Battling back after spinal injury

THE SATURDAY INTERVIEW : Stuart Mangan had everything going for him – a good job, a bright future and a love of adventure

THE SATURDAY INTERVIEW: Stuart Mangan had everything going for him – a good job, a bright future and a love of adventure. Then a rugby tackle on a Saturday afternoon last year changed his life forever

UNA MANGAN is at the kitchen counter, laying out homemade scones for her young son’s visitors. Tea lights flicker around the bright, uncluttered apartment, overlooking a lively London street. Outside, under an azure spring sky, quirky boutiques, art galleries, traditional hardware shops, launderettes and friendly cafes lend a charming villagey feel to the area – just the kind of place a sociable, young professional might like to call home for a while.

Inside, there is the usual chit-chat as Una greets her sister, Ann Harper. “How was the flight? Sorry, I forgot the Ballymaloe relish.” It’s normality of a kind. But even to an outsider, it comes in a shell of almost unbearable fragility.

It is almost a year now since Stuart Mangan, a handsome, popular 24-year-old, rose on a Saturday morning, got a haircut, got his shoes repaired and had a new tube fitted in his bicycle tyre, before haring off to play a match at Hammersmith and Fulham rugby club. “Stuart was through the gap,” says Una. “His studies were finished. He had a job . . . ”

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He got his international law degree in UCC in 2006, followed by a master’s in business at the prestigious Parisian École Supérieure de Commerce, with semesters in both Madrid and Paris, mastering five languages en route. When he landed a job selling equity derivatives in London for Banque Nationale de Paris in July 2007, it meant the last of Una and Brian’s four expensively-educated sons was launched in life.

Wherever Stuart found himself, he says now, he always “bombed” around on his bike. That last lovely, sunny springtime of 2007 as a student was spent in Paris, a city he adored, with a pretty girlfriend and picnics in front of the Eiffel Tower. Then came the job with BNP and the posting to London, where he found a “perfect” apartment near his two brothers.

For Una and Brian, it seemed, the hard work was done. “Then we got a phone call”, she says. They took a flight to London that night. She has been back to their Fermoy home only twice since.

That April afternoon, Stuart arrived at the rugby ground and took up his usual out-half position. “It was in the first half and we were attacking on their 22,” he says. “One of our guys took the ball on, got isolated, the scrum-half wasn’t getting forward quickly enough, and it was just five metres away from me. I saw him being turned over and went in to try and ruck the two guys out.”

Flinging himself into the action, he was being quintessential Stuart, the boy who never cantered if he could gallop; who hit the black runs three days into a skiing holiday; who took his mountain bike down slopes so steep, at such breakneck speed, that he practically sat on the back wheel to keep the balance. A scar on his shin still bears witness to one such episode when he crashed into a tree stump.

And here he was crunching into an everyday tackle – not a notorious spear tackle, or a collapsing scrum – but one that would change his life and that of everyone around him forever. “It wasn’t anybody else’s fault; it wasn’t like someone did anything to me. I just went in, I just hit it and whatever way my head went, it just cracked . . . ”

He was aware of shaking, of people standing around. “Then I just blacked out. And that was it.” Al Dawson, an ex-army officer, kept him alive by maintaining mouth-to-mouth respiration for eight minutes, until the paramedics arrived. “Otherwise,” says Stuart, “I might have been a mushroom. . . ”

At Charing Cross Hospital, to his family he seemed in a coma-like state, possibly brain-damaged, with his head in traction. But for Stuart, this period is a terrifying jumble of waking and sleeping nightmares, remembered now with appalling clarity, featuring a violent abduction in hospital by jihadis armed with guns and a “massive” saber among others. On two occasions, he bit off parts of his tongue, the second time so seriously he had to learn to speak again.

No-one attempted to gloss over the catastrophic extent of his injuries. “The major kick was very instant . . . The doctors only had to come in and tell you something once.” The spinal cord injury was complete; it was close to 100 per cent likely that he would never walk again. Of course, keep your eye on stem cell research, they told him, but don’t hold out for it or keep your hopes up too much.

“And I was thinking all those things, about being incontinent, being washed by other people, not being able to raise your own arm or move your leg, not being able to feel something. You’d say, ‘My hand’s cold’, and someone would say, ‘But you’re roasting’. And you realised – well, that was it. For a while, I used to wake up every morning and think, ‘Can I feel my hands? Can I feel my legs? No? No’. Then you’d go, ‘Okay, it’s another day in hospital’.”

Meanwhile, the partial movement in his shoulders and full sensation around his head began to vanish, as nerve damage took hold. He lost any sensation just below his chin, then below his jaw line, up around the ear to the top of the head. It was, said the neurologist, “an exact C2 nerve cut-off”. Now he relies on the ventilator wheezing beside him to keep him alive, connected through an opening in his throat. He requires round-the-clock care in teams of two, one of whom never leaves his sight. If his ventilator malfunctions, they have two minutes to fix it. His medical supplies – breathing filters, suction tubes, syringes – fill two floor-to-ceiling cupboards.

