For some four years my trusty Joshua, a Dufour 35 Mk1 of 1973 vintage, has had little sailing here in the Azores, mostly due to a series of personal health problems and upgrades to equipment designed to overcome some of my physical limitations.

It was a pleasure this year to finally advertise for an experienced crew member to accompany me on my summer cruise, and I was very blessed when an American doctor, Bruce, well qualified and looking to get his own boat for a retirement transatlantic crossing, applied.

Our first destination was Ponta Delgada where we had a pleasant few days before moving onwards to Velas, São Jorge Island.

The forecast was 12-15 knots wind and two metre swells from the north-east, but not worrying to me at the time.

Having cleared the West of São Miguel about 0800, we had started well, enjoying the good sailing, and freshening winds, maintaining track windward of our ideal to give a cushion for leeway.

But after a few hours the winds freshened to 20 knots, the swells built rapidly to four metres, and a loose bolt in the wind vane mechanism meant we had to resort to helming by hand.

I went below to log our position at about 2300, and as there were now also mixed rogue waves hitting us abeam, I specifically stood with my feet placed over the midline of the boat to leeward and my body well to windward angled about 65˚to the vertical.

At this point we were creamed by a large rogue wave amidships. I flew across the boat hitting the above stove locker headfirst, and hard.

I do not believe I lost consciousness, but I knew immediately this was a potential concussion.

I made it slowly back to the cockpit and we continued onward.

Bruce later admitted that I appeared stunned at this point, but awake and conversive, and that, unbeknownst to me, he was observing me closely to determine whether I was going to deteriorate or not.

Insidious onset

By the time he had his Garmin InReach out, with its SOS capability, I was looking and feeling a bit better.

As the waters between Pico and São Jorge islands would provide the nearest good shelter and we were on course to Velas, we sailed on rather than going for an alternative destination. I seemed to recover very quickly and was later able to helm a five-hour stint to give Bruce a break below, three hours of which was motoring to regain northward track, at about 20˚ to windward, then later to berth in Velas.

My headache lasted about eight days, steadily disappearing. I functioned well physically and thought I was going to be ok.

Bruce, meanwhile, was watching me carefully, consulting with another sailing doctor and monitoring my progress.

As advised I brought up the incident a few days later at a scheduled clinic appointment. By then my main complaint was soreness on the top of my head, and we all agreed that no further interventions were necessary at that time.

We sailed six days later to Terceira, then back to Velas again, at anchor, to decommission the genoa, which was now constantly jamming with a suspect fractured bearing or worse still a possible broken strand in the forestay, then we motored to Horta the next day in order to effect repairs.

Having found a friendly sailmaker we sailed the following week for Velas do Pico, our revamped sail performing well with a full main in light airs.

This should have been the perfect ending to our cruise but sadly it was not to be, for the sting in the tail was around the corner just waiting to bite me very hard.

Bruce flew home on 30 July and I set about planning the repairs needed for next season.

Slowly, yet significantly, over the next few weeks I became increasingly tired, weak, unable to stand for any length of time, and I spent lots of time at home just resting.

I saw my GP and had various tests, all normal.

On 13 September, I returned the heart trace monitor, worn for nearly 20 hours. Significant abnormal traces were found and my GP admitted me on the spot for observation.

By the weekend they suspected Guillain Barré syndrome and on 17 September I was stretchered on the morning flight to Ponta Delgada hospital and admitted to the neuro ward. I did not completely fit the pattern of the syndrome but they started treatment anyway, which I did not tolerate well, so on 20 September I was given a CT scan because of my concussion history and the neurosurgeon operated late
that same night to relieve a subdural haemorrhage affecting three areas of my right cortex.

Thankfully the outcome is good with a 100% full recovery physically, but the incident raises many questions about safety at sea.

I believe this accident stemmed from complacency on my part. The chart table retainer strap, which also doubled as the galley strap was always too small and badly positioned.

Sitting at the chart table in rough weather requires one to stretch one’s left foot to the edge of the sub basin locker of the galley; this was a long stretch even for me, and not always secure.

Also sitting at the chart table requires you to take off your harness, lifejacket and your sailing jacket, not a good idea under the conditions, hence my choice to quickly record our position in the stance I have described.

Making modifications

Reassessing in hindsight, the only potentially dangerous areas in rough weather below are the galley, the chart table and the heads.

One can walk the whole length of the main cabin holding onto good overhead handrails and berths all have leeboards, but I can see spaces to improve further with a few more judiciously placed grab handles.

One immediate job will to be to fit a short (6in, 15cm) snap hooked tether bolted through into the chart table locker.

After all, I was fully harnessed but had untethered myself from the secure forward cockpit strongpoint.

I am loath to use a traditional bum strap now as, in this particular incident, it could easily have led to other equally serious injuries.

So there we have it, I had become complacent with familiarity, and therefore careless.

In this instance what was particularly unusual was the length of time from the initial concussion to development of symptoms, which were themselves not initially obvious as neural in origin.

There was a six-week gap of apparent normal function before a slow decline ending in a crisis some five weeks later.

Concussion can lead to severe consequences, usually shortly after the event. But also, it seems, consequences can be significantly delayed for up to several months.

Thus, because one has put the incident to the back of one’s mind as past history, linking it to the appearance of vague symptoms is much more difficult.

LESSONS LEARNED

Understand concussion

Although the symptoms of concussion are usually quick to come on, a nasty bump on the head followed by any continued discomfort should be investigated fully by a doctor at the earliest possible opportunity.

Get checked out

Even though my headache had slowly disappeared over the course to the eight days it took to get from incident to clinic appointment, don’t assume just because you feel better now that you necessarily are better.

Safety below deck

It is easy to be complacent when it comes to safety down below, with sailors often minded to focus first on any potential hazards above decks.

One immediate job I’ve identified is to fit a short, snap hooked tether bolted through into the chart table locker.

Changing plans

Having taken a knock to the head and starting to feel somewhat better, I continued to push on with cruising plans. With hindsight it would have been better to give myself a break to recover – even if the doctor I saw did not seem so concerned. If you feel like you’re not quite right, you’re probably not quite right…

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