JEAN LENGENFELDER: 00:00:06.131 [music] It's now my pleasure to introduce Matt Faulkner who will be presenting today Most Likely to Survive. Matt is the co-author of the book Most Likely to Survive and the subject of the document film Recovery, both of which detail the events surrounding his near death and unexpected recovery from severe TBI he suffered shortly before his high school graduation. Revived from the brink of death and spending nearly two months in a coma, doctors did not give him a lot of hope for survival or recovery. Fortunately, Matt took part in an intensive neuro rehabilitation at Erie County Medical Center in Buffalo, New York. He beat the odds by walking out of the hospital on his own two feet after a 103 days and across the stage at his high school graduation two weeks later. He went on to graduate with a bachelor's degree in economics and finance from Canisius College less than four years after that. Today, he is happily married to his husband, Kyle. He still lives near Buffalo and works for NRG Energy. Outside of his full-time job, he's a seasoned guest speaker on the topic of TBI rehabilitation, adaptability and recovery to groups of students, nurses, and therapists. Matt hopes to use his experience to demonstrate the wonder of neuroplasticity, as well as positively impact the current paradigm of neuro rehabilitation, so that it focuses more on individual patients. Thank you, Matt, for being here with us today.

MATT FAULKNER: 00:01:47.676 Good afternoon, Jeannie. Thank you for the great introduction. Well, it is quite an honor to be invited by the Kessler Foundation to speak at this event for the traumatic brain injury, TBI, community. I have followed the Kessler Foundation for a number of years now. And I absolutely love the work that they're doing to help people with different abilities of all kinds, including those resulting from TBI. I am frequently asked to and have participated in their research studies. And someday soon, I hope to make a road trip to New Jersey to fully engage and get a functional MRI for the research. So again, it's great to be here, and I hope to share my experience today to show how we need resource organizations like this to advocate for better support for those with TBI, both in a sense of rehabilitation and ability awareness, but also in the broader sense of rehabilitation and adaptability. My story shares how without the help of others, I wouldn't have survived. Without the help of the people who were there for me when I needed the most help, I could not have chosen to recover and rebuild my life. Critically, I hope to serve this community as both a TBI survivor and as an ally to caregivers.

FAULKNER: 00:03:23.400 My story begins, it was March of my senior year of high school. I had just turned 18 years old. I had a car, and I drove myself to school where I was the editor-in-chief of the yearbook and on the board of the school's National Honor Society chapter. On the weekends, I worked at Old Navy. Not sure where I found the time, but I even went on dates once in a while. Life was pretty good. Not long before I was voted most likely to succeed by my classmates. And this fueled my ego. But I was ready to finish my AP courses, take the exams, hopefully find a prom date, finally graduate, and move on to new things. Like attending Canisius College, where I would be studying finance. I was also looking forward to living on campus with my peers in the All College Honors Program. You might say that I was ready to begin the next segment of my life, although my life took a dramatically different turn after school one day.

FAULKNER: 00:04:40.231 So I was ready for the next thing, but the next thing I knew, I woke up and what felt like a nightmare where I couldn't speak, and everyone was lying to me, including my mom and dad. They and others whom I had never met before, were telling me that I had been in a car accident. And that I had had a traumatic brain injury. I remember thinking, "This isn't true. I don't remember that." I felt like I had to escape from this place. I had to wake up. And when the opportunity presented itself, I went for it. I had to run from this. But when I tried to get out of bed and run away, my legs crumbled beneath the weight of my body, and I quickly fell to the floor. That moment on the cold hospital floor, that's the moment that I tell people that I remember waking up from a coma. I woke up to the reality that my legs and my body didn't work like they used to. I also woke up to the truth that it was now May and that months had gone by since my last solid memory. I learned that I had spent over 6 weeks in a coma before I began following simple commands. But I didn't have a real sense of what was going on until that moment, just over two months since my accident.

FAULKNER: 00:06:06.968 Although I don't remember it, I later learned that I was on an innocent trip with some friends after school one day when things changed. On our way back home, my friend who was driving made a left turn when she probably shouldn't have, and a pickup truck collided with her compact sedan right where I was sitting in the back seat of her car. After the pickup truck hit us at around 40 mph, I fell into a deeply unconscious state. I was in cardiac arrest so my heart had stopped beating, and I also wasn't breathing. Apart from some cuts, my body was fine. But my brain was not. Luckily, the first responders arrived very quickly and noted my poor condition. They saw that I was in a state of abnormal posturing known as decerebrate. This was not a good sign. But the EMS workers, most of whom were volunteer firefighters, gave me a shot of epinephrine to jump start my heart, and they also intubated me. They recognized that I needed to get to the ICU quickly. So I was flown by EMS helicopter, known as Mercy Flight, to Erie County Medical Center in Buffalo, New York. Fortunately, no one else was hurt in the accident, and all of my friends had walked away. But it didn't appear likely that I would survive, let alone attend college or return to a functionally independent life.

