A Nearly Fatal Birthday, Part 2 (Ep.48)

Last week on the podcast, we told you about a serious ski accident I was involved in on the 9th of July. And we more or less left off last week at the point where I had tomahawked unconscious down a scree and boulder field, but survived the crash, and managed to hike down off the mountain.

But making it down to the ambulance that was waiting for me at the road was hardly the end of the story. Truth is, it’s where a whole new story — with very real consequences — was just beginning. And while we believe that there were a number of important lessons to be learned from our analysis of my crash, there is just as much if not more to be learned from my two weeks following the accident.

Blister Founder Jonathan Ellsworth's accident.
Jonathan Ellsworth, about to get an MRI.

We’ll say more about this in the podcast, but it’s always exciting to hear about people surviving gruesome falls and walking down off of mountains. We all find that kind of story riveting. But the truth is that such stories can easily just turn into outdoors entertainment and adventure porn, and anyone who is serious about recreating safely in the backcountry or wilderness areas has a whole slew of related, less sexy considerations that you ought to think through before you find yourself in a life or death scenario, far from help.

In the time since my crash, I, my family, and my friends have had dozens of critical decisions to make, many of which I had not considered before. Today, it’s some of the less obvious lessons and decisions we want to share with you, so that if you or a friend find yourself in a similar situation, you might be several steps ahead of me.

So joining me again on the podcast are my good friends Nate Murray and Jamie Autumn Bobb, the friends I road tripped up to Colorado with that weekend, camped with, and after the crash, made the drive back home. But it is with Nate and Jamie that I also continued to discuss my status after the crash, the options for care, and a whole lot more. So we’re going to walk through those days after the crash, the events that led up to my surgery, and where things stand as of today. There is going to be less talk about tomahawking, but the entire point of this episode is that safe behavior requires paying attention to more than just the obviously-exciting stuff.


  • My primary pre-accident mistake (7:10)
  • The decision not to go to the hospital (12:00)
  • A very David-Lynchian birthday dinner (23:38)
  • The drive home, continued self-assessment, and health care (27:27)
  • Emergency spinal surgery? Other options? (My injury + Nate’s popsicle analogy) (43:00)
  • Important Rant: Know your “Out-of-Pocket Maximum” (54:35)
  • The surgery & post-surgery (57:39)
  • Conclusions & Takeaways (1:00:00)

5 comments on “A Nearly Fatal Birthday, Part 2 (Ep.48)”

  1. Hey everybody,

    First of all I wish you the best recovery. Take your time with it. You have decades and decades ahead of you to get out!

    Just a quick thought on debriefing. In the first part of this story you mention the importance of debriefing after an incident. I want to take it a step further by saying we need to debrief after every ski, climb, or activity with objective hazards. It doesn’t have to take long. Just ask: What did we do well? What could we have done better? What should we do different next time? When were we in the most risk? By doing this it will help to bring up unspoken concerns within the group. Such as not wanting to bootpack the headwall or addressing misunderstood in plans. The debrief helps to keep everybody in check and enables the group to bring up thoughts that were not voiced during the day. By doing this the next outing can be more fun, safe, and efficient.

    And on communication: check out this awesome podcast ‘Slide the Avalanche Podcast’ from Doug Krauss. The first couple of episodes are all about communication. ‘Effective communication has the potential to mitigate every single human factor we encounter in avalanche country’

    Looking forward to skiing with you all this winter,

  2. I appreciate this debrief, and would encourage anyone who is involved in a high-speed fall or collision to get medical attention Think about professional athletes that get hurt during a game — they immediately take them for Xray, CAT scans or MRI’s. They do this because the team is protecting their investment. You are your own team, protect the investment that is your self.

    Now the longer story — with insights drawing from Jonathan’s experience and personal experience below:

    I had my own experience this February, when I had a high speed fall in deep, soft snow in remote BC. I was with a Heli group and had done something to my leg/groin area and couldn’t suspend it or put any weight on it. I thought I had a severely pulled groin.

    After the guide’s assessment they opted to bring a heli in to lift me out since we were in a clear, relatively flat area – I got into the Heli on mostly my own power (guide assisted), then from the Heli transferred to one of the crew trucks with the driver asking — “Do you want to go back to the hotel and make travel arrangements or go to the local clinic?”

