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The Day My Son Cracked His Skull

May 1, 2018

At this very moment, my oldest son is sitting in an exam hall, taking an admissions exam for high school. He is 100% whole and healthy, and for that, we will be eternally grateful.

But that wasn’t the case three months ago.

A little over three months ago, I was doing the frantic mom thing we all do when out-of-town family is coming to stay for a visit. Making sure the house is clean, putting fresh towels out in the upstairs bathroom, prepping appetizers and food that can be out as soon as they arrive, but won’t be cold if there are travel delays. Hounding the kids to make sure their shoes aren’t in the middle of the foyer and their dirty clothes have been picked up off of their floors. Basically, being a shrill nag to everyone in the household and letting the tiny little things that truly don’t matter take over your more rational self who should just be looking forward to the visit.

At one point, I was in my son’s bedroom, at that moment when all of the details of being my household’s sole cooking, cleaning, laundry and organizing service got the best of me.

“This is DISGUSTING!! I don’t know how you live like this! Aren’t you disgusted by living in a sh*thole like this? Well??? Aren’t you???!!!!” I shrieked at my 13-year-old son.

While my family knows me well enough to know that I get stressed before company comes over, this was a new low for me. Cursing and banshee screeching. Not helping, not encouraging, just totally berating. That was me. I hauled a load of dirty laundry I had scraped up off of my son’s floor into a laundry basket and left him to clean up the rest. My younger son was staying out of the way and my daughter was playing at a neighbor’s house. My husband was outside blowing leaves off the patio. No one wanted to be around me.

My oldest son and I were both still steaming mad at each other when he slammed the door a half-hour later to go skateboarding with his friend. I continued to prepare for my in-laws visit, who were expected within the next hour or two to stay for the weekend. I muttered under my breath about having zero help as I cleaned and chopped veggies for a crudite’ platter. Eventually, my blood pressure returned to normal and I regained my sanity enough to realize everything was fine and as prepared as it needed to be.

It was around this moment that I heard a knock on our door. Thinking it might be my in-laws arriving early, I answered with a smile on my face.

It was my neighbor from around the corner.

“Stace — your oldest. Robbie? He’s really hurt. He’s down — in the street across from my house. I don’t know what happened, but I think he’s really hurt.”

I bolted out the front door, barefoot, as my neighbor apologized for still being in her slippers as she was getting ready for a party, too. My mind ping-ponged from thinking, “Oh, he’s probably fine and this will be nothing. Kids fall; it’s fine.” to “Uh, oh, if he’s down, this could be bad. Please don’t let it be bad.” Back and forth. I think I feared a broken bone at the worst, a road-rash scrape-up at best.

I rounded the corner and saw him, sitting up, trying not to cry, but obviously hurt.

“Robbie, are you okay? What happened? What’s hurt?” I blurted out, rapid-fire.

He had scrapes on his forehead, hands and left knee that I could see right away. He was holding his left elbow with his right hand.

“Uhm, I was skateboarding… and hit a rock and… fell, I think… I’m not sure. My arm hurts.” His hands and voice were shaky, but he seemed okay.

“Do you know where you are?” I asked, making sure his head was okay after seeing the scrape on his forehead.

“I fell… on Salem… with Logan, and I fell,” he said, unsure, with effort.

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“No, Robbie, you’re on the Fellsway, and you were with Thomas. Do you remember? Do you know where Thomas is?” I asked him as I got up on my knees to check his head more closely.

I was relieved to see that his head wasn’t bleeding. I parted his hair to check for any signs of head injury, not really knowing what I was looking for. All I saw were a few tiny little red dots that I chalked up to road rash.

My son wasn’t wearing his helmet.

He repeated his complaints about his arm really hurting and said he couldn’t move his elbow. By this time, my husband had pulled up in the car in case Robbie wasn’t able to walk home.

A few questions and comments back and forth between my husband and I, and we determined that, between his arm and his confusion over where he was (he is not the type of kid to mistake a street name or the name of a friend), we wanted to take him to the ER. I ran back to grab my sneakers while my husband loaded our son into the backseat so he could lie down, if needed.

I buckled in and pulled out of our neighborhood, headed to the nearest hospital, which thankfully is only 10 minutes away from our house. My husband went back to make sure the oven was turned off, our other kids were situated, and the dog was inside, then he would meet us in the ER later.

