Between Life and Death
A little mousse in his hair. Some cologne on his face.
It's a special night for Brian Cressler as he prepares for his 10-year high school reunion.
Some people travel great distances to attend a class reunion. But on this night no one will come farther than Brian for the reunion of Fort Zumwalt South High School (St. Louis, MO)'s Class of 1991.
It will be the first time many of Brian's classmates will see him since their graduation June 1, 1991. It will be the first time many of them will see him since the tragic accident four weeks later that put him in a coma for 18 months, severely damaged his brain and spinal cord and irrevocably changed his life.
On the afternoon of June 29, 1991, Brian, a popular and ruggedly built 6-footer, and a caravan of friends were headed for a float trip. Brian was riding in the car of his best friend, Chris Lawson.
On Interstate 44 near Rolla, the car suddenly left the road. No one knows why. The crash propelled Brian and Lawson from the car. Lawson died.
When Brian arrived at Phelps County Regional Medical Center in Rolla, he had a broken back, massive head injuries and severe swelling in his brain. His teeth were broken. Cuts and bruises covered his body. And he was comatose.
Hours after Brian arrived, he was airlifted to St. Louis University Hospital. Doctors placed a shunt in his skull to drain fluid that was building to dangerous levels, putting pressure on his brain.
“His brain injury alone was devastating,” said Dr. Robert J. Bernardi, one of Brian's neurosurgeons.
He was trapped in a persistent vegetative state. Doctors said he'd never speak. Never feed himself. Never live a normal life.
“You pray he survives,” said Brian's mother, Fran Cressler, recalling that heartwrenching night. “After he makes it, you pray that he's going to be him again.”
Brian hovered between life and death for four days. He would spend more than six months in the hospital. But there wasn't anything more that could be done there.
“Doctors save lives, but that's where it ends,” Fran Cressler said.
Totally Dependent
Accidents are the leading cause of death and disability of men under 35. More than 70 percent of those accidents involve head or spinal cord injuries. Of the 2 million people who suffer head injuries every year, about 500,000 have injuries severe enough to require hospitalization. Bleeding inside the brain or damage to nerve cells of the brain can result in prolonged and irreversible brain damage.
Long-term problems include personality changes, emotional disturbances, speech and language difficulties, problems with thinking and remembering, seizures, paralysis and coma.
Spinal cord injuries cause other complications, including pneumonia, blood clots and blood poisoning.
When Brian went home on Jan. 7, 1992, he was still in a coma — totally dependent.
He had to be fed through a tube. A catheter was placed in his bladder so he could urinate. He couldn't move. He couldn't talk. He couldn't respond at all.
The family had been told that Brian should live in a nursing home. But the homes they visited weren't designed to care for a young person like him.
“He wouldn't have gotten the attention he needed,” said Brian's father, Don Cressler.
At home, Brian's parents tried everything to coax him from his coma.
They would read to him. Talk to him. Stroke his arm with soft things like cotton balls and sheepskin. They'd put anything with a scent under his nose — from perfume to oranges.
But Brian didn't respond.
“He looked at you with a blank stare,” Fran Cressler recalled. “It was a look that went right through you.”
Even when his physical therapist tugged hard on his arm, urging him to say “it hurts, it hurts,” Brian just stared. Then, slowly, gradually, after about 18 months, things began to change.
“You could see a slow awakening,” Fran Cressler said. “It was like he was talking through his eyes. They just came alive.”
Brian stopped drooling. His head no longer repeatedly bobbed. His eyes focused on people as they talked to him.
“We knew he was still in there,” Fran Cressler said.
Six months after slipping out of the coma, Brian uttered his first word: “Mom.”
“It was pure joy,” his mother said. Once he started talking, “things began to click,” she said.
The Cresslers gave him his old trumpet to blow. They taught him to read letters and numbers again. They taught him to count to 10 in Spanish.
They also worked to develop his body. Brian has only partial use of one limb. He moves around in a power wheelchair.
To improve his strength, flexibility and range of motion, Brian's parents work out with him three times a week, for an hour and a half each time, in a spare bedroom converted into a rehabilitation room.
