Case Study: Dawn Pickett

20 January 2011

Dawn Pickett can remember very little about the night of April 11 2003 or the weeks that followed. As she was driving home from work as a catering manager, another driver crossed lanes and crashed head-on with her car in roadworks on the M42. With no central reservation to lessen the speed or the impact, Mrs Pickett suffered multiple injuries. Both her arms, both legs, her pelvis, ribs and foot were broken. She also suffered internal injuries to her spleen, liver and both lungs. Only a head wound, which at first appeared serious, proved superficial.

So serious were her injuries that a fast response team, who ran the last half-mile to the crash scene through backed-up traffic, made the decision to get her out of her vehicle immediately, rather than wait for the roof to be cut off. She was airlifted to hospital by police helicopter and was in theatre for almost six hours as medics stemmed her internal bleeding and removed her spleen. Six days later she underwent more than 17 hours of surgery.

Keith Porter, Professor of Clinical Traumatology says: “This lady sustained multiple injuries, such that she required cardiopulmonary resuscitation.

“She had complex injuries to all four limbs requiring innovative thought in relation to the reconstruction of her right elbow, which was essentially done piecemeal in the operating theatre with all the pieces on a theatre trolley, and then the reconstructed components reinserted into the body.

“She did require forward-thinking techniques, particularly in relation to her fracture of the distal femur. On top of all this she had other injuries in relation to torso trauma and was critically injured, although has proceeded to make an excellent overall recovery and has dealt with pain and psychological issues of trauma.”

Mrs Pickett was discharged four months after the accident but for the next two years her “life revolved around the hospital”. She has still walks with a limp, as one of her legs is 1.5cm shorter than the other. Her greatest achievement in her fight back to fitness is giving birth to twins Amelia and Jenson 18 months ago.

It is likely that in the future Mrs Pickett will require a knee replacement as a consequence of catastrophic injuries to the intra-articular (joint surface) component of the knee joint.

Personal statement

“It seems strange to say it now but, although I can’t recall the accident at all, I do remember waking up afterwards in intensive care and feeling calm. I knew where I was and what had happened to me. I was surrounded by friendly faces and I have no recollection of any pain.

“The process of getting better was down to the whole trauma team, not just the surgeons. Some days I didn’t want to make the effort: at first I couldn’t even sit up on my own and it was difficult to motivate myself. On the days I needed a push I was given one. On the days I just needed mental support, that’s what I got.

“I don’t know the technical detail of how I was put back together but I know my arm and leg posed some serious problems for the surgeons. Thanks to their experience, skill and hard-work, I didn’t lose any limbs or the use of them.

“The testament to how far I’ve come since the accident is the twins. It was a difficult pregnancy, especially as the extra weight of carrying two babies put more pressure on my hips and knees. But without the life-saving treatment I received immediately after the accident and subsequently, I may not have been able to have them at all.”

Note: Photographs of Dawn during her treatment and of the accident scene, as well as pre-recorded interviews with her and with Prof Porter are available on request.