Couldn't Happen to Me: A Life Changed by Paralysis and Brain Injury

What Happened

Late Easter morning in California in 2004, a sad, drunk old man turned left onto Santa Rosa’s Highway 12 from Pythian Road, near where he lived. Weaving, Harvey Hereford swerved onto the shoulder, hit something that shattered his windshield but he kept on going until he hit something else, and still he kept on going. About three hundred feet down the highway, he finally came to a complete stop, unable to see from inside his aging Nissan what incredible destruction he had left in his wake.

Two bicyclists were on their way home from a quick training session for the upcoming Wildflower Half Ironman Triathlon in California’s Lake San Antonio before sitting down with the family for an Easter lunch. The bicyclist in the rear, Alan Liu, was killed instantly. The second cyclist had her spine snapped like a twig in the impact. Motorists stopped and comforted her, crying and shaking, as they waited for the ambulance. Someone else clamped onto Harvey, who still didn’t really know what he’d done.

I was the second cyclist, and I don’t remember any of this.

Some of what I know now came from the news reports — the local Press Democrat and the San Francisco Chronicle covered the story; some came from the police reports. Most of what I know about that morning comes from my family and friends telling me what happened. To be on the safe side, no one told me about Alan’s death until a long time afterward. In fact, they waited to say anything about his death until I could respond back. For a long time I couldn’t even remember much of the six months before the accident, which may have spared me some early grief because it was during those six months when I fell in love with Alan.

I come from a huge, very close Italian-Irish family that celebrates holidays and birthdays together often, so I spent Saturday night and Easter morning at my Grammy Carbone’s house in San Rafael. My mom and dad were there from Grass Valley, and my brother Dan, who is three years younger, was there from Pleasanton. I woke each of them to say goodbye before driving up to meet Alan in Santa Rosa at his mother Rita’s and his stepfather Dane’s house. Because we were training for Wildflower, coming up in early May, we decided to go on a bike ride on Highway 12 before eating Easter brunch. We were both wearing our helmets, as we always did.

We loved to ride — a good thing for triathletes who also need to love running and swimming. We rode a couple of times a week together midday from Mountain View on the many good trails just off Foothill Expressway, one of the roads that runs through Silicon Valley. On weekends, we rode up to Stanford University snaking on Skyline through the foothills between Lexington Reservoir and Half Moon Bay. We’d spent a recent weekend in Lake San Antonio with a bunch of other friends who had signed up for the race in May. About ten of us rented a mobile home on the lake; the long weekend was filled with riding and swimming.

Alan’s mom, Rita Wells, told me later that I was wearing my biking clothes when I arrived. Sometimes I think, if only I had taken the time to change at their house, maybe Harvey would have made his turn, maybe he would have driven into a quiet ditch somewhere, and Alan and I would have missed our fate. But it is silly to play the “what if” game.

I rode in front of Alan. To this day, I’m not sure why I was leading. My only thought is that I could set the slower pace for us because Alan was a stronger rider. From what the police reports said, we were about 100 feet apart in the bike lane of the road. We were hit from behind at 11:29 a.m. by a car driven by a man whose blood-alcohol level was nearly four times the legal limit. He was driving a Nissan Sentra — ironically the same kind of car I learned to drive in. Alan was declared dead, once they found him off the road, and I was severely hurt.

The only reason Harvey Hereford stopped was because he could not see through his shattered windshield. A few drivers saw the collision and stopped to do what they could. Two women rushed to put blankets over me; my body was shaking uncontrollably. They stayed with me for the time it took the ambulance to arrive. Others who stopped--at least one an off-duty police officer — made sure Harvey, the man who hit us, did not drive away. People told me that Alan was not found until the paramedics arrived.

Traffic on Highway 12 was stopped for a few hours. The paramedics took me to Santa Rosa Memorial Hospital in an ambulance. Rita was listening to the radio and heard the news report about the accident. We were late for brunch, and she knew immediately exactly who the two bicyclists were.

