Monday, July 18, 2022

Book Nook: Bone by Bone - A Memoir of Trauma and Healing

Geralyn Ritter is the executive vice president at Organon & Co., a global healthcare company dedicated to the health of women, with nearly 10,000 employees and a presence in over 140 countries. She is also a leading health care policy expert, women’s health advocate, and author of the new book, Bone by Bone: A Memoir of Trauma and Healing, her story of surviving the 2015 Amtrak train derailment.

You can learn more in this interview.

  1. What led you to writing your new book, Bone by Bone: A Memoir of Trauma and Healing

The precipitating event was the train derailment itself. In an instant, I went from being a successful and self-confident world-traveling executive to a Jane Doe, crushed, unable to breathe and not expected to live. The journey back was long, challenging, painful and incredible in ways I never expected.

The more immediate impetus for writing the book was the advice of the CEO of the company that I worked for at the time, Ken Frazier of Merck & Co., Inc. As my recovery wore on for years and so many strange, unpredictable, awful and joyful events passed, I started to write them down. I considered whether I would ever write a book, but dismissed the idea because I was afraid it would seem self-congratulatory or preachy – as if I somehow earned my survival through grit, faith, hard work and my own resilience. Nothing could be further from the truth. Ken Frazier helped me see that. During a visit to the office during my recovery following a particularly challenging period, he told me I must share my experiences. I confessed I had been writing a bit but felt awkward about it and worried that people would think I was somehow trying to use the accident to my advantage.  

Ken brought me up short. “YOU have a story to tell,” he said. “You have a witness. Your experience can help others.” He quoted scripture, “The Bible says do not hide your light under a bushel.” In an instant, I realized he was right. I just needed to see it through a different perspective. There is so much I know now that I wish I had known earlier in my recovery journey. It would be wrong not to share that knowledge – even if other trauma survivors decide that my path is not their own, I humbly suggest that knowledge is valuable too.

  1. What inspired the cover imagery and how does it connect to your story?

The title and cover of the book complement each other. The title, Bone by Bone, is meant to convey the gradual and incremental nature of healing from trauma. It also, however, is a reference to a poem by Emily Dickinson which captures the feeling of dissociation, one of the defining impacts of trauma. The experts say that in moments of agony, passing into a trance is an act of self-preservation. When faced with danger, the body’s instinctive response of “fight, flight, or freeze” and the accompanying rush of endorphins and stress hormones helps you cope. If the brain continues to sound the alarm for a long period of time, you get caught in a frightening, depressing fog of confusion that is only intensified if accompanied by a continuing bombardment of pain signals from the body. The poem is powerful:  

There is a pain—so utter—

It swallows substance up—

And covers the Abyss with Trance—

So Memory can step

Around—across—upon it—

As one within a Swoon—

Goes safely—where an open eye—

Would drop Him—Bone by Bone—

—Emily Dickinson, originally published in 1929

The cover art is meant to cover both the gravity of my story as well as the hope that inspires it. The broken ribs convey the seriousness of my injuries, but the butterflies represent resilience and life.  Across many cultures and religions, butterflies are deep and powerful symbols of endurance, change, hope, and life. In Mandarin Chinese, the word for “butterfly” means seventy years and symbolizes long life. In Christianity, the butterfly is a powerful symbol of the resurrection. A Native American legend also tells of a grieving butterfly who is eventually filled with gratitude and joy for a new life as she unwraps her wings and begins to dance.

  1. Bone by Bone takes readers through your story of recovery, pain management, and healing. What can you tell us about the caregivers and supporting characters in your story?

My husband, Jonathan – from almost the moment of the accident, he focused on finding me, supporting me, protecting me, taking care of my needs and dealing with a wife who had changed profoundly.  In the book, I express my gratitude, but I also honest about the enormous stress on our marriage during my recovery. The instantaneous role reversal – from me as sole breadwinner and working mom to a position of near-total dependence on him, and for him to go from aspiring entrepreneur to full-time caretaker and quasi-single parent spawned tension that neither of us could understand and nearly broke our 18-year long marriage. We are different people that manage stress differently and these differences meant that we simply could not be the support that each other needed. We really tried and there were tender moments of compassion, but there were also awful words that we both still try to forget.

My parents – my parents, Geralyn and Jim, were rocks. They flew to Philadelphia as soon as they heard the news and didn’t leave for months. All day, every day, in the hospital, in the rehab center, and back at home while Jon and I fought. They prayed, they cried, they rejoiced and they were there. They are faithful and funny and always see the bright side.

My children, Austin, Brad and Steven – my kids are the real heroes of this story. Too old to be oblivious and too young to fully appreciate the life-long ramifications for all of us, they proved just as resilient as me. On far too many days, the only force that lifted me out of bed during the day was the thought of “being there” – on my feet – for my kids. I needed them to see me OK. Hurt, but OK. A mom in bed all day, day-after-day, unshowered, not eating, is not OK. I needed to be OK for them. Even if I wasn’t a great mom during my recovery, I hope they know that it was my love for them and their own wonderful selves that inspired me and pulled me through. To this day, I believe that I would have given up without them.

