Kathleen Skeins

During a vacation in Aruba, my husband, Ray, and I signed up for a tour on four-4 wheeled electric scooters. These scooters were built for the military and were virtually un-flippable. Virtually.
Ray was riding behind our guide, and I was some distance behind them. Ray went around a curve and was about 300 yards from the entrance to the excursion company. When I came around the corner, our guide was on the ground next to Ray, holding Ray’s head in his t-shirt. He turned and yelled to a co-worker to call an ambulance.
Ray remembers everything up to the accident when he supposedly collided with the guide and was thrown off the scooter at about 30 mph. He landed on his backside then his head on the asphalt. He was unconscious but with his eyes open and breathing very erratically. Quite a few strangers stopped to help, including a couple that were ICU nurses.
Ray was taken to the hospital and given a CT and body scan. They found no internal injuries or broken bones, but he did have a severe traumatic brain injury (TBI), and it was possibly fatal. The doctor on that day had eight years of experience in a NeruoICU in Belgum and knew what she was talking about. She made it clear how important it was to get to a more specialized facility as soon as possible. Unfortunately, Michigan (our home) was too far away, and Miami was as far as she would let him fly.
Our travel protection insurance company arranged a medivac flight, and we left the next afternoon for Jackson Memorial Hospital in Miami. This is where I was told Ray was a GCS 3 and again, his injuries were most likely fatal. We had been there over the weekend by this time, and he was not declining at all. I questioned the fatal diagnosis and asked if there was any evidence of personality making a difference in outcome. Another doctor explained he had more than three locations of his brain affected, and they were going to try and save “what was left.” Also, they made it clear they had no experience with personalities making a difference in recovery.
University of Miami is connected to Jackson Memorial Hospital. They had a research study in progress called Electrophysiologic Biomarkers of Consciousness Recovery after Acute Brain Injury. They were looking for brain activity that was clinically undetected. They asked if Ray could be a part of this study, I was more than happy to have him signed up. Unfortunately, Ray was so medicated and paralyzed as part of his medical treatment (to accommodate along with the cooling system) that he did not show any response.
As the days continued, the tubes needed to come out of Ray’s throat. He still needed help with breathing, so he was scheduled for a tracheostomy. The scans done in Miami found a bone chip at the base of his skull, which was a concern when performing the trach at bedside. A special surgical team agreed to perform this in an O.R. Ray was added to the schedule multiple times but then bumped off. The day it was really going to happen, Ray started breathing on his own and did not need the trach. On April 1st, he was extubated, and things took off from there.
A short-ish stay in the stepdown unit and then it was time to get home and into the Rehabilitation Institute of Michigan (RIM). This facility is part of the Detroit Medical Center family in downtown Detroit. Once he was approved and had a room waiting for him, the insurance flew us home on another air ambulance on April 16, 2024.
The TBI resulted in some weakness, but my memory seemed to be intact. Ray had no issues with speech aside from the gruff voice as a result from the tubes being in for three and a half weeks. Things were progressing so quickly, the stay at RIM was only one week.
Once home, we could see what emotional and cognitive issues we had to deal with and found counselors that worked with TBIs. Ray’s guy was a tremendous help with teaching him how I experienced things and how to communicate better with me. I had the same happening with my counselor from the same location.
On July 16, 2024, four and a half months from the accident, Ray took his neuropsychological evaluation. He refused to wait six months for the exam in order to see if he could go back to work. This was to be a difficult day, but he managed to complete everything about four hours and was told he made it through all the levels available. The results showed he did exceptionally well and highlighted the usual issues he had before the exam.
When I said things started to take off, they never stopped. Occupational Therapy evaluated Ray for driving a week after the neuro test. His vision was good, his decision making was on point and his reflexes were faster than many without a brain injury. Five months post injury and Ray was driving again. He was so happy to have some of his freedom back and not having to rely on me for so many things.
On September 5, 2024, less than six months from the date of the accident, Ray returned to work on a sliding schedule. Within a month he was back working full-time in his role as a Director of Strategic Planning for an automotive supplier. As he continued to improve, the doctors at the Rehabilitation Institute of Michigan met with us in October for one last time and released him from their care.
It has been a year now since our lives changed. Ray’s memory and cognition continue to improve, and he is working on ways to limit fatigue triggers. We are so grateful for the amazing care and rehabilitation he received. Thank you to all the angels who helped us along the way.