Thankful for her survival

Brooke Earl of St. Joseph well on road to recovery after suffering traumatic brain injury

Brooke Earl has her smile back.


The 19-year-old St. Joseph woman lost it on May 22, when she suffered a potentially fatal skull fracture. Because her skull didn’t break open, the blood had nowhere to go but inside, causing swelling in her brain.


Initially unable to breathe, talk, eat or walk, Brooke is now once again doing all the things she previously took for granted.


Thanksgiving has a whole new meaning to her; her identical twin sister, Brittany; and their parents, Doug and Julie Earl, 44.

“I’m thankful for great family and friend support, for Carbondale, the hospital staff and the strength everybody had in themselves to face my tragedy,” Brooke said in a lengthy interview at her home earlier this month.


Beautiful day
May 22, 2010, was a beautiful Saturday. Doug Earl was where he normally is on weekends a softball field.


A full-time employee of Caterpillar in Decatur, Doug Earl is also the girls’ softball coach for Salt Fork, the co-op team for Catlin and Jamaica high schools. They were playing in Danville that Saturday.


His daughters, 2009 graduates of St. Joseph-Ogden High School, had played softball since about the age of 9, including travel softball almost year-round from ages 12 to 18. Brooke was a pitcher, Brittany her catcher.


Wife Julie had joined Doug for the game after getting off work at her second job at Schnucks grocery store in Urbana. She also works full time for a Champaign periodontist as an office manager.


Brittany was working as a hostess at Chili’s in Champaign, the same place her sister worked.


Brooke was at the apartment of her boyfriend, Dekota Gates, 22, in Urbana. The two had dated about three years. That day they were quarreling about him staying out late.


Brooke has no memory of it, but an Urbana police report said that shortly after noon she climbed onto the hood of his car, trying to keep him from leaving the apartment parking lot on West Clark Street. He tried to talk her into getting off but she wouldn’t.


“When she didn’t, he touched the gas a little and then hit the brakes. She fell off the hood, staggered back and fell backward onto her head on the pavement. She never moved again,” the report said.

When police arrived, Gates was holding Brooke, wailing, “Don’t die. Don’t leave me.”

Arrested and jailed, Gates pleaded guilty in September to felony reckless conduct, admitting that his actions caused the grave injuries to his girlfriend. He was sentenced to 93 days in the county jail, 30 months of probation and 150 hours of public service. Brooke hasn’t seen him since, and the family rarely speaks his name.

Bad news
Brittany didn’t understand what was going on when a manager at Chili’s summoned her to the office. An Urbana police officer was calling to say her sister had been in a car accident and she needed to come to Carle.

Police had gone to the Earl home in St. Joseph, but no one was there. Doug’s parents, Richard and Karel Earl, live next door. Working outside, they got the news from an officer and called Julie. But she’d left her phone in the car while watching the softball game. And Doug’s was shut off during the game.

Heading for a pedicure after the game, Julie checked her phone and got the message from her father-in-law. She still has it on her phone.

“It was the longest drive from Danville to Urbana. I knew she’d been in an accident, but didn’t think it was as bad as it was,” Julie said.

Boarding the bus to return with the team to the school in Catlin, Doug checked his phone. The bus driver quickly figured out what was going on and hurried back so Doug could get to his daughter.

No hope
Gathered at Carle about three hours after Brooke’s accident, Carle neurologist Dr. Richard Rak huddled in a tiny conference room with Doug, Julie, Brittany and both sets of Brooke’s grandparents.

“He is an awesome physician and doesn’t give false hope. He didn’t give us any hope at all,” Julie said.

They learned that Brooke had sustained a closed head injury. Her skull was broken from the base to the eye socket on her right side. Doctors had implanted a monitoring device to measure her intercranial pressure. The family learned that a number of 40 or greater for more than 10 minutes could end in death or a vegetative state. (Numbers in the 5 to 20 range are considered normal.) Brooke spiked 60 a couple of times, her mother said.

For days, they fixated on the monitor numbers.

Medical staff worked feverishly to get the pressure down with medication, not surgery.

“The skull does not yield,” explained Dr. Huan “John” Wang, another of Brooke’s neurologists at Carle. “When the swelling is confined within the skull, the pressure builds up rapidly. She presented in a deeply comatose state and required artificial ventilation.”

Her age, Wang said, was a mixed blessing. “A young brain is more robust and more subject to prolonged swelling. The consequences are more dire.” But Brooke’s injuries were in areas of the brain that, once the swelling subsided, would not deprive her of a future, he said. “At her age, the brain is tremendously resilient,” Wang said. “The younger you are, the better chance you’ve got.”

Vigil begins
The family began a vigil at Carle that would last two months. Brittany quit her job to be with her best friend. Julie went to work about two hours a day some mornings.

Doug had been at Caterpillar for only a month when the accident happened. Both he and his wife exhausted their vacation benefits. By the end of June, Doug went back to work. He’d work 11 p.m. to 7 a.m., sleep a few hours, go to the hospital, and repeat.

Julie and Brittany were able to stay at the guest house on the hospital campus. They can’t speak highly enough of the service. They rarely went home.

The hospital staff gave the family an empty room in the old pediatrics wing for the growing numbers there to support Brooke. “We had so much food there, you could have fed an army. The custodian brought ice,” Doug said. “It was like a campsite.”

Softball and high school friends came later in the evenings after getting off work.

Brittany was writing daily updates about Brooke on Caring Bridge, a donor-supported website that allows people with health challenges to connect family and friends. On Facebook one day, she noticed that several high school friends had posted photos of Brooke.

