Saturday, December 17, 2011

Ross (part 1)

On Saturday, Dec. 10th, Ross Hiller was riding south on Lake Brandt Rd, near the intersection of Scalesville Rd and Lake Brandt Rd, and was struck from behind by an SUV.
The woman who hit him claims to have been temporarily blinded by the sun, which had also initiated a sneezing fit. She never saw him.
Ross was thrown up on the windshield and according to witness accounts, thrown 100 feet through the air... into a mailbox.
He was brought to Moses Cone Hospital with massive head trauma, fractured vertebrae, a broken ankle, a collapsed lung, as well as full body contusions and bruising. To be honest.... that he was in as good a condition as he was is nothing short of amazing. By rights, he should have been killed instantly.
He's having the staples taken out of his scalp today. When Neil and I visited recently, Neil noted that the area around the staples wasn't even shaved and the staples themselves seemed to have been placed right over the hair and everything.. to which the nurse replied, "they do that when they don't think a patient has a chance of making it."

Because he was hit from behind and never saw it coming, he was completely limp as he was thrown like a rag doll through the air. If he had tensed up.... he wouldn't be here right now.

When I saw Ross Saturday night, he was having seizures, his whole body shaking and tensing. He'd move his hand in a repetive movement over and over, but wouldn't react to any outside stimulus. The Doctor did some painful pokes which elicited a response and some hand squeezing, but whether that was just a reflex or indicative that Ross was anywhere in that shell was unknown. His wife Tanya was amazingly composed, considering. But you could tell how hard she was trying to keep it together. She'd give a detailed description of the most recent assessment and then she'd start to break down, "He looks so bad. Oh my god, he looks so bad...." Then she'd pull it together again.
The fractured vertebra were bad, but that wasn't the doctors' main concern. Ross had as least two spots of hemoraging on the brain. While his skull wasn't fractured, this was still very serious. With that kind of bleeding, there are exponential chances of some kind of lasting brain damage. Until Ross woke up and started responding to stimulus, there was no telling to what extent his brain was affected. His injury was the equivalent of "shaken baby syndrome" wherein the brain is slammed back and forth in it's casing, creating microtears that lead to bleeding and pressure. Never a good thing in a brain.
As much as we're starting to understand about neurology, the brain and how it functions and recovers from trauma like that is still relatively unknown, and the subject of countless studies. Sometimes entire neural pathways are rerouted and rewired. Sometimes memory banks are wiped clean. Sometimes dormant regions become active.
Essentially, it's possible for a person to undergo a complete personality change.
On the third day, Ross stopped the the rythmic twitching. During the assessment, the doctor asked him to squeeze his hand. Ross did. "Can you give me a thumbs up?"
Ross gave a thumbs up.
At which point everyone lost it. Ross was in there, but he still couldn't open his eyes or move much.
"Can you hear me?"
Ross nodded yes.
"Ross... do you know who I am?" asked his wife Tanya.
Ross shook his head no.
Starting to sob, Tanya said, "You don't?! Ross.. it's me, Tanya! Do you know who Tanya is?"
Ross nodded.
She squeezed his hand and he squeezed back.

At a point during the Q and A session, they told Ross that he'd been in a bike accident. For the first time that day Ross became extremely agitated. His heart rate and blood pressure went up and he began to flail.