    I thought it over, and decided that I had enough pain that if I wanted to fly home, I would need probably need pain meds, so I opted to go to the clinic. The clinic (think school nurses office) did an assessment and an Xray and gave me some morphine. I called my wife and discussed moving my flight up and calling the travel insurance company to find out how to get reimbursed for the clinic bill and any travel fees for changing flights.

    Then the doctor came in with the Xray results. I had a fractured pelvis (acetabulum) plus a fractured pubic bone. Ok, it didn’t seem that bad based on how I felt. But then he got serious. He listened to my chest and I had flu-like symptoms which is a sign of Pulmonary Embolism due to internal bleeding, which is a real risk for pelvic fractures. Now I started to question — how could I fracture my pelvis if I didn’t hit anything? I felt a cold coming on during the trip — listen everyone, this is really no big deal. Let me get home and I’ll go see my orthopedist. But the mood of the room had changed, the doctors and nurses acted with more haste. They injected me with anit-coagulant to combat a potential blood clot, and said I needed a CAT Scan, and MRI and possibly surgery ASAP.

    Whoa, shit just got real. We were 3 hours from the nearest Cat scan machine, so I was immobilized and transported to another Canadian hospital. The CAT scan confirmed an small internal bleed, and they told be they would not clear me to travel out of BC and wanted to operate on me there. There was NO WAY I was getting surgery in a Canadian hospital. In the mean time my wife had been in contact with the Travel Insurance company and turns out I had Platinum coverage with $300,000 of out of country evacuation. So now I needed to get back to the East Coast by convincing the Canadian doctors to let me travel while simultaneously arranging for a private Air Ambulance from BC to New York.

    The other option, If I wasn’t cleared for air travel., was to have her fly to Kelowna BC and drive me to Spokane WA so at least I could be stateside for further assessment. We persisted in convincing them to let me fly home after 2 days of stability, and it’s would be an understatement to say we had to fight for my life and to make my own medical choices.

    Fast-forward to arrival at my home hospital — home of one of the foremost pelvic surgery groups in the NY Metro Area — after all of that they told me I didn’t require surgery. So today, after 12 weeks of non-weight bearing on my left leg and 12 weeks of intense rehab, and I am stronger and more fit than before the accident.

    1. Buy travel insurance that includes Medical Evacuation if you are going anywhere outside the country or anywhere stateside where you will be far from the highest quality urban hospitals.

    2. As Jonathan said, know how your personal health insurance works including your out of pocket maximum, because peace of mind makes for clearer decision making.

    3. Get medical tests any time you suffer a high speed fall or collision.

    4. Take ownership of your own care once hospitalized. It’s OK to listen to friends and family, but it is up to you to make the critical decisions for yourself including gathering multiple medical opinions, and, if you have time, to do your own research.

    5. Take one step at a time, and try not to think too far into the future. I listened to both of Jonathan’s podcasts and was very impressed to hear him NOT talk about whether or not he would ever ski again. Certainly must have been on his mind, but I would argue that if that was where his primary focus was, he would not have had the strength get off the mountain that day. But maybe those thoughts crept in and contributed to the decision to forgo medical care? I’m sincerely asking for the benefit of the group. Bad news may mean a year, 2 years or maybe a lifetime without being able to do the thing we love most and in Jonathan’s case, earns a living from. Be interested to hear Jonathan’s take on this.

    6. For those of you who’ve avoided serious injuries, cherish every moment of back-country freedom as a blessing and a privilege. Don’t wait until it is taken away before reflecting on how fortunate we are to have access to God’s creation in such a profound and meaningful way.

    • More good points. Thanks Chris, and thanks for sharing your own story.

      And I can say that there hasn’t been a single moment where I ever questioned whether I would ski again. When I regained consciousness after the crash, found that I wasn’t paralyzed, and was then able to walk off the mountain, there simply wasn’t even a split second where the question even entered my mind.

      The biggest thing for me was that I felt like if the surgeon did his job on the 14th and I didn’t wake up paralyzed…then I would be golden. The surgery went flawlessly, and my prognosis is for a 100% recovery, with zero concern for the C6/C7 fusion — in a matter of time (and to quote my surgeon) that fusion will be “bulletproof.” So there is zero doubt in my mind or in my surgeon’s mind that I will be back skiing at 100%. And believe me, I am extremely thankful to be able to say all of that.

      • Make sure to keep your receipts on the out of pocket max. I would also like to point out a lot of organization like the American Alpine Club include rescue insurance as a benefit to all members. Rescue insurance is unlikely to cover the full cost of a helicopter evacuation but it will help if you are ever in that situation.

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