Josh Moore: 'A nurse came out and told us there was nothing more they could do'

Jamie Moore announced he had been forced to retire from race-riding on medical advice this week. His brother Josh had to make a similarly enforced decision in 2022 after a spell in critical care with fat embolism syndrome, a rare condition which developed when he was being treated for injuries following a horror fall at Haydock. Lee Mottershead had the first interview with a man lucky to be alive, which was first published exclusively for Racing Post Members' Club subscribers in September 2022.

Members' Club Ultimate subscribers have access to fantastic features like this and daily insight from our award-winning team of journalists, writers and tipsters.

Racing Post Members' Club is the ultimate racing subscription and you can subscribe with 50% off your first three months with code WELCOME2024.

By subscribing, you'll unlock exclusive daily emails, premium tips, unlimited access to the digital newspaper and much more. Renews at full price and terms apply.

At some point, Josh Moore's luck finally had to change. The fact he is still alive suggests it most likely did.

Earlier this summer it would have been impossible to believe the youngest of four famous racing siblings could now be playing in the garden with son Freddie. The two-year-old moves his attention between a sandpit and his new scooter, occasionally addressing the smiling man next to him as "Da-Da". There are times when he also calls him "Josh", the result of people having spent a wretched chunk of the year talking about, not with, his father.

For the moment, Freddie remains blissfully unaware of recent dramas. In time, he will learn how one of the weighing room's most popular members came perilously close to death but somehow defied medical prognosis to make a miraculous recovery. It is a truly extraordinary story. Freddie's father is about to hear it from the mother of his child.

Josh Moore, Phoebe Cruse and their son FreddieCredit: Edward Whitaker

It is not the first time Moore has been reacquainted with a period that is missing from his mind. Generally, he has been all too aware of the misfortune that has so regularly struck him, not least during a stint in a Brighton hospital last October when forced to wait over a week for spinal surgery. He recovered, as he has so often recovered, and in February landed the National Spirit Hurdle aboard Botox Has, the horse whose owners' silks he was cut out of following the October crash at Plumpton.

Like Botox Has, Gleno is trained by Moore's father Gary, who was born with a racing heritage that has been passed on to his four children Ryan, Jamie, Hayley and Josh. On Saturday, April 16, Ryan was riding at Newbury while Jamie was in action at Newton Abbot. Josh went to Haydock and teamed up with Gleno in a veterans' chase. Their fall at the sixth fence looked bad. It turned out to be one far worse than even Moore had experienced.

Josh Moore shows the scar following surgery on his back in November 2021Credit: Edward Whitaker

Phoebe Cruse was watching with Freddie at their home near Horsham, just a mile from the Moores' Cisswood Racing Stables. The following morning she spoke to her partner from his bed at Aintree University Hospital. The voice she heard was weak but understandably so, for as well as sustaining a broken femur, there was also a further possible back fracture, broken ribs and punctured lung. As Cruse had to care for the couple's young child, Moore's mother Jayne travelled to Liverpool. Cruse would soon be heading in the same direction.

"I feel good now," says the 30-year-old Moore as we chat around a table in the garden. He points out he is not yet "speaking properly", and the words do come out of his mouth a little slowly, but that is to be expected.

Moore came close to meeting his maker having developed fat embolism syndrome, a rare condition in which a serious fracture leads to the bloodstream being invaded by fat globules that thereafter cause damage to vital organs. The voice tends to be the last thing to come good, one of the nuggets unearthed by Moore's remarkable but unassuming mother, who became convinced her son was suffering from the syndrome and informed often sceptical medics he would get better. The young man sat with a coffee at the other end of the table is evidence she was right.

Yet when Jayne Moore arrived at the hospital on the Sunday after the fall, the signs were not promising. When about to be anaesthetised prior to surgery on his leg, a visibly confused Moore was unable to answer simple questions. He was placed in an induced coma, immobilised and transferred to the hospital's critical care wing, his situation subsequently made worse by pneumonia.

"You can't prepare yourself for the things you see when you walk into critical care," says Cruse, who had left Freddie with her mother and joined Jayne at the hospital on the Monday. "There were wires and tubes everywhere. They completely took over Josh's body, with machines doing all the work for him. I didn't know what to think."

Phoebe Cruse watches on as partner Josh Moore discusses his most serious injuryCredit: Edward Whitaker

There were many desperate moments in the weeks that followed. The most frightening came in the early hours of the first Wednesday. Moore's life hung in the balance.

"The phone rang at two o'clock in the morning," says Cruse, 27. "They said Josh had deteriorated and we needed to get down there now. Jayne and I were sharing a room in a hospital hostel. We shot out of bed and ran. A nurse came out, told us Josh was now requiring the maximum possible amount of oxygen and that there was nothing more they could do."

One thing they could do and needed to do was turn the patient. As a result of an unstable back fracture, Moore was having to be kept flat on his back, yet that meant his lungs were being crushed. "It took two doctors and four nurses to lift and roll him on to his front," says Cruse. "They really didn't want to move him but it was a case of saving Josh's life and worrying about paralysis later."

