Melinda is a brain injury survivor and a former patient at The Salvation Army Toronto Grace Health Centre (TGHC). She now shares her story with high-school students through the P.A.R.T.Y. (Preventing Alcohol and Risk-Related Trauma in Youth) Program sponsored by Southlake Regional Health Centre (SRHC) in Newmarket. Recently, Melinda reconnected with the senior staff at the TGHC and offered to share her story and rehabilitation journey. The TGHC is always happy to hear from former patients and gladly agreed to tell Melinda’s story.

After speaking with Melinda and her mother, Kim, it became clear that this is not just a story about Melinda’s current rehabilitation progress; it is also a story about a mother who never gave up hope.

In January 2011, in the town of Bradford, Ontario, Melinda, who was eighteen years old at the time, was in a serious car accident. She lost control of her vehicle after hitting a patch of black ice. Melinda was then immediately rushed to SRHC, where the acute care team assessed her condition and determined she had brain damage. The extent of her injury was so critical that the acute care team recommended she be taken to St. Michael’s Hospital (SMH) in Toronto.

The healthcare team at SMH determined that Melinda needed an immediate craniectomy — a neurosurgical procedure that involves removing a portion of the skull in order to relieve pressure caused by excessive bleeding in the brain. In Melinda’s case, the surgeons at SMH removed both sides of the skull, leaving a crest of bone down the middle of her head. After the brain’s swelling subsided, the surgical team reattached the skull using steel plates, screws and staples. Although Melinda’s condition had stabilized, she remained in a coma and at SMH for three months. At the time, the SMH health team didn’t see any progress or hope that Melinda’s condition would get better.

In March 2011, after that three-month period had elapsed, Melinda was transported back to SRHC, mainly because, as Kim told me, “Our family lives in the area and moving her there meant that we could be close to her and visit her more often.”

In May of 2011, the healthcare team at SRHC approached Kim, offering her the option of either facilitating the transporting of Melinda home and providing support for her care once there, or assisting Kim in finding a proper rehabilitation facility for her daughter.

At that time, Kim told me, she immediately visualized a home care setting, and said, “To have your daughter lying in a hospital bed in your living room hooked up to all these machines was discouraging. Although Melinda was in a coma, our family still had hope, and we believed she could get some therapy at a rehabilitation hospital.”

Melinda was admitted to TGHC in May 2011. When she first arrived, she required a J-tube for feeding; she had hemiparesis (paralysis) of the right side; she was not able to respond verbally; she did not respond to commands; and she was unable to make eye contact when requested. Melinda required full care as well as a mechanical lift for transfers.

The nursing staff at TGHC began to constantly communicate with her verbally. They made sure to make eye contact when providing care; as well, the medical staff provided important physical contact, such as squeezing her hand. Communication was also a focus. There were many months of reading to her and playing Melinda’s favourite music. The nursing staff would often place Melinda in her wheelchair at the nursing station to ensure that someone was with her at all times, encouraging a two-way communication.

In July of 2011, Melinda had an appointment at SMH for a CAT scan and check-up — she had now been in a coma for seven months. After the appointment with the healthcare staff at SMH, Kim said she was told, “If you haven’t seen any movement or improvement by now, this is probably what you’re looking at for the rest of your life.”

“This was the hardest news a mother could get,” said Kim. Everyone, she told me, from the nurse who assisted her and Melinda to SMH, to the paramedics who drove them back to TGHC, as well as the staff at the Grace, were all concerned about her state of mind. “I must admit,” she said, “I was in shock.”

The nurses and the healthcare team at the TGHC continued with their rehabilitation program. “It was, I think, late August or early September of 2011,” Kim said. “I noticed that Melinda was slowly coming out of her coma.” One day Kim was reading the newspaper in the lounge with Melinda by her side when she noticed that Melinda was following along with her eyes — she was tracking. Kim asked Melinda if she could read the words and if she could to blink once. “She did!” said Kim, “and I couldn’t wait to tell the nurses and staff.

When Kim shared her news, she admits there was a little doubt and skepticism from the staff — after all, it had now been nine months that Melinda had been in a coma. Some of the staff cautioned Kim, telling her that it could be a reflex or just a fluke. However, slowly and progressively the nursing staff, too, began to notice that Melinda was tracking staff members as well as responding by squeezing a hand when requested.

Although the nurses told Kim that Melinda’s recovery would be slow and that she must remain patient, Kim couldn’t wait to reach out to her daughter. One day, on the rooftop garden patio where Kim would take Melinda for a breath of fresh air and to do her nails, Kim decided to try something new. For her own satisfaction, she brought a pencil to see if Melinda could write her name. “She was able to hang on to the pencil,” said Kim, “and she actually wrote her name.” But Kim wanted to know if Melinda knew who she was. “I asked her,” said Kim, ‘Who am I?’” Melinda then wrote: MOM.

Melinda kept improving, and soon was able to respond with purposeful communication — answering yes or no to questions about needing assistance or her comfort. With assistance, Melinda progressed to the point where she was able to direct her own care. Eventually, solid food was introduced, along with a more aggressive regime of therapy to improve her condition.

Melinda’s condition improved so much between September 2011 and January 2012 that the TGHC healthcare team began to look for a facility that would help her in the next step of her rehabilitation journey. Melinda left the TGHC in January 2012 and was admitted to Bridgepoint Active Health, where she remained until June 2012.

When Melinda returned home, she began to participate in activities to help her reintegrate to life at home. She also began to reach out more to others. She began slowly to converse with her grandmother over the phone. This helped her regain her confidence in communicating with others and in using devices, such as the phone.

One day, Kim saw an article in the local paper advertising a program offered by SRHC called the P.A.R.T.Y. Program. The program is about experimental learning and tries to encourage youth that while it is important that they enjoy their life and have a good time, it is equally important to make smart and informed choices so that they will remain safe and healthy. High-school students are taken through various scenarios, including ones about drinking and driving, texting and driving, and what could happen if their attention is diverted or they drink while operating a motor vehicle. The scenarios take them from the ambulance to the emergency room and then highlight the different medical procedures that would occur depending on their injuries. The program invites speakers who are survivors to share their stories with the students.

Melinda’s speech-language pathologist helped her make contact with the therapists at SRHC who organize the P.A.R.T.Y. program. They quickly decided that she could make a significant contribution to the program and signed her up as a speaker. She has been speaking to high-school students about her story for the last two years. At first, Kim accompanied her daughter on stage, but now Melinda appears with another brain-injury survivor.

Today, Melinda requires some assistance but she is able to walk; she can transfer herself from her wheelchair to another seat or to her bed, and is able to do a lot of activities of daily living unassisted. When I spoke with Melinda, I discovered she occasionally horseback rides. She has supervision, but this is an activity that helps strengthen her core muscles.

It has been a long and difficult journey for both Melinda and Kim. Kim managed to maintain her hope by doing the little things that were implemented by the nurses, the healthcare staff and herself: constantly talking to Melinda, playing her favourite music, helping with Melinda’s daily personal care, purposely placing her at the nurses station, recruiting volunteers to provide companionship, reading books to her, dressing Melinda in her own clothes — this all contributed to her successful recovery. They also helped Kim.

Melinda spent well over half of her stay at the TGHC in a coma. Kim was instrumental in sharing with her daughter the quality of care and compassion the nurses and healthcare staff at the TGHC provided. Today, Melinda has expressed her desire to reconnect and share her rehabilitation progress with the TGHC staff because it is where her healing and her rehabilitation journey began.

Melinda is in the process of arranging a presentation of the story she shares with high-school students for the staff at the TGHC. We look forward to seeing Melinda.

By Gerry Condotta