recover. I was so damn lucky and it was scary to think about what could have happened otherwise.

While the Italian doctors told me that it would be six months before I could return to sports (prompting an immediate and total emotional cry-fest), the Swiss docs have taken quite a different approach. I have started physiotherapy already to help my lungs and I will attempt to get on the bike for 15 minutes under my physiotherapist’s supervision on Monday. I have to be very careful as I am still quite fragile at the moment, but the liver is healing well and I have medication for the pain associated with my ribs. I am doing breathing exercises to try to expand the lungs as there is some fluid accumulating around the right lung again, but the docs will keep an eye on it. I am trying to be patient – I’m horrible at it – and enjoy the simplicity of going for a short walk. Nights are still pretty painful and sleep is sporadic, but I’m getting better each day… I will return to work on Monday (working from home) so that I don’t get too behind. I am eager to keep life going as normally as possible as quickly as possible.

It is surreal for me to think that just two weeks ago today I was bleeding internally and broken in intensive care. This experience has taught me how quickly things really can change – how fragile we are, but also how resilient we are at the same time. It is hard to reconcile both of those things. I’m still feeling very disoriented about things… Life is carrying on and I will be just fine. But I do feel changed. In some moments, I just don’t feel like I belong anywhere, with anyone. When my parents left Switzerland on Friday, I panicked at the thought of being ‘alone’ again, even though I’m surrounded by friends and caring colleagues. I’m terrified at the thought of returning to the mountains and I’m terrified at the idea of having to wait to do so. I don’t know really whether I’m coming or going, so I’m trying to just be, and take things one day – one breath – at a time.

I’m grateful for all of your messages of support and offers of help. They meant so much. When I was lying in the hospital, the messages I got through my phone gave me encouragement and hope that I would pull through this – and I am. There is still a long road ahead, but I’m firmly on it and heading steadily in the right direction.  I don’t know how or why I had such a lucky escape.

I am going to try not to push myself too much. I had such high hopes for my trail running this year and I realize I may have to adjust my expectations… but I refuse to stop dreaming big, even if it scares me now. On January 5, from my hospital bed, I accepted an invitation to return to Tor des Geants in September of this year.  I am determined to return to Aosta Valley, and to the mountains that I love, with the same passion and hope that I’ve always carried with me. But perhaps next time I will tread a bit more carefully.

Thank you all. Whatever challenges you may be facing at the start of this year, I hope you find the strength to take them on… and the insight to celebrate the things for which you are grateful 🙂

If you’ve enjoyed reading my blog this year, please take a minute to vote for me in the Run Ultra Blogger Awards 2017! Winner will be announced Jan 19.

News articles about my accident:

Aostaserra (2 January 2017), “Stabili le condizioni di Stephanie Case, runner con la passione per il Tor des Géants“

Montagna TV (4 January 2017), “Sta meglio l’atleta seconda al Tor des Géants caduta nei pressi del rifugio Bonatti“

Carreras por Montana (5 January 2017), “Stephanie Case, hospitalizada tras una fuerte caída en Courmayeur“.

La Vallee (7 January 2017), “Migliora la canadese scivolata in un dirupo” 

Corredores Anonimos (8 January 2017), “Ultramaratonista Stephanie Case sofre grave queda“

For updates on my rehab, follow me on facebook and strava.