Winning the Battle

A soldier returns unscathed from Iraq, only to watch his son suffer the “signature wound” of the war

From the WebMD Archives

At first, 14-year-old Austin Story resisted the family’s plans to go hiking at beautiful Stokes State Forest on the morning of Tuesday, Aug. 31. “He didn’t want to go hanging out with adults because adults are too slow,” recalls Army Lt. Colonel Shane Story, 48. “But we insisted because it was going to be our last part of a weekend vacation with friends in New Jersey. … We wanted him off the TV and the Xbox and outside, enjoying the forest and the hills.”

Despite his initial stubbornness, as soon as the Storys and their friends pulled into the small gravel lot at the park, Austin jumped out of the car, sprinted to the base of Buttermilk Falls, and began eagerly climbing the stair stepped rocks alongside the water. Concerned about his son’s safety but not wanting to dampen the boy’s enthusiasm too much, Story kept calling to Austin to stop so they could take pictures. “Slow down!” he continued to urge as Austin scampered up the side of the waterfall, slippery leaves beneath his feet.

Austin made it to the top and started splashing through the low water to get to the other side. Distracted and scoping out directions for the trail they were about to hike together, neither Story nor his wife Lisa were watching when Austin slipped. Lisa looked up to see him free-falling, with nothing to grasp as he tumbled 75 feet, and she screamed.

War Story

A 25-year military veteran, former helicopter pilot, and strategic planner for the Army Reserve, Story is now stationed in Alexandria, Va., and works in a building two blocks from the Pentagon. During his two tours of duty in Iraq in 2003 and 2008, he had witnessed firsthand the effects of traumatic brain injury (TBI), which, according to Army field studies, has affected more than 10 percent of troops in Iraq and Afghanistan.

“I had the experience of being on the receiving end of indirect fire and was used to explosions happening in the vicinity and having friends or acquaintances, people I knew, killed by that,” he says.

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One comrade suffered a concussion in a vehicle accident; another was standing too lose to a bomb that detonated in Baghdad. Often angry and frustrated, the men still struggle to regain their memory and language skills and “make sense of the world,” Story says. “All of that just made me aware of the risks of mental challenges or injuries, and the rehabilitation and recovery process associated with trauma.”

As for his own fears of getting hurt, he says, “As a young man, I felt immortal, that I could survive anything. I took too many risks in hindsight, as a young man and a young officer. When I went off to war, even for the second time, I still believed that nothing bad was going to happen to me. I was nonetheless aware that it could and I accepted that risk.”

Parenting was a different story. When his two daughters started driving and staying out late, he worried he’d get one of those calls a father never wants to get. And when Austin, a strong athlete, took up football, lacrosse and weight lifting, Story cautioned the boy not to take too many chances. Stubborn and sometimes reckless, Austin didn’t always listen.

The Unthinkable Happens

Story helplessly witnessed the end of Austin’s fall that day as if it were happening in slow motion. Landing near the bottom of the waterfall, the teenager rolled onto the ground, hitting his left thigh, shoulder and, finally, his head. Story hurried to his son’s side. Blood covered the rocks, but Austin didn’t appear to have any broken bones. Story picked Austin up, started to carry him and soon realized that he was too heavy. A friend comforted Lisa and called 9-1-1, and several ambulances arrived moments later. “At that point, when I knew somebody else had control of him, I collapsed, weeping,” Story remembers.

A few miles away, a MedEvac helicopter was waiting to transport Austin to Morristown Memorial Hospital. There he underwent successful emergency surgery for an epidural hematoma, and doctors induced a temporary coma to let his brain heal. His neck was bruised but his spine was intact.

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“Austin was in excellent shape and I think his good muscular build really cushioned him in the fall,” says Story. “Except for some bad scrapes, he looked really good. You could look at himphysically and think, ‘This is the kind of guy that Greek and Roman sculptors used to use for models,’ because he was just in such great shape. It was hard to comprehend that somebody who looked this good was this badly hurt.”

That weekend, the nurses removed the ventilator but Austin remained in a coma. Sunday morning was especially difficult for the Story family. “It could be weeks, months, maybe even a couple of years before he wakes up,” a nurse told them. Later that day, Austin barely opened one eye.

