Back to Life. A Happy Holiday Miracle Story.
January 1- 7, 2004
cover story
by Ralph Cipriano
Abby’s room was decorated with cards and banners, and clusters of helium balloons. The staff brought along a present, a jewelry box with an angel on top, and inside, a heart-shaped rock emblazoned with the word “HOPE.” And as they sang along with family members, the medical professionals wondered whether Abby could hear or whether she was even aware of what was going on.
Abby sat in her wheelchair, looking off into space, her chin propped up by a large neck brace. Her tiny 5-foot, 96-pound body had a feeding tube attached at the stomach; Abby also had a hole in her trachea for an oxygen tube that had recently been removed.
Abby couldn’t talk or feed herself. She had been in what doctors at a previous hospital had described as a vegetative state. But doctors at MossRehab had seen some recent responsiveness, so they had classified Abby as “minimally conscious.”
MossRehab, located on the main campus of Albert Einstein Medical Center in the Logan section of the city, specializes in providing therapy for victims of disabilities such as strokes and traumatic brain injuries. Staffers there are used to dealing with people who have suffered gunshot wounds and auto accidents. Yet Abby looked strangely pristine. She had suffered a traumatic brain injury when her car was totaled, doctors said, but there were no scars or bruises on her face or body.
“She looked very peaceful and very beautiful,” recalled Ebilyss Martinez, a MossRehab social worker. “Her face was perfect,” agreed Dayna Ingham, a speech-language pathologist, who met Abby on a Friday and then spent an entire weekend thinking about her.
What got to the team at MossRehab were Abby’s eyes. “She would lock eyes on you and follow you around the room,” Martinez says. “Like she was trying to communicate.”
The team of rehab pros assigned to Abby had talked about different options for trying to establish some form of communication with her. The birthday party had been the staff’s idea, a morale booster to perk up Abby’s family, especially Abby’s mother, Blanca, who kept telling the doctors that she was a woman of faith and that God was going to heal her daughter. Abby was going to talk again, Blanca would tell doctors and therapists and anybody else who would listen. And Abby was going to walk again too, her mother insisted.
While everybody was singing “Happy Birthday” to Abby, Joe Notter, Abby’s boyfriend, raised the birthday cake to Abby’s face. Abby couldn’t blow out the candles, so Blanca did the honors. Then Notter crouched over Abby. As everybody watched, Notter took Abby’s hand, put his face close to hers and said, “Happy birthday, Abby. I love you.”
Then it happened. A single tear fell from each of Abby’s eyes. Claire McGrath, a clinical neuropsychologist, asked if anyone had given the patient eye drops. The medical professionals shook their heads. “If those are real tears ,” someone started to say.
Blanca dabbed Abby’s eyes with her fingers. And then as everybody watched in silence, a second pair of tears fell and Abby’s nose turned red.
Notter started crying. So did Abby’s mother, father and two sisters. Ingham, the speech therapist, looked at Martinez, the social worker, and said she was about to join the crowd. “Let’s not cry in front of the family,” Martinez told her.
Other staffers, however, couldn’t hold back. Martinez tried to figure out what it all meant. “Abby understands what’s going on,” she said to herself. “She’s probably in there. How do we get her out?”
Doctors and therapists were staring at each other as Abby’s family and boyfriend continued to sob and hug each other. It was getting awkward; the birthday party had turned into a cathartic group cry.
“One by one we excused ourselves,” Martinez says. “And we go into the occupational therapy office and start crying.”
McGrath, the one with the driest eyes, tried to analyze what she had just witnessed, which could have been a scene out of a soap opera.
“If she really was crying,” McGrath said, “she has a level of comprehension of what’s going on, a level of awareness and a level of emotional response.”
But McGrath wanted more proof. “We’ve got to see that one more time,” she told crying team members.
Abby’s 18th birthday party was the first time the girl from Northeast Philly amazed her doctors and therapists. But there were many more surprises to come, as over the past few months Abby has miraculously fulfilled her mother’s predictions, and learned to talk again and walk again, with the aid of a walker.
