May 8 started off normally for Carlie, a senior at The Wharton School of the University of Pennsylvania. She’d met with her mentor in Center City to finish a project, but her mind was focused on the future; in two weeks, she’d be a college graduate about to begin her career at a local start-up. The future seemed bright — until everything went dark. Though she can’t remember the accident, as Carlie and her friend left Trader Joe’s with their lunches, they were struck by an SUV. Her friend fortunately only suffered minor injuries, but Carlie — unconscious on the pavement — was rushed to Penn Presbyterian Medical Center’s Trauma Center.
Stabilizing a Swollen Brain
Carlie’s visual, verbal, and motor responses indicated she had a severe traumatic brain injury (TBI), and a CAT scan quickly confirmed that she was experiencing a bleed on the right side of her brain with swelling and elevated intracranial pressure. To allow her swollen brain to expand, H. Isaac Chen, MD, an assistant professor of Neurosurgery, and Neurosurgery resident Sophie Su, MD, performed a decompressive hemicraniectomy, removing an index-card-sized portion of Carlie’s skull.
For 16 days, she was closely monitored in the neuro intensive care unit. Everyone was hopeful, but there was no way to anticipate whether her brain’s wiring had been damaged. Incredibly, within days of coming off the ventilator, she was walking and talking. “I had a really hard time understanding what reality was. I hallucinated an entirely different reason for being there,” Carlie said. “But everyone has really funny stories — apparently at one point I started speaking Spanish to my nurses.”
“This case really shows the importance having a Level I Trauma Center that runs like a well-oiled machine; everyone knew what needed to be done, communicated with each other, and provided excellent care,” Chen said. “This could’ve been a tragedy, but there were no major complications or obstacles.”
Wharton’s vice dean, Lori Rosenkopf, conferred Carlie’s degree while she was in a medically induced coma, so after regaining consciousness, Carlie thanked her via email. A few days later, Rosenkopf arrived for a visit — with a cap, gown, and diploma in hand. “I was so upset that I’d missed graduation, so it was amazing to have that closure,” Carlie said.
Small Steps, Both Physical and Emotional
Carlie was transferred to the Penn Medicine Institute for Rehabilitation Medicine (Penn Rehab) on May 24, where she stayed for another two weeks. Every day, her physical and cognitive abilities improved — walking turned into walking while holding a conversation, for example — and Stephen Hampton, MD, an assistant professor of Physical Medicine and Rehabilitation, noted that the pace of her recovery was remarkable.
“Carlie’s care team worked together every step of the way to optimize her outcome — from the first responders who took her to PPMC, to the PPMC team who cared for her and comforted her family, to the neuro-rehabilitation team who helped her regain skills she had lost,” Hampton said. “In a short time, Carlie was walking around the unit and asking insightful questions about her recovery. The rate of improvement is often out of our control, but her progress was excellent. She persevered.”
Penn Rehab also linked Carlie with the resources she needed to come to terms with her ‘new normal.’ Kelli Williams, PhD, director of Neuropsychology, was vital in this emotional healing process. “She anticipated that it would be a lot to digest, and she was really consistent in checking in with me,” Carlie said. “Even since leaving Penn, I’ve talked to her. She made it clear that she’s still here for me if I need to work through my thoughts or emotions. That’s been a huge help.”
On the Road to Recovery
After Carlie was discharged from Penn Rehab, she returned to the Midwest with her family. While she spends weekends at home in Wisconsin, she and her parents make weekly treks to Chicago to spend eight-hour days in another rehab that specializes in TBIs — days she describes as “interesting but difficult.” Though extreme fatigue still poses an issue, she has already noticed improvements in her endurance. Carlie also received daily organizational and short-term memory tasks. “They’ll give me a sentence, then have me alphabetize the words and recite it backwards — which I guarantee would’ve been difficult before the accident,” she laughs.
Her laughter is incredible given the circumstances, but it underscores her insistence on pulling through this experience without losing herself along the way. With the support of her parents, boyfriend, and care teams in Philadelphia and Chicago, she has made significant strides, and her thoughts have returned to the future.
“This unexpectedly changed my course in life, and that has been hard to deal with,” Carlie said. “But I’m really excited to move back to Philly, see my friends, start my job, and live independently without people helping me shower or making my meals. All of that is driving me to make it through this adversity, through my recovery, and back to my life.”