FAULKNER: 00:07:52.953 At the hospital, an initial CT scan revealed multiple injuries to my brain including intracranial hemorrhages, intraparenchymal contusions in the regions of the hippocampus and the basal ganglia on the right with blood in the occipital horns on the lateral ventricle as well as petechial hemorrhages in the frontal lobes bilaterally and near the ponds. That's about as technical as I'll get for this whole presentation, but I wanted to include that. A neurosurgeon performed an emergency ventriculostomy to relieve the buildup of pressure inside my skull from the bleeding and the swelling and to hopefully stop further damage. I don't remember anything from that last day without a damaged brain. My plans were shot. My new focus was a far reach from anything that I had ever expected. When I woke up and became aware of these things, I had no other choice but to accept what had happened and that it was going to be a lot more challenging for me to accomplish when I had planned for myself. As hard as I tried, I couldn't speak, I couldn't walk, or maneuver a wheelchair. And I definitely couldn't even feed myself. College was a long shot. But my immediate goal was to relearn to walk again so that I could cross the stage at my high school graduation in less than two months.

FAULKNER: 00:09:32.068 I struggled to relearn all the normal things that I once did while my friends, including everyone in the car that day, were experiencing the last days of high school and going to prom. But I didn't focus on that. I couldn't focus on that. What I did focus on was doing what I had to do in order to return to some degree of normalcy. I wanted to recover. I had to be engaged and working with my therapists who were there for me and wanted me to recover. I had once been an honor student with a car and a part time job. But this was my new life. I took therapy seriously. I was fortunate to be offered a new full-time job. This job was physical, occupational, and speech therapies, each of them 5 days a week. But I did what I had to do. I developed great relationships with the great people who were at the hospital and wanted to help me recover. I was also lucky to have both of my mom and my dad there with me every single day in addition to other family and friends who would visit me often. On Mother's Day that year, my voice suddenly returned, and I was able to wish my mom a happy Mother's Day with just a whisper. I probably will never be able to top that gift.

FAULKNER: 00:11:01.862 Very slowly, I relearned my activities of daily living and to do all of the important things again. If you've ever heard of neuroplasticity, please know that it is a real thing. And I hope to be a case study of it. After months of intensive rehabilitation and 103 days in the hospital, I walked out of the hospital on my own two feet. Then 12 days later, I walked across the stage at my high school graduation to receive my high school diploma. Day by day, I adjusted to my new life, re-learning how to function again with many challenges along the way. It was difficult to adjusting to doing things for myself again, but I had to try. I continued outpatient speech, physical therapy, and occupational therapies for a few months, but my insurance would no longer cover me after I was deemed functional, although I was far from where I am today. Eight months after the accident, I started back at my part time job at Old Navy where I handled customer service and transactions. Working as a cashier now with a traumatic brain injury was a very different experience than I had before. And I even had a rude customer asking me bluntly, "What's wrong with you?" after I was really struggling to fold her clothes and get them into a bag. I told her exactly what was wrong with me.

FAULKNER: 00:12:44.255 Despite my shortcomings with folding clothes, I wasted no time and started college slowly that Fall with just two courses at Erie Community College while Canisius College held my scholarship and admission until I was ready. This was a great opportunity for me to figure out how college courses would be as a freshman but also with a different and damaged brain. Before the end of my first semester in college, I went to a neuropsychologist for a neuropsych evaluation. This doctor reviewed my medical records but was not very positive in his outlook, telling me that I would not be able to graduate from college without significant accommodations. Nor would I be able to join the competitive workforce. All of that before I even sat for testing. I received his results a week later, accompanied with a letter that concluded with a statement which I will never forget. "Patient is a well intentioned determined young man who may not respond adaptively to negative feedback about his neuropsychological status."

FAULKNER: 00:14:05.214 I would need to go back to him for further discussion and reviewing of my results because it was all psychometric data that I was not familiar with. But I decided to find another neuropsychologist after I received an A- in both of the courses that I had taken that first semester. It was clear to me then that I was responding adaptively to all of the negative feedback. I went to another neuropsychologist before the end of my second semester at Erie Community College. She took a different approach by focusing on my intended major, which was finance. She reviewed the results of my testing and explained to me that the testing showed that I was actually unlikely to have difficulties studying finance because my biggest areas of deficit were visual spatial organization and - quite shockingly - motor skills. While I was very thankful that she was not going to make me take the pegboard test again, the one where you put the little pegs in the little holes and you have to do it with each dominant and non dominant hand. I did horribly at that. She taught me a small adaptation for the visual spatial processing problem. And this is something that I have greatly benefited from to this day. She retested me on a few key areas related to what I would be studying, and ultimately it was determined that I would not need any academic accommodations to start school full time. I might not be great at folding clothes, but I couldn't be happier.

