‘Gotta Have the Grit’: Brendan’s Recovery from a Traumatic Brain Injury

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“Don’t ever give up, no matter what.”

That was 16-year-old Brendan M.’s motto as he tackled more than seven months of intensive rehabilitation at Shirley Ryan AbilityLab — both inpatient and DayRehab — after experiencing a traumatic brain injury (TBI) and major multiple trauma from a devastating car accident.

Brendan, along with his older sister and his friend, were driving only minutes from their home in Indiana when a semi-truck hit their car. Heartbreakingly, Brendan’s sister, Grace, did not survive the accident, and both Brendan and his friend experienced significant injuries.

Brendan was flown immediately to a hospital in Chicago. He spent more than a month in neurological and then pediatric intensive care to begin healing from his external and internal injuries. He battled through fevers, surgery for broken bones in his arms and legs, and neurostorms, which are stress reactions in the nervous system that can occur after a brain injury.

In addition to the fear and worry surrounding Brendan’s physical and cognitive condition, his parents, Jenn and Tim, and younger sisters, Lucy and Meghan, simultaneously were grieving the loss of their beloved daughter and sister.

However, despite the long road ahead of him, Brendan’s tenacious, “all grit” mindset characterized his recovery as he demonstrated perseverance and resilience every step of the way.

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Brendan was a sophomore in high school at the time of the car accident — a great student with a strong group of friends and a love of video games, fishing, robotics and football.

However, when he arrived at Shirley Ryan AbilityLab for inpatient rehabilitation on the hospital’s pediatrics floor, his active lifestyle had come to a standstill. He was not able to walk or talk. He had a tracheostomy to help him breathe, as well as a gastrostomy tube — or g-tube — which is used to provide nourishment when a patient cannot safely eat or swallow on their own.

Jenn recalls feeling hopeless at first, when Brendan couldn’t hold his head up and needed to be hoisted to transfer from a bed to a chair.

“I thought, ‘Is this what his life is going to be like?’” she said. “But, instantly, he started making progress.”

“On the very first day when Brendan got his evaluation, the thing that struck me was that the whole attitude at Shirley Ryan AbilityLab is very positive,” said Tim, who stayed with Brendan and attended his therapy during the entirety of inpatient care. “Everyone talks about what patients can do and will do — no one talks about what they can’t do.”

During his time as an inpatient, Brendan started to “wake up” from his injury and regain function. He reached small milestones at first, like sitting up on his own and throwing a ball … and then the larger milestones started rolling in.

In occupational therapy (OT), he started to discern colors and shapes again. When his therapist put a marker in Brendan’s hand, he was able to write a “B” for his name.

“I knew he was still in there, just stuck in an impaired body,” said Tim.

Speech-language therapy offered another glimmer of hope, when Brendan spoke his first words since the accident: “Hi, mom.”

During physical therapy (PT), Jenn remembers seeing Brendan’s therapists place his feet on bike pedals and move his feet for him. At first, she felt sad that he had lost the ability to push the pedals by himself.

However, within a month, Brendan reached yet another huge milestone — walking, first with assistance from his therapists and eventually on his own. His parents realized how important it had been for his therapists to help Brendan relearn how to move so he could eventually walk, run and play sports on his own.

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After rapid progress during 10 weeks of inpatient rehabilitation, Brendan finally was able to return home, readjusting to life with his parents, younger sisters and their family dog.

However, Brendan still needed to work on mobility, strength and balance, as well as to continue to improve his fine motor and cognitive skills after his TBI. For the next 20 weeks, he received physical, occupational and speech therapy two full days a week at Shirley Ryan AbilityLab’s DayRehab Center in Homewood.

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As Brendan’s left side was impacted in the car accident, he experienced foot drop in his left leg — a condition where the muscles that lift the foot are weaker, causing the toes or feet to catch on the ground while walking. As he started to walk more, he was fitted for an orthosis, or brace, for his left leg and worked on exercises in PT to help with his gait and coordination, such as walking side to side and backward, crossing over uneven surfaces and stepping over blocks.

Brendan also played a lot of games with his therapists during OT sessions (and continues to play at home with his family to sharpen his skills). Card and board games offer more than just fun; they are also effective and engaging therapeutic interventions to help patients restore function.

Specifically, games helped Brendan improve his fine motor skills; build communication and social abilities; enhance his planning, organizing and visual processing skills; and regulate emotions. Even by shuffling and dealing a deck of cards, he built strength and coordination in his hands.

Outside of DayRehab, Brendan was working just as hard to recapture his previous teenage life. He diligently kept up with his schoolwork, creating a binder featuring tips and strategies from therapy and to keep himself organized on his assignments. He started to reconnect with his friend group, enjoying movie nights and video games with his buddies.

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Just a few months earlier, Brendan needed his physical therapists to push bike pedals for him. However, in his final days of DayRehab, he zipped around outside on an adaptive bike using the full strength of his legs.

Also, Brendan walked out the door on his final day of DayRehab — or “grad day” — all on his own. In fact, he nearly ran out the door, but contained himself, Jenn quipped.

Now, Brendan is focused on returning to high school to start his junior year with his peers, and he plans to graduate on time despite the setback from the months of rehabilitation. He will receive speech services at school to continue improving his language skills.

He is once again enjoying a number of activities — fishing, swimming, walking his dog, mini golfing, going to the zoo with his sisters, and more. He also is learning to drive, hopes to get a summer job and is looking forward to a family beach vacation in Florida.

Brendan’s family continues to process their loss and the accident, but they are grateful for the support of their community.

“It is amazing to come out of a terrible accident like this and realize how much your community came together for you and your family,” said Brendan. “People who I don't even know from all over have been reaching out to us with support. It has been eye-opening.”

“I learned that I am stronger than I thought, a hard worker, and I will never give up. Gotta have the grit,” he continued.

Looking back on their experience at Shirley Ryan AbilityLab, Tim noted that Brendan’s focus on his personal grit kept him motivated throughout the challenges of his recovery.

“We encouraged Brendan to take every opportunity to participate and to put maximum effort into his recovery,” said Tim. “I don’t want him to lower the bar for himself just because of his injury. What I really want for him is to realize he can do anything he commits himself to.”