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Alastair’s Fall and Hospitalization (February 2011)

Alastair’s fall and hospitalization was a medical crisis on February 15, 2011, in which forty-two-year-old Alastair Hargreaves lost consciousness in the English Department lounge at Harvard University, fell from his wheelchair, and fractured one rib. Emergency medical services transported him to Mount Auburn Hospital, where he experienced a second loss of consciousness as his blood pressure fell from 73/42 to 68/38 and then became temporarily unreadable. A weak carotid pulse remained present while the emergency team gave oxygen and intravenous fluids. Imaging and serial blood tests did not show a major active hemorrhage, and Alastair was discharged after several days of observation.

Medical Context and Lead-Up

Alastair was autistic and lived with chronic pain, joint instability, osteoporosis, chronic fatigue, migraine, easy bruising, and recurrent injuries. Hypermobile Ehlers–Danlos syndrome was suspected but had not been formally diagnosed. Osteoporosis increased his fracture risk independently of the suspected connective-tissue disorder.

By 2011, Alastair used a wheelchair for long days on the Harvard campus because sustained walking and standing had become difficult and painful. He felt unwell through his classes and ate little during lunch with colleagues in the English Department lounge. When a colleague asked about bruising along his forearms, Alastair explained that he had run into a pole while maneuvering his chair.

Onset and Recognition

Alastair remained in the faculty lounge after lunch. His pallor, shaking hands, nausea, and increasing dizziness worsened until he leaned forward, lost consciousness, struck his side against a chair, and fell from his wheelchair to the floor. The impact fractured one rib.

Dr. Nadine Teller, one of the colleagues present, called for campus emergency assistance. Alastair regained partial consciousness but remained pale, cold, disoriented, and in severe pain. He vomited while responders evaluated him. Teller called Siobhan after the ambulance left for Mount Auburn Hospital.

Emergency Response and Transport

The emergency crew treated the fall as more than uncomplicated syncope because Alastair remained hypotensive and altered after regaining consciousness. They supported his breathing with oxygen, began intravenous fluids, protected the injured side during transfer, and transported him to the nearby Mount Auburn emergency department.

Alastair’s medical-alert information noted bone fragility, easy bruising, joint instability, and an unresolved connective-tissue disorder. Responders used additional care during immobilization and transfer without treating the suspected disorder as an established diagnosis.

Emergency-Department Crisis

Pain, sensory overload, and physical instability made spoken language unavailable during intake. Alastair used British Sign Language, with Siobhan translating his reports that he felt faint, could not speak, and was in pain. Staff established intravenous access, applied cardiac monitoring, and arranged chest imaging and blood tests.

Although Alastair was already lying down, his blood pressure fell from 73/42 to 68/38 and then became unreadable on the monitor. He warned Siobhan that he still felt as though he would faint, then his eyes rolled back and his body went limp. Staff summoned the emergency team, repositioned him, administered oxygen, and ran intravenous saline rapidly. His carotid pulse was weak but present, and his blood pressure began to rise gradually after treatment.

Assessment for Internal Bleeding

The combination of blunt chest trauma, a fractured rib, pallor, persistent hypotension, and slow response to fluids raised concern for bleeding into the chest. The team obtained chest imaging and repeated hemoglobin and hematocrit testing. No major active hemorrhage or catastrophic vascular injury was found. His hemoglobin was low, so the team continued observation and kept transfusion available if his values or condition worsened.

The bleeding concern arose from the traumatic rib injury and his clinical instability. Alastair’s easy bruising and soft-tissue vulnerability were consistent with his suspected hEDS, but his course did not indicate vascular Ehlers–Danlos syndrome.

Communication Access and Social-Services Review

No BSL interpreter arrived during the emergency intake, leaving Siobhan to translate while also serving as Alastair’s primary support person. Spoken language returned gradually as his pain and sensory overload eased; he relied primarily on BSL during the first forty-eight hours.

A nurse later noticed extensive bruising of different ages across Alastair’s arms, torso, and legs and asked hospital social services to assess whether he was being harmed at home. The concern extended beyond the bruising caused by that day’s fall. Siobhan explained his longstanding easy bruising and unresolved connective-tissue history, and the review closed after the medical context was established.

Acute Care Course and Discharge

Alastair remained in the hospital for several days. He received intravenous fluids, supplemental oxygen, anti-nausea medication, pain treatment that accounted for his low blood pressure, repeat laboratory testing, and observation for respiratory or bleeding complications from the rib fracture. No surgery or transfusion became necessary.

Siobhan stayed for most of the admission, translated Alastair’s BSL, advocated during care, and read messages arriving from his students, former students, and the theatre community. Lily O’Shea was already at the Hargreaves home when Siobhan received the call and remained with three-year-old Charlotte and Catherine. Patrick and Eileen provided food, transportation, childcare, and continuing support.

Alastair was discharged after his blood pressure stabilized and evaluation found no major hemorrhage. The rib fracture required additional recovery at home.

Public and Academic Response

Main article: Tributes for Alastair Hargreaves (February 2011)

Harvard students learned that Alastair had been taken by ambulance after discussion on a student forum. The English Department canceled his classes for the week and collected cards and messages for hospital delivery. Students covered his office door and parts of the Barker Center with cards, banners, sticky notes, lecture quotations, and expressions of support.

Former Oxford students joined an alumni Facebook thread begun by Isobel Tremayne. Miriam Callahan, one of Siobhan’s RADA classmates, called during the hospitalization and relayed messages from RADA, Broadway, and West End contacts.

Long-Term Medical and Professional Consequences

Alastair recovered and returned to Harvard. The hospitalization did not end his appointment or cause the family’s move to Baltimore; he remained at Harvard through the 2018–2019 academic year, and the family moved in summer 2019. He later received a formal hEDS diagnosis.

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