When Libby Lost Her Smile

Chapter 1 – It’s just a concussion

I never thought I’d get tired of hearing this one innocent little phrase, “It’s just a concussion.” Maybe it was the “just a” part that bothered me, or possibly it’s because the word “concussion” itself is such a broad term. It can cover anything from getting a slight bump on the head that leaves a person with a headache for a couple days, to almost total memory loss, confusion, mind boggling pressure headaches and cognitive impairments that can last for years. It was something I never really thought that much about except on the odd occasion when someone I knew was in an accident and I was told “It’s just a concussion” almost making light of the fact they’d been in an accident.

My husband Dave and I raised two very active boys who played football and rode bikes without helmets. Back then, like seatbelts, it wasn’t something most people thought about. I didn’t mind the seat belt laws or the bike helmet laws. Once they were in effect I followed them, and to me the laws made sense, but gosh, when I was a kid, or our boys were kids, we just hopped in the car or on a bike without any thought of protection.

A couple months before Dave and I were married, he took a fall at work, landing on his head, on a concrete pad, eight feet below. Dave broke his knee in the fall, and sustained a concussion. We joked about his hard head and in all honesty, didn’t think much about it because he didn’t seem to have any adverse effects, other than a mild headache. He wore a cast from toe to hip for six weeks and walked with a cane for another month after that, and that was that.

It actually became a reality again when our oldest boy Peyton got a concussion during a high school football game. Two players from the opposing side double teamed him, hitting him so hard his helmet flew off. As a sport’s mom, it was my worst nightmare watching my son go limp, holding my breath waiting to see movement, forcing myself to stay rooted to my seat and not run foolishly out on the field. I wait as the coaches run out and kneel over my still motionless baby boy and then yes, there it is, movement, as slight as it is, it allows me to let out the breath I’d been holding. I relax a little as he walks unassisted beside the coaches to the sidelines.

“Wait, what’s Peyton doing rolling around on the ground? That’s not right,” I think to myself. The coaches call me down from my seat on the bleachers to see what I think because they too see the change. My always cool, popular, wouldn’t be caught dead doing something that would draw anything but admiration in his direction, son, was crawling around on the ground, spitting streams of water into the air on the sidelines.

My fears were again confirmed, when the son I’d never heard a curse word out of, looked me directly in the eye and said scathingly “What the Hell are you doing here? Mom, you’re embarrassing me, you’re not supposed to be down here!”

“The coach asked me to come down to make sure you’re OK.” I defended myself as Peyton glared at me. One of his biggest fears at sixteen wasn’t being injured, but being embarrassed by Dad or Mom.

When the coaches asked him questions like “Who’s the president of the United States?” to see if he could answer them knowledgeably, Peyton rolled his eyes and spat out, “Duh, George Washington!”

He went back out on the field because he insisted he was fine, only to have the quarterback call a time out from the huddle, take my son by the arm and walk him back to the sidelines. Our boy, who lived and breathed football, couldn’t remember how to execute his favorite play.

We did what we thought was the right thing and got him checked out at the local ER and then took him home and watched over him for a couple days until he seemed to act “normal” again. We let him go back out on the field like so many other parents do with their athletic children, as soon as we felt he was OK. We didn’t connect, at the time that he began having migraines, or that maybe, just maybe, there should have been something in place that stops athletes from going back out on the field too soon and risking a second and possible permanent injury. I mean, for goodness sake, “It’s just a concussion.”

We were lucky. Peyton continued to play football, broke school records for rushing yards and got to live out his dream, at sixteen, to be the best running back on his team. Other than the occasional migraine, he didn’t seem to suffer any long term effects. He did eventually tell me that he answered the president question on the field that way because he really couldn’t remember who was president and didn’t want the coaches to know.

A year later, I got to experience first hand what a concussion felt like too when my car was rear-ended by a truck, while I was stopped for a school bus letting out children. I didn’t go to the hospital. I just remember waking up from a strange blackness with my head on the steering wheel and thinking; “Oh, my head hurts.” I don’t even think I consciously thought about being knocked out because as soon as I regained consciousness, my only thought was “What damage was done to my car?”