At this point, it seems right to check Moore is happy being present.

"I'm fine about it," he makes clear. "The first time I was told what they had to deal with was horrible, but I don't mind listening to it because it did all happen and I know things are okay. What makes it a bit weird is I wasn't aware of anything that occurred."

He also had no knowledge that seven days on from his fall the mood at Sandown's jumps finale was sombre. People feared the worst. At the hospital, Moore's partner and mother waited and hoped. Jayne Moore continued to manage the training business from afar but also read voraciously about fat embolism syndrome, something first mentioned to her by one of the Aintree surgeons. She managed to contact an expert every day, increasing her understanding of the condition and strengthening her conviction it was the principal cause of her son's predicament.

Botox Has and Josh Moore on their way to winning the National Spirit Hurdle at FontwellCredit: Steve Davies

"Jayne was so strong," says Cruse. "She dealt with the whole thing amazingly. She had done some research and discovered fat embolism attacks the heart, lungs and brain, but that if it doesn't kill you in the beginning, you should be okay. She was certain Josh was going to get better and that we had to keep positive.

"Compared to Jayne, I was a mess. There were times when I felt really awful. I wasn't supposed to, but I slept next to Josh for two nights. It was the only place I wanted to be."

Cruse had been sleeping with a man still in an induced coma. After the completion of spinal surgery – in which Moore's existing metalwork was removed, extended and then reinserted – doctors attempted to bring him out of his sedation.

"His eyes were open but he wasn't responding to anything," says Cruse. She began to see him moving different parts of his body but there was no response to commands.

"I was there but nobody was home," says Moore. He laughs but at the time was so lost to the world that doctors ordered an MRI scan, informing the family brain damage was likely. The scan took place during Chester's May festival. 

"It showed significant changes to both sides of his brain," says Cruse. "We were told it was hypoxia, a lack of oxygen to the brain that kills the cells. Ryan and Hayley came halfway through our meeting with the consultant, by which point a doctor had taken me to one side because I had basically passed out. It was horrendous."

Gary, Josh and Jamie Moore go through the horse roster at Cisswood Racing StablesCredit: Mark Cranham

Jayne Moore was far from convinced the analysis given to the family was correct.

"She kept butting in and asking if it could be fat embolism that had gone to the brain," remembers Cruse. Her child's grandmother wanted to know if the doctors could be certain it was hypoxia. She was told they could not. She asked if they could therefore rule out fat embolism? Again, they could not. "Right, then," she said. "I'm going with fat embolism."

Speaking now, Jayne Moore adds: "To me, all the signs were there, and it has worked out well. When you are told something by a doctor you tend to believe them, but it's sometimes good to get another opinion – and I say that with no disrespect to anyone who looked after Josh. I'm full of admiration for the critical care team at Aintree. I can never thank them enough."

It was while at Aintree the first clear signs of progress appeared, including on a day when Moore's sister was deputising for their mother at the hospital.

"I was playing videos to Josh of Freddie running around the garden," says Cruse. "I could see him watching them. We then got sent out so they could roll and wash Josh. Suddenly, one of the nurses shouted to us that Josh had moved his arm on command. Hayley and I went mad with excitement.

"Another doctor came round a few days later and admitted to Jayne they couldn't tell the difference between hypoxia and fat embolism. That made us realise we might just be waiting for the fat on the brain to break down."

When visited by Jamie, the two brothers fist-pumped. It was a symbol of the significant progress made during Moore's final week in Merseyside, from where he was moved to the Princess Royal Hospital in Haywards Heath, much closer to home. During two weeks there he began receiving physiotherapy, but following a recommendation from BHA chief medical adviser Dr Jerry Hill, there was another relocation, this time to London's Wellington Hospital for brain rehabilitation work.

"It was the start of another journey," says Cruse. "Josh's rapid improvement there took place over a matter of days. He started to do everything on command. He seemed to know where he was, who he was and who we all were, something that before then had been a worry."

He was not, however, talking.

"I remember not being able to communicate but not understanding why," says Moore. "It made me feel a bit ignorant. I was able to take in everything people were saying but I couldn't say anything back to them. I think the problem was that because I had so many tubes in my mouth for so long, the muscles went dead on me."

Numerous attempts to produce words failed, leaving Moore frustrated and reliant on a whiteboard. Singing therapy did no good – "Mate, you're wasting your time," was his whiteboard-written reaction – but when a speech therapist suggested whispering, a sound emerged. 

"Josh called me on FaceTime," says Cruse. "It wasn't a strong voice, and it was very breathy, but it was still surreal. It was like the weight had been lifted off my shoulders."

Josh Moore: 'I wanted to know if it was something I had done wrong'Credit: Edward Whitaker

He could once again talk and he could soon once again eat, albeit only initially a pureed shepherd's pie, the first meal on the road back to regaining the lost two stone that had reduced his weight to 8st 3lb. Moore also became curious. He had no memories of anything associated with the Haydock fall. That would soon change.

