Prevention Library
A real Thanksgiving story
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Jonathan Collins was at the top of his game when suddenly his life took an unexpected detour. Jonathan slipped off his skateboard one summer day in Arcata where he attends Humboldt State University. When his bare head hit the pavement, his life and his family's lives changed forever.
Accident day was Aug. 17 - the day before his junior year classes would have begun - is the date from which point Jonathan's life took a course he and his family never imagined. His parents, Gregory and Elaine, and a small army of distant relatives and friends dropped everything to rally to Jonathan's side and keep a vigil at all times.
At first, Jonathan hung between life and death. Neurosurgeon Gordon Kenji Nakata performed a craniectomy, a risky and rare operation that is considered a last-ditch effort for brain injury patients. The operation, which involves removing a portion of the skull, permitted Jonathan's brain to swell and saved his life.
Jonathan spent the first nine days of his hospitalization completely paralyzed. He's glad that is no longer an issue.
"I'm glad I don't have to ride in a wheelchair, he said.
Jonathan slowly started to come around, but he and his family had to accept there were going to be differences about him for a long time. Jonathan was not going to be the same, at least not in the immediate future.
For one thing, he doesn't remember the accident. And sometimes the rooms in his home seem unfamiliar. In fact, he can't remember most of his life, aside from random snippets. Needless to say, he is working very hard to regain his short and long-term memories.
Before the accident, Jonathan was an independent college student majoring in physical education administration. Now he is dependent upon his family for many of his needs and for much of his new education. Currently, he and his dad, Gregory, are inseparable. They travel 800 miles a week together to go to all Jonathan's classes and therapies together. And together they take long walks - up to nine miles at a time - with the family's three Irish wolfhounds.
Jonathan must wear a helmet to protect the part of his brain that is covered only by skin where his skull was removed. Gregory wears a helmet, as well, to show his support for his son.
On Mondays, they attend Brainstorm, a recreational/cognitive retraining program offered at the Janet Pomeroy Center for those with a traumatic brain injury. Tuesdays and Thursdays find them at City College's speech and memory class, a cognitive rebuilding class. The class is made up of 99 percent men, Jonathan is quick to note, men being more likely to do dangerous things than women.
On Wednesdays, Jonathan and Gregory go to doctors' appointments and take a Feldenkrais movement classes. On Friday, they conduct more memory work, occupational therapy and stretching. Fridays are also adventure days that take them to the sights around the Bay Area. They have visited the zoo, Hiller Aviation Museum and a cartoon museum, which rank among their favorites. They frequently stop for one of Jonathan's favorite meals, an In 'N Out Burger made specially to order with mustard added to the meat before cooking. On Saturday, they take music therapy. In between sessions, Jonathan works on a brain builder program on the computer.
The first six to twelve months of a brain-injured patient's recovery are crucial to achieve the most possible restoration. That's why his parents are loading up his schedule with as many classes as possible to improve his outcome. Gregory, a network administrator at Oracle, is taking a leave of absence to help.
"The goal is for him to do everything by himself. I'm trying to work myself out of a job, Gregory said.
So far, things are looking good as Jonathan's memory is slowly improving.
"Thumbs up, Jonathan said.
He remembers he quit smoking three days before the accident. He tempers his cravings by chewing gum.
After a few weeks building up to it, he can remember a string of eight numbers backwards, which is difficult even for someone who hasn't had a brain injury.
"I am always asking him questions to prompt his memory. Now he is the one asking the questions. We see how many street names we can repeat in an unfamiliar neighborhood. The more you do it, the easier it gets, Gregory said.
Jonathan feels his classes are easy. He said he is making more progress than the other people in his classes. That's a good indicator of his recovery.
He sees a lot of specialists. At Kaiser, he sees a speech therapist three times a month, occupational therapist twice a month and a physical therapist once a month. Gregory has been educating himself about brain injuries so he can be a more effective caregiver and make every moment count in Jonathan's recovery.
Jonathan signed up for classes at Skyline next semester. He's taking cognitive retraining, ceramics, physical education and yoga. He's very active. Besides long walks with the dogs, he enjoys playing hacky sac.
One thing he can't do on his upcoming 21st birthday Nov. 27 is to celebrate his coming of age with an alcoholic beverage. Even a small amount of alcohol could send him into a seizure. He'll have to worry about that for the first two years after brain surgery.
He's not afraid of skateboarding, in fact, he thinks he would like to try it again, but he will be sure to wear a helmet.
"I'm not going through this accident again, he said.