Rita looked for my cell phone and scrolled to see the numbers I had called most recently. Not surprisingly, my brother Dan’s number came up first. When Rita phoned, he had just left Grammy’s in San Rafael. He got the terrible news that his sister was near death in the hospital in Santa Rosa and immediately turned his car around and drove back to Grammy’s house. He frantically knocked on the door and then collapsed on the front porch, too weak to stand. My 80-plus-year-old grandmother took one look at her always competent, can-handle-anything grandson, and told him to get in her car. To this day, I am so glad he went to Grammy’s for help rather than trying to drive directly to the hospital in Santa Rosa. She would drive to the hospital. She knew he couldn’t.

Dan called our parents, Larry and Joanne Mason. They had started up Highway 101 from San Rafael before getting the horrible call. They just kept driving north — weeping, screaming, hysterical — praying that their only daughter would still be alive when they got to the Santa Rosa hospital. They tried hard not to think about how she might look or even if they would be able to see her. They drove. They later remembered absolutely nothing about getting to the hospital or what happened first when they did get there.

* * *

Before the Accident: Alan

“Love is the only game not called on account of darkness.”
— Anonymous

When one of Alan’s fellow coaches on the Mountain View Masters swim team heard about the accident, he said the team could have filled the pool with their tears. I had no tears for him then — I couldn’t remember that he was my boyfriend, and I didn’t even know he died until I read an email four months later about the accident. I remember now.

We meet when I joined the Mountain View Masters swim team in September 2003. I am 26, he is 31, and I suffer uncharacteristic hot flashes at the sight of him, shaking of my voice and hands, and a bad case of junior-high-school shyness. Every Monday, Wednesday, and Friday I drive into the parking lot anxious to see his slim figure poolside in his Euro shoes. Just in case we actually speak, I wear my cutest clothes, even though it’s so early, and I brush my hair and teeth with great care.

Before he opens his mouth, I love the way he moves, the way he demonstrates the drills. The rhythm drives me mad-out-of-mind. His energy is a magnet and makes me laugh louder, become giddier (and it’s only 7:07 a.m.!), as I walk through the pool gates. As my family will quickly point out, I’m not much of a morning person, but this feeling made all of that go away. I like his white broad smile. His hands. His voice. His incredible brown eyes.

Besides coaching the team, Alan is a mechanical engineer devoted to his work and his profession — not an “enginerd,” as he sometimes describes several of his MIT classmates and coworkers. Alan is motivated, witty, athletic, energetic, and loves his cat.

I have the crush of all crushes. My mom observes that this is the first time in a long time I’ve admitted being attracted to someone. I think she’s counseling some restraint, but I know that I’m more than willing to make a fool out of myself for this guy if he’s available.

I admire him from afar until I think about actually entering a swim meet, and I email him for my estimated times. He writes back!!! And he’s a great writer. Amazing. A man who can express himself in writing is so very sexy. Another excuse to interact with this fellow: he finds out about my Lake of the Pines Triathlon and posts the results on the swim team website. I proudly show him my competition-scraped knees in the pool afterwards.

He makes me utterly absentminded, and I leave ALL my shower gear and bathing suit and goggles in the shower one Friday morning. Incredible luck: He’s at the pool on a Saturday afternoon when I return to pick up my gear from the lost-and-found! Even luckier, I’m wearing a little jean skirt and my cute Spanish sandals rather than my typical thesis-writing grubbies! Oh, but how idiotic and mindless I feel retrieving absolutely EVERYTHING that’s supposed to be in my swim bag, especially with him breathing over my shoulder as we look under the desk together.

In September, after the San Francisco T-Mobile bike race, I’m eating pizza in a restaurant with my friend Erin, my brother Daniel, and his friend. I’m not on a date, but here comes Alan into the restaurant. Erin recognizes him, and Daniel whispers across the table: Is this THE swim coach you told us about? I nod and curse, with my mouth full, feeling the heat crawl up my neck. Chew, chew, I tell myself, so you can introduce him to your BROTHER and HIS friend Geoff. Relax, for crying out loud, he’s probably married. BUT, just in case he’s not, make it perfectly clear you are by no means on a double date. Alan has a permanent pen-number still visible on his calf from a triathlon in Pacific Grove the day before. I ask him about the race. He seems taken aback at first, surprised I would know about the race, and then says he did well in his age group. I only know you were racing, I think, because of my laser-like focus on your legs. I’m not stalking you, really!

