Tommy — post surgery, August 9, 2019

Beach Accident

Nick’s account of the accident

I wrote this in the weeks following my son’s accident. It was intended to simply be a record of the events and some documentation on our emotions. At some point I see it as an advisory, if not a stern warning to parents and their kids to be on guard against diving into the unknown (in our case less than 3 feet of water) but that includes the ocean, lakes and swimming pools. We have since heard about many similar accidents at the beach, either by diving in or body-surfing and some with really catastrophic results. I am Nick, Chris is my wife, Olivia is our 20-year-old daughter and Tommy is our 16-year-old son.

August 7, 2019

Chris, Olivia and my Mom went back to the beach at about 3:30 p.m. after a pretty big storm. The sun came out and Tommy and I were talking about going in the water because it was actually getting hot. We took a walk, talked about life for a bit and then he decided that we should go in the water. I even said that it seemed kind of cold — “do you really want to go in”, I asked? Of course he did so I went first with a normal run down the beach slope and a shallow dive into the water.

I swam out a way to where I was in about 5 feet of water. It was very windy and wavy that day and I knew that bodysurfing would be impossible with the way the waves were breaking. I turned around to see where Tommy was, and I didn’t see him. The water surface is far enough down the slope where you can’t see people on the beach, the result of years of dredging for beach erosion protection. I assumed he must have gone back to where Chris was sitting. I turned around again for maybe 10 seconds looking eastward and then turned back to look for Tommy again. I was actually a little frustrated that he might have ditched me.

I know that God had a hand in guiding me because out of the corner of my eye, to my disbelief, I noticed this ball of blonde hair floating, face down, maybe 10 feet away. I of course knew it was Tommy and initially thought he was swimming up to grab my leg. In seconds I knew something was wrong, so I grabbed him by the waist and pulled him out of the water. He was basically limp but seemingly in a seizure state and making strange noises — and only partially conscious. I went into high adrenaline mode and dragged him towards the shore.

When we got into about 3 feet of water, I turned east just in time to catch a large wave in the face. It took us down to the floor and I struggled like I have never struggled in my life to hold on to Tommy and keep him above water. He slipped (rather was eased) from my grip but I also knew this would help us get a little closer to shore. I stood up and was in about a foot of water and there he was, face down, not moving. I wrapped my arms around him and dragged him up the long slope to the beach. I looked up and people were watching intently. I begged for help, specifically looking at an older man who was maybe 20 feet away. He stood there, petrified and just didn’t move. An older woman came up and helped me bring Tommy up to the beach. I had no idea anything was wrong with his neck but just knew he wasn’t moving much at all. I thought initially he would be fine if we got him stabilized on the beach.

I looked north to the lifeguard, maybe 100 feet away and he was peering over. I frantically waved him over and we had Tommy lying on his back in the sand. By now, Chris, Olivia and my Mom were there, obviously upset and in distressed mode. My Mom said to call 911 — I think the lifeguard was there, so I ran to my phone and called. It was windy and hard to hear them, but I told them my son was in trouble and where we were located. The woman kept asking questions, about half of which I could hear. I pleaded with her to get an ambulance here and then hung up. 911 called back and told me I shouldn’t have hung up — I again pleaded with them to get here fast, they knew where we were.

Chris and people were tending to Tommy and a lifeguard had brought a brace and was supporting his neck (the lifeguard had figured out that Tommy dove in to shallow water and injured his neck). In the chaos of things, a woman, Susan Smith told me she was a nurse practitioner and that we should ensure his neck was stable and not to let them move Tommy until the right equipment was here. 20 minutes after I called, the EMTs showed up and took over stabilization and got him on a board. He was clearly in a lot of pain, not able to move his arms but talking a little. While I didn’t hear it, he asked Chris if he was paralyzed and she of course assured him that he was not and that we would help him to get better.

They carried Tommy on a board to the road and were looking to land a helicopter on Route 1. Then we found that it was too windy, so it was decided to ambulance him to Peninsula Hospital in Salisbury, MD. Chris jumped into the ambulance and I was going to get the car and follow. By the time I got the car and some immediate necessities, the ambulance was gone so I drove a little too fast to Salisbury. The second worst drive of my life preceded only by the drive 2 hours later from Salisbury back to Fenwick Island and Fenwick to Baltimore.

I found them in the ER at Peninsula and Tommy was in a lot of pain. Covered in sand, unable to move much at all but a remarkably brave face. I felt as if the news just kept getting worse — from maybe a quick recovery on the beach, to an impact to his neck and him being unable to move (and me thinking of people I know who have been relegated to life in a wheelchair from beach neck injuries). Driving to Salisbury, I was comforted by my friend Martin who had recently gone through a life-threatening incident with a traumatic brain injury to his son Ethan (skiing). Martin urged me to keep cool, drive carefully, take control and get him the right medical care. He basically said there were 2 places Tommy could go: Children’s in DC or Johns Hopkins (JH) in Baltimore. He also suggested calling my insurance company just to get peace of mind around coverage for what would be staggering costs.

