Resilience and Recovery – From Brain Injury to Law School

In September 2018, Pavel Rozman, then a 23-year-old Drexel Law student, was riding a bike on his way to work at Drexel’s Law Library when he had a collision with a truck. Thankfully, Rozman was not far from Penn Presbyterian Medical Center (PPMC). Emergency responders quickly transported him to the PPMC Trauma Center, where he was placed in the care of Dmitriy Petrov, MD, an assistant professor of Neurosurgery.

Rozman was in trouble. He had a severe traumatic brain injury (TBI). The first few minutes to hours after a TBI are particularly important—the bruised and injured brain swells, fluid can build up in the brain (called hydrocephalus), and blood vessels may become damaged. This type of injury can cause lasting damage. Patients who survive may suffer from paralysis, loss of vision or other senses, and cognitive and mood problems. Among his list of injuries, Rozman had a depressed skull fracture on the left side of his head—the region of the brain related to speech—making him a candidate for immediate surgery.

“Less than an hour after being picked up off the street, I was wheeled into surgery,” Rozman says. “I was lucky. Dr. Petrov has truly changed my life in ways I could never repay. I think a lot about what could have been if one of those things went differently. The little things along the way made such a difference—like the fact that he was able to speak to my grandparents in Russian.”

Petrov remembers the day well, as Rozman was one of his first patients after he completed residency. What’s more, Petrov recalls the experience as a true example of the life-saving importance of an integrated trauma system.

“It’s really a success story thanks to the trauma team. Pavel was brought in right away and quickly went to get a scan. Our residents were there immediately, made the correct assessment, and called me. I called his father and broke the news—he didn’t know that Pavel was in an accident, or moreover, that he was in extreme danger. Thanks to our team, he was in the operating room 10 minutes later,” recalls Petrov.

With an injury like Rozman’s, there can be a growing blood clot and swelling in the brain, leading to a life threatening syndrome called herniation. The skull is a closed structure, it only has so much volume—swelling or blood clots overtake the available space in the skull, choking off arteries. Time is of the essence. During the procedure, Petrov removed pieces of Rozman’s skull and cleared out the bone pieces in his brain.

But Rozman was not out of the woods yet. He has no memories from the first 10 days after his surgery. Over the long course to recovery, he had to relearn how to speak, how to communicate with the world, and how to make sense of what happened to him and what he went through.

“There are still things that are really spotty,” Rozman said. “For example, I know I had surgery on my collar bone. My left side was pretty damaged after the accident. Of course, the priority once I arrived in the ER was the brain. So after two weeks, I had a procedure on my collar bone—but I don’t remember that at all.”

After 21 days at PPMC, which included three procedures, Rozman continued his recovery with physical and neuropsychiatric therapy, improving over the months to regain strength and focus. It was a tough road, but looking back, Rozman says there was no other way to get to where he is today.

What Rozman calls his “invisible scar”—hearing loss in his left ear—is still a challenge. But he is learning to cope, and thrive. For example, he’ll eat at a very specific side of a dinner table or sit on the left side when watching a movie. But it’s upsetting for him to think about things like not listening to The Beatles in stereo again.

“Dr. Petrov said to me during a follow up, ‘Look, I know there’s a long road ahead of you, but a year from now, you’re going to walk into a bar and you’ll tell someone what happened, and they won’t believe you.’” But it didn’t take a year. For Rozman, that moment took just eight months.

Rozman returns to PPMC every few months to visit the nurses, keep them posted on his progress, and thank them for taking care of him. He stays in touch with Petrov as well, texting him updates—like the first time he got back on a bike.

“I wouldn’t have been able to recover without the care team—the nurses, aids, and doctors at Penn, and the speech, occupational, and physical therapists at Magee Rehabilitation. I also couldn’t have done so well without my friends and family driving me around and pushing me to get better, and the mentors who went through similar injuries—they were inspirations, letting me know that they had made it and that I could too. If anyone is in this situation as a patient or parent and they want to reach out, I’m happy to help.”

At the time of the accident, Rozman was 20 credits shy of his second law degree. This month, he was able to return to law school and aims to finish his degree this year. But it’s still a constant battle as he continues to heal from his injuries.

“In trauma, we occasionally have these success stories. I really connected with Pavel. He’s an ambitious, smart young man, and I’m incredibly proud of how well he recovered,” Petrov reflects. “As neurosurgeons, we are really focused on what happens in the hospital. But it’s also important to follow these patients, and have a strong system and relationship in order to connect and treat patients through their entire cycle of care.”

It’s the life-long recovery journey for brain injury patients that inspired Petrov to create the TBI Recovery Project, a nonprofit organization supporting TBI survivors through the sponsorship and development of patient-facing projects and community rehabilitation initiatives.

On February 23, 2020, the TBI Recovery Project is hosting a Brazilian Jiu-Jitsu Tournament, a sport Petrov enjoys outside of the hospital. All proceeds will go to the Rose Gracie Foundation, which encourages combat sport athletes to prioritize their brain health, and Mind Your Brain @ Penn Medicine, an annual, free conference each March to support brain injury patients, caregivers, and families on their road to recovery.

“The goal of the TBI Recovery Project is to bridge the gap between the acute care for TBI and a meaningful recovery and return to work—or graduate school in Pavel’s case,” Petrov said. “He’s an incredible individual of outstanding character, and I hope other TBI survivors who hear about his story are inspired.”