I’m sure he’s married, or at least wildly unavailable, and my crush turns to agony. But he speaks to me, and he even seeks me out sometimes. I am speechless and hopeless. A few weeks prior to the first date: Drill, kick, swim, breathe, swim, breathe, rest, kick, hop out of pool. Walk towards locker room . . . oh, he’s walking toward me. Oh my, he’s turning to cross my path. Oh god! He’s walking this way. What do I say? Aaaah! He speaks. I am stunned, like a deer in the headlights but determined to be myself. After the encounter, I hope I didn’t say anything weird because I can’t remember anything either of us said. In my mind, I silently celebrate in the shower!

Finally, he asks me if I am going to celebrate my second-place finish at the Lake of the Pines Triathlon. Totally clueless, I say I am going out to dinner with friends on two different nights that week. He drops the bomb (as I almost drop my goggles and fall over) asking, “Can I take you out sometime?” Gulp. Uh, excuse me? I think I hear him right, but I blurt out that I think he’s married. He laughs and says, no, that he’s not. I’m elated, shaking even, in the shower, can’t stop smiling like a dope. I call my mom, my friends Kina and Becky, and my brother Daniel on the way to work (during the seven-minute commute), and I don’t get a thing done at work that day.

And that’s how everything started: The runner and swimmer and biker Jill Christine Mason met the swimmer and runner and biker Alan Barry Liu. I grew up in a little town called Grass Valley, but was born in Lincoln, Nebraska, and went to Santa Clara University and San Jose State for graduate school. He grew up in the Oakland hills, went to Massachusetts Institute of Technology and then Stanford for graduate school. I was working in marketing communications for an engineering company; he was an engineer. We both loved each other, music, athletics, and our cats — his was Emma, mine was Charlie. We both had, and I still have, lots of energy to share.

I was still pitifully nervous when we met at an Italian restaurant in downtown Mountain View for our first date, but then I saw he was, too, so I settled down and focused on being myself. We had a great time! I wrote my brother Dan that I thought he was a keeper, and I told him everything I’d found out during our four-hour date: he had been swimming competitively all his life, played golf, traveled in Italy one summer using books about Italian wineries as a guide; was on the varsity water polo and swimming teams at MIT and earned his master’s in mechanical engineering from Stanford. He had been at Applied Materials in Silicon Valley for eight years. Alan was a huge sports fan of the Raiders, unfortunately. In spite of that, he was, in short, perfect. We made our next date — running at Rancho San Antonio — that night.

Alan also loved his cars and his wine, both conveniently housed in his carport. He had a silver BMW 2002 with the license plate “ABL 2002” and a green Bronco. Once we went to Calistoga with his friends Paul and Dotty. We both brought our road bikes and running clothes and rode our bikes from winery to winery. He knew one of the wine makers at Olabisi Winery and we had a private tasting in the cellar with the owner. (I shared the last bottle of Olabisi Wine with my girlfriends just a few months ago.)

We often went to dinner together at the great restaurants in Mountain View, especially Yakko, a place that serves sushi. The restaurant has tables with a bench on each side connected to the wall. The person who sits against the wall, facing the kitchen, needs to climb into the seat. On one of our first dates there, Alan gave me a Foxtrot comic he cut out of the paper, slightly edited as follows: “I’m thinking I’d like to run a marathon with Jill. You should call Alex Bixby’s husband then. He runs marathons with Jill? He sells life insurance.” This kind of comedy was so Alan. He especially liked giving funny award to his swimmers, awards like: Best Runner Pretending to be a Swimmer, Most Punctual Award, Best Suit, etc.

Alan had this way of tipping his head back and laughing whole-heartedly. I loved his laugh; it was infectious. I have a digital video my parents, Alan, and I took of Dan when he was competing in a bike race at Mather Field in Sacramento in February 2004. I caught the sound of Alan’s laugh on my digital video, and I love to hear it. Sometimes I can still see him walking along the pool deck, carrying his thermos as the team members swam, sipping his coffee that he kept on the ladder of the high diving board, laughing from the bottom up, demonstrating the swimming drills, and loving life.

I often think that he is watching me and making sure my life is as good as possible. I always picture what it would be like with him there. When I’m with my family and friends, I keep thinking, even now, many years later, ‘Alan would have loved this!’ Watching my cousins play in the pool always makes me think of how much Alan would love to be doing the same. I wish we’d had more time, but we didn’t.

