Monday, March 11, 2013 3:25 am
After crash abroad, Mass. student strives to heal
By BRIDGET MURPHYAssociated Press
Most of her hair was gone, but that wasn't the worst of it: There was a dent on the left side of her head. A chunk of her skull was missing.
Meg's parents told her there had been an accident, that she bumped her head. But that was two hospitals and a long plane ride ago.
Whatever had happened to her, she didn't remember any of it. And photos posted around her Boston hospital room of a 21-year-old coed, her chestnut hair flowing below her shoulders, looked like a different person.
Now Meg's two front teeth were cracked into peaks. Her boy-short hair was matted beneath a black hockey helmet. It protected her brain, but made her face break out in blemishes.
She could remember her semester abroad in Australia - even if some details of traveling in the Outback, scuba diving on the Great Barrier Reef and bungee jumping in the rainforest were coming back slowly. But she couldn't remember New Zealand, and the last days of her foreign adventure. Something had broken and her mind wasn't filling in the blanks.
Her parents, Todd and Deb Theriault, were there by her hospital bed in New Zealand after she came out of her coma.
"I love you, Meg," Todd had whispered.
"I love you," she answered.
Another month would pass before Meg smiled. She was still hospitalized, but back home in Massachusetts.
Her parents had hope, but doctors warned Meg might never be Meg again, the Boston University student who'd been on track to finish school and land an accounting job in the next year. Two months after the accident, connections to her brain were still scrambled.
The business major couldn't remember multiplication tables. She mistook a doctor at Spaulding Rehabilitation Hospital in Boston for her sixth-grade teacher. She looked forward to reuniting with a dog that hadn't lived with her family for years.
Meg wobbled as she learned to walk. Therapy filled her days, including speech and reading exercises. She had to practice spooning up her food, and how to bathe and dress herself.
But if Meg didn't understand where she had been, she knew where she wanted to be.
"It's just like being in school," a therapist said one day when she faltered during a drill.
"That's good," Meg said.
Because whatever it took, she wanted to be back at BU for her senior year.
She was the first victim they reached in the road.
"Meg, are you OK?"
Her classmate Dustin Holstein didn't get an answer. Deep, fast draws of air were all he heard. It was the kind of breathing, he would say later, "where it's like you're on the verge of dying."
It was the morning of May 12, 2012. Steam from a volcano in the distance curled into a cloudless sky in New Zealand's countryside.
The BU students - 16 of them in two minivans - had been headed to Tongariro Alpine Crossing, a trek through volcanic terrain with a view of the peak portrayed as Mount Doom in the "Lord of the Rings" movie trilogy.
Police said it seemed the single-vehicle crash happened after the minivan drifted to the roadside.
Stephen Houseman, the student who was driving, would say later the van began shaking and he couldn't control it. Police said he tried to correct course before the van rolled several times.
Students Austin Brashears, Roch Jauberty and Daniela Lekhno also landed in the road. Friends covered their faces with sleeping bags or blankets before the first fire truck arrived.
Meg was luckier - but far from lucky. Dustin pushed his friend's hair from her face as American pop star Adam Levine's voice streamed from the stereo inside the wreck. Blood leaked from a laceration on her chin. Skin had ripped off her right arm, baring part of the muscle.
But the worst damage was on the inside. Her skull had fractured. Blood was clotting on her brain.
A helicopter flew her to a hospital, where surgeons removed part of her skull to relieve the pressure from her swelling brain and purge the clot.
Meg had been due back in Boston in a few days. She'd sent ahead an early Mother's Day bouquet of lilies, tulips and roses, promising a celebration when she got home.
Instead, her parents had boarded a flight to New Zealand. Mother's Day melted away as they prayed their daughter wouldn't die.
Meg climbed the front steps, one at a time.
Four baby steps, with her mother poised to catch her.
"You gotta use the railing."
When Meg had pictured coming home to Salisbury, Mass., she expected a trip from the airport, not the hospital.
But there was comfort in the kind of rewind that comes with a return to a childhood bedroom and a family cat's meow.
"See, Charlie's waiting for you," Meg's mom said.
"I know, adorable kitty."
It was early August. Meg finally took a seat at her family's kitchen table again.
Reminders of the accident were all around. There was a second bannister along the stairs to her room, and support bars in the bathrooms. But Meg could start showering by herself in a special chair. She could shave, too.
Meg had planned to move into a city apartment, and start a summer internship at PricewaterhouseCoopers when she came home. Instead, her parents would drive her to Boston a couple times a week for therapy.
"You just can't put words to it, getting her back," said Deb Theriault, blotting tears. "She's worked so hard."
Meg felt more like herself, but craved the day when doctors would rebuild the missing part of her skull and she could ditch her helmet.
"Sorry you have to see me like this," she told two of her friends.
But soon they were laughing and chatting about Meg's plan to return to school.
"I want to be better as soon as I have the second surgery ...," she said. "I want to go back on time."
"I don't remember seeing this shape at all. ... We just went over this, but I don't remember."
Meg's mind wouldn't work the way she wanted.
"This is really pushing your brain to compensate for difficult material," her therapist said.
But something inside Meg urged her forward, a kind of determination captured in a poem on the wall of the therapist's office.
"That one day, changed my life ... That one thing that counts, one thing that I can't let go, the faith that one day I will be whole again," the verse said.
She had been home for more than a month. Her complexion was clearing. She was thinner and back to wearing makeup and earrings. She had been reviewing an accounting textbook and seeing more friends.
But her parents made her sleep with a baby monitor at night. She still couldn't drive a car.
