Geraldine Lavelle's "When the Apple is Ready, it Will Fall"

Author: Geraldine Lavelle Publication Date: 2025 Publisher: Book Hub Publishing ISBN: 978-1-0685633-5-5

I. Executive Summary
Geraldine Lavelle's "When the Apple is Ready, it Will Fall" is a profound and deeply personal account of her life following a tragic cycling accident in 2013 that resulted in a spinal cord injury and paralysis. The book serves as a detailed exploration of her journey to find mental strength, resilience, and purpose amidst immense physical and emotional challenges. Lavelle critiques the systemic failures of the healthcare and disability support systems in Ireland, particularly regarding institutionalisation and inadequate care provisions. A central theme revolves around the nuanced relationship between hope and pragmatic action, with the author ultimately advocating for a realistic, adaptable mindset in the face of insurmountable obstacles. The narrative is a testament to the human spirit's capacity to not merely survive, but to actively live and flourish, even when confronted with profound loss and an uncertain future.

II. Main Themes and Key Ideas

A. Resilience: The Indomitable Human Spirit
Lavelle’s primary message is the extraordinary power of human resilience, which she defines as "the capacity to bounce back" from trauma and loss. Her own experience of spinal cord injury and paralysis did not break her, despite numerous physical and emotional hardships:

Overcoming Adversity: "A tragic cycling accident that resulted in my spinal cord injury and paralysis from my chest downwards didn’t break me." This sentiment is echoed throughout the initial chapters, listing a litany of challenges including "multiple operations and blood transfusions," "constant nerve pain 24 hours a day, seven days a week," and "the loss of my permanent job and long-term relationship."

Growth from Struggle: Lavelle asserts that her disability, while paralyzing parts of her life, allowed "the strong, resilient other parts [to] never have evolved, developed or existed." She notes, "The more we fall, the more we learn how to get up, hopefully bigger, better, and stronger for the next challenge."
Positive Psychology: The author highlights Martin Seligman's "positive psychology," which shifts the focus from what went wrong to "what constitutes and underpins human resilience and how to cultivate or build these factors."
Internal Strength: Lavelle concludes that this "resilience or indomitable will...was inside me; I just needed to engage it." She champions a "flexible, forward-looking mindset" over a rigidly fixed one.

B. The Nuance of Hope: A Double-Edged Sword
Hope is presented as a complex and often contradictory force, both essential for survival and potentially detrimental if unrealistic.

Hope as a Motivator: Initially, hope is described as vital: "Hope resides in the hearts of the good, liberating us from despair and giving us the strength to move on." Quoting Jane Goodall, "So by being active, perhaps we become more hopeful, but you won’t be active unless you hope that your action is going to do some good. So you need hope to get you going, but then by taking action, you generate more hope. It’s a circular thing.”

False Hope as an Impediment: Lavelle painfully recounts how "my hope to walk again stopped me from progressing." She quotes Nietzsche: “Hope in reality is the worst of all evils because it prolongs the torments of man.” Unrealistic hopes led to "great disappointment and disillusionment" when expectations were "irrevocably crushed."

Realistic Hope and Action: The author advocates for "tempering the idealism that grants us hope with the hard, unalterable facts of reality." She learned to direct her plans towards "hope that was achievable," such as becoming "as independent and as happy as possible." Barack Obama's quote reinforces this: “The best way to not feel hopeless is to get up and do something. Don’t wait for good things to happen to you. If you go out and make some good things happen, you will fill the world with hope, you will fill yourself with hope.”

C. Survival vs. Living: Finding Purpose Beyond Mere Existence
Lavelle draws a clear distinction between merely existing and truly living, emphasizing the importance of purpose.

Defining the Difference: "I chose to live, to actively experience aspects of life, not just to occupy space...for me, living is when you enjoy life, the bitter and the sweet, the struggles and the hopes. And surviving is when you only just live, you don't enjoy the life, you don't have hope. You just keep living because you haven't died yet."