The doctors and therapists at MossRehab don’t discount miracles, but in interviews, they say their job is to analyze behavior and track a patient’s progress. But that doesn’t mean they can’t brag about Abby.
“I tell the whole world about Abby,” McGrath says. “She’s like our superstar.”
Eileen Fitzpatrick-DeSalme, the neuropsychology supervisor in the hospital’s Drucker Brain Injury Center, says over the past 10 years while treating about 200 patients with traumatic brain injuries, only a handful have recovered as quickly as Abby.
Abby’s case has kindled an ongoing discussion about how to explain her amazing recovery, as well as the role of faith in healing.
“We don’t know what the contribution of prayer is,” says Fitzpatrick-DeSalme. “Do I discount the capacity for quote-unquote miracles?” she asks, smiling and staring. “I do not. But what it means and how it translates to others ” Her voice trails off.
Abby was a sales rep at 579, a clothing store at the Neshaminy Mall in Bensalem. That’s where she met Notter, a sales rep at the Verizon Wireless store in the same mall. Abby and Notter knew each other a year before they started dating. They had been going steady for about a year before the accident.
“She’s a pretty girl; that definitely caught my eye,” says Notter who, at 22, is four years older than Abby. “She was persistent on me being with her,” he says, because she had a crush on him. Abby’s parents worried that Notter was too old and they told their daughter to find a high-school boy to date. But, as Notter says, “it was one of those things that was meant to be.”
Notter liked to take Abby to fancy restaurants down the shore or in Old City. “I kind of spoiled her,” he says. “She was like a senior in high school and all her friends were envious of what she would do.”
Abby graduated from George Washington High School in the Northeast last June. She was scheduled to start college on July 8, attending the summer semester at Kutztown University. Abby wanted to become a graphic designer, like her father and older sister, Nadine.
On June 29, a Sunday morning, Abby was driving home on Knights Road, attempting to make a left onto Street Road, when a car ran a red light and rammed Abby’s car.
Ben and Blanca Padilla were getting ready for church when the phone rang. A friend listening to a police radio had heard that Abby had been involved in a car accident and was on her way to Frankford Hospital-Torresdale in an ambulance, in critical condition. The Padillas called the hospital to confirm the bad news. They also called Notter, to let him know before they sped off to the hospital.
Notter beat the Padillas to the hospital. He barged into the intensive care unit just as they wheeled in Abby. She was covered with tubes and monitors, but other than that, “she looked perfectly normal, just knocked out,” Notter says. The doctors promptly kicked Abby’s boyfriend out of the ICU, but when the Padillas got there, they told the doctors, “He’s with us, and he’s coming in.”
Abby was on life support. The doctors said she was in a coma and they didn’t know if she was going to come out of it. A Bensalem police detective came to the hospital to investigate the accident. The detective told the Padillas that the police found Abby lying on the floor of her car, like she was sleeping. There was no blood or bruises on Abby’s face or anywhere else on her body.
Blanca is a secretary to the pastoral counseling department at Christian Life Center, a nondenominational Christian church that the Padilla family belongs to in Bensalem. A Bensalem police officer told church officials about the accident, and the pastor interrupted the service to ask the whole church to start praying for Abby. Some assistant pastors left to go to the hospital.
In the hospital waiting room, Blanca dropped to the floor and started crying and praying. She told God she had dedicated Abby as an infant to the Lord, and “now I give her back to you so you can heal her.”
Blanca spent the night in the hospital. She was crying so much she couldn’t sleep, so she decided to read her Bible. “Lord,” she said, “I know I can go to your word and find the promises that you have for me, but I need to know you’re here. I need to know that this is you. I need to know for sure, so there is no question in my mind.”
Blanca was looking for a sign, so she closed her eyes and opened her Bible to a random page. When she opened her eyes, an Old Testament verse from the 43rd chapter of Isaiah jumped out at her:
“When you pass through the waters, I will be with you; and through the rivers, they shall not overflow you. When you walk through the fire, you shall not be burned, nor shall the flame scorch you.” Blanca began to pray this promise over Abby, and she asked God for complete restoration.
