A miraculous journey after a terrible accident
“The preliminary result told us that he was brain dead,” said Courtney Pawlowski, Ethan Pawlowski’s mother.
Ethan, an 18-year-old high school student, had been driving to school when the car’s tie rod broke. This forced the car to swerve toward a concrete wall and, in an effort to avoid it, Ethan tried to correct the turn. He missed the wall and, despite his best efforts, Ethan hit a school bus head on.
The collision crushed the car, making it difficult for emergency personnel to rescue him.
After receiving news of the accident, Ethan’s parents rushed to Toledo Hospital. “They took us back to a room to wait to see Ethan,” said Courtney. “A nurse came in and explained how bad the accident was and that his injuries were severe. They said we could go into the room but we couldn’t touch him.” The medical equipment and swelling from his injuries made Ethan nearly unrecognizable to his parents.
Ethan was moved to the neuro ICU, a unit that was better suited to working with his traumatic brain injury. Once again, his parents were allowed to see him but “we weren’t allowed to turn lights on or make any noise. He needed to stay as calm as possible.” Ethan’s doctor informed them that he was, perhaps, the patient in the most dire situation in the ICU. “[He said] that we may need to make some difficult decisions in the future and to think about quality, not quantity of life,” Courtney recalled.
Doctors removed a flap of bone from Ethan’s skull to relieve the pressure on his swollen brain and, because his condition had not improved, they performed a tracheostomy for breathing support and placed a feeding tube to help meet Ethan’s nutritional needs.
Then they placed Ethan on a continuous EEG to monitor his brain activity and the initial results were not promising—he appeared to be brain dead.
“We prayed and prayed that this was not true,” said Courtney. “Later that evening my husband was coming out of the bathroom in Ethan’s room and looked at the EEG waveform and saw a slight blip. After a short time the blips came more often and stronger … it was a miracle.”
Now showing signs of improvement in his brain function, Ethan’s doctors spoke with his parents about transferring him to a different facility. They chose Regency Hospital – Toledo. “I was absolutely terrified of the thought that he would be transferred anywhere,” said Courtney. “For the first one to two weeks we stayed every day. I finally became comfortable enough to leave and that was because of the amazing nurses and staff at Regency Hospital.”
Ethan’s rehabilitation journey began in earnest. A physician-led team of expert nurses, therapists and other clinical staff developed a care and treatment plan that was geared entirely toward helping Ethan become more alert, strengthen his body and mind and regain the ability to communicate.
Still unable to communicate or respond well to stimuli when he was admitted, Ethan began in the high-observation unit. The staff there used sensory stimulating activities to begin reinforcing Ethan’s ability to respond. They talked to him, played music and put wash cloths on his face. Ethan also could not move his tongue or lips on command—his brain could not tell his muscles what to do. So, his therapy team used ice chips and frozen glycerin swabs, which helped him begin to move his tongue and lips. These activities, and a carefully managed medication regimen, brought Ethan into a state where he was more consistently awake and aware of his surroundings. This allowed his care team to begin the next leg of his therapy.
Physical therapists started by sitting Ethan on the edge of his bed; a perfectly normal maneuver that Ethan, at this point, could not do on his own. With the help of his therapists, this activity began to strengthen Ethan’s core and balance. Now a little stronger, Ethan began participating in exercises while he sat on the edge of the bed, which further enhanced his balance and prepared his lower body for the task of standing. In time, Ethan began standing at the edge of his bed with assistance. Next, he took his first steps with support from a physical therapist.
In speech therapy, Ethan began to show off his playful personality as he grew stronger. “He used to gather his saliva in his mouth and play with it,” shared his therapist. Courtney let the therapist know Ethan did this because he knew it grossed her out. Ethan was unable to speak at first, so his speech therapist began working on automatics like counting to 10 or reciting the alphabet. Ethan mouthed the words, unable to turn his voice on. His therapist knew he was frustrated but Courtney was helpful in calming him down and encouraging him. While they continued working on his ability to speak, the therapist also focused on sharpening Ethan’s focus and ability to follow directions with family photos. The therapist would ask Ethan to point out a particular family member and name them.
Ethan grew stronger very quickly and once he was able to do a task, his parents worked with him on the activity outside of therapy. This culminated in the return of Ethan’s voice. One day Courtney called Ethan’s therapist to his room and was greeted with a “Hi” from Ethan.
Stronger and able to communicate, it was time for Ethan to transition to an inpatient rehabilitation facility to continue his recovery journey.
Upon discharge, Ethan’s family shared their gratitude for the care and support from the team at Regency Hospital. “They showed me how to do so many things to help Ethan,” said Courtney. “Everyone was 100 percent team Ethan.”