When I checked in with the ER nurse, I told her he fell, while not wearing a helmet and we needed him to be seen for a possible broken elbow and possible concussion. Those were two biggest concerns I had for him, based on his complaints. She entered his info into her computer and we sat down to wait.

As we waited, my son started getting more confused and my concern became less about his arm and more about his head. When I asked him where the pain hurt the most, he kept saying his arm, but sentences weren’t clear. I asked him to point where his arm hurt and his hand went to his head.

My husband walked in at that moment and I told him Robbie was getting more and more confused. He went right up to the triage nurse’s station and told him they needed to take a closer look at Robbie immediately.

The wonderful triage nurse asked Robbie only two brief questions, looked in his eyes with her pen light, and instantly got on the phone, ordering an emergency pediatric CT scan for a level two concussion. In a matter of about 30 seconds, our visit went from worried to downright scary.

In that triage nurse at Overlook Hospital, we met the first of many angels we would encounter that day.

We followed Robbie, now on a rolling gurney, up for his CT. They got him immediately in, despite others who were obviously waiting. As we stood outside in the hallway, my husband and I could see into the room outside of the CT unit where the computer monitor was. I was watching my son in the machine when my husband, a former first-responder, glanced at the monitor and said, “It’s not good.”

I looked at him, then to the monitor and my husband pointed out the gray blob on the image of our son’s brain, which shouldn’t be there.

“It’s a bleed,” he said.

Robbie came out of the CT and just wanted to lie down and fall asleep. In a blur that I can’t quite remember, we were walked out of CT and into an emergency treatment room. We met Dr. Chang, the ER doctor on duty, who briefly greeted us and asked a few questions, then got busy snapping orders at surrounding nurses and other personnel.

My first impression of Dr. Chang wasn’t favorable. He was so busy barking commands at people that I wasn’t getting any information. Little did I know that Dr. Chang was the second angel in that hospital who helped to save my son’s life.

All Robbie wanted to do was sleep. He kept saying, “It hurts…my head…hurts,” and kept trying to close his eyes to go to sleep. In an effort to keep him awake, I kept talking to him, asking him questions. The confusion was getting worse.

“Robbie, you need to stay awake, kiddo. Let me see your eyes. What color are your eyes?”

“Orange.”

“No, they’re brown. You have beautiful brown eyes, Robbie, and I need to see them. They were reading this morning, remember? What were you reading?”

“Math.”

“Okay, you were doing math homework. Can you remember what your homework was?”

“Vocabulary.”

“Robbie, you’re going to be okay. Just stay awake, babe, just stay awake. Do you know where you are?”

“Here.”

“Where is here? What town are we in?”

“Charlotte.”

None of his answers made any sense. The pressure of the blood on his brain was affecting his memory and his speech.

By now, our son was hooked up to monitors and had an IV port put in. He kept trying to pull the leads off of his chest so he could curl up to sleep. The heart monitors kept going off. Nurses kept having to come in and hold him down to reattach lines. He pushed away grown men who were trying to help monitor him. He wasn’t speaking anymore, just thrashing and trying to get people to stop poking and prodding him so he could sleep.

Then he lost consciousness.

At some point, we were ushered out of Robbie’s room as machines and more medical professionals were brought in. We tried to watch our son and listen in, my husband on one side of the open door, me on the other, the traffic of people coming in and out in a blur between us. We caught words and phrases like, “heart rate dropping,” “need to protect the airway,” “life support,” and, “intubation.”

I looked across the doorway to my husband, both of us just standing there, helpless. I looked to him and he looked at me, each of us silently beseeching the other for words of hope, support or optimism. Neither of us had anything for the other.

I remember feeling so lost, so hopeless, so bereft of any comprehension as I stood there. I turned my back to the doorway, leaned against the wall, folded my hands, dropped my head, closed my eyes and began to pray.

I prayed, “Dear God, that’s my SON. Please come. Please be here. Please save him. Bless him. Save him. You have to save him. You have to save him.”

My prayers were not eloquent. They were not focused. They were not rooted in scripture. They were desperate. I was desperate.

I don’t know how long I stood there with my eyes closed, but when I opened them, my husband was standing in front of me with a nurse, offering me a folding chair. I started pacing back and forth outside Robbie’s doorway.