Lying on his back on a mat, he whacks a tennis ball suspended from the ceiling with a paddle, counting each hit. One. Two. Three. Finally, 99. 100.
“At first, I was slow,” said Brian, whose face maintains an impassive expression. “I was wondering, 'What are we doing this for?'”
Every day there are reminders of the impact of the accident on Brian's life.
His parents must remind him to get something to drink when he's thirsty and to ask for food when he's hungry.
Brian takes medication to control seizures that still sometimes occur. The seizures can last hours. Brian has virtually no short-term memory. His parents have never talked to him about his best friend's death in the accident.
A Special Night
The Cresslers had the house made-over to accommodate Brian. Doors were widened to allow passage of a wheelchair. An elevator was installed in the living room to create access to the basement.
Brian was moved into the master bedroom, where his father affixed glow-in-the-dark stars across the ceiling — a nightly reminder that the sky's the limit. The master bathroom was completely remodeled to make it wheelchair-accessible.
Another bedroom was converted into the rehab room. The walls are covered with posters of some of Brian's favorite interests, including military airplanes, Michael Jordan and the Chicago Cubs.
Life is far better now than when Brian first came home. But it is far from easy — or normal. “You get down,” Fran said. “The days are long. There's a lot of frustration. You just want the best for your child.”
On reunion night, Aug. 25 at Heart of St. Charles Banquet Center, old friends and acquaintances swarmed around Brian, who wore a gray high-collared shirt and black slacks specially purchased for the night.
Brian glanced through old photos. Laughed with former classmates. Renewed old acquaintances. But not everyone felt comfortable.
Kim Burgdorf passed Brian “probably 10 times” that night before finally gathering the courage to talk to him. “I apologized for taking so long,” she said later. “'I know the barriers wouldn't have been so difficult for him, if it was me sitting there.”
Brian was getting ready to leave with his older brother, Justin Cressler, who had driven him to the banquet hall and helped him through the evening.
Three women approached. Wanna dance?
“One dance?” Brian asked Justin, raising his index finger.
“It's your night,” Justin said.
One woman took Brian's left hand and the others danced around his wheelchair.
Burgdorf saw the same sparkle in Brian's eye and playful sense of humor that she knew as a friend in high school — “glimmers of the old Brian,” she said.
This was the first time Burgdorf had talked to Brian since the accident. She had seen him in public places at least a half-dozen times. But she had never had the nerve to approach him. Now, recalling the Brian of his high school days — polite, kind, helpful and funny — personality traits evident 10 years later on reunion night — Burgdorf regrets not talking to Brian sooner.
The following week she visited Brian at home. She stayed four hours. And she plans to return.
“I can't change the last 10 years,” Burgdorf said. “I can only change the future.”
(This article, which originally appeared in the St. Louis Post Dispatch, is reprinted courtesy of Pro-Life Infonet. To subscribe to their email newsletter go to www.prolifeinfo.org or email infonet@prolifeinfo.org.)
His Parents' Love
Yet Brian still manages to surprise everyone. Like last year when he was invited to speak to a high school physical education class. He implored the teen-agers not to let any obstacle keep them from accomplishing their goals.
“The sky's the limit,” he told the class. “It can be done.”
At Fort Zumwalt South in St. Peters, Brian was an honor student. He sat on the student council. Co-captain of the wrestling team. A swimmer. A lover of the outdoors. A pilot.
His parents have fought to make those activities a part of his new life. He swims every Tuesday. He flies in a glider on weekends.
Brian held a private glider's license before the accident and dreamed of becoming a fighter pilot. Now he rides as a passenger in the cockpit of a plane donated by the Silvercreek Glider Club in New Douglas, Ill., of which he was once a member.
“These are things we couldn't imagine him doing when he first got hurt,” Don Cressler said. “But once he came out of the coma, we tried to do everything we used to do.”
Brian has no fear of the water, despite his paralysis. But it wasn't always that way.
“At first I thought: 'no way,'” said Brian, who speaks slowly, struggling to capture and express each thought. “In my mind, it seemed so hard. But it can be done.”