The next day, Ross opened his eyes. It was an effort, and they kept rolling back in his head. But he looked around and saw where he was for the first time.
He answered some more questions, nodding and shaking his head. Then, for the first time, he tried to talk.  "It hurts," he mouthed around the tubes going into his throat. "I can't breathe."
And then... "I'm scared."
Every day and hour there's been some improvement, often coupled with a setback.
Ross's ankle, previously thought simply sprained, was definitely broken. And he was very swollen, all over his body... his cheeks protruding past his ears... his abdomen full of fluid....his feet and toes 3 times their usual size.
"Have you ever seen Ross's legs?" Tanya asked. I nodded. "They're tiny" I laughed.
"I'm going to take pictures of them now to show him," she joked. "He'll love knowing he had big legs at least once in his life."
Despite the progress of the day, that night was very hard for Ross and his family. As he pulled himself further and further into conciousness, his pain and discomfort also increased. His body was full of tubes: catheters, feeding tubes, breathing tubes. He'd been lying prone in the same position for three days, restrained to keep him from yanking at the tubes as he swam in and out of conciousness.
He was thrashing against the bed and getting increasingly agitated.
Tanya would have to hold his head and say "Ross. Listen to me honey. You can't do this. Do you want the tube out?" Nod yes. "Then you need to stop fighting it. You need to relax. I know it's hard, but you have to." And he would. But then he'd start to fight again, and she'd have to firmly tell him to stop, almost yelling at him.
But he was getting there. And once he was drawing enough breath on his own that the doctors weren't concerned, they took the tubes out. And they unbound his hands.
And Ross started coming out more and more.
When I visited him last night, he'd had an amazing day. Had been able to move out of the bed he'd been a prisoner in for the past 5 days... he sat in a chair.... even gotten a tray of solid food. He'd talked with people... joked with them. Recognized their faces.
But he was still out of it, and temporally disoriented. Once they got him talking, sometimes it wouldn't stop. And he might talk about what was happening... about how much his back was hurting and how he had to pee. But he would often say things like "Get it off!"
"Get what off, Ross? What do you need?"
"My helmet. It's hurting my head. Get it off... the straps are digging in to my neck."
or "My finger.... it hurts! My finger. It's stuck in the brake. Get it out."
or "Yes... 3,2,1. Yes. I can hear you..." ...Clearly having flashbacks of the accident, where they were asking him questions. Because by accounts, he was concious when they came up on him. And it wasn't until he was in the ambulance that he went out like a light.
When I stepped back into his room, I was nervous. I didn't know what was waiting on the other side of that curtain. There's nothing more disconcerting than when things aren't "right."
....When something is "wrong." That sounds nebulous and vague, but it's hard to explain.
It's like a missing a limb.... there's something wrong... a visual disconnect. Something missing... out of place.
Or when a person is out of their mind... and there's something in their eyes and in their movements that just isn't right. As if they weren't even in there.
I hadn't seen Ross awake yet. Everytime I stepped by he'd been unconcious or sleeping. And by the accounts I'd heard, I didn't know what to expect.
When I'd called to say I was on my way, Tanya was sitting next to Ross.
"Ross... Watts is on the phone. Do you know who Watts is?"
I heard a surprisingly strong voice say something. Tanya laughed.
"Did you hear that? He said.... 'the funny guy from Revolution.'"

Ross was out when Tommy and I came in... in what I hope was a blissful, painkiller induced slumber. But Tanya woke him up.
"Ross... can you hear me?"
Yes.. he nodded.
"Ross.. guess who's here. Who is that?"
Ross opened his eyes groggily. He turned to me for a moment, then turned back to her. "Jay," he said before lapsing back into sleep.
"No. It's not Jay. Who is that, Ross?"
Ross looked at me again... and despite the confusion... despite the drugs... despite everything, I could see in his eyes that he was there. That he wasn't out of it. That there was a person in there. That ROSS was in there.
"Watts," he said. "And Michael" he said, looking at her for confirmation as he referred to Tommy.
Then he passed out.
Again... despite whatever confusion he had... I could tell that this was Ross... and that some of that confusion was no different than the confusion one would feel if someone random but familiar ran into their room in the middle of the night, woke them up and immediately started asking, "Do you know who I am? Hurry. Do you know? Who am I? Where are you? What's the date?"
Ross has a long way to go. And there are still alot of unknowns about his condition. His progress thus far is extremely encouraging. But it might be that he has memory issues for a while to come. Or, as the nurse put it, have slight "personality differences." Meaning that while he's fundamentally the same Ross, there might be small but meaningful changes in his interests and behavior. His brain is healing, and as those pathways reconnect, there's no telling what happens.
Kevin Pearce, the snowboarding prodigy who suffered massive cranial trauma during a competition, awoke with an insatiable craving for basil pesto. What part of his brain was jostled to trigger that change?
And then... there's the possibility that there will be no changes. And that he just needs to heal, and the memory loss will go away and things will fall back into place.
Short term memory loss and no impulse control are two of the biggest symptoms of brain trauma. Ross is certainly showing both symptoms.
But at this point Ross is so far above and beyond the expectations, that everyone expects the best.

Here's Ross watching Star Wars with his son Spencer. (And now... a weak attempt at humor: The only good thing I can think of to come from a brain injury would be the ability to watch Star Wars for the first time again. I think Ross would agree.)

Hang in there, Ross. We're all thinking about you.

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