Hope seems too trite a word for what you encounter at the National Rehabilitation Hospital

My father always says that his worst driving experience was the day he drove my older brother, the firstborn, home. The crying baby in the back seat made him acutely aware of just how dangerous Irish roads could be.

I think of this as I drive to the National Rehabilitation Hospital (NRH) in Dún Laoghaire, Co Dublin. I am running late to meet patients recovering from road crashes and get stuck in an unexpected traffic jam in Donnybrook. I watch as drivers’ impatience gathers with each passing minute: they accelerate at amber lights, chance risky U-turns and ignore yellow boxes. An enraged taxi driver gives the finger in the direction of a car refusing to let him in.

I do not have a newborn in the back seat, but with my destination in mind, I feel viscerally aware of the many near misses unfolding around me and the inattention that impatience can prompt.

When I arrive at the NRH, I hear Myles O’Brien laughing before I see him. He and a fellow patient are tucked under the entrance having a smoke and quite the chin-wag. O’Brien was in a motorcycling crash in May that left him mostly paralysed from the neck down. He has been here since August.

Netflix, Prime Video, Disney+, Apple TV+: 10 of the best new shows to watch in May

---

Is Dublin still an option for first-time buyers?

---

Anthony Boyle: ‘My dad had to go to Gaelic training, and the same British soldier would throw his kit in a puddle every day’

---

O’Brien shows me up to his room which faces out towards the Wicklow Mountains. “It’s not Westport but it’s not bad!”, he laughs when I comment on the view. O’Brien has not been back home since his crash. “But I’m very lucky to be here, it’s a special place,” he says of the hospital.

He has just been down at the cafe where an art exhibition is being staged by a former patient. There were teas and coffees, cakes and biscuits. Before long, a guitar was brought out and a spontaneous singsong erupted. Whatever I expected of the NRH, this was not it.

“You see all bravery and the courage in there, but fun and joy too,” O’Brien’s wife Ruth says. “I have to say, I don’t see any tears, I see immensely brave people that are just getting on with their lives and dealing with injuries in life that they would never have imagined that they would deal with.”

Myles and Ruth O’Brien have been running the award-winning Tavern Bar and Restaurant in Westport together for the past 22 years. He misses it but refuses to give into self-pity. “When I first arrived here, part of me turned around and said ‘well, poor me’. And then I realised how much I was affecting my family and that, well, you still have to get up and make the best of your life.”

Former patient and now a volunteer at the NRH Jim Clarke explains that this realisation is crucial to the recovery process following a life-altering crash. “Everybody wants to get back to normal but you can’t. There’s a new normal. It doesn’t have to be worse than the old normal, it is just new,” he says.

Clarke had been riding motorbikes for 35 years when he had his accident. He had toured all over Europe on his bike, never had a crash, and even achieved a RoSPA (Royal Society for the Prevention of Accidents) Gold – an esteemed road safety qualification aimed specifically at reducing life-ending and life-changing accidents. “It can happen to anybody, but no one thinks it will be them,” he says.

Last year, 2023, was one of the deadliest years on Irish roads in a decade with 184 being killed in traffic collisions, compared with 155 in 2022 and 137 in 2021. Already in 2024, seven people have died on Irish roads. Just as shocking is the fact that for every one death, 10 people are seriously injured. Over the past 10 years, the number of those suffering life-changing injuries has almost tripled.

In response to these figures, the Government signed off on the publication of the Road Traffic Bill 2023 in December, paving the way for penalty point reform, mandatory drug testing at the scene of serious collisions and safer speed limits. The Road Safety Authority (RSA) launched its Christmas campaign in November, focusing on the benefits of a 30km/h speed limit in urban areas. The call came as part of a larger plan to halve the number of road deaths by 2030 and have none by 2050 as part of its ambitious Vision Zero campaign.

[ Lower speed limits and mandatory drug testing among new measures aimed at reducing road deaths ]

But for those for whom it is too late, such things as plans, ambition and hope have taken on a new meaning. Clarke gets emotional recalling a day early in his recovery when he managed to take his T-shirt off by himself. He holds his head in his hands as he catches his breath. “It sounds silly but I was 56, a grown man who hadn’t been able to take his T-shirt off”, he explains.

Everyday acts loom as mammoth challenges in the early days of recovery, which can be an isolating experience, Clarke says. O’Brien agrees, pointing out that fellow patients are as crucial to rehabilitation at the NRH as its remarkable staff and facilities. “It’s a huge relief because they’re going through the same struggles,” he says. “They know the nitty gritty so there’s an immediate intimacy with them.”

Clarke concurs with this. “It’s like you’ve met them before,” he explains. “They ask you what happened to you and you say bike accident and they’re asking what kind of bike was it,” he laughs. “There’s no barriers here, the barriers are gone.”

