Former Patients Make a Comeback to Their Lives and Work
Vocational services and personal resilience help Shepherd Center patients resume their careers.
On a Thursday night this past June, basketball fans poured into Atlanta’s Philips Arena to watch live coverage of the 2014 NBA draft. Like all special events, this one was crafted out of countless moving parts: floor plans, stage setup, projection screens, precision lighting and the orchestration of dozens of Atlanta Hawks partners who provided everything from food to furniture.
At the epicenter of the fan fest was Catie Scott, manager of the arena’s building and event operations. And as she’d done so many times before, Catie deftly managed the intricate logistics and infinite details for the occasion – despite having sustained a serious brain injury two years earlier.
It was June 15, 2012 when a drunk driver hit Catie while she crossed a street in Midtown Atlanta. The collision left her with a broken skull and multiple other fractures, as well as a traumatic brain injury. She remembers nothing of the accident or her early days at Grady Memorial Hospital, where her family was told she might not survive.
But Catie, now 35, persevered, and after two weeks, she was stable enough to be transferred to Shepherd Center’s Acquired Brain Injury (ABI) Program. She arrived having lost hearing in one ear. Communicating was a struggle: She confused words, identifying a TV remote as a guitar, for example. And she was easily fatigued and emotionally wrought. “There were some days at Shepherd when I didn’t want to get out of bed,” she recalls.
Despite her frustration, Catie never lost sight of her goal to return to work and a normal life. In helping her achieve that goal, Shepherd Center’s physicians, therapists and vocational services team played a prominent role.
Three weeks after being admitted, Catie transferred to Shepherd Pathways, Shepherd Center’s post-acute ABI rehabilitation program. After taking a comprehensive neuropsychological exam (see sidebar) that identified remaining deficits, she continued therapy to improve her speech and short-term memory, as well as to strengthen processing and problem-solving skills.
“From day one, Catie was very goal-driven,” says Payal Fadia, M.D., Catie’s doctor and the medical director of post-acute services at Pathways. “She was such a go-getter, and in spite of her brain injury, she had such determination, tenacity and motivation to improve.”
Dr. Fadia notes that Catie had to overcome short-term memory and executive functioning deficits, such as organizing, planning, sequencing and problem-solving, all of which played a major role in her job. “We took a cautious approach at first,” Dr. Fadia says. “But as she continued to make improvements, it became clear she would be able to return to work someday.”
Getting back to work after a car accident was also the first priority for Ambrose “Eli” Tabb. Employed as a barista at Starbucks in metro Atlanta, the newly enrolled college student was struck in a pedestrian crosswalk in September 2012 by a car going 50 miles per hour. The impact of the crash injured his spinal cord at the T-5 to -6 level, leaving Eli paralyzed from the chest down.
Instead of starting classes, Eli was starting spinal cord injury rehabilitation at Shepherd Center. And instead of learning about Sign Language Interpretation at Georgia Perimeter College, he would be learning how to get around in a wheelchair. He spent three months at Shepherd Center as an inpatient and completed another three months of outpatient therapy in Shepherd Center’s Spinal Cord Injury Day Program.
For Eli, the goal to return to work as a barista seemed formidable. “Starbucks didn’t have anyone in the area in a wheelchair,” Eli says. “So no one was really sure what that was going to look like.”
Jackie Breitenstein, MS, CTRS, CCM, a former transition support coordinator in the Transition Support Program who now manages the Center’s SHARE Military Initiative, started the process by contacting Starbucks. She did an onsite job analysis at Eli’s store to determine potential obstacles and accommodations that could be made. During therapy, she and Eli engaged in role-playing: He would prepare beverages for her, and together they came up with different adaptations and strategies.
They then visited the store to help Eli reacclimate to the environment. When he was ready, Jackie even organized a test run, in which Eli worked a short shift and was observed by a team that included Starbucks management, Shepherd Center vocational case manager Debbie Page and a representative from an outside vocational agency.
“We don’t want to tell patients like Eli what to do,” Breitenstein says. “It’s much more important and effective for them to figure it out and solve problems for themselves.”
Eli recalls: “It was like I had my own team of coaches. They all watched me and gave me tips on what was and wasn’t working.”
Likewise, Catie credits both the Shepherd Center staff and colleagues at Philips Arena for collaborating on her behalf. “Everyone has been incredibly encouraging and supportive to me through this whole thing,” she says. “And I wouldn’t be here without them. Shepherd helped me prepare to go back to work, and Philips held my job for me and allowed me to return to work gradually.”
