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January 14, 2022 – Bruce “BJ” Miller Jr., a 19-year-old sophomore at Princeton University, was racing with friends near the railroad in 1990 when they spotted a parked suburban train. They decided to climb over the train, and Miller was first on the ladder.
Suddenly, electricity from nearby power lines struck his metal watch, firing 11,000 volts through his body.
The explosion echoed in the air, and Miller was thrown to the top of the train, his body smoking. His terrified friends called an ambulance.
Sticking to life, they brought him by air to burn unit at Saint Barnabas Medical Center in Livingston, NJ.
Doctors saved Miller’s life, but they had to amputate both his legs below the knee and his left arm below the elbow.
“You burn with electricity from the inside out,” says Miller, now 50. “Voltage enters your body – in my case, the wrist – and moves from the inside until it finds a way out.”
With him, the current tried to escape through his chest, sustaining more burns, but it did not spare his legs.
“I think I had about half a dozen surgeries during the first month or two at the hospital,” he says.
Awakening to a new body
Miller doesn’t remember much of the accident, but he does remember waking up in the intensive care unit after a few days and feeling the need to use the bathroom. Disoriented, he withdrew his cooling fan, got out of bed and tried to walk forward, unaware of his injuries. His feet and legs had not yet been amputated. When the catheter line ran out, it collapsed.
“Eventually the nurse stormed in, responding to the fan alarm bells,” he says. “Dad wasn’t far behind. It then became clear to me that this was not a dream and [I realized] what happened and why I was in the hospital. “
For months, Miller lived in a burn unit, receiving countless skin grafts and surgeries. His feet were amputated first, and later his legs.
“In those early days out of the hospital bed, my mind turned to identity issues,” he says. “What should I do with myself? What is the meaning of my life now? I was challenged in those ways. I had to think about who I was and who I wanted to become.”
Miller eventually moved to the Rehabilitation Institute in Chicago (now called Shirley Ryan AbilityLab), where he began the arduous process of regaining his strength and learning to walk. prosthetic legs.
“Every day was filled with a mixture of optimism and good fighting and, 5 minutes later, resentment, frustration, a ton of pain and insecurity in my body,” he says.
His family and friends offered support, “but a lot of work depended on me. I had to believe that I deserved this love, that I wanted to be alive and that there was still something for me. “
Miller didn’t have to look far for inspiration. His mother lived with him polio most of her life and acquired post-polio syndrome as she got older, she says. When Miller was a child, his mom walked with crutches, and she had to use a wheelchair until he became a teenager.
After their first foot amputation surgery, Miller and his mom shared an in-depth discussion about how he joined the ranks of the “disabled” and how their bond is now even stronger.
“In this way, the injuries unlocked even more experiences that we can share among us and more love for the feeling, and thus some early sense of gain that will make up for all the losses that happen,” he says. “She taught me so much about living with a disability and gave me all the tools I needed to reshape my sense of self.”
From burnt to medical student
After returning to Princeton University and completing his undergraduate studies, Miller opted for medicine. With his experience, he wanted to help patients and find ways to improve weaknesses in the health care system, he says. But he agreed with himself that he would not become a doctor just to become one. He would enter the world of medicine only if he could do the job and enjoy it.
“I wasn’t sure if I could do it,” he says. “There weren’t a lot of triple amputees who could be pointed out, to say if it’s mechanically possible at all, to undergo training. The medical facilities I spoke to knew they had some legal obligation to protect me, but there is also an obligation that I have to be able to fulfill jurisdiction. This was unknown water. “
Because his biggest physical challenge was standing for long periods of time, instructors at the University of California, San Francisco, made changes to ease the strain. His clinical rotations, for example, were organized near his home to limit the need for travel. He was allowed to sit on a chair during surgical rotations.
Medical training progressed smoothly until Miller completed a rotation in his chosen specialty, rehabilitation medicine. He didn’t enjoy it. They lacked the passion and meaning he hoped to find. Disappointed and as his last year in medical school came to an end, Miller dropped out of the program. His sister Lisa died at about the same time suicide.
“My whole family life has been in disarray,” he says. “I felt like, ‘I can’t help my sister either, how am I going to help other people?'”
Miller graduated in medicine and after his sister’s death moved to his parents ’home in Milwaukee. He was close to giving up medicine, but the deans persuaded him to do a postdoctoral internship. As an intern at the Medical College of Wisconsin, he completed an elective course in palliative care.
“I immediately fell in love with it on the first day,” he says. “This was a field dedicated to working with things you can’t change and dealing with a lack of control, what it’s like to live with those diagnoses. This was a place where I could dig into my experience and share it with patients and families. This was a place where my life story had something to offer. “
Creating a new form of palliative care
Miller completed a scholarship to Harvard Medical School hospice and palliative medicine. He became a palliative care physician at UCSF Health in San Francisco, and later led the Zen Hospice Project, a nonprofit organization dedicated to teaching awareness-based care for professionals, family members, and other caregivers.
Gayle Kojimoto, program manager who worked with Miller at the UCSF Palliative Care Clinic for cancer patients, said he is a favorite among patients because of his authenticity and ability to make them understood.
“Patients love it because it’s 100% present with them,” Kojimoto says. “They feel he can understand their suffering better than other doctors. He’s open to hearing about their suffering when others may not be, and he doesn’t condemn them.”
In 2020, Miller co-founded Mettle Health, a company of the first of its kind that aims to reshape the way people think about their well-being in relation to chronic and serious diseases. The team provides advice on a range of topics, including practical, emotional and existential issues. No recommendations needed.
When the pandemic began, Miller says he and his colleagues felt it was time to bring palliative care to the Internet to increase access while reducing burnout for caregivers and clinicians.
“We set up Mettle Health as an online palliative care counseling and teaching company and pulled it out of the health care system so that, whether you’re a patient or a caregiver, you don’t have to meet some insurance needs to get this kind of care,” he says.
“We’re a social service, not a medical service, and that allows us to complement existing care structures, not compete with them.”
Having Miller as a leader for Mettle Health is a big driver of why people are looking for a company, says Sonya Dolan, director of operations and co-founder.
“His approach to working with patients, carers and clinicians is something that sets us apart and makes us special,” she says. “His way of thinking about serious illness and death and dying is incredibly unique, and he has a way of saying and humanizing something that is frightening to many of us.”
‘Surprised how much more I can do’
After the accident, Miller went a long way in navigating his physical limits. In his early years, he says, he was determined to do as many activities as he could. He skied, rode a bicycle and forced himself to stand on his prosthetic legs for a long time.
“For years, I would force myself to do these things just to prove I can, but not really enjoy them,” he says. “I would go out on the dance floor or expose myself to vulnerable social situations in which I could fall. It was kind of brutal and difficult. But around the age of five, I became much more relaxed with myself and more at peace with myself.”
Today, Miller’s prosthetics allows for almost all activities, but he concentrates on activities that bring him joy.
“Probably what I can still do and what surprises people the most, including me, is riding a motorcycle,” he says. “As for the upper body, I’m totally used to living with just one arm and I’m still surprised at how much more I can do.”
It took a while, he says, “to figure out how to clap! Now I’m just banging my chest for the same effect! “
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