A good start

EUH Jon WillieNeurosurgeon Jon Willie recognized the cause of French's inability to participate in his own recovery.

Day 1: Emory University Hospital

When his brother got sick, 52-year-old Harold French came to Atlanta to help out for a few weeks. Then, while mowing his brother's lawn, he suffered a massive stroke.

At Emory University Hospital, neurosurgeon Jon Willie removed a piece of French's skull to give his damaged brain more room to heal. Once he was medically stable, French was moved to the neuroscience floor.

Stroke patients need to begin rehab as soon as possible, but French was unusually uncooperative. When therapists arrived, he turned his head to the wall or shook his fist and shouted incoherently.

Neuroscience social worker Hannah Hamby held multiple conference calls with French's family to discuss long-term placement in a skilled nursing facility closer to their home, as they wanted. Some facilities expressed interest—until they learned of French's unwillingness to participate in his care.

Neurosurgeon Willie recognized what was happening. Absence of the piece of skull removed to relieve swelling was now causing the brain and scalp to sink, resulting in further mental deterioration. When French was well enough, Willie took the bone flap from the freezer where it had been stored and fused it back into French's skull, restoring the original contour of the head.

The change in French was quick and positive, and he began to work with his therapists. After four weeks, he made enough gains to be transferred to Emory Rehabilitation Hospital. After three more weeks of rehab, he was able to feed himself and perform other tasks of daily living. Now, instead of going to a long-term care facility, he could head home with his family.

As French prepared to leave, Hamby helped arrange transportation, a medical escort, and donation of a specialized wheelchair. Emory provided enough medicines to cover him until his family enrolled in Medicaid. French still has a long way to go, but four months of uncompensated care have given him a good start.

French was stuck. He wouldn't accept rehab, and he couldn't remain indefinitely on the neuroscience floor.