While giving the reports to the trooper a little later, I vaguely remember telling him what happened. I think I answered all his questions intelligently, but in all honesty, I don’t remember and I don’t even think I mentioned that my head hurt. I remember waking up the next day feeling really fuzzy headed, like a heavy curtain of fog was dropped around my head and I had to try to hear, see and think through the thickness. I couldn’t concentrate on anything because I had a whopping headache. My head felt like it weighed fifty pounds making it almost impossible for my neck to hold it upright.

I went to the chiropractor a couple days later because Dave kept insisting I see a doctor and finally wore me down. I was treated for whip lash and remember discussing how my head felt. It was then that the word “concussion” was again used and my first thought after that was; “Ahh, so this is what Peyton felt like.”

It took me a little longer to recover and it came in stages. I remember waking up in the morning and not feeling that fuzzy thickness and thinking “Oh good, I can get this done and this done and this,” making a mental list of everything I’d forgotten to do the day before. Then, in two hours, the fog would return leaving me helpless not even able to remember that I had a list. I didn’t have a choice but to lie down on the couch from exhaustion by noon wishing this thick fuzzy feeling in my head would just go away so I could think again.

I did really embarrassing things. About a week after my accident, I was picking the boys up from football practice. I stopped at the local chain restaurant because teenage boys are always starving. I ordered the food at the drive thru window, handed the girl my money and drove away. Luckily before I got out of the parking lot my very hungry boys reminded me that food would be nice, so I drove back around to the front of the restaurant and sheepishly walked inside where the girl behind the register smirked and handed me my food.

It was so embarrassing to ask someone to repeat what they just said to me because I couldn’t understand it. I remember friends and family jokingly making comments that my “elevator didn’t go all the way to the top”. At the time I didn’t even understand what that meant so I laughed along with them not understanding the implications. Not once during that time of recovery did I realize my actions were strange. I might be confused or embarrassed over something I attempted to say or do, and failed at, because I could remember that I could do the same thing months ago. My brain just didn’t allow me to process that next step or to understand I was really injured.

Luckily again, after a couple months, I recovered, like my son, and could even joke about the silly things we had done after our concussions. 85% of the people that sustain concussions go through very similar circumstances, possibly not even going to the emergency room, because with a head injury it’s so often just termed “got their bell rung,” or “it’s just a concussion.” It’s not that big of a deal really, we all know someone in our lives who has had some type of concussion and after all, they got over it. It’s just a natural assumption that everyone does.

September 25, 2006 changed all of that for our family when our youngest child Elizabeth (known to her friends as Libby) was involved in a school bus accident. It was considered a minor accident that happened in the school bus loop. Libby’s bus was about to enter the street that the bus loop starts and ends at, when a teacher flagged the bus down, running across the grass in the center of the circle with a little girl who was about to miss the bus. So naturally Libby’s bus driver stopped. Here’s the catch, though. Normally when entering the street, even though there is a stop sign at the end of the bus loop, the busses are directed into traffic by a crossing guard. It’s one continuous line rolling along, then splitting left or right when turning on to the street. So when Libby’s bus stopped, they broke the routine of not stopping. The driver behind them was preoccupied by students and didn’t see that the bus in front of him had come to a halt. Before he had time to react, he hit Libby’s bus and sent it out into the street. The rear of Libby’s bus barely showed damage except for a cracked window and bent bumper, but the front end of the bus that ran into hers had damage. The grill was smashed and radiator fluid spilled out onto the ground.

Libby’s normal seat was the very back seat on the passenger side and it just happened that was where the bus hit, sending her head snapping backwards, then forward. She hit the back of her head on the seat she was sitting in and then flew forward, hitting her forehead on the bar encased seat in front of her.

I received a call from the school within a half hour after the accident occurred letting me know that Libby’s bus would be delayed because there had been a minor accident at school. They had to wait for another bus to load the kids on and take them home. I was assured that everyone was fine, but something in the woman’s voice sent warning bells off in my head. For the next hour I paced, glancing out the window, and then wandering into the kitchen, puttering, staying busy and making coffee I didn’t really want to drink. I finally called my mother just to pass the time until the bus arrived home.

