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Flat Out in Pieces: Crippled by Concussion–An Athlete's Journey Back

Flat Out in Pieces: Crippled by Concussion–An Athlete's Journey Back

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Flat Out in Pieces: Crippled by Concussion–An Athlete's Journey Back

270 pagine
4 ore
Mar 21, 2018


Paul Suter was an elite endurance athlete who went from competing in Ironman-distance triathlons to being unable to take his dog for a five-minute walk. Despite suffering a serious concussion, he continued to train and compete until his exhausted adrenal system collapsed. Paul knew his body wasn’t working, but couldn’t convince the medical community that his illness actually existed. The ongoing search for a cure contributed to his depression and suffering—how could he continue to hope, when what he had didn’t fit into any doctor’s shoe box of remedies?

Paul’s relationship with his wife and training partner, Christine, was based on their mutual love of endurance sport. Over seven years, his illness and invisible disability threatened to destroy the bond that held them together. Paul’s search for recognition of his condition and for an effective treatment was a quest to restore not just himself but his marriage and their future.

Mar 21, 2018

Informazioni sull'autore

Paul Suter lives in Whistler, BC, where he continues to recover and reinvent himself.

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Flat Out in Pieces - Paul Suter

Flat Out in Pieces cover


Paul’s epic journey in Flat Out in Pieces encompasses every human emotion of tenacity, perseverance and a relentless will to overcome his emotional and physical condition. After reading the book, there isn’t a comparison with athletic feats that are simply planned, calculated and choreographed. Paul’s twisted roadmap to his recovery is defined by his compassionate wife, Christine, and their collective and endless pursuit to figure out what truly was haywire with his mind and body. My comment may seem potent but it simply puts an exclamation point on Paul and Christine’s persistence to never give up.

Reading Paul’s story, there is an undying theme of many fears. Fear of the unknown, fear of disappointment and fear of commitment all surface in his struggle to return to normalcy. However, there is one fear that never stopped his journey—the fear of failure. Paul never allowed himself to fail. Flat Out in Pieces is hard to believe but Paul’s conquest is real.

Dave Scott, six-time Ironman World Champion

While this story is a detailed account of his struggle for athletic excellence and life-changing traumas that dashed that hope, there is far more to Paul’s story than what at first meets the reader’s eye. Flat Out in Pieces challenges us to think about change that seems imposed upon ourselves and the courage it takes to transform from deep woundedness and loss to new victories and life-affirming reasons to go on living.

ben hoffman, Ph.D, author of The Violence Vaccine

Paul’s story takes us into the life of an athlete forced to reinvent himself and the battles he faced with the medical system, loss of identity and depression. This is becoming an increasingly common story, and one sure to inspire anyone facing adversity in their life.

GARRY VALK, broadcaster and former NHL player

Through a tragic combination of overtraining and multiple sports-related hits to the head—Paul was left to wrestle with deep depression and overwhelm regarding the grief and loss of hopes and dreams, as well as all of the medical, chemical and nutritional disturbances and mis-diagnosis.

His story is one of doggedness and despair but also one of ultimately choosing an attitude of gratitude. It proves that the mind can be a mentor or a tormentor, that sometimes you can ‘win more by losing’, by adapting and adjusting—by focusing on what you can do and not on what you can’t do. That a new and unplanned phase requires new lenses—that when you are in need of lifting up—you can ultimately feel renewed by helping lift others up.

steve king, author, counsellor and CBC commentator

Flat Out In Pieces

Crippled by Concussion: An Athlete’s Journey Back

by Paul Suter

Tidewater Press logo


Copyright © 2017 Paul Suter

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means—electronic, mechanical, audio recording, or otherwise—without the written permission of the publisher.

Published by Tidewater Press New Westminster, BC, Canada

ISBN 978-1-7751659-1-0 (html)

Cataloguing in Publication data available from Library and Archives Canada

Photography: David McColm— cover, pages 71 and 91

Cover photo editing: Liana Mascagni


: Some names and identifying details have been changed to protect the privacy of individuals.

For Christine

You never gave up.

Thank you for being so resilient.




Chapter 1: Take It Easy

Chapter 2: Mountain Home

Chapter 3: Transformation

Chapter 4: Marriage of Iron

Chapter 5: Ironman

Chapter 6: A Year to Remember

Chapter 7: Early Season

Chapter 8: Training with the Champ

Chapter 9: Running into a Wall

Chapter 10: Stranger in the Mirror

Chapter 11: A Metaphor

Chapter 12: A Bed of Flowers

Chapter 13: A Memorial

Chapter 14: Icebergs and Penguins

Chapter 15: Taking Flight

Chapter 16: East Meets West

Chapter 17: One Step Forward . . .

