The other side
of the bed

By Nancy Humphrey

Marsha Kedigh, VUH Admitting
manager, sees another side of the hospital
after her son was seriously injured

In 11 years as a trauma and emergency room nurse, Marsha Kedigh, R.N., made her share of middle-of-the-night phone calls to parents, waking them up to the words no parent wants to hear—“your child has been in an accident.”
The 26-year nursing veteran worried about being on the receiving end of one of those midnight calls. “It was always in the back of my mind,” said the mother of two sons who is now manager of admitting for Vanderbilt University Hospital. Kedigh, a transplanted Kansas native, also worried who, besides her husband, would come to her aid if something tragic happened to one of her sons, since many of her family members are scattered throughout the country.
In July, Kedigh found herself on the other side of the hospital bed, so to speak, when her older son, Caleb, 22, was in a head-on, near-fatal automobile crash and spent more than a month in Vanderbilt’s trauma unit and an additional three weeks at Stallworth Rehabilitation Hospital.
Caleb, on summer break before going to college with a baseball scholarship to Martin Methodist College in Pulaski, had gone out with friends late the night of July 22. Kedigh woke up about 2:50 a.m., and noticed Caleb’s dog, an American Staffordshire terrier, was still on her bed instead of Caleb’s. The dog normally left their room when Caleb got home. She felt uneasy, but fell back asleep, then woke up at 4 a.m. hearing her husband, Larry, say, “he’s in the emergency department? We’ll be right there.”
As she was hurriedly getting dressed for the drive from her home in Bellevue to Vanderbilt, she checked her pager, which gets all trauma notifications, and found Caleb’s. The time of the page was 2:48 a.m., which she later remembered was two minutes before she had awakened and realized he was not home. “Was it a mother’s intuition? I don’t know,” she says.
The pager told her what the nurse from the hospital hadn’t—that a 20-25- year-old male had been involved in a head-on motor vehicle accident, had multiple fractures, a head injury, and “snoring” respirations, indicating his airway was obstructed. “I knew that wasn’t good, but I tried to stay calm and wait until we got there,” she remembers.

Overwhelmed
When they got to the emergency department, an administrative coordinator she knows met them at the greeter’s desk and took them to the trauma unit, where Caleb had been transferred. “She wasn’t saying a lot, and I wasn’t sure if it was because he was really bad off or because she didn’t know how to convey what was wrong with him,” Kedigh says. “And I wasn’t wanting to ask because I was afraid of what the answer might be.”
She and her husband were taken into a small conference room, which “scared me to death,” Kedigh remembers, because she knows that bad news is often delivered in those rooms. A resident came in to tell them the extent of Caleb’s injuries, and there were many. A small subarachnoid hemorrhage in the brain. Fractured jaw with a dislocated temporomandibular joint. Collapsed right lung. Lacerated liver. Left femur fracture. Compound tib-fib (tibia and fibula) fractures on the right and left legs, the left tibia break so bad that it pushed two inches through the bottom of his left foot.
Sunday morning, he was rushed into surgery with Philip Kregor, M.D., associate professor of Orthopaedics and Rehabilitation. Before Caleb was taken into surgery, Kregor told the Kedighs that there was a chance Caleb’s left foot couldn’t be saved, and that although he knew that Caleb was an athlete, sometimes amputation in an injury this serious couldn’t be avoided.
Before Kedigh’s sister, who lives six hours away in Georgia, arrived, her “family” began to show up. Her Vanderbilt family. As the news got passed along to colleagues, they came to the Trauma Unit family waiting area, along with Caleb’s girlfriend, who came from Chattanooga, and several of his friends.
“They sat with us. They went to the chapel to pray for Caleb. They asked what they could do. It wasn’t any one thing. It was everything. The asking how he was doing, the hugs, sitting with me and not having to say anything, saying a prayer, the things I didn’t even see. We were just overwhelmed.”
Kedigh’s staff and colleagues took over, securing an available room in the Clinical Research Center so she could get some sleep and a shower on Sunday night. After that, they had a cot put in her small office off the lobby of VUH, and she was offered the use of the Emergency Department’s shower.