HE LEFT THE Royal National Orthopaedic Hospital in Stanmore just before Christmas, after an ongoing battle to show he could handle the risks of living in the community. In Britain, the use of step-down facilities such as nursing homes is avoided where possible for people in Stuart’s situation, says his father, Brian. Care packages are sub-contracted to approved agencies and Stuart chose the agency and interviewed potential carers himself.

The deeply intimate daily engagement with his carers begins with a three-hour physically and mentally demanding routine, involving medication to control his blood pressure as he is lifted, suppositories, feeding, bowel evacuation, washing and dressing. Everyone has learned, for example, that he can’t bear to have unnecessary intrusion around his face, so they know not to lift a plate of food close to his mouth. He likes to dress correctly every day, in a shirt or polo shirt and jumper; no tracksuits or pyjamas.

“He wants jeans, he wants to be normal,” says Una, “but he can’t have clothes with seams because his skin is like a baby’s.” Her constant dilemma, she says, is not to crowd him. “I don’t want to disable him any further.” Una, a devoutly religious woman, retains hope. She recalls the woman who touched the hem of Jesus’s robe and was cured. “It’s my way of trying to believe that all is well and all will be.” But the grief is etched in her being. “He was so playful. Sometimes you think, ‘Okay, Stuart, the game is over, jump up now’.”

When he left Stanmore, the challenge of adapting to a different life began in earnest. In good times, he can spend 12 hours up and around in the wheelchair. He reads avidly – Richard Dawkins’s The God Delusion in on his book stand – and watches every rugby ball kicked across the television channels. He was busy, doing a little translation, focusing on refining the computer’s indifferent voice-recognition capability. But in recent weeks, as a result of pressure sores, he has been bed bound.

“When I was in hospital, they would ask do I ever get down, and I’d say, ‘Of course I get down when I think, for eff’s sake, why did it happen to me?’ – and then you’d cry for a bit and . . . but it only lasts about 20 minutes and then I’m back. But I’m becoming more and more aware of the things that affect me. I notice things more, everyday things – people walking around, just walking past the window, or I see a guy bombing by on his bike, or a couple walking together . . . something like that. Sometimes, it’s things of the past or things I would have done – something like my brother and his wife heading off on their honeymoon to Argentina to go hiking in the mountains or riding horses at a ranch for three weeks. I love it when they come back and tell me about it and I think that’s great, but at the same time, I know it’s not going to be possible for me . . .

“And there are things in the future – I see my brother playing with his child and I wonder will I have children. Before the accident, I had a lovely girlfriend – things weren’t going all that well to be honest, but she was great at the same time. You have aspirations and ideas of what you want your life to be . . . I’d already travelled a bit and there were so many places I wanted to go. I really wanted to go to South America – I have Spanish now – and Cuba, China, Australia . . . And there were times when I’d have thought, ‘Ah why don’t I give up rugby and do something interesting like photography or fencing or mountain biking?’ But, of course, I never did, purely because I absolutely loved the camaraderie of rugby and just the thrill I got from it. I just loved it, I loved it when you played with someone who was good, just scoring tries – I just loved it. Life was perfect before . . . and then it was quite a shock when it happened.”

HE STILL LOVES rugby. “What I watch on television is the Six Nations, the Premiership, the Super 14, everything . . . I do see scenes and say, ‘Oops that’s a bit similar to my one . . .’ But no, I don’t think any change in the rules would have helped me. The rules are stern enough now.”

Former England rugby captain, Lawrence Dallaglio, has been in touch and offered to help. “He said he knew of the fears that even professional rugby players feel each time they step on to a pitch, that it could happen in a tackle and you could be finished forever. But because we love the game, he said, we still go ahead with it. And that’s the same way I feel. If you’d asked me before all this, I’d have said, ‘Yeah, it could happen’ – but if you think like that, you’d just wrap yourself in cotton wool and would never go outside and play . . .”

His brother Barry introduced him to the Hammersmith club and still plays there. “It’s difficult for me but it’s difficult for him as well. But it’s so unlikely it’s going to happen to you, you can’t worry that because it’s happened to your brother that you have to stop playing . . . Looking back, I wouldn’t have changed anything.”

He skirts no issue. It has not escaped his attention that another young rugby player, Daniel James, who was paralysed from the neck down, chose to die by assisted suicide last year in Switzerland. “Someone gave me the paper and I read about him . . . It said how he wasn’t feeling great in hospital . . . how he was dead set in his mind that he was living a second-rate life and he said, ‘No I’m not willing to do that; either I live to the full a first-rate life or I don’t live at all’. So he obviously said, with all the problems that go with it – because there are so many things, whether it be removing a limb, wheelchair sores, people looking at you, girlfriends, anything like that – I suppose he just said, ‘Right, that’s it’. And his parents went with him and said, ‘If that’s his choice, then.’

“Everybody was saying to me, ‘You’re so brave, you’re so brave’ or whatever, and saying he wasn’t as brave . . . but I said that’s not true. If you look at it this way, some people are too scared to die, and others are too scared to live. He may have been too scared to live and took the easy option to die. Or he might have been too scared to die but said, ‘You know what, I’ll do it anyway, because it’ll be easier on my parents, and just make life easier for everybody’. So he may have done the brave thing . . .”

