I knew I was still breathing. I laid on my belly in a Superman position—albeit with zero superpowers. Veering in a different direction from my friends while skiing left me physically and medically humbled by a new version of an old sensation: powerlessness.

As a friend led us down the ski run in Colorado, I saw on my path a 6-foot snow berm leading to a smooth cat track, the flatter trails used by snowcats to move around a mountain. The last thing I remembered was skiing across it. Then I awoke on the ground. My neck was turned to the left and the ground’s surface was hard on my right cheek. I noticed blood on the snow next to my nose and reached out to stop it. Well, I tried to reach out and stop it. My arms were pinned behind me and wouldn’t move.

I'm a neurosurgeon who can't move, I thought.Now what?

—David Langer, MD

That was the moment I realized I couldn’t move my legs. I’m a neurosurgeon who can’t move, I thought. Now what?

“I’m a quadriplegic,” I screamed to a fellow skier who asked how I was doing.

I waited for ski patrol because it was all I could do. I became anxious and felt complete loss. The idea that I’d utterly failed my wife and children washed over me.

I thought about the tremendous impact my new, physically limited physical self was going to have on me and my family. I imagined how my wife, Nancy, would take care of me. I thought of my son seeing me in distress, just as I’d seen my own dad after his stroke when I was just 22 years old.

I’ve screwed up my life, I thought. For a few minutes I cycled through fear, anger, disbelief, and loss. There was no controlling my emotions.

Even before the accident, I was not the picture of the detached surgeon. I know the limits of my professional powers and skills. That has shaped me into a surgeon who strives to connect with my patients and offer them not just surgical precision, but empathy. It’s a point of pride for me and a daily reminder that I entered this field for personal reasons. I’d lost my dad to a stroke; it would be a disconnect for me to manage my work without my whole heart.

Laying there with my own livelihood and life on the line, I wondered, would physicians and surgeons embrace my humanity, the way I did for my patients, or would they see me as a bunch of broken parts?

Pain overtook me. My neck hurt so much that it was painful to speak.

I won’t have to worry about operating anymore, I told myself. I can sell my city apartment—maybe trick out our house to be wheelchair accessible.

I continued to reimagine my life as I waited for the ski patrol: I’d walk my children down the aisle at their weddings in an electric wheelchair. My wife would have to take our dogs for long Sunday walks.

When the ski patrol arrived, I told them I was a neurosurgeon with a cervical spinal cord injury.

“I need an airlift from the mountain,” I said, knowing I was too unstable to make it down several ski trails secured to a backboard and sled. As they took me away on a sled, I watched the sky and trees and snow. The thought that this might be my last time on a mountain was interrupted by shock waves of pain from the bumpy ride to the helicopter. When the pilot asked me which hospital I wanted to go to, I let the ski patrol decide. I leaned on others to be the experts.