Gradually, he gained more awareness of his surroundings, and one day he moved his left hand and foot. On September 11, Lisa held the phone up to his ear so his grandmother could speak to him, and a huge smile spread across his face for the first time.

A few days later, Austin was transferred to the pediatric brain injury program at Baltimore’s prestigious Kennedy Krieger Institute. He impressed the staff when, on the first evening, he walked 20 feet down the hall with his dad holding on.

When he arrived at Kennedy Krieger, Austin “had very little controlled use of the right side of his body,” says Dr. Stacy Suskauer, director of the institute’s brain injury program. “He was able to do just a little bit of standing and walking, but required assistance to do that. He was not able to speak at all. He was just starting to have moments of trying to communicate with a ‘yes’ or ‘no,’either through pointing to a hand or giving a high five for ‘yes.’ … The other thing he wasn’t able to do was eat at all when he first came here. In fact, he was breathing through a tracheostomy tube.”Austin was also quite agitated, just like the wounded soldiers Story had encountered over the years.

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For the next two months, the Kennedy Krieger team worked with Austin, providing physical, occupational and speech therapy; behavioral psychology services; and therapeutic recreation— the same treatments military personnel with severe brain injuries receive. Although he’s a bit unsteady, he can now walk without assistance and use his right side. “I saw him play Othello last week, pick up those little pieces and turn them over. But it takes some extra focus and attention for him,” says Dr. Suskauer. Austin is also talking again, in full sentences, but sometimes has difficulty finding the right words. And his sense of humor has returned.

Before his accident, Austin was extremely accurate with his soccer throws and kicks, and very fast. One day, while goading him to kick the ball harder, the physical therapist at Kennedy Krieger remarked, “Man, that’s one of the weakest touches I’ve ever seen.”

Not the End of the Story

When this article was written in November, Austin was about to move from inpatient rehabilitation to the Specialized Transition Program at Kennedy Krieger, where he would continue intensive therapy in a day setting “to tease out his cognitive strengths and weaknesses,” according to Dr. Suskauer.

He’s changing very quickly at this point, which is the best prognostic indicator I have for how much he’s going to continue to change,” she notes. “But I think there will always be some differences in Austin from prior to his injury. I think in a year he’ll be integrated back into school, but he’ll probably need some accommodations to do his schoolwork. And he may need to learn in a different way than he did before. He may still have some problems with memory, attention and finding the right word, but I’m hopeful that he’ll be able to continue to complete schoolwork and graduate from high school.

“A lot of parents have been told that recovery ends at a year, and that what you have at a year is basically what you’re going to get,” she adds. “But we know more and more that that isn’t true. Usually the fastest rate of recovery is seen early on or in the first year, but we know that meaningful recovery can continue to happen after that and can continue for years. There’s always hope.”

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Dr. Suskauer and her colleagues stress the need for public education about TBI—how to prevent it, how to recognize it, how to deal with the aftermath. “I think it’s really important that the general public understands what it mean to have had a traumatic brain injury, that when Austin goes back to school and pretty much looks physically the same, it may be hard for peers or teachers to understand why he needs special accommodations, why he might be a little bit slower to answer questions or need more time on tests. Traumatic brain injury can be a silent or invisible injury, if somebody looks fine. You can’t see their brain.”

For now, Story is relieved that Austin has recovered as much as he has. “It could be so much worse,” he says. “I’m thankful that we’re ready to push forward to outpatient (rehab) and we can see the day he’s coming home and getting back to school.”

For more information about the brain injury program at Kennedy Krieger Institute, see www.kennedykrieger.org.

Nancy Henderson is an award-winning writer whose articles have appeared in Smithsonian, The New York Times, Parade, US Airways magazine and many other publications. She is the author of Able! How One Company’s Extraordinary Workforce Changed the Way We Look at Disability Today (BenBella Books). Nancy often writes about disability issues and people who are making a difference through their work.

WebMD Feature from “Exceptional Parent” Magazine

WebMD Feature from “Exceptional Parent” Magazine

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This article is reprinted with permission from Exceptional Parent Magazine, with permission from EP Global Communication

Copyright © 2010 by EP Global Communications

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