As for Stuart’s own mindset, he says simply: “I’ve thought about it quite a bit.” Then almost frame by frame, he describes films where assisted suicide is central to the story. One he has re-watched is the much-garlanded Spanish film, Mar Adentro (The Sea Inside), directed by Alejandro Amenábar, and based on the true story of Ramón Sampedro, a world-travelled, ship’s mechanic from La Coruña, who was paralysed in a diving accident and spent 28 years waiting to die. It is a movie where all views are aired but also one with stunning romantic passages, at one point showing Ramón appearing to rise from his bed and flying, soaring over wooded hills and to the sea, where his love is waiting.

Ramón lived among a loving family, says Stuart, but eventually decided that “this is getting too hard for them . . . and I can’t contribute in any way towards them”. The family argue fiercely about his wish to die but finally agree and each contributes in some small but significant way to the final act. “Then he talks into a video, saying that he has been driven to this by the government and their refusal to change the law.”

He understands the impulse, he says. “Sometimes I do think it gets too tough and you say, really, ‘What’s the point in battling or forcing yourself to live every day’. You do start thinking about life and death and what’s out there after death. If you’re going to die anyway, whether you die now or whether you die later shouldn’t make a difference. So sometimes I think if things got too tough or I felt I wasn’t getting the full enjoyment out of life, then I wouldn’t feel bad about saying, ‘I could end my life’. But it wouldn’t be easy because I couldn’t do it myself. I’d obviously have to use a similar way to the guy who went to Switzerland, which is a pity.

“I know that life is precious and it has to be upheld in the courts . . . but if someone makes a decision to end their life, then it was their decision based on the terrible situation they found themselves in. It’s not a stain on them, it’s just sad that their lives couldn’t have been better; maybe they could have been helped by someone, maybe it could have been made easier if they had financial problems, or if it was something about my situation, if they never find a cure for spinal cord injuries through stem cell research . . .

“But that’s just thinking. Sometimes you just go, ‘Ah God, why can’t I just end this, what’s the point, why does it have to be so tough?’ and sometimes they’re just passing thoughts. But then when you’ve time on your hands, like I’ve just had with two weeks in bed, and in hospital, you start thinking over the possibilities.”

He knows those words are devastating to those around him. “The people close to you are really shocked when you talk so frankly about things like this. But it’s probably like when people go to war and how frankly they can talk about killing someone. They talk about it quite coldly and people think that’s horrible, how could you . . . But the soldier looks at you and says, ‘That’s just what you have to do’. It doesn’t make him a bad person. The circumstances just do that.”

He believes the law should be changed – “but extremely carefully written to protect vulnerable people” – to allow euthanasia. “Let’s say someone is in a coma or sits there and has no reaction to you, staring blankly into space, and not responding. Should his family have the right after some stage to say, ‘Listen, I think it’s time to turn off the machine?’ I think yes. Otherwise, it’s just cruel. You wouldn’t do it to an animal. You can’t have a dog live like that.”

He acknowledges the goodness all around him – the London taxi drivers who refused to charge his mother on her daily journeys out to Stanmore, the cousin who dropped off the homemade scones today, the technology experts such as UCD’s Dr Gary McDarby who are working to refine his computer’s voice recognition capability and wheelchair apparatus, the local art gallery director, Daniel Tills, who struck up a conversation with Una one day and instead of allowing her to buy a small painting (for which a donation had been specifically made to the Stuart Mangan fund), offered a painting on loan each week, chosen by Stuart from a gallery catalogue. Today, Daniel arrives with a picture of a mysteriously beautiful brunette. Next week’s choice is a twinkling Parisian cityscape.

And whatever about the down times, Stuart Mangan certainly has a head full of plans for the future. The way forward is through computer technology and stocking his brain. And while his speech is almost perfect, he plans to work on a type of microphone that will allow him to project and control his speech volume, in a nightclub for example.

He wants to help design a seat to prevent pressure sores, since that is the biggest challenge for people who are tetraplegic.

“Also I want to create a brace so I could ride a horse again.”

He has similar thoughts about sailing. And he is determined to get back to work, using his languages. He has already had offers to work on websites, including one in New Zealand for the rugby World Cup.

In the meantime, the fundraising drive designed to give him an independent future is gathering pace around the world, spearheaded by his brothers, Keith, Barry and John, and a host of extended family.

Rugby veterans such as Mike Gibson, Keith Wood and Ollie Campbell, are involved, as well as the Olympic rower from Fermoy, Gearoid Towey.

Teams are putting their shoulders into golf classics, comedy nights, coffee mornings, mountain hikes, horse weekends and fashion shows. Munster rugby players and soprano Cara O’Sullivan are involved in a CD to be released in April. During the same month, he plans to make it in person to the Champagne and Diamonds Ball in the Intercontinental Hotel on Park Lane. And today, as a matter of fact, we make it down the street to Carluccio’s for lunch.

Information about the Stuart Mangan Appeal is available at www.stuartmangan.org. Letters and donations can be sent to the Stuart Mangan Appeal, c/o Keith Mangan, 23 Avoca Park, Blackrock, Co Dublin.