In his room, Dr. Chang was calling out to the nurses’ station while on his own phone. They all were searching for a pediatric neurosurgeon for an emergency operation.

My neighbor, another angel in this whole ordeal, was texting me, asking how Robbie was. She is herself a nurse and a nursing professor, working on her PhD. She is also the mom of Robbie’s friend who had been skateboarding with Robbie before the accident.

I texted her, giving her updates when I could get information. She gave me the name of a pediatric neurosurgeon who works in that hospital. I called the nameshe gave me into the nurses’ station, trying to help expedite things, just needing to try to DO something.

A nurse then told us we could go in and sit with Robbie and talk to him, that he could probably still hear us, even though he was unconscious. This angel cleared a way through the dozen or so people in that tiny room, surrounding his bed.

I can’t remember what I said to him in those moments. I only remember holding his hand and looking at him. The intent gaze of a parent, not all that different from the kind of enchanted staring we all do as we watch our sleeping infants, attempting to memorize every facial feature, marveling at this amazing creature. My baby was 13 and his slumber wasn’t natural; his features were masked by breathing tubes and tape, but I held his hand and I stared at him, afraid of what might happen if I looked away, even for a second.

The flurry of activity shifted at some point. Time has a way of simultaneously stretching into seemingly endless intervals while passing by in a dizzying blur. They were moving Robbie again. He was going into emergency surgery.

We had spoken again to Dr. Chang, as well as another nurse, who introduced himself as part of the neurosurgeon’s team. He explained that they were going to take Robbie into an operating room to try to drain excess blood and see the extent of his injuries.

As we were talking to this male surgical nurse, they rolled Robbie past us, out the room and through the double doors down a hallway. Another nurse encouraged us to follow.

“You should be up there with him. To say good-bye.”

I know this was an inadvertent slip of the tongue and that she meant that we should say good-bye before his surgery, but the shock of her words along with the unknown outcome of his surgery rocked me. I wasn’t ready to say good-bye to my son.

Robbie was rolled into surgery and we were led to the OR waiting room. My husband and I both made phone calls to our parents and to the people watching our other kids at home. We didn’t have much to update since we didn’t know the extent of his injuries, even now. All we knew was that our son was on life support and undergoing an emergency craniotomy.

I had wandered into a small room with its own door to make my phone calls. Once I hung up, I fell to my knees in that tiny room and prayed again. I can’t remember what I prayed or how I prayed. I only remember the act. With my elbows on a chair, my folded hands propping up my head, I knelt and I prayed harder that I have ever prayed before.

It was then that the tears finally came.

I’m not sure why I hadn’t cried before that moment, on my knees in that little room. My husband came in behind me and closed the door. He put his hand on my shoulder and we both cried. Tears of worry. Tears of fear. Tears of pain. Tears of incomprehension, desperation, and helplessness. Hot, stinging tears filling up my eyes and spilling down my cheeks.

Pulling ourselves together, we walked back into the main waiting room, not wanting to miss any updates coming from surgery. We each texted more family members, letting them know what happened and to please pray for Robbie.

I can’t tell you how long we waited. It felt like an eternity plus an eon, with a measure of infinity tacked on to the end. The neuro nurse finally came in to tell us that surgery was going well. Robbie’s vitals were holding up and the draining was taking place. He told us it was an epidural hematoma and a skull fracture, and described the surgical procedure.

He explained how they cut out a circular section of my son’s skull (he called it a “puck”) to remove the blood that putting pressure on his brain, causing it to shut down. He told us that the craniotomy was going well and hoped they would be finished soon. Frantic for information about HIM, about Robbie, I asked this angel, who would return to the OR and my son’s open skull, if that meant he would be okay. The nurse responded that we’d know how he fared once he woke up.

He didn’t tell us when that would be.

The next visit to the OR waiting room was the nurse telling us that they were closing up and surgery was completed. He told us that two surgeons were working on him: Dr. Baskin, the adult neurosurgeon who started the procedure, and Dr. Tomycz, the pediatric neurosurgeon who was paged from Morristown. My brief panic was calmed when he explained it was just to transfer Robbie’s care to the right doctor for follow-up. Two surgeons, two more angels who saved my son’s life, weren’t necessary for any reason other than precaution.