The Inadequacy of Survival: "Merely surviving is no way to pass your days." She highlights that survival, while sometimes necessary temporarily (e.g., a plane crash), "is not (and should not be) a way of life."

Finding Purpose: After her injury, Lavelle "found myself merely surviving...so I looked for purpose. I found writing—something that brings a sense of accomplishment to myself and helps others (I hope)." Her memoir itself is an act of living, not just surviving: "I write my memoirs; to show others that the human will compels you to persevere in the face of adversity, to meet challenges armed with courage, strength, and resilience."

D. Health Challenges and Self-Advocacy
The book provides a stark look at the extensive health complications faced by individuals with spinal cord injuries and the critical need for personal responsibility in managing one's health.

Chronic Health Issues: Lavelle details "frequent infections, weight loss, pressure sores, and being bedbound for several months." She also discusses "reduced lung capacity and several hospitalisations due to pneumonia" as well as "neuropathic pain" and the risk of "osteoporosis" and fractures.

Antibiotic Mismanagement and Resistance: A significant personal struggle was "60 courses of acute antibiotics" between 2016-2021 and an "excessive antibiotics at the beginning of my spinal cord injury". She explicitly states the danger of antibiotic resistance, noting how it "leads to higher medical costs, prolonged hospital stays, and increased mortality." This led to "onset liver failure with decreased enzymatic functioning of my liver, unusual blood cell profile and kidney distortion."

Natural Remedies: Lavelle found relief and reversal of some organ damage through "herbs and natural remedies," inspired by Maria Treben's "Health through God’s Pharmacy." She uses dandelion, milk thistle, horsetail, ginger, and turmeric to support her liver, gastrointestinal health, and hair growth.

Taking Control: Emphasising self-advocacy, she states, "it’s your responsibility to get to grips with your health, your medication, your body and staying as physically active as possible."

E. Bureaucracy and Institutionalisation: A Systemic Failure
Lavelle offers a scathing critique of the Irish disability support system, highlighting the profound injustices and mental toll of battling bureaucracy.

"Bureaucracy is hell": Lavelle's struggle for an "ordinary life, independently, in my own home" was met with constant resistance and inadequate funding. Her care hours were reduced from 47 to 42 per week, despite a documented need for 56 hours. This was attributed to "a limited 'PA budget due to a lack of investment for many years'."

Impact of Institutionalisation: She spent "almost a decade in a residential setting", which she describes as an "enemy of one’s sense of personal control." She defines institutions as facilities that "deprive residents of essential freedoms, segregate them from their communities, suppress individual choice and personal expression, and foster a perception that people with disabilities are different and unable to take a place in society."

Human Rights Violations: Lavelle explicitly states, "The segregation of people with disabilities is a human rights violation," referencing the United Nations Convention on the Rights of Persons with Disabilities.

Waiting Lists and Underfunding: She highlights that "Countless disabled people in Ireland are eligible to receive HCBS but are on waiting lists due solely to a lack of funding."

Critique of Disability Reform: Lavelle vehemently opposes the "Government’s Green Paper on Disability Reform" to medically examine and "categorise" people with disabilities based on their ability to work, calling it "a dystopian and Dickensian attack on disabled citizens and carers." She notes similar policies led to suicides in the UK.

Pay Parity Strike Action: She details the anxiety caused by the impending strike of Section 39 staff due to "untenable pay inequality" compared to HSE counterparts, underscoring the "disdain for the government for allowing widespread disruption, fear, and angst to spread throughout the disabled community."

F. The Changing Self and Acceptance
Lavelle reflects on how her identity and perspective have transformed since her accident, emphasizing acceptance and present-moment living.

Loss of the Former Self: She acknowledges the "raw grief of losing her [old self] has faded," but still misses "her physical strength, her raw determination and power to get stuff done, her agility and speed."