FAULKNER: 00:15:58.219 Shortly after that, I was evaluated by an occupational therapist and approved to drive a car again. By fall of 2010, I was ready to move into the dorms at Canisius College like I had originally planned. Just one year off schedule. And by 2013, after three years at Canisius College, I graduated with a bachelor's degree in economics with about a 3.5 GPA. Many people used to say to me that you only have one year to make the most of your recovery. And all this gave me was fear. Looking back, I don't believe this is even remotely true. My brain injury was almost 14 years ago, and I'm continuing to recover, living a life that I could have only dreamed of when I woke from the coma. My philosophy remains that your brain thrives off of new experiences and that it doesn't stop adapting throughout your life, even after brain injury.

FAULKNER: 00:17:10.818 My life was well planned out before I had a TBI. But as things changed, I had to learn to reassess those plans. I did not spend much time focusing on how or why this happened to me. Instead, I focused on what I wanted to get out of my recovery. In 2009, what primarily motivated me was being able to go to my high school graduation and walk across that stage. Then I moved on to the next thing. After that, I focused on using the skills that I had retained like my ability to learn new things. And to use a computer to research ways I could make the most out of my current situation. So I could begin in college and eventually get my dream job, which was really just working in a corporate business office. Today, I am proud to say that I am working in my dream job. I work full-time in regulatory compliance for NRG Energy. I'm also married, and my husband and I are building a family of our own. I drive myself places. I live pretty independently. I even make the coffee and do most of the laundry at home. I still have difficulty with a lot of motor skills like speaking normally, moving around quickly, and working with my hands. Lucky for me, cooking and snow blowing are best handled by my husband.

FAULKNER: 00:18:51.220 The brain injury also left me with central pain syndrome, which manifests in my left foot. And it's really annoying because it only hurts when I think about it. And there's nothing I can do except think less about it. And guess what? It hurts right now just because I'm thinking about it. While I sometimes struggle to get rest and tie my shoes, I am truly grateful that I don't have any issues with my executive functioning or with language. I'm able to live a mostly normal and productive life. I hope to have an impact on my community by sharing my experience as a past patient to help future clinicians develop a passion for individualized treatment. Outside of my full-time job, I work in the community by speaking to high school students about motivation and adaptability. I also speak to graduate and undergraduate college students in medicine and rehabilitation science as well as professional therapists about my experiences as a patient recovering from TBI. I've spoken to doctorate of physical therapy students at the University of Buffalo for going on 10 years now. It remains the highlight of my year.

FAULKNER: 00:20:19.258 Every year the students in the class are so focused on learning to and learning from my perspective after they spend a semester learning about neurological disorders and hearing some really grim statistics. I encourage them to focus on the patients' individual goals to help them assess a way to achieve what they want. I believe an individualized approach eases the burden of statistical prognoses. And I remind students that a recovery begins with a patient's willingness to recover, and it ends with a patient's goals being realized. Their job as therapists is to develop a plan to help a patient get there. TBI survivors deserve to be treated like the person they were before their injury. This is my best advice for people caring for those who have suffered from a TBI. I love to share my experience with brain injury rehabilitation and recovery with others. I don't want people to be discouraged by that old adage that all the recovery only happens during a one year critical period after brain injury. I feared the truth of this statement. But looking back, I think that I have continued to recover while beyond this. I believe I still see a small improvement each and every day.

FAULKNER: 00:21:52.009 Obviously, these opportunities to speak and share my experience were not in my life plan 14 years ago. But I adapted my plans to use my experiences to serve others and the community who might benefit from my story. All plans are likely to change, so make it a priority to adapt to those changes. There are so many opportunities today to challenge yourself with new perspectives or to grow your skills. And so long as you trust your instincts and remain adaptive, you will always be ready to take the next opportunity. My best advice for those recovering from TBI is to accept what has happened and don't be afraid to ask others for help in your own way. Choose an adaptive response to your goals, communicate to others what your goals are, and work with others on ways that you might be able to achieve them. You might be surprised at the willingness of people that help you when you just ask. There are so many resources that you can use to learn about yourself and your strength. Remember that your brain can always change and rewire itself to adapt to your goals. Thank you so much.

ERICA WEBER: 00:23:17.118 Thank you so much for that wonderful presentation, Matt. It was really inspiring to hear your story and get to learn a bit more about your journey.

JOAN BANKS-SMITH: 00:23:27.402 Tune into our podcast series lately? Join our listeners in 90 countries who enjoy learning about the work of Kessler Foundation. Be sure and subscribe to our SoundCloud channel, Kessler Foundation, for more research updates. Follow us on Facebook, Twitter, and Instagram. Listen to us on Apple podcast, Spotify, SoundCloud, or wherever you get your podcasts.