THE SHEPHERD CENTER PHILOSOPHY
The drive to reintegrate patients back into society – work, school and all other activities – anchors the philosophy of Shepherd Center, and the hospital’s approach mirrors this philosophy. Professionals conduct real-world simulations, thinking through potential obstacles and challenges, while tapping the support of a larger network to aid in the person’s transition back to work and life.
Shepherd Pathways’ partnership with MedShare, a medical supply nonprofit, is one example. Pathways patients like Catie volunteer at MedShare, and the experience enables them to work on organization and management skills, as well as build the physical endurance and focus needed to complete tasks.
To apply her rehabilitation to real life, Catie brought work from her job into her therapy regimen. She shared outlines, program sheets, and other tools and documents required to plan special events, so therapists could help her figure out how best to organize. “This got me back into a routine I was used to,” Catie says, “and that was very helpful.” To supplement the simulations, she also worked on word recall in her off-hours, practicing with flash cards every night at dinner with her sister, Heather Durbin.
MAKING THE TRANSITION
In October 2012 – a remarkable four months after her accident – Catie was cleared to resume her job. Working with the staff at Philips Arena, the Shepherd team set up a gradual return – one day a week for four hours, then two days a week – so Catie could build her endurance. By February 2013, she was back at her job full-time, which sometimes requires more than 40 hours a week. Since her return, she was promoted to her current position of building and operations event manager, which gave her even more responsibility.
While Catie says the effects of her injury are sometimes challenging, she’s developed strategies to surmount the obstacles. “There are definitely moments when I have to stop and think, ‘Did I do that?’ because I can’t always remember,” she says. “I find I have to write everything down.” Because of her hearing loss, she has to wear a hearing aid, making it difficult to hear a radio during an event. Here too, she’s found a workaround: Event staff members know to text her if they need to reach her.
For Eli Tabb, the transition back to work was in some ways more complicated.
In June 2013, he was back home in Mississippi visiting his parents when he got the phone call he had been waiting for. Several months after the test run, the Starbucks corporate office cleared him to return to work at his previous store in Tucker, Ga. “It was the most exciting news I could’ve heard,” he recalls.
Though he was approved to come back, Starbucks had a different plan of what he would do. The corporate office created a position called “café attendant,” a front-of-counter job greeting people and answering questions. Eli was happy to try it, but after a few months he decided it wasn’t enough of a challenge.
“I think they were worried about my safety, being behind the counter with hot coffee, and I understand that,” Eli says. “But I told them I could and wanted to do more.” His manager listened to him. A month later, Eli was working the drive-through cash register.
While he was confident he could do the job, Eli still had doubts about how he would be perceived in the workplace. “I was worried about how the staff would view me,” he says. “Would I be in their way? And how would customers see me? Would I make them late for work?”
He credits Shepherd’s Jackie Breitenstein with changing his perspective to recognize that he wasn’t an inconvenience. “She gave me a pep talk and helped me realize that I was an asset to the community and an asset to Starbucks, and that I was also quite valuable in informing the public about people with disabilities,” Eli says.
Nearly a year after his return, Eli is working part-time as he focuses on earning an associate’s degree in Applied Science in Sign Language Interpretation. To communicate with hearing-impaired customers, he taught himself sign language through watching YouTube videos and now plans to make it his career. He hopes to one day get a degree from Gallaudet University in Washington D.C., for the hearing impaired.
While Breitenstein credits Eli’s determination and motivation for making the transition back to work, Eli says he could not have returned to Starbucks if it weren’t for her and Shepherd Center.
“She cheered me on the whole time and offered suggestions about how to do my job and how to educate people about my injury,” Eli says. “Fear is a big thing with the injury. It’s a new experience, a new way to live. Shepherd helped me get over that.”
Read our sidebar article: Shepherd Center Helps Patients Meet Goal of Returning to Work
Written by Sara Baxter
Photos by Louie Favorite and Gary Meek
Shepherd Center, located in Atlanta, Georgia, is a private, not-for-profit hospital specializing in medical treatment, research and rehabilitation for people with spinal cord injury, brain injury, multiple sclerosis, spine and chronic pain, and other neuromuscular conditions. Founded in 1975, Shepherd Center is ranked by U.S. News & World Report among the top 10 rehabilitation hospitals in the nation. In its more than four decades, Shepherd Center has grown from a six-bed rehabilitation unit to a world-renowned, 152-bed hospital that treats more than 743 inpatients, 277 day program patients and more than 7,161 outpatients each year in more than 46,000 visits.