I am a worry wart by nature and, if given enough time, my imagination can picture the worst. I’ve learned through the years that sitting and thinking about what might be, does me no good and I’ve learned to put those worries out of my head by staying busy or doing something that takes my mind off those doomsday thoughts.

I finally heard the bus as it slowed to a stop, more than an hour later than usual. As soon as Libby got inside, I knew that, this time my worries hadn’t been unfounded. Something was definitely wrong. She was pale, hunched over, wouldn’t look at me and wouldn’t answer questions but went to the nearest chair and gingerly sat down; resting her elbows on the arms and cradling her head in the palm of her hands. Her long dark brown hair fell around her hands and covered her face, hiding her expression. I knelt down in front of her and placed my hand on her wrist. I tried asking questions while she moaned and gave noncommittal, guttural answers.

“Libby, did anyone check you out to see if you were ok?” I asked. The paleness of her skin frightened me. “Honey, talk to me. I need to find out where you hurt. Did anyone check on you?”

“The nurse, but she said I was fine,” Libby finally whispered. “Oh and Trooper John asked me questions, but I think I gave him the wrong answers.” She moaned again and was silent for a few seconds.

“Am I thirteen, or fourteen?” she asked, looking up finally. Her big brown eyes were so filled with pain they looked almost black in color.

That’s all I needed to hear. It was my signal that said to head for the emergency room. I called my husband Dave, quickly filled him in and helped Libby to the car. Dave drove straight from work and met us at the hospital within the hour.

Once we arrived at the emergency room and talked to the receptionist, she explained that Libby would have to wait in the waiting room. They seemed very busy and the waiting room was almost full too. Every few minutes a nurse would open the door to the waiting area, glance around the room, and then disappear again.

As I looked around, I realized that the faces were familiar. They were other students from Libby’s bus, so I wasn’t the only concerned parent bringing a child in from the accident.

We sat in the waiting room for only a few minutes when a nurse looked out and saw Libby’s distress. Libby wouldn’t stop moaning or sit still. She’d try to lean her head on me for a few seconds, then moan and bend over in her chair holding her head in her hands. The nurse came over and asked me a couple questions about Libby’s condition. I told her she’d been complaining of head, neck and back pain.

We were immediately escorted back to a curtained room as the nurse shouted orders. “This child needs to be looked at immediately, she has a head injury!” There was a flurry of activity as Libby was placed on a back board and a collar was placed around her neck, immobilizing her.

Libby did several things in the emergency room that concerned me. She didn’t remember the doctor who looked at her even though he’d been her pediatrician when she was small and had treated her in the ER several times for sprains and stitches. They had a standing joke between them every time they saw each other. When Libby was two, she used to take the stethoscope from around the doctor’s neck and put it to her ears telling him she wanted to hear his heart beep. Whenever they would meet he’d ask her “Want to hear my heart beep today?” Libby also swallowed a penny when she was two years old and this doctor had treated her for that. He nicknamed her “Piggy Bank”.

He had a charming English accent, and a couple times Libby commented that he talked funny when he was examining her. I explained that he was English.

“Don’t you remember? He’s the doctor that stitched your face and put a cast on your hand.” Libby didn’t have a clue. “She doesn’t remember you,” I whispered to the doctor.

“That’s ok, Mum; I’m not really all that memorable.” I noticed after my comment he paid closer attention to her, even though he continued to reassure me that her actions were completely normal for what she’d been through.

Libby did the opposite of what the doctor and nurses asked her to do. If they said “Hold still,” she’d move, trying to sit up, pulling against the restraints they had placed around her. Several times Libby tried to remove her neck brace, but the nurse would take her hands and in a calm demeanor, reassure Libby that she needed her to be still.

The hospital staff was wonderful to us, but one nurse in particular came into our room and said, “I don’t know about you Mom, but if I were you, I’d be really upset. The school handled this all wrong. They could have called us in advance and we could have had a triage set up and ready for these kids. This was just wrong!”

I nodded in agreement, but at that moment my main concern was for my daughter. It did plant that seed, causing me to wonder a little later; why the school hadn’t noticed what I thought was Libby’s obvious distress. Why hadn’t they called for EMT’s? Our small community hospital was full of students, all from the accident. The girl who had been seated in the other back seat was in the cubby next to us and she too had a neck brace and was strapped to a back board just like Libby.

