“They weren’t sure I would survive, much less wake up.”
Bethesda Hospital patient Tracy Hacker
What Tracy Hacker remembers most about waking up in her bed at Bethesda Hospital on October 22, 2006 was a sense of calm. “I just waved at my mom. Nothing was surprising to me,” she recalls. In the meantime, her family had been coping with devastating news: After a vicious attack with a bat crushed the right side of her head, Tracy had spent three weeks in a coma, and doctors weren’t sure she would survive, much less wake up.
The initial challenge, in fact, was to stay awake. “All they wanted me to do was stay up for a half-hour after breakfast,” said Tracy. “It was really, really hard. I was so tired all the time, I would have slept all day.” The difference from her former self was profound: “I’m not the kind of person who sits around a lot, so they put me on a rigorous rehab schedule. Looking back, I’m thankful they pushed me that hard. It forced me to stay determined about recovering.”
Bethesda’s brain injury team created a treatment plan that addressed everything from medication to therapies to nutrition. “We started just flexing my muscles in bed. Then every day we’d add something new, until I re-learned how to walk. Occupational, physical and speech therapy, meetings with psychologists, I had to work hard.” Her progress was nothing short of a miracle. “I remember my therapists saying they were amazed at my progress, and I’d say, ‘I’m a horseback rider. I’m not afraid.’ In addition to recreational riding, Tracy had competed as part of a Western drill team, and missed it greatly. “I kept a picture of myself and my horse in the hospital room, and looked at it every single day. All I wanted was to get back in the saddle.” The determination paid off: Tracy was discharged a mere three weeks after she woke up.
She credits the relationships she developed with Bethesda caregivers — and their compassion — as being an integral component of her recovery. “I think it was Matt, my nurse, tucking me in at night and spending time with me having one-on-one conversations, April, my speech therapist, and so many others — the littlest ways they helped me really made the biggest difference. I never, ever felt alone.”
The effect of their kindness has inspired Tracy to become a social worker. “I feel very lucky, and I have to pay it back somehow. I started at St. Thomas last fall, and I’ll graduate in spring 2011. I’m so happy to be where I am now. I went to Barcelona by myself, and I thought, ‘Here I am, just a couple of years after almost dying, and look at what I can do.’ And when I have to, I just put on my warrior face. I keep persevering — I don’t want to get stuck living my symptoms. I have to keep going.”
Support for families in crisis: Social Worker Kristi Johnson
The average length of stay for a brain injury patient at Bethesda Hospital is three to four weeks. During that time, the patient may be in many possible stages of recovery from their injury but usually is not in a condition where they can make decisions about treatment plans or their longer-term future. This is the crucial stage where a social worker steps in — like Kristi Johnson. “I do my best to provide families and other support individuals with an education about brain injury recovery and inform them about some of the outcomes we’ve seen. I try to provide hope, but also prepare them for what could be a difficult time ahead.”
Families, understandably, are still in some level of crisis when Kristi first connects with them. “I deal with a lot of grief and loss, but it’s complicated and ambiguous. Their loved one hasn’t died, but their lives have been changed, and their hopes and dreams for the future have altered as well. I have to read where a family is at in accepting this, and reach them where they are. I try to move them along to acceptance and understanding, but at their own pace.”
Kristi’s work with Tracy Hacker’s family provides some insight to the value a social worker adds to Bethesda’s treatment plans. “I don’t think any of us could have guessed that Tracy would be doing as wonderfully as she is today. After a brain injury, even someone doing as well as Tracy may have some cognitive deficits, requiring 24-hour supervision by family or friends. So I worked with the care team and her parents to come up with a plan for where Tracy would go and who would take care of her.”
Foremost in Kristi’s mind is coming up with a discharge plan that helps families sort through what their loved one would want. “The plan is not just about a single patient and their illness. It’s also about who that person is, and the other people in their lives. I help with the social aspect of their recovery, thinking about what someone like Tracy’s life was like before, and how we can best honor the person they were before their injury.”
Tracy is now studying to become a social worker — a fact that touches Kristi deeply. “Tracy came to Bethesda to visit a few weeks ago and was talking with people about her career choice, and she would say, ‘Yeah, I’m going to be Kristi.’ Knowing that she looks up to me, that I was support that she trusted — that feels really good.”