In the days after the accident, doctors cut a hole in Abby’s trachea so she could breathe, but they didn’t think there was much more they could do for her. Doctors called Ben and Blanca into a meeting, explained that Abby was nonresponsive and that they expected she would remain in a permanent vegetative state.
Devastated, Ben and Blanca stumbled into Abby’s room and formed a circle around Abby’s bed, with Abby’s three older siblings. Looking at her unconscious daughter, Blanca felt nothing but anger inside. She turned to her family, and in an uncharacteristically strong voice said she was simply not going to accept the doctors’ verdict. And what’s more, she didn’t want anybody else in the family to accept it either.
Blanca told her family she was praying that God would completely restore Abby, and no matter what the doctors said, she believed that her daughter would talk again and walk again.
On July 17, Abby was transferred to MossRehab, where the staff noted her only purposeful movements: She tracked with her eyes, and she pulled at the tube in her trachea. The doctors classified Abby as “minimally conscious.” Katie Stephens, a physical therapist, remembered seeing Abby in a wheelchair with her bulky neck brace. “She just sat in her chair and she didn’t move,” Stephens says. “Her family was surrounding her.”
The therapists took Abby out of the wheelchair and sat her on a mat. James Dugan, one of the therapists, sat down next to Abby and tried to work with her. Abby had her head down, Stephens remembers. “If [Dugan] let her go, she just fell right over,” Stephens says. “That went on for a while.”
Blanca, however, kept repeating her mantra about being a woman of faith to all the doctors and therapists. “I believe that my daughter’s going to be healed,” she said. “I can’t explain it to you. I don’t have a choice. I just gotta believe.”
McGrath, the neuropsychologist, says that Abby’s traumatic injury involved the white nerve tracks known as axons that connect nerve cells to each other in the brain and transmit electrical signals. Abby’s head had been shaken so violently during the accident that countless nerve tracks in her brain were torn apart in what McGrath described as a “global shearing.” There are millions of axons in the brain and there is no way of telling on a cellular level how many axons were damaged, McGrath says.
Abby’s other problem was bleeding. “She had a subdural hematoma,” McGrath says, referring to internal bleeding between the covering of the brain and the brain itself. Abby also had multiple lesions all over her brain. One spot on Abby’s head was shaved because doctors had to drill two holes in Abby’s head, one for drainage, the other to install a monitor.
McGrath says there is “a good deal of misinformation in the media” about coma patients suddenly waking up. It just doesn’t happen that way, she says. If a patient emerges from a coma, it’s a gradual awakening. And there are limits on what doctors can do.
“We can’t make a brain heal faster,” McGrath says. “All we can do is to provide the patient with rehab to optimize recovery. Whether or not someone emerges from a coma is dependent on the type of injury received and other factors, such as the age and general health of the patient.”
Abby did have some things going for her. She was young and strong and the doctors had gotten to her right after she was injured. And her family was constantly around her, offering love and encouragement. The family kept seeing signs for hope.
Blanca saw her daughter’s eyes flutter. Ben told the doctors he saw facial expressions that convinced him that Abby could feel pain and frustration. The doctors were more cautious, counseling Abby’s family on how long it takes to recover from a traumatic brain injury.
A doctor tried talking to Abby. She put a phone on the bed and asked, “Abby, what do you do with a phone?” As her parents watched, Abby slowly stretched her left hand toward the phone. Her parents started cheering her on. “You can do this, Abby,” they yelled. Abby not only grabbed the phone, she also lifted it slowly to her ear.
On other occasions, Abby would hand a ball to a therapist on command and point to a cup. The MossRehab team continued to classify Abby as “minimally conscious.” Then Abby’s birthday party rolled around, and everybody was even more hopeful for Abby.
The entire staff continued to shower Abby with attention. “She was like a Barbie doll,” her mother says. “The nurses, they all loved to dress her and comb her hair.”
Abby’s boyfriend was becoming a concern. The medical staff and Abby’s family began to wonder if it would be better for Notter to get on with his life. But Notter just refused to go away, showing up after work to see Abby and spending his entire day off with her.