They observed Libby for several hours and after the X-rays came back negative and her pain had been slightly relieved with pain killers, Libby was released to go home. Of course we were told if we had any concerns, to contact her regular physician but they felt it was just a concussion.

And that was that. No ambulance, nobody really thinking anything other than like Dave, Peyton and myself, she’d recover in a couple days. She never lost consciousness, wasn’t in a coma. She didn’t even have to spend the night in the hospital.

I’d seen what my son looked like and knew how I’d felt, but this just seemed different. I could look into Libby’s eyes and see that she didn’t really comprehend. She was slightly detached from reality, but I listened to the doctor, took her home and tried to get her to bed to rest. It didn’t feel right.

On the way home, Libby became very upset because she had done poorly on a Biology test. She was to retake the test the following day giving her the chance for a better grade, and was angry that she’d spent the entire evening in the hospital when she should have been studying and doing homework.

“Libby, I think the teachers will understand…”

“Mom, you don’t get it, I have to retake that test tomorrow and now I’ve blown it cause’ I couldn’t study.”

“Honey, I’m sure if we talk to the teacher, she will reschedule the test for you another time…”

“Ugh…, we can only take the test the next day. She won’t let me. I’ve blown it. Now I’m gonna have to take a seventy two and I won’t make honor roll.”

Libby continued to argue as I tried a few other suggestions. Finally I gave up. This conversation was upsetting her and she needed to stay calm. By the time we got home Libby was exhausted and in tears. I walked her to her bed, found her favorite jammies, helped her into them and tucked her in.

“Mom, will you sleep with me tonight? I don’t want to be alone and I really hurt all over.” Her brown eyes, usually so sunny, were brimming with tears.

“Of course, Honey, I need to keep an eye on you anyway. Just let me go get my nightie on and I’ll be right back.”

I was relieved she’d asked because, at fourteen, Libby was in that stage between childhood and womanhood and I never knew whether my little girl or this almost-woman would appear, hugging me one minute or the next acting as if I had leprosy. Tonight, I just wanted to be close and watch over her.

I called my cousin on the way to my bedroom. Her little girl rode Libby’s bus and I just wanted to make sure that Kaitlin was OK. The conversation only took a couple minutes, with my cousin reassuring me that Kaitlin was fine, but Sherry was upset that no one had called her to let her know that the busses would be late. Then I knew. If they called me and not Sherry, they must have known about Libby’s injuries.

Libby was a tough, athletic girl and had had her share of minor injuries. She grew up on our horse farm and when she was nine, was bitten on the cheek by one of our horses. The injury required eight stitches. While I worried that the scar would embarrass her and be a constant reminder of the bite, Libby came home from school the next day all smiles telling me how the boys thought it was awesome that she had stitches. She seldom over reacted to pain, but usually thought stitches and casts were pretty cool, and wore them as badges of honor. I just couldn’t convince myself that she was really OK this time because her actions in the hospital and in the car were so out of character for our usually happy-go-lucky daughter.

Don’t get me wrong, there were tears and drama as the stitches were sewn and the exams on broken fingers and toes took place, but once the cast was on and the stitching done, Libby’s eyes would light up with relief and she would be back to her chatty, bubbly self. She would be ready to show off that new accessory at school the next day.

This person in front of me, eyes filled with pain and tears, was a daughter I wasn’t used to seeing. I crawled into bed and snuggled up against her back; put my arm around her in comfort. I spent the rest of the night sleeplessly listening to her breath, offered her ice packs for her neck if she moaned, or more Ibuprofen when she complained.

As I lay there, I thought about the phone conversation I’d had with the woman from the school. This woman seemed to hesitate just a few seconds too long when I asked if everyone was OK. She stumbled over her words as she tried to reassure me that Libby was fine. Why hadn’t they sent her to the hospital? Why hadn’t they at least called EMT’s? Why had they sent her home or worse, made her wait on the bus for over an hour while they brought another bus around to finish delivering the kids home? I had a lot of questions that I planned on getting answers to when I called the school the next day.