The guy we dealt with did fight us. When the local medics arrived at the meet point (we were working an event, this occurred in the back country), the first thing they asked us was, "Why doesn't he have a collar on?" (it was under his neck, but he clearly wasn't tolerating it). I told the guy, "You try... 3 of us couldn't keep it on him, or him on the board 100%". It took 4 firefighters + sedation to finally get it on him. Tom - Yes, ouch is the word for this one. This is, by far, the worst injury I have treated since I started working in event medicine (Worse happened when I was on standard ambulance duty years ago). Shortly after this gentleman's injury, the bicycling world had a fatality at a large biking event in California. Massive head and neck injuries. He was dead the second he hit the ground. The guy we dealt with was damn lucky. He can still walk. He has some neuro issues, but considering the level of injury, it is amazing he survived, let alone survived relatively intact after all was said and done.