Triumphs and setbacks
That first week, her staff and colleagues from other units at Vanderbilt brought food to her friends and family members waiting at the hospital. Her boss, Lenys Biga, told her not to worry about her job and the work she was leaving behind. “She said, ‘when you’re ready, we’ll discuss it then.’ What I came to find out and what I so greatly appreciate,” she said, wiping away tears, “was even though I didn’t have my immediate core family with me, other than my sister, I found I had a great family in Vanderbilt.
Caleb’s first surgery, the day of his accident, went well. His foot was saved, but he was by no means out of the woods. He has had 12 surgeries and 11 procedures since July 23. More surgeries are planned. His weight dropped from 185 to 138 pounds. Because of his broken jaw, he required a feeding tube, two, in fact, because Caleb yanked the first one out. The days were filled with triumphs and setbacks. John Morris, M.D., professor of Surgery and director of the Division of Trauma and Surgical Critical Care, told the Kedighs to remember they were in for a marathon, not a sprint. “And, boy, was he ever right,” Kedigh says. “He told us it would be a constant rollercoaster of ups and downs, emotional highs and lows, but to hope to always be ahead in our good days.”
In one of Caleb’s most extensive surgeries, Marc Tressler, M.D., instructor in Orthopaedics and Rehabilitation, rebuilt Caleb’s left ankle, heel, and the arch of his foot. The ankle had to be fused. The surgery, booked for six hours, took 10. And several weeks after he was released from the hospital, Caleb returned to have surgery on his right foot because his toes were contracting.
Aided by specifics from the police report, here’s what Kedigh believes happened early the morning of July 23. Caleb was only a couple of miles from home when he fell asleep and crossed the yellow line, ending up on the wrong side of the road for about 100 feet. He more than likely hit a bump in the road, which woke him up, and he quickly pressed the clutch with his left foot as the Jeep, which didn’t have airbags, hit another vehicle head-on. Caleb wasn’t wearing his seatbelt. After he hit an oncoming car, he was partially ejected, and was found with his body hanging outside the back window.
Kedigh says her experience has given her a different perspective on what Vanderbilt’s patients and their families go through during stressful times and tragic circumstances. She kept a small journal for Terrell Smith, director of Patient and Family-Centered Care for VUH and the clinics. Some of what she’s learned: it’s important to give family members any little bit of information possible to help lift their spirits and keep them informed. It’s good to know the plan of the day—any tests that are planned or surgeries being considered. And even though staff may not have an exact time to give a patient’s family—about when a bed is going to be available, or how much longer they are going to have to wait—it’s important to say to them, “let us help you find out.” She also has suggested some things that might make the family waiting area in the Trauma Unit more comfortable.

Hitting the curve
Kedigh says Caleb is doing well. Although he has a limp, he walks on his own. He is driving and working. Despite the head injury, he has kept his same personality and good-natured spirit.
Caleb, has been back to visit the unit twice. He wanted to go to thank Ken Stroop, R.N., a nurse he feels especially connected to.
Kedigh praises the trauma unit staff who every day go above and beyond to help not only the patients, but their families as well. They allow family members to stay at the bedside much of the time, unless a new patient is being admitted, and they also invite a family member to be at the bedside when they are going over daily reports. “I got in trouble a couple of times. They want you to be quiet and let them do their thing and they will answer any questions when they’re done. The nurse in me wanted to ask questions. I was told more than a couple of times they’d answer me when they were done,” she recalls with a smile.
Caleb’s outlook is good, Kedigh said. His coach at Martin Methodist visited him once in the hospital and once while in rehab and said they’re holding a spot on the baseball team for him, either in a playing or coaching capacity.
“He has some melancholy days, when he says he’ll never be the same again. And physically, that is true,” Kedigh says. “But we told him that life throws us little curves every now and then. And you never know when they’re going to come. But when they do, you have to look at it as an opportunity to become a better person. What life throws at you makes you stronger.”