"I couldn't believe it when Phoebe told me the horse had been Gleno," he says of the unscathed ten-year-old whose fall he then watched repeatedly on his phone. "I was intrigued as to how he made the mistake," explains Moore. "I wanted to know if it was something I had done wrong. When I watched it back, I could see it wasn't my fault."

Nor did he merit blame for catching Covid. There were no symptoms but it delayed his return home by one final week. Given all that had gone before, a July 8 discharge was still remarkable.

"Everything was slow, slow, slow, then, all of a sudden, he was coming home," says Cruse. "It almost feels now as though it didn't happen. Normality is back but I still think about it every day. There are a lot of what might have beens."

There was a stage when she felt she would need to become Moore's carer. In the hours after she and Jayne Moore were woken at 2am, Cruse faced a prospect even bleaker.

"I thought I was going to lose him," she admits. "I'll never forget that phone call." She then repeats the words said to her at the time. "Josh has deteriorated, you need to get here now," says Cruse, before switching her focus to Freddie's father. "That was the night me and your mum thought it was very serious," she says. "We thought you might not make it."

Moore has made it to the extent he is now back in the yard each morning with Cruse, who has returned to riding out two lots a day having spent three months feeling completely unwilling to sit on a horse. 

"I resented racing for a long time," she says. "Even now, when I walk into the lounge and see Josh watching racing, I think, 'What does he want to do that for?'.

"He hasn't ever really been emotional about this. Jayne and I lived it for months. It was emotional for us, but for a long time Josh wasn't aware of anything. In a way, he doesn't have any effects from it all, except for having to recover from a broken leg and back, which is normal for Josh – but not in the future."

The greatest joy in this story is Moore has a future.

Josh Moore, pictured at his father's Cisswood Racing Stables in November 2021Credit: Edward Whitaker

"I would love to ride on the Flat but 8st 3lb is a long way behind me," he says with a smile, not yet ready to formally announce his retirement but surely accepting the reality he will not return to being a jockey. He has, though, returned to a racecourse, visiting Goodwood last week.

"The best thing was seeing the doctor Lucy Free," he says. "She wrote to me every week when I was in hospital. She's a brilliant person and I've known her for years. I've dealt with Lucy a lot." 

We both laugh, knowing the joke barely hidden in that last sentence.

"Obviously I'm gutted at the amount of injuries I've had," says Moore, looking back at a career that yielded 269 jumps wins, including a 2015 Grade 1 triumph for his father on the ill-fated Ar Mad. 

"A lot of the lads get lucky with their falls and some have never even broken a bone," he says. "I've lost count of how many I've done. I think I've had five shoulder operations over the years. That alone should have been enough to tell me not to carry on, but I've always felt I could do the job quite well. I like to think I don't muck up too often – although when you think about the amount of injuries I've had, I must do something wrong! 

"Back in October, when I did my back, I did realise I probably couldn't be doing this for much longer. Typically, I then got an even worse fall that had consequences. The thing is, I enjoy riding horses. I enjoy racing them even more. It's hard to let it go."

Let it go he must, but in the future Moore will almost certainly take over from his father at Cisswood, where he has for some time been an invaluable part of the operation. "He's going to be an amazing trainer," says his mother. She has a proven track record of being right about thing

"I've learned that the human body is incredible," says Moore, whose latest MRI scan showed only two small areas of fat on the brain are yet to break down.

"I feel very lucky. That's the only thing I can feel. There's no good being angry or bitter. A lot of jockeys haven't been so fortunate. When something like this happens and you can still carry on doing everything as a normal person, I do think you're lucky.

"I've had so many letters from people, even from a church in Ireland. They said they had prayed for me twice a day. I guess someone's prayers were answered."

While the person at the centre of so many prayers and good wishes was at Aintree University Hospital, there was a note above his bed. It provided hope and sustenance to those who love him. Simply but significantly, the note said the goal was to get him back home to his family.

Josh Moore, a young man loved and admired throughout racing, is indeed now home, back from the brink and with so much ahead of him. 

Following a career packed with injuries, this, at last, was his first decent break.

More Sunday Reads:

Sean Bowen: 'I'm useless at everything else bar riding horses - it drives my partner mad!' 

Luca Morgan: 'I thought, 'What the hell am I doing?' I was burning myself alive to lose weight and it wasn't even working’ 

Venetia Williams: 'The first time you almost stumble upon it, and when you strive for it again, that’s the difficult part' 

Colin Tizzard: 'I had to have five pints before I could ask a girl to dance!' 

Patrick Mullins: we came, we saw, we left with our tails between our legs - but I've never seen anything quite like it 

Harry Cobden: 'I came home that night and half thought, right, I've had enough of this - but that's a coward's thing to do' 

Sign up to receive On The Nose, our essential daily newsletter, from the Racing Post. Your unmissable morning feed, direct to your email inbox every morning.