Chapter 18: Overtraining Syndrome

Chapter 19: Running Free

Chapter 20: Lost Lake



by Matt Fitzgerald

concussion has been a recognized medical condition since antiquity. Only recently, however, has it become the subject of widespread public attention. The new interest in brain injury has come about as the result of a variety of factors; chief among them are scientific and medical advances that have given us a better understanding of the causes, nature, effects and proper treatment of brain injury.

These advances have, in turn, given rise to a greater appreciation for the pervasiveness of the phenomenon, particularly among athletes and soldiers. As our understanding of the pervasiveness of brain injury grows, and as the devastating long-term impact of repeated concussions in particular becomes better known, pressure builds for responsible institutions, such as sports leagues and the medical establishment, to do more to prevent brain injury and to support those suffering from its effects. There is a general feeling today among those who are either directly or indirectly affected by this problem that we aren’t yet where we need to be as a society where this type of injury is concerned.

What is the solution? Undoubtedly, it is more than one thing. But I believe that Paul Suter’s poignant memoir, Flat Out In Pieces, is part of the solution. Human beings are narrative creatures by nature. We tend to think in stories and to be receptive to storytelling. A powerful story—especially a true one—has the capacity to create change in a way that is very different from, but certainly equal to, that of other forms of advocacy.

I did not know Paul Suter before I read his story. Nor did I have much of a personal connection with the topic of brain injury. That’s all changed now. Within minutes of picking up this book, I found myself really liking Paul and strongly rooting for him to survive and surmount the incredible challenges he has faced in his eventful life. Paul comes across in his writing as earnest, passionate and dogged, an appealing combination of traits that drew me into his tale and pulled me all the way through to the end, suffering as he suffered, grieving as he grieved and celebrating as he overcame. I challenge anyone to read this memoir and come away from it without sharing Paul’s remorse for his personal naiveté and his frustrations at the institutional inertia that have made his ordeal so much worse than it might have been.

The more people are exposed to Flat Out In Pieces, the more likely it will be that future Pauls won’t have to go through what he has. In this sense, something good has come out of the terrible wrong turn his life took on an otherwise ordinary day in December 2006.

But a story is more than just an agent of change. It’s also an experience, an event intended to take you out of your own life and into another’s, and to feel things. Paul’s story succeeds on these levels too. It’s an experience I won’t soon forget, and I’m confident you won’t either.

Matt Fitzgerald is an award-winning endurance sports journalist and bestselling author of more than 20 books on running, triathlon, fitness, nutrition and weight loss, including How Bad Do You Want It.

Brandenburg Gate Berlin Marathon


berlin, september 27, 2015: I am standing 20 yards from the Brandenburg Gate in what used to be West Germany. Today the air around the Gate is filled with excitement and the streets are lined with thousands of spectators cheering on the nearly 42,000 athletes running in the Berlin Marathon. I’ve spent the last two hours watching these able-bodied men and women running, envious of their ability, wanting so badly to be out there with them. As I watch them pass by, I can’t help but think how handicapped I really am.

My wife, Christine, and I are here working for a tour operator who specializes in organizing travelers to compete in marathons around the world. I am one of seven staff managing 380 guests at the event. Most of the other staff are running in the marathon today, but not me.

Some of our guests have asked me, Are you running in the marathon, too?

It’s a reasonable question. I look like an athlete, with an athletic build, and I’m usually wearing running shoes. Not too long ago, I would work out two to three times a day. For fun after work, I would ride my mountain bike or run up the ski runs a vertical mile above Whistler Village, my hometown, sometimes making it close to the summit and back down before sunset.

No, I’m injured. I can’t run anymore, I answer.

Sometimes they ask, What injury do you have?

Athletes love to talk about the injuries they have suffered while training. Injuries are a rite of passage to get to the start line of a major event. They’ll guess I have a foot or leg or back injury, something typical for an endurance athlete, never suspecting the real reason. My body won’t let me exercise anymore. Often, they prod to get the rest of the story, which I recall reluctantly. In 2006, I completed three and a half Ironman triathlons in a six-month period. Then I suffered a serious concussion. Since then I have basically been stuck in an over-trained body.