We were directed to wait upstairs outside the ICU for him to be wheeled up.

The ICU waiting room was overflowing with people. My husband and I couldn’t take the noise, the heat and the congestion in the room, so we stood outside of the elevators, waiting for him to be brought up. While pacing the hallway, I saw a door marked “Chapel” and went inside.

Once more, I knelt in prayer for my son’s life, for his quality of life. I was relieved that he made it through surgery and that he was no longer in danger. But I wondered what version of Robbie we would get back. Would he still be the same bright, clever kid who doesn’t talk a whole lot, but has a great dry, witty sense of humor when he does? Would he have the same shy smile when he discovers that you’re watching him? Would he retain his ability to move, to walk, to speak? Would he have all of his memories? Would he remember us? Would he know how much we love him? Will his life be filled with hurdles and obstacles and hardship?

“Lord, please give us back our Robbie. Our WHOLE Robbie. Please let him be okay.”

I stood up and rejoined my husband in the hallway. We took in the art hanging in that hallway while we waited. Finally, we were invited into the ICU to be with Robbie.

He was still intubated with the ventilator breathing for him. The rhythmic whir of machines, IV tubes and electrical monitoring leads were filling my senses and blocking a clear route for me to find  his hand to hold. I reached out and realized that they had restraining straps around his wrists, holding his hands to the side of the gurney.

“Were these to keep him immobile during surgery?” I asked a nurse standing nearby, marking down information on his chart. Another on the angel team.

“No. He started to come out of sedation too soon and tried to pull out his breathing tube on the way up, so we had to restrain him.”

I looked at my son, at 13, so lanky that he looked sickly on the gurney. His height taking up most of the length, but having no girth to fill the width of the bed. No color in his cheeks and no movement in his body made him look so lifeless, so strange, so foreign to me.

We were told we were waiting for an ambulance to come get him to take him from Overlook to Morristown to the Goryeb Children’s Hospital, where they have a Pediatric Intensive Care Unit, better equipped to handle him and our family.

A team of three men and a woman came up in their blue EMS jackets to move Robbie to the ambulance. Ron and I stood out of the way as they lifted Robbie from the hospital bed to the mobile gurney.

I had almost forgotten about what the nurse said about Robbie’s wrist restraints until he suddenly SAT UP on the gurney, arms flailing, thrashing and pushing grown men away from the bed as he tried to fight all of the equipment. Acting in a blur, a team of nurses, EMS techs, doctors and other staff converged on Robbie, increasing his sedation and using physical FORCE to push him back in his bed and restrain his arms again.

“Your son is STRONG,” said one of the EMS guys, a young twenty-something angel, taller than I am and in excellent physical shape. He saw how shaken we were from watching that episode and assured us that it was a good sign that Robbie that would be okay.

They boarded Robbie into the ambulance and allowed me to ride shotgun, while my husband drove up behind us in one of our cars so we would have a way home. Throughout the ride, the techs relayed information to me about Robbie’s care, letting me know that they were carefully watching his heart rate. He needed the sedation to keep him from thrashing and fighting the breathing tube, but too much sedation would slow his heart too much. Too little and he would wake up, possibly jarring his skull. The whole ride was a tenuous back and forth of heart rate versus sedation.

Some time later, we were settled in a room in the PICU and met Jessica, the wonderful angel nurse who would journey with us through the rest of this awful night.

Jessica explained that we would know how Robbie fared as soon as he woke up, but that it might be a while before that happened. First, he would need to stabilize enough to come off of sedation. Then we would need to keep him calm enough to keep the breathing tube in until he could breathe on his own. Then, maybe, he’d be able to speak and we would know more about the state of his brain.

The doctor came in and introduced himself to us, further explaining the process, and gave permission to take him off sedation. After seeing him react so violently in the ICU at Overlook, we anticipated a quick waking once sedation wore off. Like most parenthood experiences, though, Robbie decided to give us the opposite of what we expected and took his sweet time waking up.

He had quick bouts of wakefulness, where he would start and thrash, and we’d have to jump to grab his arms to keep him from tearing out his ventilator. Then, we’d look into his eyes and explain that he had a tube in his throat to help him breathe and that it needed to stay there, that he had had a bad accident and hurt his head. As soon as any hint of recognition or understanding passed through his eyes, he’d close them again and fall back asleep.