* * *

Vigil at Santa Rosa Memorial Hospital

“Enjoy the little things, for one day you may discover they were the big things.” 
— Anonymous

Of course I remember absolutely nothing of Santa Rosa Memorial hospital, but within three days of the accident, friends from work launched my website, www.jillmason.com, so any updates or news could be posted. The website chronicled those terrible days. Some of what follows comes from that record, but more comes from my parents and their own notes.

The second night after I was hit, the Santa Rosa Bike Coalition held a candlelight vigil in the front of the hospital, a show of concern from complete strangers that my family found touching and helpful. They just lit candles and watched them burn. No one said a word, although they were available to talk if my parents approached them. Betsy and Rusty Dillon turned up to tell my parents about their son’s horrific brain injury cause by a driver-biker accident like mine and his continued slow recovery. I think they offered one painfully thin shred of hope.

Far more powerful, though, was the huge group that showed up at the hospital, what my friends described as the “Jill Mason fan club that was beyond primo.” My large family naturally fills out a lot of the numbers, but I’m lucky to have so many friends. My parents let them see me “sleeping” and on a respirator, and Danh wrote on the website of how hard it was to see me lying still; “In all the time that we have known her, she has never been still for more than 0.8 second.”

The outlook was desperate in those first few hours — I was unresponsive when I arrived at the hospital. The trauma doctor and the neurosurgeon took my parents and brother into a small conference room when they arrived. He proceeded to brief them on the long list of critical injuries that I had sustained. Each description was delivered with the big caveat: “If she survives.” The first, and most critical problem was widespread severe traumatic brain injury. I was suffering many small infarcts or strokes in my brain, and there were indications of major damage to the brain stem and cerebellum. My mother wrote in a small notebook someone thoughtfully provided that the suggestion would probably be made to “pull the plug.” “If survives,” she continued scribbling, “functional level is comatose—could get pneumonia.” After saying this, the doctor explained that my spine had been fractured in at least three locations and had been completely dislocated at the T-12 level. This dislocation led them to believe, with high confidence, that my spinal cord was not just dislocated but completely severed at that level. In addition to these two highly critical injuries, I had a long list of other issues: a puncture wound to the liver, rib fractures including lung bruising, a severe fracture to left wrist, fractures to heel and foot bones, and many lacerations, abrasions and contusions. The mind-numbing length of the list seemed unimportant in the face of the most basic fact that my injuries would likely be fatal.

The small notebook swelled with medical updates, questions, and to-do lists. Optimistically, they created a separate section right away: Milestones. Even on that first disastrous day, they noted my pulse and blood pressure were lowering and that I blinked my left eye. Heavily sedated, my father added, maybe hoping this explained it all. They found it impossible to believe I would always be paralyzed and had no comprehension of brain injury. All they wanted was for me to live. The future stretched from hour to hour at that point.

My parents and brother spent the first night in the hospital taking turns at my bedside. With no hopeful signs from the doctors looking over me, they were left to spend their time staring at my battered and sedated body, hoping that I’d wake up and be my same old self at any moment. The more realistic fears were that I could never wake up from the coma into which I had dropped. The doctors finally made them leave at 5 a.m. They tried to sleep in the waiting room for an hour and returned at 6 a.m.

Tubes and machines were everywhere, beeping, blinking and spewing numbers. In addition to the typical vitals on the monitor (heart rate, blood pressure, etc.), I had a hole drilled into my skull which allowed my intracranial pressure to be continuously monitored. My family would spend hours agonizing over every small change in any of these parameters: is that too high? too low? does this number mean she’s feeling pain? It was possible for them to torture themselves for hours just staring at the silly monitors.

My face, they said, was swollen beyond recognition and my hair and face matted with dried blood, probably from a huge cut and several smaller ones still visible. Road rash on my right arm was bright and angry. Curiously, the flowers that had been painted on my toenails during my last pedicure were nearly intact; only one was scraped when my bike shoes flew off on impact. My legs, finely tuned for the upcoming triathlon, still looked strong.

