It was a still, steamy morning in January, and Bloom had a pineapple juice she wanted to drink while overlooking Ban Krut beach, where she had arrived the previous day, on holiday with her husband Cameron and their three young sons, Rueben, Noah and Oliver.

Once at the top, Bloom, who is 41, leaned against what appeared to be a secure metal railing. But the railing gave way and Bloom fell backwards, landing on the tiles about 5 metres below, snapping her back like kindling.

"There was no noise, no scream, no nothing," Cameron says. "One of our sons saw her feet going over, and that was it. Then there was the clanging of the metal railing landing below."

Cameron rushed down to find Sam lying on her back, struggling to breathe. She was bleeding heavily from her head and her eyes had rolled back; she had also bitten through her tongue, and her jaw had locked shut. "Get an ambulance!" Cameron screamed. Oliver, their seven-year-old son, began vomiting, "probably from shock," says Cameron, "although it could have been from the chicken soup we had at breakfast."

When Cameron rolled Sam onto her side, into the recovery position, he noticed a large round lump, the size of an orange, just to the side of Sam's spine. "That's when I realised that she'd broken her back."

Bloom is one of roughly 1200 Australians who get hospitalised every year while travelling overseas. For most of us, this is just another statistic, numbers leached of meaning, or worse, confirmation of a carelessness that Foreign Minister Bob Carr recently referenced, telling journalists "We can't be your nanny when you come abroad."

But the Blooms were in no way to blame. (The hotel admitted the railing was faulty and paid a small amount in compensation.) Sam's misfortune was brief and devastating, a random, life-changing moment, the ramifications of which she and her family still wrestle with. "I was so angry at myself," she says. "It just seemed so stupid, so bizarre, something I never ever thought would happen."

At the time, however, it was all Cameron could do to get Sam back to Sydney alive. Aside from her spinal injury, her lung had collapsed, and she had bleeding on the brain. After two hours in the tiny hospital in Bang Saphan, Sam was loaded into an ambulance, with the three boys in the front seat, and driven at 160km/h to Hua Hin Hospital, three hours away. When she came around, Sam took the opportunity to swear, loudly and frequently. At Hua Hin, Cameron was faced with a terrible decision: whether to have Sam's spine operated on there or, at the insurance company's request, move her to Bangkok, risking further injury. He chose Hua Hin. Surgeons inserted two titanium rods in Sam's spine to stabilise the fracture. But they were cagey about her prognosis.

It wasn't until Sam got back to Sydney - the flight, as well as all medical expenses in Thailand, was covered by credit card insurance - that she finally found out her fate. "It was when I came to Royal North Shore, the second day here, the surgeon came in and said to me: 'You're never going to walk again.' That didn't go down too well.''

Sam, who is a former nurse, is still in hospital, dealing with complications from her injury, such as an intractable pressure sore. She and Cameron oscillate between fits of bitter regret and steely good humour. When Sam's pressure sore was operated on on Valentine's Day, she texted Cameron: "Just had 1.5cm hole scraped out of my bum." He texted back: "That's not as deep as my love."

"He's so romantic!" Sam tells me from her hospital bed.

She has movement in her arms, but can feel nothing, she says, "from the boobs down". "I used to go surfing, shopping, bushwalking with the boys. How will I do that again?" she says. "At first I thought that it would have been better if I'd died, but now I have just accepted it, that this is how it is."

Besides, she says, "in many ways I'm lucky. I could have broken my neck. This way I can still hug the boys; I can still touch them, and feel them. That's a huge thing."