At the ER, Tommy got the CAT scan and the doc came back and diagnosed a “fracture” in C5. I didn’t know much about that but as I mentioned before, the news kept getting worse. I made the mistake of googling C5 fractures and found bad news, horrible news in that basically he would be a quadriplegic at best (later realized this was a law firm basically trolling for business). The ER doc suggested that the neuros at Salisbury were not equipped to handle the surgery that was needed and said that JH was indeed the place to go. It was an easy decision for us, and we looked to get him air-lifted there. Again, the weather was bad, so we had to drive — Chris went in the ambulance and I took the car back to Fenwick Island to gather our stuff, situate Olivia and my Mom who fortunately had a car.

I threw stuff in the car and got on the road for the almost 3-hour trip to JH. My phone was blowing up and I violated the law and common sense by texting and talking the whole way. Notable was a conversation first with our friend Karen Kuchins who flew into high gear, urging calm but making phone calls to help us out at JH. I got a call from Dr. Joe Shrout, our Orthopedic surgeon friend who said that he was calling/texting the right folks at JH and that they were expecting Tommy. Another friend, Dr. Tom Jarrett (TJ) was also helpful in lining things up with the surgeons at JH. Karen insisted on heading up to JH to meet Chris and like the true amazing friend that she is, she was there, with food and clothing.

I got to Hopkins at about 11:30 that night and went immediately to the ICU to find Tommy stabilized and sedated. The sense of fear, emotion and anxiety that I had been experiencing for the past several hours was eased by the absolute efficiency and professionalism of the staff at JH. There was no bullshit — just facts and an amazing ability to care for the patient and respect the parents/friends of the patient. Our friends Karen and Eric were there with an awesome show of support until well after midnight. At about 1:00 a.m., the medical staff said that Tommy would get an MRI and that we could go with him. Chris and I walked with nurses who wheeled him through dark corridors at JH — we must have walked for 10 minutes twisting and turning through the seemingly empty hospital.

When Tommy got into the MRI, they told us it would be about an hour so Chris and I could relax in an empty waiting room. It was semi-dark with 2 short couches and we thought that maybe we could shut our eyes and pretend to sleep. A few minutes later, we heard the door open and a big bearded man came in. Tom Ditonto, who lives a mile away in Canton, somehow made it through security and found where we were. He had bags of toiletries, food, blankets, phone chargers, water bottles, t-shirts — everything. I will never forget this selfless act of kindness — the guy knew we were in trouble and in the middle of the night, found a store and managed to bring stuff that we needed and stuff we didn’t need but he was there. Chris and I were amazed and thankful but really looking to just get a few minutes of sleep. Tom stayed for a bit and then left the room. When Tommy was done with the MRI, I think Tom joined us for the long walk back to the ICU. Again, major impact on my psyche was the support that Tom D offered not only that night but throughout the entire ordeal.

We went back to the ICU and were told that the surgeon, Dr. Mari Groves would be there at 5:30 a.m. I was told that her and the head of orthopedics (Dr. Sponseller, who my friend TJ had contacted) were huddling over the night to determine the strategy for surgery. Dr. Groves and the team were very communicative, explaining the issues, the risks and the plan to go in through the front of the neck and not both front and back. She was confident, composed and reassuring even though the words “shattered vertebrae” now entered the conversation. They prepped Tommy for surgery and took him a little after 6:00 a.m. for a 3.5-hour procedure. Neither Chris nor I slept that whole night or that morning and it was all we could do to have a little bit to eat.

Dr. Groves and another surgeon, Dr. Riggs, both assured us that in spite of a pretty damaging injury, they thought that Tommy would come out of this well with partial recovery over the next few months, but full recovery could take years. They explained the cage fusion procedure and the titanium screws that had been inserted to hold it in. Now it was a matter of keeping him stable in the ICU, nursing him and soon enough Occupational and Physical Therapy. The docs were top notch, empathetic, super smart and explained everything patiently and honestly. Clearly, the decision to get him to Hopkins was the right one.

The care offered by the nursing staff was exceptional. We were assigned TJ, a lead nurse as the main caretaker for Tommy. TJ is the star of the pediatrics ICU ward at JH. Smart, caring, a sense of humor, great with Tommy and great with us. He really made the experience more bearable for all of us, always looking to help and always knowing what to say and do. Really, all of the nurses and admin staff were far beyond any of our expectations.

