A recovery that has the doctors worried

Three years ago, Inquirer reporter Michael Vitez wrote about Matt Miller, an aspiring young triathlete from the Philadelphia area who survived a cycling crash that, but for an extraordinary stroke of luck, would have killed him. Vitez gives a full account of Matt's accident and his struggle to recover in a newly published book, "The Road Back: A Journey of Grace and Grit." All this week, Philly.com will be sharing excerpts from the book. In today's installment, Matt's doctors' failed attempts to slow him down.

Matt Miller's recovery was simply astonishing. A week after emerging from a pharmacologically-induced coma, 10 days after sustaining what the medical record officially called parenchymal shear injury, contusions, intraventricular hemorrhage, and subdural hematoma, doctors came in to Matt's room that Wednesday morning to find him reading his physics textbook.

This was truly just mind-blowing to these doctors, who of course thought they had seen it all. In fact, his behavior alarmed them. Jason Sheehan, the neurosurgeon, was concerned that all this reading and studying was going to tax Matt, exhaust him, and be too much of a strain on his recovering brain. Sheehan would have been immensely pleased just to see somebody who had been through what Matt had to be sitting up in bed. That would be a triumph. But studying physics? Using a highlighter?

"You could see it in their faces," Matt's Dad, Mike Miller, said. "Doctors would be blown away by that." Sheehan literally scratched his head the first few times he saw it, tried to suggest to Matt that maybe he wanted to slow down, take it easy. But Sheehan began to see this was therapeutic for Matt, and became more supportive.

And then there was the issue, frankly, of Matt's face. He looked like a stroke victim. Not only was he still prodigiously swollen, but it was clear now that he had suffered extensive nerve damage in the accident. Nerves controlling the left side of his face didn't work. He couldn't close his left eye, and doctors had inserted a gold weight into his left eyelid, to enlist the aid of gravity. This was another surgery.

His mouth zigzagged like a plunging stock-market table. He was drooling. He couldn't smile. There was no way of knowing at this point if his nerves would ever work again, or if so, to what degree. Matthew Miller had been a healthy, handsome college student and now he looked visibly deformed. There was no way to sugarcoat it. Yet this fact didn't appear to bother Matt in the slightest.

Jared Christophel, the chief resident working with Stephen Park, a facial plastic surgeon, would come into Matt's room every morning, sometimes even before 6:00 a.m., to check on his patient. Matt, assorted tubes in tow, would get out of bed, walk toward the door, and, with his casted paw, shake Christophel's hand. "Get back in bed!" the doctor would order.

Christophel was still a relatively young doctor, a fifth-year resident, but he had never seen such a thing before. A patient, one as injured as Matt, had every right to be so thoroughly depressed and withdrawn, to lament what he had just lost, to be devastated by the enormity of what had happened to him, to rage at the world, or at least want to withdraw from it. But to get out of bed to shake the doctor's hand? Christophel was blown away. And Matt was always cheerful and pleasant and so positive.

Matt was in fact so positive that Park and Christophel worried about him. He had such obvious physical and facial deficits, and such uncertainties about his future, that it was normal and expected for him to go through a grieving period of his own, to experience anger and sadness. Park at first thought that Matt's positive behavior and attitude was an obvious consequence of his brain injury, a personality disorder, a sure sign that his brain wiring had been damaged and his emotional responses were irrational. A brain injury was the likeliest explanation for his behavior.

But after a few days, and more interaction with Matt, and more observation, Park decided that this wasn't the case. Christophel was still so concerned about Matt's behavior - believing Matt was bottling up his true feelings inside and this could ultimately be very harmful - that he twice spoke privately to Matt's mother Nancy in the hallway, expressing his concern. Nancy wasn't worried about this. She was beginning to understand her son's mettle. This was just who he was.

Even Matt's friends who knew him as a positive person were stunned. Chris Morrow went in to see him for the first time a week after the accident, and he walked into the room to find him reading a triathlon magazine. Matt, granted, had no recollection of the actual accident. This was common among trauma patients, and in particular head-injury patients.

Matt's inability to remember the actual accident, Sheehan explained, was caused by a combination of the injury to his brain and also by the drugs used to induce the coma which had an "amnestic effect." Sheehan thought the emotional horror of being in the accident — and the brain trying to block it out — probably had little or no influence on the amensia. Chris Morrow, however, had all too vivid a memory. And he could also see clearly the pain on the faces of Matt's parents, a pain he never wanted to cause his own family.

Monday: A visit to the anesthesiolgist who saved Matt's life out on the road

To Read More

Tuesday through Friday, philly.com/roadback will feature a daily excerpt from Michael Vitez's book "The Road Back: A Journey of Grace and Grit."

You can order the book at www.michaelvitez.com, amazon.com (Kindle and hard copy), or BN.com (Nook edition). The print version is not available in chain book stores, and must be ordered on line.

The Irish Mile, 350 Haddon Ave., Haddon Township, Tuesday, May 22, from 6 to 8 p.m.

Haddonfield Library, for a discussion and signing, Wednesday, June 13, at 7 p.m.

Breakaway Bikes (with Matt Miller), 1923 Chestnut St., Friday, June 22, at 7:30 p.m.

Free Library of Philadelphia, Central Branch, for a discussion and signing, Wednesday, July 18, at 7 p.m.