Less than a week before our trip to Berlin, I suffered an adrenal crash, my second in six and a half years. Not nearly as bad as the first, but the effects have limited my ability to function, both physically and mentally. I have to limit the amount of energy I spend, and I’m still not able to fully accept my injury. It’s tough for me to stand motionless on this side of the fence while 84,000 or more feet slap out a metronomic sound on the pavement. I so badly want to be on the other side.

I started the day making an excuse not to join another guide, who was heading out to watch the start of the race and cheer on the runners. A couple of hours later, I left our hotel room to cheer on Christine and the other staff who are running. Waiting for her to come running through the Brandenburg Gate, I notice the bullet holes freckling the surface of the monument, evidence of a violent history. Twenty-six years ago, it was caught between the two walls that divided East and West Germany, and was the lone structure standing in No Man’s Land.

I’m stuck in my own no man’s land now. As I stand here, my mind runs through the events of the last nine years that have brought me to this place, this symbolic divide. The noise of the crowd fades from my consciousness and I get lost in thought, trying to recall the details of December 2, 2006, the day of my last concussion.

Hope . . . yellow . . . taxi . . .

Hope . . . yellow . . . taxi . . .

Hope . . . yellow . . . taxi . . .

A man in blue scrubs gave me these three words to remember, and said if I could remember them when he returned, I could go home. I wasn’t sure what he meant, I was confused by his words, but I knew I didn’t want to be there any longer.

There was a woman sitting in a chair next to my bed, looking very worried. She was dressed in warm clothes and a wool toque; she looked like she had been outside in the cold. Her blue eyes looked at me with concern. I wasn’t sure I knew her, but she talked to the guy who gave me the three words, about me, about my condition. There was stuff going on around me that I didn’t understand. There were questions inside my head that confused me: who am I, where am I and why am I here?

A woman dressed in white clothes appeared beside the bed and asked me if I remembered the three words the guy in the blue scrubs had given me. I didn’t, so she volunteered them again.

Hope . . . yellow . . . taxi . . .

I didn’t question why it was I had to remember these three words to get out of there. The guy said, Remember them and you can go home. It didn’t strike me as an odd demand. I kept repeating them aloud, over and over, while the lady wearing the wool toque sat there and watched.

Again, I was asked if I remembered the three words. No, I replied, embarrassed. Again, the lady in white repeated them. This time, I asked if it was okay to form the three words into a sentence to help me remember them. She may have thought that was a fairly rational request from someone who couldn’t remember three simple words, but she didn’t know I was methodical in most challenges I faced.

I hope I remember the yellow taxi!

I hope I remember the yellow taxi!

I hope I remember the yellow taxi!

Chapter 1: Take It Easy

over the years, I have run into several people who are susceptible to breaking bones, and lots with weak ligaments or cartilage issues. I have fallen out of trees, skied off cliffs, had high-speed mountain bike falls and have never broken a bone. I am, however, particularly prone to hitting my head.

My history of hitting my head began when I was three. While at the bank with my mother, I fell off the chair where I waited and somehow landed on my forehead. Mom carried me two doors down the street to our doctor’s office for stitches. I can’t say for sure that I suffered a concussion on that occasion, but it was a definite precursor to the next 40-three years of accidents and bad luck.

I come by it honestly. My father, Stan, was known for having accidents, rather minor ones, but accidents that would land him in the hospital for stitches or observation at fairly regular intervals. He went about day-to-day activities in an absentminded way that often resulted in injuries needing the attention of my mother or, in the worst cases, a medical professional. Once, while backing up our old station wagon, he stuck his head out of the window to look behind just as the car hit a telephone pole and came to an abrupt stop. His forehead slammed into the car door frame, giving him a sizeable gash. Our next stop was the hospital for stitches. And this wasn’t an isolated incident.

My dad was a very intelligent man who, after being relieved of his duties as a sailor at the end of World War II, completed four years of high school in only a few months. He went on to complete a Bachelor of Science degree and worked in the forest industry for several years before deciding on a teaching career. He continued his education, simultaneously earning his Master of Education and working his way up to high school vice-principal. He would pioneer a computer system for creating timetables and for tracking student reports and grading that is still used, in part, today.

i was born in December 1960, in Huntsville, Ontario, in a small one-level hospital that resembled a motel, located on the banks of the river. Huntsville is surrounded by the lakes, trees and rolling hills of Muskoka, cottage country for the Torontonians who flock there in the summer. We lived in a two-story house on the side of a hill overlooking town, not far from the high school where Dad taught. My mother stayed home to raise me and my four older sisters. We were a one-income family and, in the ’60s, that still afforded us a decent lifestyle. Our house always seemed to be under renovation, as Dad would start a new project before completely finishing the last.

