The morning of June 4, 2012, Travis Rouwhorst, then 12, sat in the back seat of a maroon four-door Saturn, driven by his older brother, Justin.
After dropping off their younger brother at day care that Monday, Justin headed down a country road toward Hamilton Middle School to drop off Travis.
They never made it.
At 7:13 a.m., Travis’ life forever changed.
“They got T-boned by a pickup truck,” said their mom, Carla Rouwhorst. “They rolled and landed in a field. Justin received a few broken ribs and a punctured lung but was basically able to walk away.”
Travis, pinned in the rear passenger-side seat, suffered life-threatening injuries.
“He was pinned in for 20 minutes,” Carla said. “He had to be intubated. He lost his airway so they couldn’t take off right away.”
Aero Med airlifted Travis to Spectrum Health Helen DeVos Children’s Hospital in Grand Rapids, Michigan. Carla met him in the emergency department.
“He was hooked up to so many things,” she said. “He had broken both legs, broken ribs, his pelvis was fractured in three spots, he had cuts on his head and face and fractures in one of his orbitals. There was a lot of (brain) shearing damage due to the rolling of the car.”
Medical professionals couldn’t say if Travis would survive the severe traumatic brain injury.
“They told us, ‘First, we watch for 10 minutes,’” Carla said. “They just kept tracking increment by increment, then hour by hour. Travis’ pupils were dilated and they were not coming back down. He had a 5 percent chance of living.”
Carla met with doctors the following morning.
“They told us within 24 hours Travis could be completely brain dead,” she said. “They gave us the worst-case scenario. Everything that we got was a blessing.”
A shimmer of hope
Intensive care unit nurses asked Carla if she wanted to crawl into bed with her son, to hold him in the moments that could be his last.
“I was crying,” Carla said. “He was hooked up to so many things. It was so hard. But I firmly believe that was a turning point for Travis. After a couple of hours of lying there, Travis started to have purposeful movement.”
When Carla met with doctors Wednesday morning, hope seeped through.
“They said they thought for sure we would be talking about organ donation, but clearly Travis wasn’t ready to go yet,” Carla said. “God had a plan. Travis wanted to stick around. The doctors talked about putting him into an induced coma. They placed a probe in his brain Thursday morning to monitor brain activity and swelling.”
Carla stayed in Travis’ room every day and every night for the next month.
“It was amazing how God works,” she said. “It got to the point where we could get Travis in a chair and walk him around. He wasn’t talking yet of course, but it was quality time. He just stared at us blankly, but he was awake.”
About two and a half weeks later, Travis woke.
“His eyes came open and it was a miracle,” Carla said. “It was like, ‘Wow.’”
Travis transferred to a rehab facility on July 5 of that year, where he received therapy five days a week.
“With a severe traumatic brain injury, you get the least amount back,” Carla said. “But we were seeing progress. You get the greatest gains within the first six months.”
By the third week in August, Travis started to communicate. Labored, but communicating.
“One day the speech therapist plugged his nose and out came a sound,” Carla said. “His speech was very slow processing. I was constantly playing Christian music and realized Travis was singing with me to the music. He would match a word maybe one every 12 words.”
When Travis uttered “Mom,” Carla’s tears flowed.
In November 2012, after a trial weekend at home, Travis beamed. The family decided that’s where he belonged.
“I was tired of living at the hospital,” Carla said. “I wanted him to come home so we could be a family again. Because it was an auto accident, we could get therapy coming to the house for OT, PT and speech.”
After plateauing with another therapy firm, Spectrum Health Neuro Rehab Services staff started working with Travis about three years ago.
“Travis is making improvements ever so slowly,” Carla said.
During a recent in-home therapy session, Spectrum Health occupational therapist Maureen Fallon-Krueger greeted Travis and asked how he was doing.
“I am grrrrrreat,” Travis said in his best Tony the Tiger impersonation. “Do you want to play a game with me?”
Fallon-Krueger sat next to Travis at the kitchen table and checked the splint on his right hand.
“When I first saw Travis he had a support for his wrist,” Fallon-Krueger said. “His hand was fisted because of the abnormal tone. This new splint provides wrist and finger support and his hand is no longer fisted. As Travis has grown, a new splint was necessary.”
The years have ticked away in a blur of caregiving and therapy appointments. Travis is 20 now.
Dressed in a black hooded sweatshirt and gray pants, he flexed his hand at Fallon-Krueger’s commands.
“Just relax,” she said.
Fallon-Krueger was reassessing range of motion throughout Travis’ right arm.
“I can feel his shoulder and biceps tightening up,” she said. “Deep breaths.”
Carla pulled out her cell phone and showed Fallon-Krueger a photo of Travis turkey hunting with two guides. He didn’t shoot any, but he had fun.
“One of the things I think is awesome about Travis and his family is they get him out in the community and do just about what anyone else would do,” Fallon-Krueger said. “He is very active in the community. The family also keeps Travis busy with activities within the home that assist with visual skills, problem solving, strategy and hand usage. It’s just awesome.”
He’s been horseback riding and deer hunting. He loves to help his mom cook. He wears a can opener on his necklace so he can help open their homemade canned goods—strawberry jam, canned peaches, applesauce, salsa, tomatoes and grape juice.
“Travis loves to pick peaches and apples,” Carla said.
In a low, guttural voice, Travis added: “And squash and zucchini.”
The weekend prior Carla and Travis had baked a blueberry cake with meringue.
“Mom, do you have some of that cake left?” Travis asked. “Can we give it to them?”
“You’ve grown,” she said. “And you’ve got your manly voice.”
Fallon-Krueger visits every six weeks to review the family’s home exercise program, go through range-of-motion exercises and check the wearing and fit of the splint.
“Travis is a growing boy,” she said. “Sometimes equipment may change, splints may change, the tone in his hand may change. If we get a call from Carla, boom, we’re over here. He doesn’t have any pain, and he’s more and more independent.”
‘I’m really pleased with what I’ve seen’
Fallon-Krueger said she’s impressed with Travis’ progress in the almost three years she’s been seeing him.
“We encourage daily living skills, like getting him involved with cooking and baking,” she said. “He does as much as he can for himself. I’m really pleased with what I’ve seen.”
After Fallon-Krueger departed, Travis grabbed his four-pronged cane from next to the kitchen cupboard and, with the assistance of his mom holding his gait belt, slowly walked through the back yard to the chicken coop to look for eggs.
“He has a carpenter’s pouch—that’s how he gets the eggs back to the house,” she said. “He cracks the eggs and stirs it all up. I hold the bowl. …He participates as much as he possibly can.”
She sees improvement, but acknowledges limitations. He’s not the 12-year-old bookworm who lost the life he knew in the 2012 car crash. But he’s gaining.
“His processing is faster,” she said. “But he still needs time, depending on what you’re asking of him. His eyes aren’t well. They don’t work together. He has irreversible muscle damage. His right side is his weak side. He can walk with a quad cane and a gait belt, but you better be hanging on. He’s almost like a leaning tower of Pisa. He loses his balance and over he’ll go.”
But the two walk, side-by-side. Every day.
They walk to the family garden, to check the growth of peas, beans and other vegetables.
As Carla helped her son take small steps toward the garden, she smiled. What started as an invisible seed of hope is bearing fruit. And sustenance. Just like Travis.
It’s not like things used to be, but it’s the best they have. And she’s grateful. Given the initial prognosis, and his brain injury, she knows it’s a blessing to have Travis still among us.
“My old Travis is gone, but I have a new Travis and it’s OK,” she said. “He has a happy-go-lucky personality and sense of humor. He’s still very, very happy.”