On the third day, Tuesday morning, though, the neurosurgeon delivered a sliver of hope. He informed everyone that some of my major brain swelling had gone down and that the critical portions the trauma doctor thought were cut off due to strokes were possibly getting blood flow after all. He detected some sign of activity in my brain as well as indications that the damage initially thought to be fatal was perhaps not to that level. He was concerned about strokes in the cerebellum and trauma to the brain stem, but he asked for a delay of two or three days before discussing his prognosis of future function. My family interpreted this as a positive assessment, At this point the neurosurgeon’s warning that I had a high probability of ending up in a “persistent vegetative state” was not something that my family had the emotional capacity to ponder.

The doctor explained that my body had been under severe stress, that high blood pressure, raising arms and shrugging shoulders — unmeaningful movement — were normal reactions. He tossed my parents and brother a small bone, however: blinking my left eye might actually mean something. Wednesday, day four, was much the same as day three, except that I opened both eyes. Trouble was, my pupils had shifted to the side, a sure indication of brain damage. My dad thought I reacted to my mother’s voice, though.

The fourth day, the website reported that I was continuing to get better, that I opened both eyes, that my family thought me more responsive. We’ve always been an optimistic, fiercely determined family, and later I could read that optimism in the website postings. My back was broken, my brain was damaged, my lungs were bruised, I was infected, but the good news, whatever smidgen available, was reported daily.

On April 15, day five, the good-news flash was a confirmation that the doctors believed I was truly responding voluntarily to my family's voices and moving my arms and eyes. Later we weren’t so sure, but the belief must have helped my family at the time. On day five, the doctor described meaningful movement I managed: I wiggled my left pointer finger when asked, and blinked my eyes (one for no, two for yes) when asked. My dad wrote that I greeted them in the morning with both eyes open for 15-20 seconds, and that my eyes were more in line, especially the left. They were delighted to see me turn the corners of my mouth down in a frown and to squeeze Daniel’s hand. My parents were grasping at anything. It wasn’t for another week that I started to squeeze my parents’ and brother’s hands more consistently. Hope was my family’s best friend.

I had tracheotomy surgery to insert a breathing tube on day five. I could still breathe over the tube (over-breathe), but because it was more comfortable inserted in my neck instead of my nose. I couldn’t talk because the trach blocked all air traveling past my vocal chords, but my brother wrote on the website that I also probably didn’t have the mental capacity to put together sentences in any case. Although we didn’t know it at the time, the medical assumption was that the trach would likely be permanent.

I also needed a feeding tube inserted directly into my stomach. This replaced the tube through my nose. Two temporary tubes replaced with two permanent ones.

On the sixth day, I was making more eye contact (or what my family perceived as eye contact when they stuck their faces within a foot of mine, and I opened my eyes) and tracking moving targets — like people. I was doing more breathing on my own, and I opened my mouth when asked in the evening. When asked to squeeze a hand, I could use both hands.

A week after the accident, I was taken off the ventilator. Optimistically, my brother thought I was trying to speak, which I couldn’t do in any case because of the tracheotomy tube still in my throat. He reported that I was showing some emotion, mostly by scowling at the nurses when they brushed my teeth. The most touching sign that I was alive was that reportedly I smiled twice, once for my grandmother and once for my college friend Heidi. My brother even planned to go back to work the next day to try to clear his thoughts, although my parents did not give up the constant vigil for many, many weeks.

For about a week, I was on a special bed that rotated me until the surgeons could do the back surgery on April 21. My mom said I hated the bed because of the jostling, but it was supposed to improve my circulation. In response to the position changes, I would flex the muscles in my upper body as if bracing for the movement. About this time, my cousin Jessica told me that she and Dan were trying to get me to spit on him, a complicated command. Unthinkable, but they begged. They were desperate — I spat.

Temperature regulation was a big problem — I sweated profusely. The nurses explained that temperature regulation emanates from the lower brain, which had been damaged, and the sweating was called a neurostorm.

Ten days after the accident, April 21, I finally had the surgery to stabilize my spine. My white cell count had been high because of infection, most likely in my lungs, the doctors said, but the count was down early on Wednesday. Doctors Alan Hunstock and Eldan Eichbalm worked on my severed spinal cord for nearly twelve hours, and the younger, stronger Dr. Eichbalm apparently had to use brute strength to align it. They initially thought that I would need a second surgery, but I ended up not needing one.