Clarke does not remember anything of May 2nd, 2021. What he has been told is that on his 56th birthday he crashed his motorbike into a van, got airlifted to Tallaght Hospital and stayed there for two months. His pelvis was shattered, sciatic nerve stretched, all of his ribs and a bone in his back were broken. He suffered a brain shearing (tearing) that compromised his short-term memory. Two rods were inserted into his right arm, plates in his left, and he even contracted a dose of Covid that landed him into ICU for a month. When he arrived at the NRH, he could not walk.

It is difficult to reconcile this image of Clarke with the person sitting before me. Of course, physically he has come a long way, but it is the psychological journey that is most striking. To have emerged from such immense, traumatic change implies a level of hopefulness that is too grand for the small plastic table at which we are sitting.

But even hope seems too trite a word for what one encounters at the NRH.

Clarke tries to explain what it is that he loved so much about motorcycling. “You have open air, you can smell and see more, there’s the sound of the engine,” he says. “When you’re driving along, you’re in your own head. There’s a peacefulness. The pipes are going off but it is peaceful, not in a lonely way, it’s just lovely.”

For him, there is a complicated “loneliness in not being able to ride a bike” now. “Your world is taken away, there’s an emptiness,” he says. Part of his rehabilitation has been trying to figure out “how to replace that emptiness with something”.

He recently bought a Mercedes SLK convertible and plans to take it to Spain next year. “Just to dip the toe back in,” he says. He pauses before adding: “And sure, doesn’t everybody like having something to look forward to?”

There seems to be a delicate balance to strike in both grieving lost futures and reimagining new ones in the aftermath of a serious road crash. Patients may be constantly haunted by what could have been while having to work out what can and will be, all the while constantly encountering new and unexpected ways in which every aspect of their lives has become unfamiliar.

For O’Brien, this challenge is epitomised by his home. He is desperate to get back but also aware that it will be different. “But I’m just dreaming of sitting in the kitchen with my family and my dog, being in my own house, eating my own home-cooked food,” he explains. He is reassured by the thought that some things will remain untouchably the same. “A rare roast beef, Yorkshire pudding, can’t get better than that,” he says. “Definitely two types of potatoes. Definitely roasties and ...” he pauses, “it has to be mashed potato.”

His wife Ruth is similarly hopeful about his return home, but equally aware that it will herald the next phase of his rehabilitation and, in turn, a series of new challenges. “I think at the moment we are very much in a cocoon because he’s being so well taken care of,” she says. “So much hasn’t really happened yet, everything is still so new, so it will only be when he gets home properly that we’ll begin to know what’s ahead.”

For loved ones, the aftermath of a serious accident is unwieldy and challenging in its own distinct way. A counsellor made this clear to Ruth when she told her to imagine waiting at Heuston for the train to Westport with her husband. “You are both headed the same direction but you’re not on the same trains and you won’t be for approximately two years,” she was told.

“You will see each other, you will wave at each other and you may even meet on one or two of the platforms along the way, but you’re on completely different train tracks,” Ruth remembers the counsellor telling her. “I had thought that I was standing beside Myles, I was getting him on the train, looking after him, but when she said that to me, it just made sense, I just understood it.”

In the midst of all of this, however, Ruth says that they both find reason to be “very grateful that our story could be a lot worse”. For O’Brien, it is not difficult to do so when he is surrounded by so many patients at different stages of recovery at the NRH. “How lucky I am to have full use of my arms, full use of my brain,” he says.

Clarke is similarly eager to focus on the positive. He uses the word “luck” when describing his crash – a paramedic and a nurse both happened to be walking by when it happened and an air ambulance was in the area. He was also “lucky”, he says, that he had just bought new rider trousers that were able to “take some of the impact”. He uses “luck” again to denote the unlikelihood of recovery from his traumatic brain injury and also the fact that the medical team managed to save his arm in surgery when he was first brought in (his wife was initially told that he was going to lose it). And finally, he has been lucky, he says, to be “so stubborn” – he believes it has bolstered his recovery.

There is nothing contrived about this search for silver linings. People such as Clarke, O’Brien and his wife Ruth have a profoundly changed sense of what luck, chance and “what if” can mean. I think about this as I leave the NRH and join the stop-and-start dance of rush-hour traffic. I pick up a friend of mine on the way back into the city. We are late for a concert.

[ ‘I’ve got a second chance at life’: The patients on the long road to recovery at the National Rehabilitation Hospital ]

• Sign up for push alerts and have the best news, analysis and comment delivered directly to your phone
• Find The Irish Times on WhatsApp and stay up to date
• Our In The News podcast is now published daily – Find the latest episode here