Children's Hospital is at its best when the cases are at their worst. After a Maryland teenager was severely injured in an accident last year, the staff was afraid to hold out much hope. But the patient recovered in excellent fashion. My associate on this year's Children's Hospital fund-raising campaign, Lynn Ryzewicz, has the story:
Every head trauma patient is different.
That's what Karen Olson, a neurosurgical nurse specialist at Children's Hospital, kept telling Bobbi Harrington after Harrington's daughter, Amanda, was hit by a truck 14 months ago while riding a dirt bike near her home. Olson was trying to give Harrington some hope, although the odds were against Amanda.
When Harrington arrived at the emergency room at Children's on Sept. 18, 1998, the outlook for her daughter was terrible. Amanda, then 13, was suffering from multiple fractures and a blood clot on her brain. Amanda's brain was swelling beyond the point her skull allowed. If she lived through the night, chances were she'd be brain dead, Harrington was told by the Children's staff.
Robert Keating, a pediatric neurosurgeon who has worked at Children's for three years, cut a window in Amanda's head to relieve the pressure. Since the damage was so severe, Keating also removed part of her front temporal lobe.
This is not normal procedure for head injuries, Keating said, but Amanda's case required it. The bruises to the lobe were beyond repair, and partial removal allowed more room for swelling.
Doctors kept telling Harrington that they wouldn't know Amanda's status until the swelling went down. They estimated that would take 72 hours. It took nine days.
After two weeks, Amanda's condition stabilized and doctors repaired her nearly severed arm, lacerated foot and broken femur, hip and pelvis. To cool a fever, they put her under a cold rubberized blanket.
"Everyone went 150 percent," Keating said. "Everything that we have was used on her, and she was still flirting with death."
Harrington, a secretary who works in Upper Marlboro, depended on Olson, a 20-year employee at Children's, to explain the medical treatment her daughter was receiving and to comfort her during the next 6 1/2 weeks, all of which Amanda spent in a coma. "We call her 'our angel in the flesh,' " Harrington said of Olson.
Harrington also learned that Children's gives equally excellent care to every patient. "I saw so many [patients at Children's] without insurance, and they were getting the same wonderful care as my baby," she said.
One day in mid-October 1998, Amanda opened her eyes. On Nov. 1, she was moved to Kennedy Krieger Institute, a rehabilitation center in Baltimore. When she left Children's, Keating and Olson predicted that Amanda would be physically and mentally limited for the rest of her life.
Olson called Bobbi Harrington every two weeks to check on Amanda's progress, even though Amanda was no longer a patient and might never be one again. At Christmas, Amanda said her first word: "Mom." In late February 1999, she was able to leave Kennedy Krieger, walking with a cane.
Keating saw Amanda in May and didn't recognize her. Olson saw Amanda in September and burst into tears. Amanda looked like a normal teenager.
"She is one of those miracle saves," Keating said. "She's testimony to how well the system works."
Amanda still struggles with her "new" memory and has trouble recalling events of five years ago. But she attends the eighth grade at Northern Middle School, in the Calvert County town of North Beach, where she lives with her mother and four siblings. Amanda says she is adept at trying on makeup with her friends and at arguing with her mother.
Amanda works with a therapist to improve her memory and exercises with her older sister, Maggie, 17, who hopes to be a physical therapist. Amanda wryly tells her sister, "You can thank me for the experience."
Children's sees more than 100 head trauma patients a year. Perhaps one or two do as well as Amanda, Keating said. Some are brain dead; others have severe physical or mental disabilities. How did Amanda end up being so lucky?
Bobbi Harrington credits the hospital staff. During her time there, she saw a banner in the lobby of Children's. It read: "Fifth Best (Children's) Hospital in the Country."
"I said to myself, 'Where's the first?' " Bobbi Harrington said. "I'm convinced there's no better place."
Our goal by Jan. 21: $650,000.
In hand as of Dec. 3: $73,945.12.
TO CONTRIBUTE TO THE CAMPAIGN:
Make a check or money order payable to Children's Hospital and mail it to Bob Levey, The Washington Post, Washington, D.C. 20071.
BY VISA OR MASTERCARD:
Call Post-Haste at 202-334-9000 on a touch-tone phone. Then punch in K-I-D-S, or 5437, and follow instructions.