My spine needed fusing from T4 to L4, and the doctors were attempting to reduce T12 and L1 dislocation. They planned to use screws and clamps to fuse the spine to nearby bone. The doctors were extremely happy with their accomplishment — a feat that could have easily have resulted in the nicking of the aorta and my bleeding to death immediately. They were using a brand new machine to do the surgery. The doctors were extremely happy with their accomplishment — a feat that could have easily have resulted in the nicking of the aorta and my bleeding to death immediately. They even told my family that it may take a few surgeries to realign my back and fuse the vertebrae. They were using a brand new machine to do the surgery. It was the latest imaging technology, which allowed the doctors to see exactly where they were putting their tools in my back. Miraculously, the doctors were able to complete all of the repairs in one surgery. (Does it sound like I’m talking about a car??)

Post-surgery, they excitedly showed Dan, the mechanical engineer, the before-and-after x-rays. Despite their apparent technical success, the surgeons were not optimistic about my recovery. My nerves were damaged badly, and they put my spinal cord back in as best they could. The doctors took my parents and brother into a small room and said, despite their beautiful work, that things didn’t look promising. I would not use my legs again, they said.

For several days, I was generally unresponsive. Even though they had been warned that I was getting the rest I needed after the trauma of the surgery, my brother wrote that they “really long to see [my] eyes.” My cell counts were up and down, as was my fever, but my consciousness far less advanced than before the surgery. Daniel even admitted to my having a difficult day on the 24^t.h_.

As my unresponsive days wore on, friends held a mass for me at Mission Santa Clara on Sunday, April 25, two weeks after the accident, and a service of prayer and encouragement at Peace Lutheran Church in Grass Valley. My parents and some of my mother’s family were able to go to Mission Santa Clara; my father’s sister and more of my mom’s family attended the Grass Valley service. Alan’s memorial service was later held at Stanford, and my parents and some of mom’s family were able to attend. I would not begin to mourn the loss of Alan for many months.

The day after Alan’s funeral, the decision was made to send me to Santa Clara Medical Center — which was known for its impressive rehabilitation facilities — when I was stable enough to go. My family was anxious to get me started in specialized treatment, but I was still fighting fevers, oxygen problems, and infections.

My right arm and hand were absolutely rigid. Dan reported that I opened my hand for my mom, a major breakthrough, and actually extended my arm by April 29, eighteen days after the accident. The spastic rigidity is related to brain damage.

The weekend Alan and I were supposed to be racing the Wildflower Triathlon, I was still in Santa Rosa Memorial Hospital. Daniel described my three states: sleeping, a real, restful sleep unlike earlier ones; awareness, with eye contact, following motion, and even a few big smiles; and uncomfortable. Typical engineer, he estimated the “uncomfortable” state at around 40-50% of the day. He couldn’t tell whether I felt the pain of my injuries, nausea from the mediations or confusion about what was happening. I kept my eyes closed and scowled.

Occasionally I was wheeled outside in a special big chair similar to a bed. The weather was always beautiful, but there was too much stimulation for me. I was overwhelmed by the feel of the sun and the wind. My eyes would glaze over (even more than they already were) and I would sometimes appear to be in more pain. This was true for months to come.

Here’s my diagnosis: Basically, paralyzed at the T-12 level with an unknown degree of brain damage. My mom wrote out the details later:

• Traumatic Brain Injury with shearing (intracranial pressure 13-15)
• T12 Spinal Cord Injury (complete)
• Vertebral artery injury
• Puncture wound to liver (Grade 1)
• Rib fractures and lung bruising
• Fracture to left wrist
• Fracture to heel and foot bones
• Lacerations, abrasions and contusions

For the first few weeks, my family’s ability to determine a “bad day” vs. “good day” and “responsive” vs. “unresponsive” was an extremely imprecise ritual. They were constantly struggling to differentiate between meaningful signs of cognitive activity and comatose restlessness. During the time I was in a coma, aside from when heavily sedated, I didn’t lie still very long. Instead, I would flex my arms, clench my fists, and make horribly contorted facial expressions. Doctors were constantly telling us that these were typical among comatose patients, but my family and friends insisted on reading more into them. They would spend every day — emotionally drained and sleep deprived — clutching for some indication that the old Jill was in there. After a few initial indications that I could hear them and respond with facial expressions, there was nothing for weeks.