It was the day after Christmas 2022, and Dr. Robert Zick was enjoying a family vacation at Beaver Creek, Colorado. An avid snowboarder, he and his son had already spent several days on the mountain and were looking forward to taking several more runs together before heading home to sunny San Diego, California.

The conditions that day were foggy because of the high elevation—11,000 feet—and Dr. Zick and his son had taken a pause on their boards to survey the terrain and decide which path to take next.

It was a moment of calm that didn’t last long. A novice skier who had gotten onto the expert slope crashed into Dr. Zick, landing 15 feet down the hill. “I was literally blindsided,” Dr. Zick said. “He came from my backside and knocked me down.”

Dr. Zick was wearing a helmet, something he does religiously regardless of the sport. “I’m a medical professional, so I take wearing a helmet pretty seriously,” he said. “In fact, it’s something my family teases me about—I have an entire ‘helmet wall’ in our garage!” So, despite the intensity of the collision, Dr. Zick’s immediate symptoms were surprisingly mild.

“I wasn’t knocked out, and I didn’t see stars,” he said. Having experienced concussions during his football-playing days as a young man, he knew what they typically felt like—and this didn’t seem to match that experience. “I was frustrated with the guy that hit me, but I didn’t feel any different than I did before the crash, so I chalked it up to luck.” He and his son decided to call it a day after that, and other than a low-grade headache that went away after a few days, there was nothing that raised serious concern.

When minimal symptoms hide a serious condition

After returning from vacation, life went on as normal for Dr. Zick. He continued to work three days a week as a radiologist and maintained his intense training schedule for the upcoming Tokyo Marathon, which was taking place at the end of February.

A dedicated runner for over four decades, Dr. Zick was chasing a goal—to run all six marathons that make up the Abbott World Marathon Majors. After completing the Chicago, New York City, London, and Berlin Marathons over the course of his running career, Dr. Zick had his sights set on Tokyo. He was also looking forward to another milestone: retiring from his radiology career on March 1, 2023.

Three days before his planned departure to Tokyo, having just completed an 18-mile training run, he made a decision that would ultimately save his life—though for a surprisingly casual reason. “Because I was retiring, I had money in a health savings account to use up,” he said. “I figured getting a CT scan would be a good thing to get, so I made an appointment for one, saying that I had been having persistent low-grade headaches.”

As an experienced radiologist who had diagnosed countless subdural hematomas throughout his career, Dr. Zick had a mental image of what patients with serious brain injuries looked like. “The patients were usually comatose,” he said. Expecting a negative result, he went in for the scan.

While chatting with the emergency room doctor during his scan, the doctor received a phone call. He handed the phone to Dr. Zick.

“Do you have access to a monitor in that room?” the emergency room radiologist asked. Looking at the nearby workstation, Dr. Zick spotted the scan and went into assessment mode. “Oh, it looks like this patient has a chronic subdural [hematoma].”

The radiologist replied, “That’s you.”

From marathon training to brain surgery

After the diagnosis, things moved fast. A chronic subdural hematoma—a collection of blood between the brain and its outer covering—was pressing down on Dr. Zick’s cerebral cortex, dangerously close to causing brain herniation. Brain herniation occurs when something inside the skull produces pressure that moves brain tissues.

Surgery was scheduled for that night. Doctors conducted a procedure to drain the accumulated blood. However, the procedure wasn’t without complications. The process of removing blood from one side of the brain created a vacuum effect, which led to a hemorrhagic infarct—a stroke—in his right cerebellum.

Dr. Zick spent those first days of his recovery in the ICU, largely unaware of what was happening. He later found out that he had 13 additional CT scans over the course of five days. “I wasn’t waking up, so they kept needing to run scans so that they knew what was happening,” he said. After he became stable, he experienced another frightening episode. “I noticed a cart right outside my room and a bunch of people standing around it,” Dr. Zick said. “My nurse comes in and asks me if I’m dizzy. I said no, and she said, ‘Well, your heart stopped beating for eight seconds.’ A pacemaker was put in after that.”

The road to recovery

After his time in the ICU, Dr. Zick was transferred to a rehabilitation hospital, where he progressed from using a walker to a cane to walking independently within a matter of days. The facility had him practice basic life skills and physical activities to ensure he could function on his own after discharge.

Following discharge, he continued his recovery at home, sleeping with his head elevated and taking medication to prevent further bleeding. Two years after his injury, Dr. Zick has returned to an active lifestyle that includes mountain biking, running 5K races, being a part of a training group with the San Diego Track Club, and recently completing a 28-mile hike for the Make-A-Wish Foundation.

Lessons learned about invisible injuries

Dr. Zick’s advice is given from his lived experience as a brain injury survivor and a retired medical professional: brain injuries don’t always present with dramatic symptoms. “This experience has taught me that there doesn’t have to be tremendous trauma for something serious to occur,” he said. “The symptoms of the chronic subdural I experienced weren’t what I expected them to be.”

When he was in recovery, he asked his surgeon what he believed would have happened if he hadn’t gotten that CT scan, flown to Tokyo, and completed the marathon. His response? “I think you’d have a 50/50 chance of having come home.”

Today, Dr. Zick says he’s still vigilant about wearing a helmet, and he’s also proactive about protecting his brain. “If I were to fall while mountain biking, I wouldn’t wait for symptoms,” he said. “I’d get a CT scan immediately.” He did exactly that recently when he started experiencing low-grade headaches again. This time, the CT scan came back negative.

Despite his close call, Dr. Zick hasn’t given up on his dream of completing the Tokyo Marathon—the only one of the Abbott World Major Marathons he hasn’t finished. He’s gradually returning to running and hopes to possibly attempt Tokyo when he’s 75.

“You’ve got to have goals,” he said.