Jonathan’s Story: Beating the Odds of a Traumatic Brain Injury

When her phone rang in the middle of the night, Joyce Wilcox knew that something was wrong. “Jonathan's girlfriend called us at 3:28 a.m. I had that horrible, dreadful feeling that this was a terrible phone call and it was,” Joyce remembers. “She was screaming, ‘It's the worst thing ever, Joyce. I cannot tell you. It's the worst thing ever.’"

Joyce explains that her son Jonathan is an electric lineman and he works long hours, 12-hour shifts. He had just finished working six days straight. It was almost the Fourth of July weekend, and that evening when he got off work, Jonathan and some of his friends, his girlfriend, and others were out enjoying themselves.

“Late in the night he got on his bike, his motorcycle, and didn't make a turn and hit a telephone pole,” Joyce says.

After receiving the phone call, Joyce and her husband rushed to the scene of the accident. 

“We had firemen, we had police officers there, all their cars were strung out. I'd asked was my son dead and they said, ‘I am so sorry, I cannot tell you,’” Joyce recalls. “I said, ‘Well, is he breathing?’ and they said, ‘I cannot tell you that. You need to get in your car and go to Miami Valley. We're fixing to take him off in the helicopter.’"

While in the air, the CareFlight Air and Mobile Services team assessed and monitored Jonathan’s condition. Upon arrival at Miami Valley Hospital, the team briefed the hospital trauma team, led by trauma surgeon Gregory Semon, DO, FACS, who immediately took over his care.

Maintaining an Airway

Brad Hoops, BSN, RN, CFRN, CEN, EMT-P, clinical operations manager for CareFlight, says that, “with a head injury, it's pretty significant. You need to maintain their airway. That's one of the biggest complications of a head injury is that they can't maintain their own airway.”

Additionally, the patient could vomit, or aspirate and cause more problems than just the head injury. 

“You want to try to decrease what's called their inner cranial pressure, the pressure that builds up in their skull,” says Brad.

“Jonathan arrived via CareFlight, which is our helicopter system, and he was brought immediately to our trauma bay,” says Gregory Semon, DO. “Immediately, our whole team jumped into action and were quickly assessing his airways. Is he breathing properly? Is his blood pressure and heart rate okay?”

Brad says that in the trauma room, you need to give [the trauma team] as much information about the scene and about what you have identified as accurately and concisely as possible.

Peter Letarte, MD, FACS, FAANS, neurosurgeon at Miami Valley Hospital, says, “That initial resuscitation is critical. One of the beauties of institutions that do trauma well is they have a team that can do that. You have to make sure that resuscitation has occurred and that the patient isn't imminently going to die from something other than the brain.”

A Waiting Game

Jonathan was on a ventilator and it was discovered via CAT scan that he had a severe traumatic brain injury, says Dr. Semon.

“The team does a neuro assessment and we have a scale that we look at, a Glascow Coma Score, to decide how to give some number to how badly the patient's nervous system is depressed, says Dr. Letarte. “That goes from three to 15. Three is the worst you can have. You are essentially doing nothing if you're at three. Jon's was four at the time he presented.”

Dr. Semon says they put Jonathan into a medically induced coma but it didn’t control the pressure in his brain. “Ultimately, I just took him to surgery, where the neurosurgeons removed a portion of his skull. When you take that portion of the skull off, it allows the brain to swell into that defect, which greatly decreases the pressure.”

The doctors had done everything they could at that point to decrease the pressure and swelling in Jonathan's head. “It’s really a waiting game. It's a waiting game to see if he'll wake up and when he'll wake up,” says Dr. Semon.

After three weeks and no signs of improvement, Joyce, her husband, and the medical team were deciding whether or not to continue Jonathan’s current treatment.

“We had a prayer vigil here with a whole group of people, 70 to 80 people met here out on the grounds. They prayed, and I told them I would [decide] that Saturday night after the prayer vigil,” says Joyce. “It looked like we probably would be saying goodbye to our son, but I would not hold any conference with the doctors until after [the vigil].”

‘The Power Of Love And Prayer’

Joyce went to be with Jonathan, to let him know about the prayer vigil. She says that at that time, “Jonathan, who had not moved at all, no stimuli to pain, no movement at all to show us that he was in there, he up and moved his head from right to left.”

Dr. Semon says it was nothing short of a miracle. “I've never seen anything like it before. There's a lot we don't know about people with traumatic brain injuries, how they recover, how well they do. There's only so much we can do as physicians and it's kind of all up to the patient and the love from the family he's had to recover from something like this.”

Jonathan continued to regain motor functions and was discharged from the ICU 20 days later to start rehabilitation.

“You could kind of see him coming back. It was him,” says Joyce. “It wasn't a new person where we were so afraid that we would have someone different than Jonathan, a new Jonathan. Of course, Jonathan's looking at you like, ‘I haven't left. I've been here all along.’ He still does that even today.”

Dr. Letarte says that, “the judgment that a good neuro trauma team has to make is if we do this, are we likely to save a life of quality? That judgment was made in this case. He had the decompressive craniectomy and this is one of those wonderful cases where the team was right.”

Dr. Semon says that he will remember Jonathan and his story for the rest of his life. “I've learned a lot about what can be done for people with severe traumatic brain injuries, and I've also learned a lot about the power of love and prayer and support from family that I'm going to keep with me for a long time.”

Joyce is beyond grateful. “I'm just so thankful for the physicians that were on that day. They did not stop. They worked on him like it was their own child. I appreciate them to no end.”

“I am very grateful for all the help. It worked for me,” says Jonathan.

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