This process of violent waking and a rush to restrain and explain repeated on and off for about two more hours.

At some point in the dark hours between midnight and morning, Robbie finally came fully out of sedation and returned to wakefulness long enough for us to communicate what had happened. He was able to nod his understanding and I saw brief glimpses through his eyes that our boy was still there.

Jessica, our wonderful God-send of a PICU nurse, helped explain that Robbie’s breathing rate had to increase to a certain number on the ventilator monitor before the doctor would agree to remove his breathing tube.

Robbie continued to cycle in and out of sleep for a few more rounds after that. Each time he woke, we reminded him that breathing around the tube was his goal. We knew he hated it, so we used that to get him to focus on breathing. We could tell he was just so tired from everything, but he also wanted to get rid of the tube. At least he no longer fought it each time he woke up. We let him touch it, to fully understand what it was, and showed him a picture on our phones so he could see it.

Finally, Robbie reached the magic number to signal that he could breathe strongly enough on his own to take him off the ventilator. The doctor and nurse worked to extubate him and rearrange the remaining leads, wires, tubes and ports still attached to him. They added an external source of oxygen through a nose tube to assist his breathing until he regained strength.

All the while, Ron and I talked him through it all. He was scared, and I know the extubation was painful. He sucked on some ice chips and took his first sip through a straw. Even those tiny movements were blessings. The ability to swallow, blink and breathe were all good signs.

We waited with baited breath to see if all of Robbie was returning to us. He croaked out his first few words. “My hands…”

I asked the nurse if we could remove the restraints now that the breathing tube was out.

The instant Robbie’s right hand was out of the restraint, he brought it up toward his face. Ron caught it in his hand, stopping him.

“Robbie, that’s an oxygen tube in your nose. It has to stay there. If you fight it, they’ll need to put you back on the ventilator with the breathing tube down your throat.”

“No…my eye…” he rasped. So Ron released his hand.

Robbie moved his right arm and brought his hand toward his face. Then he very precisely rubbed a tiny bit of sleep from the inner corner of his right eye.

“Sleep in my eye,” he replied, and looked at us through confused, swollen, tired eyes like we were insane for being so over-the-moon joyful at this motion.

“Great sign of motor skills,” nurse Jessica commented and tears of joy sprung to my eyes.

After letting him regain his voice and sip a bit more water for a few minutes, we recapped all that had been through.

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“So how do you feel, Robbie?” I asked him about an hour after he came off the ventilator.

“My head…hurts,” he replied.

Not long after that, we recorded a thirty-second video to serve as a PSA for all kids who ride anything without helmets. My poor kid was still in a lot of pain, and it likely was not the nicest mom move I’ve ever made. But at that point, I was transitioning from the worry and fear, through the relief and back into disbelief that this had all happened and the worst for us, was luckily over.

The aftershocks of the ordeal would continue to sneak up on Ron and me for months after it all was over. And Robbie had to go through weeks of recovery, concussion treatment, physical therapy and healing. But we had our boy back. He was whole, and he was healthy.

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I shudder to think about how close we came to the unthinkable as parents that day. And there are times when it still sneaks up on me without warning. The chill creeps over the back of my hands and travels up my arms to my spine, making me shudder with the memory. My heart rate speeds up and my face will flush. I compare it to that feeling you get when speeding and you pass a cop car, wondering if you’ve been caught.

 

 

Once the physical reaction passes, I’m left with the terrible mixture of relief, grief and guilt. My physiology is reliving the worst moments, but once those pass, I am haunted by thoughts of all the parents who weren’t as lucky as we were.

My “What Ifs” consist of:  “What if our hospital wasn’t only 10 mins away?” “What if we had taken him home to sleep instead of to the hospital?” “What if the neurosurgeon hadn’t been there in time to operate?” “What if surgery hadn’t been successful?”

“What if?” “What if?” “What if?”

There are parents out there, though, who have a different series of questions that still haunt them. Their what ifs are the opposite from ours. “What if our hospital was closer?” “What if we had gotten to him sooner?” “What if our son/daughter had survived?”

“What if?” “What if?” “What if?”

I am helpless to answer any of these and feel paralyzed for the parents I know are out there with a much more horrific ending to their story. For them, I will continue to pray for comfort. For me, thankfully, I only have prayers of thanks.

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