Coincidentally, in his own youth, Gregory tested prototype skateboards. He wore an experimental helmet when he rode, but helmets were a rare sight in those days.
"No one wore helmets back then. I took a bad fall at 40 miles per hour. That cured me from skateboarding, Gregory said.
Jonathan is scheduled to have cranioplasty his skull replaced on Dec. 21 at Kaiser in Redwood City, the sixth hospital he will see since this ordeal began. Relatively speaking, the cranioplasty is a lot easier than what Jonathan has already endured. He'll spend two to three days in the hospital. The stitches will come out a couple weeks later. Then, at last, he (and Gregory) will no longer have to wear their helmets.
His Kaiser doctor couldn't stop smiling about the progress Jonathan has made, Gregory said.
"He was giddy. More than half the neurology patients don't recover. The ones who do recover have severe limitations. They can't walk and they can't talk, Gregory said.
Jonathan not only wowed the doctor with his recovered cognitive abilities but also with his physical strength. Because of all the exercise he gets, he was stronger than the doctor.
Jonathan hopes to return to Humboldt State in fall 2005.
"We're going to do everything we can to get him ready, Gregory said.
His remaining deficits still are long- and short-memory loss, but he is making remarkable progress. Until recently, he couldn't remember what he did a few hours ago. Now he remembers not only what he had for breakfast a couple hours before, but also what he ate the day before and the day before that.
Shortly after the accident, he remembered his hounds, but not his parents. Now he remembers not only his parents, but also a whole array of his own friends and his parents' friends. And even if he doesn't remember them, he greets them warmly. His friends from high school made him a photo album to help jog his memory. Gregory will make a video for him that will show him growing up and include footage from when he was an exchange student in England.
"He doesn't remember most of his life. He remembers a few random things. Emotions are difficult. You don't have the history that goes along with the emotions. Emotions are returning. He is laughing more, Gregory said.
His parents don't yet know if he will retain everything he learned in school.
"Jonathan's educational skills have not been tested yet, but he cannot remember much of anything that he reads. He can recognize words but cannot retain what he has read at this time. We will know more after testing with the neuropsychologist on Dec. 10, his mom, Elaine, said.
Jonathan was never alone in the hospital and he is never alone now. The Collins family called out to their extended family of relatives and close friends to support them by visiting Jonathan. They rotated their time every few hours for a vigil at his hospital bedside. They filled notebook after notebook with their best wishes and observations and they took pictures every day of Jonathan to record his progress. His sister, Rebecca Collins Wall, and her husband who live in Sacramento took many of the overnight shifts watching Jonathan at the hospital in Eureka. They continued to visit him every weekend at the rehab facility he went to in Vallejo.
Even now, months after the accident, Jonathan requires supervision because his memory comes and goes. His own living room may suddenly become unfamiliar to him. Besides wearing the helmets, both Gregory and Jonathan also carry walkie-talkies so they can communicate with each other if Jonathan should become disoriented.
Seeing the duo walking around with helmets sparks some comments from inquisitive people.
"You just never know what people are going to say. It's easier for him to know I'm going to wear it, Gregory said. They got a picture in the mail from a family of their cousins all wearing helmets, of course.
They also have to wear sunglasses most of the time because Jonathan is more sensitive to lights, sounds and crowds.
"If he doesn't wear sunglasses, he'll get a headache. Gregory said.
The last picture taken of Jonathan before the accident was one from Puget Sound in early summer about a month before the accident. He spent a month there with his parents kayaking and canoeing. He had taken a fly fishing class at Humboldt and he was practicing what he had just learned. He looked very relaxed and he confidently smiled into the camera for a family photo.
Unfortunately, he doesn't remember that vacation at all.
In addition to family and friends, the wider Pacifica community is helping the Collins family. The Girls Scouts cooked meals, teachers from Oceana High School - where Elaine is a guidance counselor - organized meals and housecleaning services. Friends came around to help paint the walls of the Collins home, just because it was something Gregory would probably have put off for a while. Some people have been kind enough to send checks. The expenses for extra therapies and extra classes that are not covered by insurance total $1,000 a month. Dr. Gordon Kenji Nakata, the neurosurgeon in Eureka, waived his fees of $2,400 when he learned it wasn't covered by the Collins family's insurance.
The Collins family is working very hard to build strong connections for Jonathan to his past memories and to his current routines. They surround him with positive messages and hope that he is coming back to them and to the community that cares about him.
Reprinted with permission. © 1999-2005 MediaNews Group, Inc.