The staff was puzzled. “I hate to make stereotypes,” Fitzpatrick-DeSalme says. “But the guys are usually out of here.”
The family asked Martinez, the social worker, to talk to Notter. So she did, taking him aside to give him the lowdown on the long odds Abby was up against, and how long it was going to take.
Notter listened to the grim news, then told Martinez, “This is not about me, this is about Abby. And I want to be as supportive as I can.”
“He had plenty of opportunities to walk,” Martinez sighs. Yet she saw him the morning of Abby’s birthday, sitting with Abby in her wheelchair with the “I Love You” balloon he had just bought tied to the back of her chair. “What are you doing here so early?” Martinez remembers asking Notter. “I’m just so happy that I’m just touching her hand,” he said.
There was a time after Abby’s birthday when Abby was looking around and the family began to wonder if Abby was able to recognize them. But there was no mystery about whether she recognized Notter.
Whenever Notter walked into the room, something came over Abby. “It was like Christmas every day for a child,” Martinez says. “How you wake up in the morning with that glow. That’s how she was every time he walked into the room.”
Blanca remembers that when Notter was in the room, “It was like I disappeared. That’s young love,” she says.
The therapists and doctors made the same observation. When Notter was around, Abby didn’t pay any attention to what the medical pros were trying to get her to do.
In late August, Abby tried to mouth words, but no sound came out. A few weeks after the birthday party, Notter showed up after work to watch TV with Abby. He was laying on the hospital bed when Abby tried to talk again. It came out in a slow, barely understandable whisper.
“You’d better not be kissing other girls,” Abby said.
Notter almost fell off the bed. “Abby,” he said. “You just talked.”
Notter picked up the phone and dialed the Padillas’ number. And then he handed the phone to Abby.
Blanca heard breathing, and then, “a slow, squeaky little voice” just louder than a whisper.
“Mom? Mom, it’s Abby.”
“Oh my God,” Blanca said. “Abby, you’re talking!”
Abby continued to amaze her doctors and therapists. As fast as the staff would work out protocol for new therapies, Abby would get it in a day and then the staff would have to come up with a new protocol. Everybody in the Padilla family, as well as Notter, took outpatient training so they would know how to assist Abby.
Abby kept setting goals for herself, and meeting them. She left MossRehab in a wheelchair in early October (staff members cried). She vowed to be walking by Notter’s birthday, Nov. 14. And she did it as an outpatient, taking her first steps with the aid of a walker.
Abby continues to regain the use of her right arm, which was paralyzed, and the use of her right leg, which she also couldn’t move. She started writing e-mails to the staff and Notter. She continued to struggle with short-term memory loss, but tackled that by keeping a journal. Last week at MossRehab, Abby was climbing stairs.
“Oh wow,” said Dugan, as he watched Abby charge up the stairs with forceful steps. “Excellent,” Dugan yelled to Abby. He was also impressed with her muscle tone. “Abs of steel,” he yelled.
Stephens taught Abby and Blanca how to do knee bends while holding their backs to a wall. Abby was better than her mother.
“Hold, hold, hold,” Stephens exhorted. “Feel the burn. Nice work, ladies.”
“She continues to amaze us,” Martinez says. She remembered all the times the staff tried to get Abby to talk. “Now, she initiates conversations,” Martinez says.
McGrath is still trying to figure it out. “The brain is so terribly complex,” she says. “No matter how much research, we only have a tiny window of understanding.”
“For some reason, Abby’s brain was able to reorganize so that she could regain functions that she lost,” McGrath says. “Not all patients are as fortunate, despite the prayers of their families.”
That’s a subject that continues to mystify — the role of faith in healing. “Ninety percent of the families here are praying,” McGrath says. Her team leader, Fitzpatrick-DeSalme, agrees, saying that she can’t explain why other patients who are as “deserving of a miracle as anybody else” do not come around.
Abby has no memory of the accident. She doesn’t remember her 18th birthday party or much about her time in the hospital. But she does know how she got this far.
“God,” she says. “He saved me.”
Ralph Cipriano is freelance writer and a member of the Christian Life Center.