When Rich O’Brien came out of a coma, recovering from severe head injuries and what he estimates were 14 broken bones, he set two goals. “The first was to play golf again. The second was to walk a thousand miles, because the journey of a thousand miles begins with the first step.”
On May 10 at the Medical University of South Carolina, he’ll celebrate achieving both of those goals at Trauma Survivors Day. “A survivor is different than a victim,” O’Brien says. “One thing I’ve done every day since my accident is I celebrated the day I almost died because it was also the day I survived. It’s pretty amazing I survived.”
O’Brien was working at the Kiawah Island Club golf course Cassique on the day that changed the course of his life. “We’d just finished a round of golf, and we were coming in,” he remembers. “I was on a golf cart, and it was raining. As we came down a steep hill, we turned hard left. I was thrown hard right, out of the golf cart.”
Golf cart injuries usually aren’t that serious. Only about 8 percent lead to hospitalization. But O’Brien was one of the unlucky ones. He hit a concrete curb — hard. “My head and neck snapped back, and I had fractures in my neck and my back. I had four skull fractures. I wound up with brain damage in every lobe of my brain,” he said.
“In the space of a few minutes the blood filled my brain, and I started having seizures as well. I stopped breathing for a very long time, I'm told by an eyewitness — turned gray, purple and then blue — was his description of it.”
He was rushed to MUSC Health, which has the only Level 1 trauma center in the Lowcountry, where emergency doctors focused on treating the most severe injuries. “I was (placed) in an induced coma,” O’Brien said.
When he came out of it, something happened that haunts him to this day. “My perception was I couldn’t move. I was still paralyzed at the time, and I couldn’t communicate with my doctors. I couldn’t move, and my speech was garbled.” It was the beginning of what would eventually be diagnosed as post-traumatic stress disorder.
O’Brien learned to walk and talk again but struggled with chronic pain for years. “When you’re having a PTSD attack and at level 8 pain every day, no matter how much exercise you do in the morning to try to create endorphins like I did, by noon every day the freight train of pain came roaring back.”
He became addicted to painkillers. “I’d spend every afternoon stoned. Level 8 pain is toxic, soul- crushing.” But O’Brien knew he had to stop. “I was motivated to get off [the painkillers]. I knew death was lurking if I didn’t.”
He finally got the help he needed, including acupuncture, which he gives much of the credit for easing his pain and helping him quit. “Acupuncture helps me release a lot of the negative energy.”
O’Brien also turned to his old love, golf, to help with his recovery. “I do what we call golf therapy,” O’Brien said. He met a partially paralyzed military veteran in his church and got him on the golf course as well. Both are now involved in the PGA Hope chapter in Charleston, a year-round program for veterans associated with the Professional Golfers’ Association, and have written a book together.
O’Brien is glad more resources are becoming available for trauma survivors, including the MUSC Health Telehealth Resilience and Recovery Program, which helps trauma survivors suffering from PTSD and depression.
Telehealth Resilience and Recovery Program
The Telehealth Resilience and Recovery Program is designed to catch trauma patients early and screen them for PTSD and depression. Ken Ruggiero, Ph.D., directs the program, which launched in September of 2015.
“If you look at trauma centers across nation, only 7 percent do any screening related to PTSD and only a quarter screen for depression,” Ruggiero said. “We focus on patients who experience traumatic injury. In emergency departments across the county, there are 40 million people a year who come in with injuries. We’re talking about the 2.5 million - 6 percent of the 40 million – who have to be hospitalized after a very serious injury.”
That includes people hurt in car crashes, motorcycle accidents and pedestrian incidents, along with people who have been shot or stabbed. “Twenty to 40 percent of that population goes on to develop significant symptoms of PTSD and depression,” Ruggiero said.
The TRRP team checks in with patients while they’re still in the hospital to tell them about the program, then follows up by phone after they’re home to screen for PTSD and depression. It then uses technology to connect them with specialists in treating those conditions. The program supplies iPads to people who need them.
“Once they get connected to a provider, a standard mental health treatment is conducted,” Ruggiero said. “This usually lasts about 8 to twelve sessions. We’ve noticed with population that unique challenges often arise beyond those that are specific to PTSD. These patients are often dealing with many other issues, such as challenges around mobility and worries about being able to get back to work - even just navigating their own health insurance issues.”
In some cases, the patients’ mental health needs are urgent. “We assess suicidal thoughts at our 30-day screen, and positive answers to this question are addressed with more in-depth screening, consultation, and possible intervention as needed,” Ruggiero said. “This has happened rarely, but it has happened a few times where we have needed to intervene and did so successfully.”
The TRRP team is also working to identify people who may be dependent on opioids so they can get help.
Olivia Eilers, program coordinator for TRRP, said it’s important for not only trauma survivors but also family and friends to acknowledge the emotional repercussions that can follow an incident. “We need to reduce the stigma of mental health and encourage people that it’s ok to reach out for help when they need it.”
The TRRP team learned earlier this week that The Duke Endowment and MUSC Health Center for Telehealth will support an initiative to expand MUSC’s TRRP into three other trauma centers in South Carolina.
O’Brien applauds the efforts. “We don’t want people to feel apologetic about having post-traumatic stress,” he said. “When you experience a traumatic event and it leaves an indelible mark on your memory, that’s post-traumatic stress.”
MUSC Health marks Trauma Survivors Day Wednesday, May 10 from 11 a.m. to 1 p.m. in the Horseshoe area in front of the main hospital. For details, call 843-792-1068. For information about the Trauma Survivors Network, contact Regina Creech.