Assault: Kelly and Holly

After one daughter was involved in a car accident and left with a brain injury, Kelly Hallett thought she had been through a once in a lifetime journey.

In November 2013, the unthinkable happened all over again. This time it was an unprovoked assault on her eldest daughter.

Published: October 2015. Date of brain injury: November 2013. In November 2013, my eldest daughter was hurt. We have been here before. Less than three years ago, my middle daughter was hurt in a car accident. Hurt doesn’t really describe it. Both were critically hurt with no immediate way of knowing what the outcome would be. Both required life support and were in medically induced coma’s to give the doctors full control. I have alluded to my middle daughter's accident a few times over the course of my blog but have never yet written fully about it. They say that lightening doesn’t strike twice, but it does. There are several amazing doctors and surgeons at both St Mary’s Hospital in London and The Royal London Hospital that are the only reason that we still have our girls with us, and in one piece, and we thank these people and these facilities on a daily basis. I have decided to write about my eldest daughter's injuries as there is a very serious message and opportunity for other lives to be saved – simply by reading the story. Holly  

A call in the nightime

My eldest daughter Holly, has a two year old daughter. She doesn’t go out very much as obviously, she has her little one to care for. Holly hadn’t planned to go into town on this particular night. My brother was looking after the little one and Holly was spending the evening at a friends. Late in the evening, Holly and her friend decided to go into town. The entered a particular club with no knowledge of the events that were to unfold. Several hours later, at 5.30am in the morning, there was a loud banging on our front door. Now, those of you with teenagers will know that they can have a habit of rocking up at all hours with friends – even after they have moved out!! So, on being woken by the door banging, we assumed it was Holly. It was the police. They had come to inform us that Holly had been assaulted earlier that evening and needed details for her. They explained that she was seriously hurt and was being transferred from our local hospital to St Mary’s hospital in London. As soon as they said where she was being transferred to I knew it must be a head injury. St Mary’s hospital is a major trauma hospital in London, with a speciality in Neurology. The police confirmed that she had suffered a serious head injury and offered to take us straight to the hospital. The police didn’t seem to have many more details than that. They had a duty to ensure that Holly’s daughter was safe and well and asked for the address of where she was staying. As I was finding the address one of the police women were outside on the radio. She came in and advised us that we had to get to the hospital immediately. Her words were ” you need to get dressed right now – we need to get you to the hospital – Holly’s situation is deteriorating.” Needless to say, we were dressed and out within minutes, being blue-lighted to the hospital. On arrival, we were shown to the family waiting room. We have been here before. The little room with bereavement posters on the wall and tissues on the table. It’s when it becomes real, and you know that the news isn’t going to be good. A nurse came in and gave me Holly’s jewellery, explaining that the Doctor would be in shortly to see us.  
I honestly thought that we were going to lose her. I just didn’t believe that we could get lucky a second time, with a second child."Kelly

The incident

The Doctor came very soon afterwards. He explained that soon after entering the club earlier that evening, Holly had been assaulted by being hit across the head with a bottle. Initially she appeared fine. The strike had caused a small but deep cut on her forehead and she had attended A&E for stitches. She had walked in and given all of her details etc, chatting quite happily with the doctors and nurses. He explained that whilst she had had a few drinks, she did not appear particularly drunk and whilst she had been taken to the hospital on advice of the police in an ambulance, was considered a voluntary patient. The Doctor explained that it is routine to keep anyone with a head injury under observation for an hour or two afterwards for observation. So initially all seemed straightforward. However, after being stitched up, Holly became more unwell. She remembers feeling strange and her head hurting. She remembers going back to the desk to tell them that she felt unwell. She remembers nothing after that point. But the Doctor informed us that whilst under observation, Holly became unwell. She started to get very sleepy, her speech was slurred and she was no longer able to answer the questions that she had been able to answer on admission to the hospital. When asked her date of birth, Holly had been talking about horses. The Doctors had realised that something was very wrong and immediately sought a CT scan of her brain. The scan showed a life threatening brain injury. Holly had been struck across the head with such force that her skull had been fractured. This in turn had caused a very large bleed into her brain. The pressure from the bleed was compressing her brain and she needed urgent specialist neurological care. Hence, her being transferred to a specialist hospital in London. Holly had already been put into a medically induced coma and onto life support so we could see her only briefly. The Doctor began to explain about the various tubes, staff and machines that would surround Holly until we explained that this was not the first time we had been in this situation with a child and were familiar with the equipment. The police had appointed us a police liaison officer who would blue-light us behind the ambulance into London. We already knew from our previous experience that this is normal practice when the outcome is unknown. Holly's head after the operation