With the aid of a physical therapist, he swims laps, snorkels and plays pool games such as water hockey.
“Shoot now. Shoot now,” Don and Fran Cressler jumped up and cheered last month at poolside as Brian played water hockey with his therapist during one of his weekly swim sessions at the YMCA in St. Charles. The 45-minute Aqua Ability sessions provide physical therapy for people with disabilities.
“We don't stop trying,” they say.
Some parents take advantage of this time to run errands or take a break. But not the Cresslers. They watch their son's every movement.
“I feel responsible,” Don explained. “I just want to be here.” He pauses. There's another reason.
“There's just something new all the time — and seeing the smile on his face — I just don't want to miss any of that,” he said.
The image of a physically active Brian is one his doctors still find hard to visualize.
“When I think about Brian, I think about when I first saw him in the intensive care unit and so close to death,” said Bernardi, the neurosurgeon. “Now, when his parents come in with pictures of him hitting tennis balls in his wheelchair and swimming laps in a pool, it's hard to imagine.”
People with traumatic brain injuries typically reach a plateau in their mental and physical recovery within six months of the start of therapy. Brian continues to learn new skills, although progress is occurring at a slower pace.
He works on a computer, plays ping-pong and does household chores such as folding towels and smashing cans in a crusher. He can shave and comb his own hair. With remote controls he can turn off his stereo and bedroom lights and operate the doors and wheelchair lift in the family van.
His parents work obsessively with him to increase his independence. “We don't stop trying because we don't know where it will stop,” Fran Cressler said.
Sara helps, too. She goes almost everywhere Brian goes.
The pitch-black Labrador retriever serves as another set of arms and legs for Brian — fetching everything from a telephone to a long-handled gadget that enables Brian to pick up out-of reach objects.
“Sara, Come. Come here Sara,” Brian commanded softly and waited for the energetic 3-year-old dog to retrieve his gym shoes one morning.
Later, a bottle of spring water tumbled to the floor and Sara grabbed it in her mouth and dropped it on Brian's wheelchair tray — on his left as usual. Brian used to be right-handed, but the paralysis allows only limited use of his left hand and arm.
Trained as an assist dog, Sara's responsibility first and foremost is to be a companion to Brian.
“The sad part for us has been the lack of friends,” Fran Cressler said. “It's frustrating that we can't make that happen.”
Doctors are clearly impressed by what Brian's parents have made happen through their relentless dedication to their son. “It's really his parents who are responsible for this miraculous improvement,” said neurologist Dr. Denise Taylor. “He seems to continue to make strides.”
Bernardi never ceases to be amazed by Brian's mother and father. “His parents are unbelievable,” he said. “I don't think I have seen anyone like them in terms of how they care for him. They are really extraordinary people.”
The Cresslers credit family, friends and neighbors for keeping them going during tough times. “Even with something so terrible, we've been blessed with knowing and meeting so many wonderful people,” Don Cressler said.
Despite Brian's remarkable progress, he still needs round-the-clock care.
Fran Cressler quit her job as a secretary for the Edward Jones investment firm to care for Brian. Her typical day stretches from 6:30 a.m. to 11:30 p.m.
She knows about the importance of parents. Her own parents died within six months of each other when she was just seven. Fran and her four siblings grew up in an orphanage in St. Charles, Ill., a Chicago suburb.
Don works the 3-to-11 p.m. shift transferring and loading freight for TWA Airlines LLC, now owned by American Airlines. He's a 33-year employee. Before he leaves each day and after he returns each night, Don helps care for Brian. Every night at 3 a.m., Don wakes to turn Brian so he won't get bed sores.
The Cresslers call themselves nurses without degrees.
They dispense medications, identify signs of gallstones and have learned a technique for emptying Brian's bladder without using a catheter. They regularly check Brian's legs for evidence of blood clots and make sure his Achilles tendons don't stiffen and permanently flex his feet upwards.
Dilantin, Coumadin, Neurontin. A chart next to Brian's bed keeps track of his medicines and blood levels.
“We're always on alert to make sure everything is working smoothly,” Fran Cressler said.
