June 23, 2008
A Jackson family learns to navigate the long road back from a brain injury
By Susan Christensen
Health and Research News
“Your son has been hit by a car and critically injured.”
It was April 27, 2007, and the words coming over the phone line shook Leila Lane to the core. “I knew from the sound of her voice how very bad it was,” Leila said. “I asked: Is he alive?”
“He was when they brought him in,” replied the hospital social worker. “Let me go check.” Minutes later, Leila learned that her middle child was alive, but breathing with the help of machines. “Get here as soon as possible,” said the caller.
When Leila and Sam Lane Sr. finally reached Athens Regional Medical Center in Georgia, they didn’t dare contemplate the future – their brain-injured son had too fragile a hold on life. But as the recent anniversary of that evening approached, the Jackson couple was envisioning a better year ahead.
Today, 23-year-old Samuel Lane Jr. can celebrate a long list of hard-won achievements – a B average in a Millsaps College English course, a solo plane ride to Atlanta and a growing level of independence.
Much is the result of a rehab experience that his father describes as “all positive, all uplifting.”
“The good people at Methodist Rehabilitation Center in Jackson gave us hope,” Sam Sr. said. “And in an ordeal of this magnitude, hope is all you have.”
Defying the odds
A nationally recognized brain injury researcher, Dr. Stuart Yablon has tracked the progress of hundreds of patients like Samuel. Males between the ages of 15 and 29 top the list of brain injury victims. But even with the advantage of youth, not all have been as amazingly resilient as Samuel.
“It is extraordinary to see a patient who was minimally conscious at the time of rehabilitation admission being able to walk and participate in college classes at one-year post-injury,” said Dr. Yablon, medical director of the brain injury program at Methodist Rehab.
Samuel’s ability to defy expectations may have something to do with his knack for non-conformity. At the University of Georgia, the award-winning high school lineman became a bike-riding vegetarian on a campus better known for barbecue and pickup trucks.
“When he went to college, he said he didn’t want to play any more football,” said his mother. “He became a vegetarian and dropped 40 pounds. And instead of working out with weights, he got into bike riding and yoga.”
He also got into writing, and had recently gifted his family with a collection of his poems and essays – all written while on a hiking trip in Maine. But it remains to be seen whether Samuel will pen a first-person account of the last year.
“I don’t know how I would write about my five weeks in a coma,” he says with a grin. “Maybe I could just leave some pages blank.”
Like most traumatic brain injury survivors, Samuel doesn’t remember his accident. But his fellow bikers – who formed a protective wall around Samuel until help arrived – told his parents what happened.
A motorist (who was later indicted for driving under the influence) turned into Samuel’s path as the tall, slender red-head was pedaling to a group bike ride. The impact flipped Samuel so high that his feet touched overhead power lines. His unprotected head took the brunt of the blow when he crashed into the car’s windshield. “People across the street said they thought there was no way he could have lived,” said his mother.
Athens neurosurgeon Dr. Tim W. Phillips also doubted Sam could survive when he saw the widespread damage to his brain. “He had diffuse injury and diffuse hemorrhaging,” Dr. Phillips said. “It wasn’t something that could be treated surgically.”
Dr. Phillips inserted a special gauge inside Samuel’s skull to monitor the potentially deadly pressure building on his brain. ICU nurses closely watched the monitor so they could alert the surgeon to dangerous pressure on the brain stem – the area that controls breathing and heart rate. If that happened, part of Samuel’s skull would have to be removed to allow the brain room to expand.
Leigh Anne Landers, a charge nurse for the Neuro ICU at Athens Regional Medical Center, tried to be reassuring as the Lanes kept a worried vigil at Samuel’s bedside. “I said: Don’t look at the monitor numbers – that’s my job.” But the truth was, she was worried, too. “Looking at him those first few days, I thought his recovery would be a miracle,” she said. “But from one weekend to the next, he was like a different patient.”
“Boot camp” begins
On May 29, 2007, Samuel moved to Methodist Rehab. While the Lanes were happy to be closer to home, the demands of rehab were daunting.
“After being ‘spoiled’ in ICU for five weeks – where we didn’t have to do anything – I quickly realized we were in for a different experience in rehab,” said Sam Sr. “Not only is it boot camp for the patients, it’s also boot camp for the family learning to care for the patient.
