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First Weekend Home

First Weekend Home: After the Coma

Tori Marlan

NOVEMBER 15, 2008

Justin Logan in rehab with his son Michael

(Courtesy Judi Logan)

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Traumatic brain injury - or an injury caused by a severe blow to the head - is the leading cause of death and disability for children and young adults. One of the most common causes of those injuries is car accidents. That's how high school student Justin Logan wound up in the hospital a few months ago. As part of our series "First Weekend Home" reporter Tori Marlan follows Justin out of rehab and through his first weekend home in his mother's care.

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On a recent Friday morning, 17-year-old Justin Logan and his mother Judi stand in a lobby at the Texas NeuroRehab Center in Austin. A tracheotomy scar peeks out from under the neckline of Justin's t-shirt. As he waits for his discharge papers, a rehab technician comes to wish him well. "Take care, OK?" she says. "Come back and visit me. You remember my name?"

"No," Justin says. "Sorry."

"Lisa."

"Hi, Lisa. I forget every time."

"I know! You gotta remember."

Justin doesn't remember a lot of things these days, including the terrible accident that landed him here. Three months ago, he was riding shotgun in a friend's pickup truck when it veered off a state highway and flipped several times. The driver and another boy survived with minor injuries. The girl sitting behind Justin died at the scene. Justin was ejected and suffered a severe traumatic-brain injury. He says he's glad he forgot this particular experience: "I'm sure I would have bad memories."

Justin was in a coma for three weeks after the accident. When he came to, he couldn't speak, walk or even swallow. He would get easily agitated and hit people. And he would say bizarre things. "One of the weirdest things he said was, 'I don't want to go back to Vietnam,'" Judi recalls. "Or he'd think he was older and he was out of college already."

Actually, at the time of the accident, Justin did seem older than his years. He'd become a father at 15 and was working two jobs to pay for his two-year-old son's diapers and day care.

In other ways, though, he was a typical teen in Llano, a small town in central Texas. He enjoyed playing video games, hanging out with his friends and fishing. He also played linebacker for his varsity football team, the Yellow Jackets. But now his gait is uneven. And the muscles in his right arm are stiff. Its default position is bent at the elbow.

"He misses playing football and he wishes he could do it again," says Judi. "But it's out of the question. He won't be doing that."

Justin's physical challenges seem minor compared to his memory loss. He has forgotten some life-altering events - like the fact that his father was murdered last year. In the hospital, Judi had to remind him over and over about it.

"He would ask, 'Where's my daddy?'" she explains. "And I'm like 'Justin, don't you remember he died a year ago, and you went to the funeral?' And he goes, 'No, I don't remember.'"

Hearing repeatedly about his father's death wasn't like reliving it. It was more like being reminded of a distant event until it became a remembered fact. "It was kind of sad," he says. "Even though my dad didn't live with me, I still loved him."

On Justin's first weekend home, Judi finds herself in the role of caregiver. When he showers, she plants herself outside the bathroom door, ready to help if needed. She also has to drive him everywhere and keep him under 24-hour supervision. "I can't walk out the door and leave him here, like we're so used to doing," she says.

Judi and Justin have always liked to tease each other, and they seem to cope with their new situation with humor. Justin's memory loss is fair game. On Saturday afternoon, at Justin's favorite BBQ restaurant, Judi tries to convince him that he likes onions and pickles - condiments that have always repulsed him. He doesn't fall for it.

"I tried," Judi says.

"Yeah, you tried, but you failed," Justin cracks.

Joking may help keep things light, but Judi has her limits, like when Justin fakes a stumble or pretends to choke on his food. Over lunch, Judi asks him to stop doing that. "You're the only one who thinks it's funny," she says.

She tries to explain why his family might not appreciate the scare. "It was different for us, waiting and waiting and worrying while you were just kind of out of it."

"I don't remember," Justin says.

"I know. We do."

Justin, though, can also be sensitive to what his mother is going through. He worries about holding her back from her life. She tries to reassure him. "It's not a hold back. You're more important to me than that."

"I know," Justin says. "But still, I'm saying if I didn't need supervision, you could just go do whatever you want."

"It's OK," she tells him. "It won't be like this forever."

Soon, Justin will return to school in a special-needs program and start outpatient therapy. How much more he will improve is unclear. Healthy nerve cells in the brain can learn to function for cells in damaged areas - though never as well. Justin's neurologist says that if you look at an MRI of his brain in 30 years, it will still be scarred and that he's likely to always have cognitive and physical deficits.

Judi, though, remains optimistic: "In my heart I believe he's going to be 100 percent. That's how I feel."

In the meantime, she manages to find silver linings. Justin used to talk about joining the Marines and wanting to experience combat. These days, Judi doesn't have to worry. The Marines wouldn't take him. And, besides, he seems to have forgotten he was interested. "You know," Judi says, "he doesn't mention it."

On Sunday, Judi's small duplex swells with family and friends who've come to welcome Justin home. Among them are Justin's two-year-old son, Michael, and Michael's mother, Cecilia.

Michael gives his father a quick hug before scrambling off into another room. Minutes later, the boy reappears with a small red football and hands it to Justin. Justin doesn't say anything. He just holds the football on his lap. Before the accident, he was teaching Michael how to catch.

Although Justin can't remember much about how he used to spend time with his son, the gaps in his shared history with Cecilia trouble him more. He doesn't remember basic things, such as how they met, what went through his mind when he found out she was pregnant, or that they broke up a year ago. Cecilia has had to remind him that they're broken up more times than she can count.

"If it's not every day, it's every other day," she says. "And sometimes it's like twice a day. He thinks we're a couple still sometimes, and that's been hard to deal with."

As she talks, Justin fixes his eyes on her. He seems to concentrate hard on every word. It's the first time I've seen his demeanor change. He looks forlorn. "I didn't believe her at first," he says. "It sucked. I wish we didn't break up."

As with his father's death, any insight or wisdom that came to Justin as a result of living through this heartbreak is now lost to him. The accident erased that. But simply knowing that he had grieved and moved on is a necessary step in his recovery. Justin is creating new memories now. And they will shape who he is and who he will become.

• Music Bridge:

  Milk Tea

  Artist: Takahiro Kido

  CD: Fleursy Music (Plop)

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