I doubt genetics are involved, but somehow I am cursed with Dad’s ability to turn something mundane into a memorable occasion. It seems that, once I set my mind to a task or activity, I can’t keep the part of my brain functioning that says, take it easy.I focus so intently on the end goal that I lose sight of self-preservation or safety.

This determination to succeed also comes from my mom, Margaret. She grew up on a small farm outside of Toronto during the Depression. She didn’t have many opportunities in the way of sport but did enjoy skiing in the local ravine and riding her bike on the dirt roads around the farm. Being an only child and living on a farm taught her to work hard, and she passed this same work ethic along to me.

From the time I first started to compete in ski racing, when I was six years old, right through to all the other sports I played in high school and university, she was my biggest fan. On the way out the door to an event, I can still hear her words of encouragement. With a big toothy smile and a clap of her strong hands, she would chant, You can do it, you can do it! And whatever it was, I went out the door fully believing I could. She would show up at my basketball or football games and often be the only parent in the bleachers. Her cheers were easy to single out, and I could tell how proud I made her. It was great to have her support, and I still hear her in my head when I begin to doubt my abilities.

When I was five we moved from Muskoka to Pembroke, a logging town on the banks of the Ottawa River. Again, it was a small town, a little larger than Huntsville, surrounded by lakes, trees and hills. During the winter, a main staple of entertainment for my friends and me was Friday night public skating at the local arena. We would walk across town to the rink, where it was nearly as cold inside as it was out. The old building had a particular smell that was a combination of locker-room sweat and Zamboni fumes. The bright lights were dimmed, as families and local kids skated either clockwise or counterclockwise, depending on the hour.

On one particular Friday night, eight years after falling off the chair at the bank, the rink became the venue for my next head injury. I woke up in the office of the general manager with several people standing around asking me questions: What’s your name? Where are your parents? What’s your phone number? None of them were my friends.

After several hazy hours, my parents arrived to take me home. They quizzed the manager to see what they could learn about my accident. The details weren’t exactly clear, but the ice burn on my face and the cuts running from my chin to my left eyebrow told a bit of the story.

I had fallen and landed on the left side of my face. Out cold, I slid across the ice on my cheek. A friend rolled me onto my back just as a group of kids playing tag skated by. One of them didn’t see me lying on the ice, unconscious. At the last second, he lifted his skate just high enough to miss my neck, but his blade grazed my chin, lower and upper lip and left eyebrow. The gashes would require stitches, but my parents were more concerned with the ice burn that was swelling the entire left side of my face. The fact that I had been unconscious for some time and couldn’t remember what had happened was overlooked. Concussions and brain injury weren’t given much serious attention in those days, even in an 11-year-old. I had to spend a week in the hospital while the burn to my face healed. If it hadn’t been for this enforced rest, I likely would have been back at school the next day, playing and carrying on as if nothing had happened.

During the next five years, I escaped serious injury, although I remember several occasions when I had my bell rung. The most notable was in gymnastics, learning to do back handsprings, when I landed on my head and spent time on the bench with blurry vision and ringing in my ears. I didn’t tell any of the coaches, but I did have a sense something wasn’t right and sidelined myself before any more damage was done.

I loved athletics and seemed to have a natural ability to learn a new sport or excel at a familiar one. Throughout junior high, I was involved in every sport possible and, when I entered high school in 1974, I wanted very much to try out for the varsity football team. I knew a bit about the game from watching it on TV, and my friends and I would often have a pick-up game. It was widely known that a freshman would have a hard time being picked for the team, but I still decided to try out with my best friend, Rick Quinn, and several other freshmen. Rick was a great athlete, built low to the ground and very strong. He had muscles on top of muscles and could run like a deer. Rick’s curly, fire-red hair was fashionably long for the ’70s, and he had freckles to match.

For a few weeks we tried to impress the coaches with our talent and determination. Several cuts to the team roster had been made, and we were down to the last cut before the final lineup was announced. Rick and I met after class and hurried to the bulletin board outside the coach’s office. As we read down the list, we both found our names and were ecstatic that we had made the team; we were the only two freshmen to do so.

That afternoon we were

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