Treatment and recovery

On arrival at St Mary’s the Neurosurgeon saw us briefly. He explained that Holly needed emergency surgery to stem the bleeding and relieve the pressure on her brain. The more compressed her brain became, the more serious the damage. At that point, the Neurosurgeon could give us little idea of the expected outcome and was obviously in a hurry to get the operation started. Unfortunately, there is no give in a skull. Therefore there is no room for a brain to move – any pressure simply compresses the brain. Eventually the pressure becomes so great that the brain has nowhere to go other than out of the base of the skull. If that happens then there is no recovery.  Four hours or so later and we were sat back with the Neurosurgeon, who, was/is a truly great guy. He explained that the surgery had gone well and that the bleeding had been stopped. Having realised how upset we were, and that we had previously been in a similar situation before with our other daughter, albeit with very different injuries, he explained that he had not wanted to give too much details of possible outcomes prior to surgery. He explained that he was concerned when he initially received the referral and scans from our local hospital – knowing that Holly was still an hour from reaching him. Speed is of the essence with these types of injuries. He had been worried during surgery at how much bleeding there had been and at how compressed Holly’s brain had become. We later learnt that practically half of the right side of her brain had been compressed. He explained that Holly would now go to Intensive Care and that we wouldn’t really know the outcome of any damage until they started to wake her up. As well as the staples from surgery she had a pressure monitor fixed into her head to keep a close eye on the pressures within her brain in case of further bleeding. The surgeon explained that best case scenario was that Holly would wake up and within a few days would be responsive and chatting with us. Worst case scenario was that we would have a very disabled daughter. Unthinkable scenario was that she simply wouldn’t wake up. Age was on her side we were told. Bluntly, a 40-year-old or older would not survive such an injury. A 30-year-old might survive but it would be unlikely that they could escape without brain damage. A 20-year-old had better odds. The surgeon then gave us a “cautiously optimistic” verdict. To cut a long story short, Holly has made an amazing recovery. I struggle with the word lucky in a situation such as this but someone is looking down on us. Within 24 hours Holly was awake and responsive. Making progress every day she came home just five days later. Aside from some problems with vision in her right eye and more frequent headaches she is back to leading a normal, happy life. Grateful is not the word. She had been in the club for just minutes when she was assaulted. I hope that the person who assaulted her has some idea of how seriously he hurt her. I can’t comment further on that as there is an on-going criminal case. The surgeon who operated on Holly and without doubt saved her life, visited every day. Even he was amazed by her recovery. On leaving the hospital she was sat outside with her Dad waiting for a cab. The Neurosurgeon who had treated her ran past on his way to another emergency surgery. He did a double take when he saw Holly and realised that we were taking her home. He asked to have a photo with her – explaining that he simply didn’t see such good outcomes as this very often. He explained that more often than not, they just didn’t happen.

Walk and die

The point of sharing this story is this. The Neurosurgeon explained to us that they (Surgeons and Doctors) call this injury a “Walk and Die” injury. The person is initially well after a bang to the head, fully aware and conversant. Over a course of hours, as the bleeding puts more pressure on the brain they become unwell, and loose consciousness.  A proportion of people who sustain a bang or injury to the head go home and go to bed. They never wake up again. A further proportion, feeling fine initially, stay out and keep drinking. When symptoms of the brain injury such as confusion, slurred speech and sleepiness take effect, others assume that they are simply drunk, and no treatment is sought. These people will also die. A smaller proportion seek or are sought medical help and purely by luck, are in the right place when the symptoms take hold and treatment is given. These have a chance of living and recovering. If Holly had gone home that night, and gone to bed she would never have woken up again. Equally if she had stayed out, she may never have got the timely treatment that she did and would likely not have survived. Hundreds of lives are lost needlessly each year from head injuries like these. A lot of people do not realise that a head injury may not have immediate symptoms or know what the signs of brain injury are. So, I am hoping that by sharing this story we can help to raise awareness and hopefully more people will survive as a result.
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