Mercia – Our nanny/babysitter for five years at the time of the accident, she put her own life on hold for almost two years to dedicate it to helping my entire family adjust to our new normal. Her faith, deep empathy and love were so often exactly what we needed. She is still working with us today and we consider her family.

My siblings – I have always been close to my siblings, but we are separated by age and (as adults) by geography. The way they dropped everything – their impressive careers and family responsibilities -- to fly to be by my side, and in the many years since the accident, to answer every call, question and concern, make me constantly realize how lucky I am.

My friends – My friends also were a critical part of the posse that saved me. They brought joy and laughter and normalcy to many of my days. Some doctors ascribe to a “fake it till you make it” philosophy. In other words, push aside the pain, fear, weakness and fatigue and eventually, you will find it all fades. I believe in pushing yourself. I do not believe in faking it. With my friends, however, the desire to join in the fun, share the laughs (and the wine), rsvp to the summer picnic and just get out of the house trumped my inertia and pierced my zombie-veil to motivate me to get up, get dressed, and wait at the driveway for someone to pick me up for the party. I have no doubt that they were a huge part of the “cure” for my depression and PTSD symptoms.

Doctors and other health care professionals – I had such a wide range of injuries and was treated by a huge number of specialists during my recovery. I had fantastic doctors and others whose bedside manner was horrendous. They are not so much characters in the book as a commentary on the American health care system.

  1. What would you like people to take away from your story or understand about their own life from you book?

It depends on the reader and their background. For trauma survivors, I hope that the book is an enormous source of comfort that they are not alone. I also hope that they find nuggets (or even boulders) of wisdom and advice that is helpful to their own recovery journey. For caregivers, my hope is similar. Writing and researching the book gave me a new appreciation for what Jonathan went through and the incredible challenges a caregiver faces – perhaps especially when thrust into the role so completely and unexpectedly. For medical professionals, I hope this book provides deep insight into the patient perspective on trauma recovery, coordination of care, pain management and many other aspects of the patient experience in the U.S. medical system.  

I believe that this book will appeal to broader audiences. I cover many current topics that are often in the media:  stories of strength and resilience (especially post-COVID), the importance of mindfulness and the power of the mind-body connection, the power of faith, women’s re-entry into the workforce, the opioid crisis and others.  

On the topic of resilience in particular, I have several messages and elements of advice based both on research and my own experience. Whether a reader is a trauma survivor or has experience some other form of pain or tragedy – a broken relationship, a child with a terrible diagnosis, a crushing professional setback – I believe these same messages are equally relevant. The first is the importance of realistic optimism. All too often during my recovery, my blind optimism and lack of appreciation for the significance of my injuries set me up for a feeling of defeat and failure. Optimism and gratitude are critical – based they have to be grounded in a realistic appreciation of the situation. The second key point is to allow oneself to Feel the Bad.  In other words, allow yourself to grieve what has been lost. I was so determined to stay positive that I repressed any sense of frustration or pain until it became overwhelming – and then I felt guilty about it because so many others had lost their lives in the accident. I felt I didn’t have the right to grieve for my own loss. The third lesson I learned was to Find the Good. It sounds strange to suggest that anything good came out of this mass disaster, but I had to work to appreciate the new perspective it gave me on life, on relationships, on my health, on how I spend my time, and ultimately it is why I wrote this book – to ‘pay forward’ what I learned from my experience and try to help others facing similar challenges. The final lesson is to Share It. Trauma and recovery are lonely. I was surrounded by supportive family and friends, but it was difficult for them to understand what I was going through. By pushing myself to engage and to let them in, I often found myself laughing or joking just moments after I had been crying. By giving speeches to churches and other groups, I was forced to examine what I had learned and came to understand more profoundly that almost everyone has been through a very difficult period in their life. A huge volume of evidence backs up the concept that the pace and quality of recovery are improved when patients have strong social support systems and can engage with peers.  

Finally, my book touches on the support I found in my own faith. I believe that readers with a strong faith will find the story rewarding, reaffirming and inspiring. Most of the faith references, however, are not specific to Christianity and could equally apply to those of different religions. Moreover, they are not so numerous or emphatic as to limit the audience of the book to religious readers – my faith is simply part of my story, not something that I evangelize.


A recognized expert in healthcare policy, Geralyn Ritter is executive vice president at Organon & Co., a global healthcare company dedicated to the health of women, with nearly 10,000 employees and a presence in over 140 countries. She was formerly senior vice-president at Merck & Co., Inc., one of the largest pharmaceutical companies in the world. She has spearheaded global government affairs and policy, led initiatives on corporate governance and corporate responsibility, created and launched a widely acclaimed half-billion-dollar philanthropic initiative to end preventable maternal deaths around the globe, and served as President of the Merck Foundation. In 2020, on behalf of Merck, Geralyn accepted the Disability Employer of the Year award. Ritter is also the author of a new book, Bone by Bone: A Memoir of Trauma and Healing about her recovery from injuries in the 2015 Amtrak derailment.

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