James was rushed into Gloucestershire Royal Hospital in the early hours and, because his wife had the presence of mind to say to the operator that she suspected he had had a stroke, he was put straight into an MRI scanner whereby they discovered the bleed and immediately transferred him to Frenchay Hospital for emergency surgery at 3 am that saved his life.

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But he wasn't out of the woods yet, he then spent a month in Frenchay Hospital, where he underwent a number of procedures, the main one being an operation to 'coil' his ruptured aneurysm. He also needed to be treated for several life-threatening complications, including both vasospasm and hydrocephalus. And he had to relearn a great many skills that most of us take for granted, how to walk and talk and one of the most challenging for him has been understanding non-verbal communication. Eventually, he did return home, and for the first three weeks, he had to be woken up every 4 hours, day and night, for medication.

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The journey back to scuba diving was a difficult one, and by no means certain. James was initially told by his surgeons that he would never dive again, their concern was 'pressure' on the aneurysm, and whilst his surgeons are highly skilled in their field, what they didn't appreciate was that the pressure associated with scuba diving primarily affects the body's airspaces and not the vascular system, consequently, the pressure associated with scuba diving literally has no effect whatsoever on his coiled aneurysm. Once the surgeons understood this they were happy to entertain the notion of James returning to diving, but only if a specialist diving physician was prepared to sign off on it being safe for him to do so. And so James contacted Dr Oliver Firth who, at that time, was the Medical Director at the London Diving Chamber. After an initial consultation, Dr Firth advised James that he would consider his case if the DVLA were happy for him to return to driving. James had surrendered his driving licence, as legally required, and had to undergo a medical assessment in order to have his licence reinstated. This process took just under 8 months as there is a mandatory 6-month period whereby the patient is not allowed to drive.

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Once assessed, James's driving licence was returned and at that point, he contacted Dr Firth again. He was then told that Dr Firth had already been very busy discussing his case with a number of his colleagues, including vascular neurosurgeons, and that the consensus of opinion was that he should undergo a basic 'Fit to Dive' medical and a phased return to diving. James duly completed a 'Fit to Dive' assessment and did his first post-SAH dive at Cromhall Quarry on the 17th of July 2014. Understandably he was a little anxious! In the 12 months that followed James completed a total of 192 dives, the majority of which were deeper than 50 metres.

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He then returned once again to Dr Firth in 2015 and asked him if he could undergo an HSE medical intending to return to instructing. It should be noted that James didn't need to do this, he has only ever taught for fun and not for commercial gain. But he elected to go down the HSE medical route entirely to prove to others in the dive community that he was medically cleared to dive and deemed safe enough to dive commercially.

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He took his log books with him for the preceding 12 months and upon inspecting them Dr Firth chuckled and commented that he didn't see much point in depth limiting him! James passed his first post-SAH HSE medical and returned to teaching, purely for his own enjoyment and to give him a sense of purpose in life as he continued to recover from his haemorrhage and come to terms with the limitations that had been put on his life as a consequence of that life-changing incident.

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It would be nice to say... 'and he lived happily ever after'. 

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However, subarachnoid haemorrhage, vasospasm and hydrocephalus don't leave their victims unscathed and sadly society and human nature can be extremely cruel, especially towards things that scare them or they don't understand. Hidden disabilities can be the hardest to adapt to and live with and society is often all too quick to judge, as a result, James experienced an enormous amount of prejudice and discrimination, particularly from amateur dive clubs and even from his business partners and some so-called friends. He also struggled with loss of identity as the damage caused robbed him of the ability to continue to run his own publishing business. He was left a shadow of his former self and had to not only come to terms with that, but rebuild the shattered remains of his life whilst not really knowing who he was any more! A lay person reading this is unlikely to be able to comprehend, but this Headway Factsheet on 'Loss of Identity' is extremely good at explaining some of it.

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Fortunately, he did have several close friends that supported him and one of the extremely positive things that came out of the early discrimination was the idea to try and complete a 24-hour scuba dive to help raise awareness of the issues associated with acquired brain injury and raise much-needed funds to support Headway Gloucestershire, the regional branch of Headway.