One friend, Josh Dees, added to his post: “B.E.lieve,” the first two letters representing Brooke’s initials.

“That really stuck with everything,” Brittany said.

Coma
For 19 days, Brooke was in a coma, and Doug, Julie and Brittany found themselves talking about her future and theirs, struggling with the possibility she might not fully recover.


“We had decided as a family we didn’t want her to live that kind of life. We did not want to take home a house plant,” Doug said.

They discussed organ donation, funeral arrangements and burial plots, Julie said, reliving her feelings of hopelessness and helplessness. “When we took her off sedation medication, I was feeling terrible. I gave her to God. I couldn’t do anything,” she said.

At one point, after disappointing news from an MRI, Julie recalled Doug saying to her, “I wish I had a crystal ball and could know what Brooke will be like in six months, nine months, a year.”

That same day, Doug went back to the “campsite” and picked up a devotional book a relative had brought in.

“I just opened it and read: ‘He promises a lamp unto our feet, not a crystal ball into our future,’” Doug said.

It was from Psalm 119.

On June 3, her 13th day in intensive care, Brooke began responding to simple commands. Four days later her ventilator was removed. Her family held their collective breath. She not only breathed on her own, but she moved and swallowed.

On June 20, she whispered “Happy Father’s Day” to Doug, the best present he said he’d ever received. And days later, she wrote the words “Happy Birthday” on a card that she and Brittany made for his 44th birthday. That was a keeper.

On June 25, she ate “real food” for lunch and dinner, her sister wrote on the Caring Bridge site. Two days later, she was texting on her cell phone.


 Brooke clears another hurdle
Although the pressure in her brain was subsiding, Brooke was not out of the woods. Wang said she developed “post-traumatic hydrocephalus.” The fluid her brain was normally producing was not draining because the injury had blocked those passageways.

Doctors decided to insert a shunt into the brain to drain that fluid into the abdomen. That happened on June 29.

“Afterward, she just sailed,” Wang said.

Brittany’s Caring Bridge entries talk of Brooke’s progress. “Each day is bringing something new. Today she walked with her walker just like a normal person would,” Brittany wrote on July 2.

Independence Day had this entry: “For physical therapy, Brooke walked up and down a flight of three stairs today all by herself. She also worked on her wheelchair skills going up and down hills in the hallway.”

Those entries were being read by people the Earls never knew. Among them was a Pesotum woman who had sustained a brain injury in November 2009 and who had gone to the NeuroRestorative Institute in Carbondale, which specializes in rehabilitating people with spinal cord and brain injuries.

The Earls checked it out.

Another leg of the journey
On July 18, Brooke and her family said goodbye to the family they had made at Carle and headed for Carbondale. After a brief stop at home in St. Joseph, they were on the road. Brooke was suffering tremendous headaches.

Her parents had been told that her stay at NRI in Carbondale could be anywhere from six months to a year.

“We wanted to do whatever it took,” Julie said. “We were still worried about the shunt,” Doug added.

 Looking around them, they saw a lot of “participants” in much worse shape than Brooke. And when they learned upon arrival that her condition was good enough that she could skip right to the second level of care, they were even more encouraged. “We brought the walker, but she never touched it,” Julie said.

“Not once,” Brooke said.

On July 20, Brooke began making her own entries on her Caring Bridge website. “I miss my family greatly and cannot wait to be back home with them,” she wrote that day.

That bond was motivating as she worked her therapy like a woman possessed.

There was physical therapy balancing, stair-stepping, ladder-climbing and cognitive therapy putting sentences in reverse order, solving sudoku puzzles, map-reading, taking lecture notes.

Her entries documenting her progress are at once exhausting and exhilarating to read.

“Please keep my friends, family, doctors and nurses in your thoughts and prayers so that there can be more stories out there like mine,” she wrote on a particularly jam-packed July 28.

Her parents and sister made frequent visits. Her grandparents came even more often.

She was able to spend Labor Day weekend at home, and not long after being back at NRI, moved into her own apartment as the next phase of her road to independent living.

On Sept. 22, a check of her eyes pleasantly revealed no change in her prescription. A bigger highlight of the day was getting a tentative discharge date of Oct. 28.

“Toward the end it was like a job 8:30 to 5,” Brooke said. “And I wasn’t getting paid.”

It’s too soon for all the bills to be tabulated for Brooke’s care, but Julie said the family’s insurance didn’t cover much of the doctors’ services and that NRI was “very, very expensive.”

“You can’t put a price on somebody’s life,” she said.

Home again

Brooke made her discharge date of Oct. 28, returning home five months and six days after the accident.

She and Brittany are both living with their parents and back in class at Parkland College. Brooke is working on a kinesiology major with plans to become an athletic trainer. She’s been cleared to drive and is back at Chili’s as a hostess about 25 hours a week.

“It’s just back to life,” she shrugged.

She can’t hear in her right ear and has no ability to smell or taste. It’s unknown if she’ll regain those senses. But she did get her smile back. After working on her balance, that was her “next biggest thing.”

Wang characterized Brooke as having made about 70 percent of her recovery.

“She has another one to two years to continue to improve, but the improvement will not be as dramatic as the first three to six months. In my language, she has made a remarkable recovery, but I wouldn’t call the local newspaper. Ten out of 100 (similarly situated) will do just as well,” he said.


Statistics and odds aside, Julie Earl attributes having her daughter back to one thing: “God is awesome.”

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