After 2 days in ICU, Tommy had still not eaten. He was starving of course but we had to wait for an MRI to ensure that there wasn’t a reason to go back into the neck. The MRI was supposed to be at 5 pm, then 6 then 8 but apparently imaging services was very busy that day. Chris left for a hotel and I was determined to get the boy’s MRI done. It wasn’t until a lot of complaining that we finally got to the imaging lab (about midnight). After the MRI, we found out that there was nobody to read it. In the end, Tommy fell asleep and eventually I did too.

The next morning, I was able to order breakfast — scrambled eggs, bacon, toast and yogurt. I fed Tommy the bacon and eggs and he said to me “Dad, this is the best food I have ever eaten”. Scrambled eggs were lukewarm and looked like they had been made the night before. At some point, Tommy also re-connected with social media. He wasn’t able to hold his phone due to the nerve issues but if we wrapped it in a hospital glove, he could hold on and type with his left hand. I don’t follow him, but I suspect he got a lot of attention on Snapchat.

I think it was this same day that his friends started pouring in to show support. I can’t say how meaningful this was to him and to us because we know that the trip to Baltimore from DC is not easy and it really lifted Tommy’s spirits. These guys and girls would come bearing gifts and stay for hours at a time. Even though he was exhausted, Tommy loved it and I am convinced that the brotherhood and sisterhood shown by his friends helped him to recover both physically and mentally. We also had a parade of visitors from friends and family — Chris and I always appreciated the sensitivity and generosity that people visiting showed. It helped us to cope with the stress and really helped to take our minds off the tough situation we were in.

Over the next several days, Tommy stayed in the ICU and made good progress with his overall health. He took all of the injections, the wake-ups, even the catheters like a champ. Getting him to take a step felt like going back to his first birthday and trying to get him to walk. After 6 days in ICU, they told us that he was ready to move to a regular hospital room. Tommy moved to a regular room, but the excellent care did not change. Still, friends of his and of ours showed up, some on a schedule that our friend Katy Anderson set up and some unannounced — it didn’t really matter, it was all a blessing. I should mention the tireless, compassionate effort and dedication that Katy showed in organizing a community prayer campaign with email communication/updates on Tommy’s condition. Katy Anderson is a friend who was just an amazing, inspirational messenger. I can only imagine the countless hours she spent thinking about, praying for and communicating on behalf of our son.

In the new room, we were afforded a little more privacy but still the care from the nurses was outstanding. Anything he (or we) needed, the nurses were there for us and would comply. They were especially conscious that this was a 16-year-old boy who might be modest in some respects. I was staying in Baltimore (Ronald McDonald house) about every other night by this time and Chris continued to sleep in the room every night. The nurses helped Tommy to start walking and it was huge when he took 10 steps, then all the way down the hallway, then around the entire floor. Milestones came and were surpassed quickly.

After another 7 days, we moved to the pediatrics floor of the Kennedy Krieger Institute, considered to be among the top 2 spinal rehab places in the world — it is next door to JH. They had to ambulance him there, but we got situated quickly and the therapy regimen began. Here Tommy had a roommate, a boy with a debilitating nerve issue but who was very much on the mend. We were told that 95% of kids at KKI would not be able to walk out of the place. The seriousness of the injuries/illnesses that kids have there is heart-breaking. Still, the staff works with their little patients with an abundance of patience, dedication and love. Tommy excelled there — they worked him 5–6 hours a day and helped him to get the strength and feeling back in his right hand. It was great having Chris’s Dad and his wife (Manny and Shelly) come up during this time. They were totally there for Tommy and for us — making this time more bearable. By the end of his stay at KKI, Tommy was actually outside tossing a lacrosse ball — truly amazing progress.

Finally, in late August, we were able to take Tommy home. It was truly a miracle that he was so alert, relatively mobile and still gaining strength. By this time, we really felt like we were “out of the woods” but given all of the medications and general uncertainty around nerve related issues, we were still wary. Olivia left for Spain on September 1 for her fall semester and Tommy had to deal with our probably over-bearing care for the time being. He started half days at a very understanding and compassionate Gonzaga High School in October and moved on to full days by the end of the month. On to November and December and Tommy was playing CYO basketball (carefully and with his parents nervously watching) and we even let him ski locally one night.

In the end, this was an extremely unfortunate accident followed by many lucky breaks. Lucky that I happened to see him in the water, lucky that we got him stabilized soon, lucky that we had such great surgeons and medical care and lucky that he didn’t enter that water and hit the sand a little harder such that there would have been more damage. We are especially lucky to have such great friends, family and a caring community who showed their true colors.

Update 1 year later:

The picture tells a thousand words. We were recently told that JH was preparing for intake of a quadriplegic on that fateful day a year ago. We are thankful every day for our good fortune. Here he is on vacation in Cape Cod this year:

Tommy Jacobs — August 2020

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