Road traffic accident: John and Josh

John’s son Josh was involved in a road traffic accident when he was nine. Josh was dead at the scene, but his father, a police officer, was able to revive him. 

Published: April 2012. Child’s age at time of brain injury: 9 years. When Josh first came out of a coma, he had difficulty eating and walking. He was unable to talk, had no purposeful movement of his limbs and was doubly incontinent. 
John and son Josh
John and Josh

How Josh had his injuries

“Josh was out on his bike playing with his brother. He was riding on the footpath, but as he looked behind him, he veered into the road and into the path of an oncoming car. Josh’s brother came and got me and I was able to revive him, but the impact meant Josh had three skull fractures and three separate severe acquired brain injuries. He was airlifted to hospital where he was put into an induced coma for eight days, and then in a natural coma for 73 days. We were told in no uncertain terms that Josh would be in a coma for 12 months, and following that he would have serious disabilities for the rest of his life.”

At the hospital

“What happened to Josh was difficult in three main respects. Firstly, it’s just the suddenness of it all. One day, you’re going about your daily business – I was cutting the grass at the time – and then you’re sitting in a hospital a week later. Your life just comes to a standstill. You can’t think about anything else, and you’ve got bills going out unpaid and everything else. Another thing I found very difficult was the time Josh spent on the ward in a natural coma. When he was in intensive care, he was in an induced come and there was a lot of equipment and monitoring. That was easier to cope with because you could see these little improvements in things like his blood pressure or the medication having an effect.  But when he was on the ward, he was lying in a bed with a heart monitor and nothing else. I really struggled with that, if I’m honest. So I took to keeping a diary, and I gave myself a target of putting one positive thing down each day, be it a twitch, or an improvement in his heart rate. Like a lot of people, I’d thought that a coma was just something you woke out of one day. But it’s only when you experience it that you realise it’s a very gradual process. I think we also assumed that when Josh had woken up from the coma he would be as he was before, but he wasn’t. It was strange, because I was talking to him and playing with him like I used to, but he was reacting completely differently. It was only later that I was more educated about the brain. And that the part of the brain that affects Josh’s reasoning or his ability to regulate his thoughts and emotions was injured. It’s then that you begin to understand what has happened and why he was reacting the way he was.

 

Arriving at rehabilitation

We were told that Josh would have his best opportunities for getting better at a specialist centre. Funding really is a major issue with rehabilitation, though. We know parents from different areas who haven’t had any issues, and it can feel like a postcode lottery. Like a lot of things, it’s an unknown that you haven’t had any experience of before as a parent. You don’t know who to speak to and where this funding comes from. I sent letters to our MP and the chief executive of our primary care trust and that seemed to make a difference. We know parents who haven’t pushed for funding, and you can understand how that might happen – the situation is stressful enough as it is. Pushing for funding is time-consuming and there’s a lot of bureaucracy to it all. It’s the last thing you want to be doing when you’re in that situation, but unfortunately, it’s a necessary evil. And it is worth it in the end.”

 

ABI can be hard for others to understand.

“One of Josh’s main difficulties was the ability to reason and to regulate his emotions. The problem we’ve had in trying to explain what brain injury is to other people is that it doesn’t fall within a set criteria. It’s not something that you can easily label and every injury is unique. Josh has a brain injury, but no two children with a brain injury are the same. To the outside world, Josh might look like a naughty, bad-tempered boy if he’s not getting his way, but in actual fact it might be because people aren’t talking to him in the right way.”

 

Brain injury is hard for all the family

“Josh’s brother is a year older. He actually witnessed the accident, so that’s had a massive impact on him. He spoke to someone about it all about three or four months later – he wasn’t ready for it at the time. But we’ve talked to him about how important he was in helping Josh. He actually came and got me after the accident so I could revive Josh, and if it weren’t for his fast reactions then Josh might not be with us now.”  

Back at home

“I think every child with an acquired brain injury has their own specific ways of settling back in at home. In Josh’s case, he struggles with his ability to reason. If we say to him: ‘You need to get up and get dressed because we’ve got school in an hour’, it doesn’t mean anything to him, because he doesn’t want to go to school. So he doesn’t see why he needs to do those things. We have to say: ‘If you do this for me, then you can have some time on your Playstation’. As I say, it’s going to be different with different children, but that’s the way it works with Josh.

 

Back to school

“Josh used a wheelchair at first, but now he can get around the house on his own. He’s made a lot of progress. I think he would be physically okay to go back to his old school, but I don’t think he’s at that stage from a mental point-of-view just yet. I think he’d struggle to cope with the speed and pace of the curriculum.  So Josh is at a specialist school at the moment. Because of his fatigue levels, he struggled to do full days at first and was only doing mornings. But three or four weeks later he was there full-time and handling that quite easily. He’s not using his wheelchair and he’s walking around all day in school, which is really good. The school has been fantastic. The staff there have listened to what we and everybody else has said. Josh is aware he has difficulties with some things. When we first came home and Josh’s friends came over to play, I think it highlighted some of the issues he has. They couldn’t play or go out and do the things they used to, and that was quite a hard thing for Josh – that realisation that things aren’t as they used to be.
But I think he feels like he fits in with the other kids better at the specialist school. Another thing that’s been really good for him has been horse-riding. I’d never have considered it before, if I’m honest, but it helps him in building his core stability. That was invaluable in getting him on his feet again, and he loves it.”
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