Evolved Perspective: "My metrics in life have changed. I no longer care much about the little things that used to bother me." She learned to "be less judgmental" and to "do what I want rather than what is expected."

Embracing Change and Present Moment: "I am unable to think or plan too far ahead; my plans are made a week in advance at most." She has learned that "the only things I have control over are myself, how I feel, and how I respond to life’s situations." The Buddha's Four Noble Truths resonate, advocating for relinquishing cravings and living each day as it comes.

Acceptance of Suffering: "By recognising that suffering is integral to our lives and that there are other benefits to pain, such as the cultivation of wisdom and compassion, we become more accepting of our suffering and suffering of others. And when we truly accept grief and sorrow as inevitable, we actually suffer less."
Redefining Identity: "As a wheelchair user, I am not worth less; my disability doesn’t define who I am and it is not a problem."

III. Important Ideas and Facts

Author's Injury: Spinal cord injury and paralysis from the chest downwards due to a cycling accident on October 31st, 2013.

Brain's Power: The human brain, "more complex than any other known structure in the universe," wields "immense power, enabling us to endure seemingly impossible situations."

Neurological Advancements: Lavelle finds hope in the case of Gert-Jan Oskam, a man paralysed in 2011, who could stand and walk with assistance after doctors implanted a "digital bridge" device that reads brainwaves and sends instructions to his spine. This system re-established communication between brain and spinal cord, allowing for "more natural movements than before because standing up and walking were initiated and controlled by thinking about the actions."

Hospital Overcrowding: The INMO Trolley Watch figures show "over 121,526 patients have gone without a bed in Irish hospitals in 2023," making it "the worst year for hospital overcrowding on record." Lavelle personally experienced waiting "six hours in an ambulance" and a further "16 hours on a trolley in the red zone of the Emergency Department."

Catheter-Associated UTIs (CAUTI): A frequent reality for SCI patients, these infections are a "major health concern" and contribute to antibiotic resistance.
Long-Term Care and HCBS: Home and Community-Based Services (HCBS) are crucial for independent living for people with disabilities but are severely underfunded in Ireland, leading to long waiting lists.

Personal Care Assistant (PA) Budget: Lavelle's struggle highlights the "massive burden on a small budget" for PA services, with a typical maximum of 14 hours per week, far below her needed 56 hours.

Disability Allowance Concerns: The Department of Social Protection's proposal to medically examine "a quarter of a million people" on Disability Allowance is criticized as "vile and repulsive" and potentially detrimental to mental health, drawing parallels to a failed UK policy.

UN Convention on the Rights of Persons with Disabilities: Ireland is a signatory, but its actions, particularly regarding institutionalisation and disability reform, are seen as falling short of its commitments.

Institutionalisation's Definition: Not just about size, but about the "regimented culture" that "deprive[s] residents of essential freedoms, segregate[s] them...suppress[es] individual choice and personal expression."

Coping Mechanisms: Denial can be a "protective barrier" but "long-term it’s not good." Cultivating "self-compassion and self-care" is essential.

The "Irish Grand": A cultural tendency to downplay suffering, saying "everything is 'grand'," which can "hide the soul crushing apathy that really lies beneath it."

Healing is Gradual: Lavelle emphasizes that "Healing is a gradual process...There is no magic solution and everyone’s process and timeline is not the same." She recently sought grief therapy, acknowledging the emotional toll she had previously suppressed.

IV. Conclusion

Geraldine Lavelle's "When the Apple is Ready, it Will Fall" is a powerful and candid narrative that goes beyond a personal story of overcoming disability. It is a critical examination of societal attitudes towards disability, the shortcomings of public services, and a profound philosophical inquiry into what it means to truly live. Her journey from paralysis and despair to a purposeful, independent life, despite ongoing battles, serves as a compelling call to action for greater empathy, understanding, and systemic change for people with disabilities. The book's core message is the immense, often untapped, power of the human spirit to adapt, find meaning, and flourish in the face of life's inevitable storms, temp