Her left arm floated away from her side when she walked, giving her a robotic gait. She exercised to build her core strength and banish left-sided weakness from her brain injury.
Physiatrist Seth Herman said Meg's memory and mobility had improved a lot, but might never be what they once were. Due to the frontal lobe injury, she had trouble with insight, including recognizing her shortcomings.
"She probably still thinks she can go back to school," the doctor said.
But the day in September the fall semester started, Meg woke before dawn and went back to Massachusetts General Hospital.
The time had come for surgeons to fix the hole in her head.
Dr. Anoop Patel marked the left side of Meg's head with violet ink, prepping the area where he and Dr. William Curry Jr. would operate.
"How are you feeling today?" Patel asked. "Ready to get this thing taken care of?"
Meg was more than ready.
She'd drifted away on anesthesia when tufts of her hair began dropping to the operating room tiles. Scars on her fresh-shaved head snaked like lines on a map.
Blood pooled in the pocket of a surgery drape as the doctors sliced into old incisions, dissecting skin and scar tissue.
They wouldn't reuse bone New Zealand surgeons removed from Meg's skull. To minimize infection risk, a custom-made plastic implant would patch the gap.
Designed with 3-D imaging, it had a lima bean's shape. It was a little less than 5 inches long and 4 inches wide.
The surgeons used tiny screws to connect miniature titanium plates to the prosthetic and then to Meg's skull. They perfected the implant's contour by shaving it down with a drill, before washing away blood and sheared plastic.
Several layers of stitches later, the left frontal cranioplasty was complete.
Meg's head was round and her scars would be hidden once her hair grew. She wouldn't bang her brain if she fell.
Meg had more to build on now.
Strangers at a waterfront cafe sneaked glances as Meg sipped coffee with a friend. Maybe it was her inch-long hair, brown bristles that stood straight up.
But six weeks post-surgery, some of those closest to Meg said she was well on her way to recovery.
Her friend Julia Petras recalled hospital visits when Meg didn't understand what happened to her, or that students died in the same accident.
"Just talking about the accident itself was really surreal. I don't think you were in a place to really process it," Julia said.
At one point, Meg believed she had some memories of the wreck. She'd been sleeping at the time of the crash, and not wearing a seatbelt.
But five months later, Meg's accident recall - which she and doctors weren't sure was real -- was gone.
She'd also spent time with other students who were there that day, including Stephen Houseman. He had pleaded guilty to careless driving charges in New Zealand, where a judge forbade him to drive for six months. Meg and her parents didn't blame him for the wreck, saying it could have been any of the BU students behind the wheel.
Meg said survivors and eyewitnesses didn't talk much about the crash. They told her she was lucky, that it was good to see her getting better.
By late October, she had an appointment to fix her teeth and had been shopping for new sweaters.
But neuropsychological testing showed Meg had memory and attention gaps. Her brain injury also was keeping her from grasping how far she still had to go. A clinician suggested she enroll in a community college course or audit a BU class.
It wasn't what Meg wanted to hear. She was missing her senior year.
"I can't believe we happened to be here at the same time," Meg told Dustin Holstein. "Today of all days."
Meg beamed when he walked into the sushi place near Boston University. Her friend had chosen an auspicious moment to appear: In a few minutes, she and her parents would meet with BU officials to discuss whether she could return to school, nearly six months after the accident.
Dustin was a senior and looking forward to a job after graduation. But he also did a lot of looking back. He'd suffered flashbacks since the crash. Sometimes, they made him freeze up as he walked down the street in Boston.
But seeing Meg was a salve, and having her back in school would be even better medicine.
"She can tell her story on how she fought back from such a terrible accident," he said later. "And that alone, at least people will remember who was lost on that day and the good that can come out of a situation that was so horrible."
It was agreed that morning that Meg would audit an accounting class when spring semester started in January.
She'd already taken the class for credit and it wouldn't count this time. It was a test to see if she could handle school.
Meg was disappointed. She wanted to move back to Boston and start regular classes. She struggled to see her own progress, or what it could mean to other people.
But Dustin understood and appreciated all she had accomplished.
"I expect her to graduate," he said.
Meg's old seat was waiting for her when she slipped into Intermediate Accounting I class, just a little late.
"I was in the traffic but everything's good," she told senior lecturer Eng Wu.
"Excuses," he teased.
A scar on Meg's wrist peeked out of her sleeve as she started to take notes.
But that was the only hint of what had happened. Her hair had grown into a pixie style. She was back working part-time in a Chinese restaurant and in a BU mailroom, and volunteering at an elementary school.
On this morning, Meg had lugged her book bag, set her cellphone down on her desk and swigged her coffee like any other college student.
But then the professor played a video clip his son, a neurosurgeon, had sent him. It wasn't something meant for Meg, just a way for a teacher to connect with students on the semester's first day. The clip was part of a British comedy sketch in which a brain surgeon belittled an accountant.
"Filling in those tax forms can get really confusing, can't it?" the doctor said. "Still, it's not exactly brain surgery, is it?"
Meg laughed with the rest of the class. Because, as just another accounting student, it was funny to her. Because, at just that moment, she knew she was back where she belonged.
In February, Meg got back her first test.
"I got a B, which is OK," she said. "Not great, not phenomenal."
She never thought to hang it on the refrigerator of her new studio apartment in Boston.
It just wasn't something a normal college kid would do.
EDITOR'S NOTE: This story is based on a series of interviews with Meg Theriault, her family and friends, doctors and medical personnel. The AP witnessed her surgery and therapy; the description of the accident and its aftermath was drawn from police information and interviews with an eyewitness and the Theriault family.