‘After fracturing my skull, I knew if I fell asleep in the ambulance, I would not wake up’

Bath City striker Alex Fletcher is graphically describing the moment he nearly died on a football pitch.

He remembers the routine sprint down the touchline for ‘lost cause’, a tussle with a full-back near the byline, and then the awkward spin which caused the back of his head to make a forceful impact with an advertising hoarding pinned to a brick wall two metres from the pitch.

He remembers the ‘worst headache in his brain’ imaginable, an incessant ringing in his ear, and the panic as players and senior club officials surrounded him. He remembers the harrowing realisation the match was abandoned after ten minutes as paramedics and emergency services rushed to make a life-and-death decision about which hospital was most appropriate for emergency brain surgery.

And most chillingly, Fletcher remembers ordering himself to stay conscious.

“I felt like if I fell asleep that could have been it,” he says. “That is what sticks with me most vividly. It is a scary thought.”

Fletcher had begun the evening of November 8, 2022 seeking to maintain the prolific goalscoring form which made him Bath’s player of the year months earlier,  Dulwich Hamlet in his sights in the National League South. He ended it in a coma, his family warned if he did awaken, he might not be the same person.

As he recalls a 50-minute ambulance ride from Bath’s Twerton Park to Bristol’s Southmead Hospital, the details are unflinching.

“I was pinned down with a neck brace protecting my head. I was drowsy and I was sick. I actually vomited over the paramedic,” he says.

“I remember telling myself, ‘you have to stay awake for as long as you can’. Then I remember the lights as I was wheeled into the hospital, really bright lights above my head.  I knew I had made it somewhere where I would be looked after. That was the last thing I can remember from that initial chain of events. I blanked out after that. I was fitting and unresponsive when I arrived at the hospital.”

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Surgery extracted brain fluid and a small piece from Fletcher’s skull, which had suffered multiple fractures. Part of his vertebrae was also removed to ease further brain swelling. The 23-year-old remained in an induced coma for a week, every ‘small step seen as massive’.

Five months on, Fletcher’s mood is one of courageous optimism and appreciation, his eloquent account testimony to an extraordinary recovery.

“The NHS is remarkable beyond words,” he says. “Whoever made that decision to go to Bristol may have thought it straightforward because of the neurosurgery ward. I feel it was a massive part of why I am alive.

“The surgeon, Dr Neil Barua, would have received the call getting ready for bed that evening and been briefed on the way to hospital. Then he is there ready to operate and save my life. I still struggle to comprehend the pressure he was under. He said he had never seen anything so severe from the impact of a sports injury.

“My family was told my injuries were synonymous with a motorcycle accident. They were given the worst news; that my chances were pretty slim and that even if I pulled through it might not be possible to live my life as it was before.

“They were prepared for me waking up and not recognising them, or being a completely different person. To begin, the signs of progress were slow.

“I am told when I first moved my foot they were screaming in my ear to respond. They did that a lot, apparently. It was seen as a remarkable sign of recovery because it would mean I had the capacity to repair myself and move again. That was not a given until then.

“Another area that could have been affected is memory and personality. I remember waking up with tubes in my mouth so I could not speak, and pointing to things for my family to talk to me to show signs I was still the same person. I am most grateful for that most of all – that I recognised them and still had me memories – because I have so much of my life left to live. It had no impact on my long-term or short-term memory. Not at the moment, anyway. That could be in the future. I do not know. I may be at high risk of other conditions. Dementia maybe. But for now I have my personality and memories intact.”

The accident has left Fletcher deaf in his left ear, with extreme double vision and suffering from tinnitus, doctors anticipating it will be at least two years before his brain has fully recovered. Part of his rehabilitation involved learning to walk again.

His enduring positivity comes with a sober warning and passion to expose the archaic health and safety regulations which will make such horrific incidents common as the game gets quicker, even at the lower levels.

Stockport County’s Macauley Southam-Hales was fortunate to avoid similar injuries after colliding with an advertising hoarding during this season’s FA Cup tie with Charlton Athletic.

“What I want to do is raise awareness,” says Fletcher. “Clubs have to sit up and take notice of what happened. Maybe there can be more protective equipment around the sides of the pitches, or maybe we could bring the pitches in a bit to allow more of a run off. I know changes cost money but ultimately lives are at stake.

“It is not a lot to ask for more consideration about the safety of the pitch. There are a lot of health and safety procedures for spectators, but it just seems that there is not so much thought into the guidelines for players’ safety.

“The PFA have helped me to contact the Sports Minister [Stuart Andrew] and I believe they are pressuring the Football Association to try and tighten the regulations.

“In all honesty, until it happened I had never set foot in that stadium and thought, ‘It’s dangerous because there is a brick wall behind the goal’. A lot of clubs at lower levels will have that kind of brick wall. At other grounds you will have the metal bars that surround the fences. That is still a metal around the perimeter. Regardless of where you are on the pitch, when you go full throttle – even at somewhere like Old Trafford – you have the pitch and the runoff and straight into the crowd. You see it at the highest level where the regulations are much tighter and the players can still end up with the fans after just a little nudge. You are not in control when you are sprinting full throttle. You can’t stop with a limited run off.”

A Bath City FC Spokesperson said, “Our ground has to comply with the ground grading regulations which stipulate that there must be a ‘permanent fixed barrier of sound construction (e.g. concrete and steel)’ that is 1.1m high and is a minimum of 1.83m from the goal line. The perimeter barrier at our ground is over 4m from the goal line. We fully support Alex in his campaign to change regulations to increase player safety.”

‘Would you put a brick wall at the end of a 100 metre running track?’

Encouragement during recovery has been overwhelming, England coach Gareth Southgate among those delivering a personal message.

“That was a real eye-opener for me,” says Fletcher. “For him to take the time and send that message to me during the World Cup really gave me the strength to think: ‘Yeah, I can do this and continue making good progress’.

“The support was off the scale. I did not know that kind of love exists in football.

“There was a GoFund page set-up by one of the Bath supporters to raise funds for my family to enable them to stay closer to me. It has raised about £18,000. The donations that came in were so varied, from primary school kids doing cookie sales and fellow professionals, team-mates, ex-teammates, clubs. A notable one was from Taunton Town. They are local rivals in our league. I played against them earlier in the season and scored an equaliser in the 97th minute. I took the celebrations a bit too far at their place, but when I came out of ICU and was able to start catching up on the messages I saw they donated about £500. It really blew me away. I’m not an emotional person usually, but it did bring a tear to my eye.”

Now Fletcher is cherishing normality. He will marry his girlfriend, Ellie in May, has returned to his day job as a project manager for an IT company and is adamant his football career is not over.

“Two weeks post-surgery and I was telling my surgeon, ‘I’m playing football again, you can’t tell me otherwise’,” he said.

“That has been a massive part of my recovery – that one goal, that one focus: ‘I’m getting back on the pitch no matter what’. I’m striving to get back to where I was, effectively. But I guess I need to have a more grown-up conversation with my surgeon and be realistic about what might be.

“I’m smashing it, really. I’m back on the pitch running, changing directions, being able to run backwards, that kind of thing, physically and mechanically I’m starting to get there, back to where I want to be to return to football.”

The determination of the ex-Plymouth Argyle forward to get back onto the pitch is matched by that to ensure such grounds are fit for purpose.

“Would you put a brick wall at the end of a 100 metre running track when people are competing to get to the finish first?” he asks. “You never would, so why would you do it so close to a football pitch? It does not make any sense.”