“The first day … I was more afraid than I have ever been in my life. We were in the therapy room, and I looked around and saw the condition of many of the patients and realized this was also our life now. I asked one of the mothers there: ‘How do you handle the fear?’ ”
To this day, Sam doesn’t remember the answer. But the Lanes soon learned their own ways to cope. “You have to take one day at a time,” Leila said. “Once we made the decision to come to Methodist Rehab, I would focus each day on taking care of Samuel and try not to look much beyond that. I knew he was getting the best care in the world.”
Twice named a Traumatic Brain Injury Model System site, Methodist has a staff highly experienced in the science of rehabilitation. Just as importantly, it has a brain injury team whose compassion has been cultivated by countless hours in the company of distraught families. They know what to do when an overwhelmed parent hits the wall.
“That’s when we say: ‘We’ve got it. Go home and rest,’ ” said Susan Haseloff, a registered nurse for the brain injury program.
Families face a huge learning curve when they come to a rehab setting. And one of the hardest lessons is how to deal with a loved one who is being uncharacteristically uninhibited or combative – two early stage behaviors of brain injury victims.
“Samuel was swinging his fists and biting, and that is scary for parents,” said Arash Sepehri, a neuropsychology fellow at Methodist Rehab. “They think: This is not my child – he would never hurt me. We tell them it is normal to be restless or agitated early on. He will grow out of this phase.”
As Samuel progressed from one phase to another, his family celebrated each new triumph − his first unprovoked words (I’m a vegetarian), the ability to read and play games and the transition from wheelchair to cane.
Samuel walked out of Methodist Rehab’s Jackson hospital on July 27, 2007, but his therapy was far from over. He has since continued his progress at the center’s outpatient facilities.
“We tell patients that recovery can take one to two years, if not longer,” Sepehri said. “Acute rehab is just the first step in a staircase. Samuel still has a long way to climb.”
An uphill battle
On a recent spring afternoon, Samuel stood with a loaded backpack slung over his shoulders, hiking poles in his hands and the memory of better days on his mind.
He used to love climbing and “jumping off crazy rocks.” But on this day, he’s limited to a slow plod up a modest incline with a physical and occupational therapist at his elbows.
The exercise is part of his therapy at Quest, a Methodist outpatient program that serves as a sort of way station for brain injury survivors who are fighting the uphill battle to return to school, work or community life.
Quest occupational and physical therapists have devised a variety of therapeutic activities with Samuel’s interest in mind – including yoga, hiking and stationary bike riding. All are designed to improve the strength and range of motion in his partially paralyzed right arm and leg.
To help him handle the rigors of the classroom, Samuel also has worked with a Quest speech therapist to improve his memory, attention and organizational strategies.
When Samuel thinks of some of the things he can’t do, he experiences what he calls “negative energy,” said his mother. “He feels in a way he is missing out, but at the same time he is very thankful to be where he is.”
“It has been bad,” Samuel said, “but bad things happen. I’ll live with that and be at peace.”
Samuel has decided to enroll at the University of Mississippi in Oxford this fall. His sister, Mary Mills Ritchie, and her husband, Spencer, live nearby and can provide support.
Meanwhile, he and his family have been taking time to thank the people who played a role in Samuel’s recovery. Sam Sr. gave a glowing account of Samuel’s care at Methodist Rehab’s annual legislative luncheon, and he sent a letter of praise to the local newspaper.
The Lanes also penned a letter to the editor to commend the staff at Athens Regional Medical Center, and they even nominated Landers for a Georgia nursing award.
“It was very humbling that I meant so much to him,” Landers said. But even more touching was a recent visit from Samuel himself. “I cried,” Landers said. “To see him walk through the door was amazing. It just validates why I love my job.”
While all involved in Samuel’s care are appreciative of the Lanes’ gratitude, they say the family also deserves recognition for playing a monumental role in his recovery. “Family support is one of the biggest predictors of outcome,” Sepehri said. And Samuel was fortunate to have a family devoted to his well-being.
“It was exhausting for them, but I told them when you look back, you’ll realize how strong you were,” Landers said.
For Sam Lane Sr., right, time with son Samuel is something he will never again take for granted.