Contributor: Jay Slagle, Prep Running Nerd
What a time it was to be Emmett Hassenstab.
On May 22, 2021, he placed second in the State triple jump with a personal best of 45-05.25, after jumping 21-04.5 the previous day to finish seventh in the long jump. After completing final exams at Omaha Skutt on May 27th, Emmett arrived on Sanibel Island (FL) the next day for a weeklong vacation with his best friend Jake Hegge and Jake’s extended family. Once back in Omaha, Emmett and Jake would spend the rest of the summer preparing for their senior football season.
Emmett, Jake and the Hegge cousins hit the ground running at the Sanibel hotel. In the first 90 minutes they explored the island on bikes and played sand volleyball. Sandy and sweaty, the group of kids descended on the pool where the adults began planning dinner. Jake was already in the pool when Emmett dove in.
Perhaps because of the crowded pool, because it was his first dive of the season or who knows why, Emmett entered the shallow end of the pool at a sharp angle. Less than a second after he broke the water’s surface, the top of his forehead struck the pool bottom.
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Is it better to be fully conscious after a major injury, or better to wake up hours later in a hospital bed? Emmett remained fully conscious after he hit his head, which was both good and bad. On the bright side, he retained the ability to hold his breath under water. On the downside, Emmett was fully aware of everything that was happening to him.
His body had sunk to the pool floor. He was surrounded by dozens of legs, although he could only see a few while he lay face down. He wanted to reach out, to grab one of them, to plead for help, but he couldn’t do any of those things. You see, as soon as Emmett’s head hit the bottom of the pool, he could no longer use his limbs.
He knew he was at risk of drowning if he was not found quickly, but he did not panic. He simply prayed that he would live.
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No one is quite sure how long Emmett was under water. He thinks it was about 90 seconds, and Kristin Hegge is certain it was over 30 seconds. Kristin is Jake’s mom, and as a former ER nurse her antenna for injuries may be a bit more in tune than the general population. As she stood on the pool deck, one of her nephews asked why Emmett was doing pushups on the pool bottom, just six feet away from where they stood. It took her a few moments to register that the situation wasn’t right, and then she screamed at Jake to grab Emmett.
Emmett was 6’4”, 185 pounds at the time of the accident. Jake pulled Emmett’s head above water, and then a man in the pool helped Jake lift Emmett onto the pool deck. Emmett’s skin was grey from oxygen deprivation.
The man who helped lift Emmett was a physician’s assistant – Kristin never caught his name – and he stabilized Emmett’s head and neck while Kristin assessed Emmett’s condition. Emmett was breathing and was conscious, so a brain injury seemed unlikely. Lying flat on the concrete, Emmett could only see what was directly above him.
Kristin asked, “Can you talk?”
“Yes.”
“OK, tell me when I touch your foot.”
Nothing.
“Emmett, tell me when I touch your hand.” Seconds go by.
“Emmett, tell me when I touch your hand.”
Emmett grew frustrated. “When are you going to do it?”
Kristin raised Emmett’s arm so he could see it. She was holding his hand. He didn’t feel a thing. Not her touch, not his arm, not anything. He was paralyzed from the neck down. Kristin had feared it from the moment Jake pulled Emmett off the pool floor.
Time seemed to stop for Emmett, the Hegge family, and everyone near that pool. Kristin’s brother called 911 while Kristin still assessing Emmett, and Kristin told the dispatcher that Emmett needed a life-flight helicopter.
An ambulance arrived at the resort within six minutes of the call; it seemed like a lifetime.
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If the Hassenstab family had ever been more separated than at that moment, Cheri Hassenstab cannot recall it. Emmett was in an ambulance in Florida. Cheri and her husband Tom were 2,000 miles away in Estes Park, Colorado, just settling in for a week’s vacation with Cheri’s mom and sister. The oldest Hassenstab child, Clara, was driving to Minneapolis to see friends for Memorial Day weekend. Jack, a rising junior at UNL, and 15-year-old George were back home in Omaha.
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As soon as Emmett was loaded into the ambulance, Kristin called Cheri and put her on speaker. “Cheri, Emmett has had a serious injury and he can’t move his arms or legs. I’m with him in the ambulance and we’re on the way to the fire station to meet a helicopter. Emmet would like to talk to you and Tom, and we want you to hear what the paramedics say.”
“Dad, I’m scared.”
“Emmett, everything is going to be ok. I promise you, everything is going to be fine.”
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After 12 hours of traveling, Cheri and Tom arrived at Lee Memorial Hospital in Fort Myers at 9:00 a.m. on Saturday morning.
Before they even saw a doctor, Tom and Cheri rushed to Emmett’s ICU room, where Tom made three promises to Emmett:
· You will walk again.
· You will run again.
· You will compete in the Cornhusker Games this summer.
First on the phone call and then 14 hours in person, Tom had twice broken the cardinal rule of spinal cord injuries. As the ICU doctor would instruct Tom and Cheri a few hours later, “Whatever you do, don’t promise your son anything.”
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Our spine is complicated and delicate, an engineering marvel. Run your hand down your spine and you’ll feel the vertebrae that allow you to sit upright. Between those vertebrae are ‘discs’ – rubbery pads about 1” in diameter and a quarter-inch thick that serve as shock absorbers and keep the vertebrae connected. The spinal cord – smaller than a penny in diameter and less than twenty-four inches long – runs through protective notches in the vertebrae from the brain all the way to the sit-bone.
Spinal cord injuries (SCI) used to be the domain of the young – in the 1970’s the average age of a SCI patient was 29 – but the average age today is around 43, perhaps due to more active lifestyles by mature adults or because trauma physicians have improved their ability to save the lives of seriously-injured people. Vehicle crashes (38%) are the most common cause, followed by falls (32%), violence (14%, including predominantly gunshot wounds) and sporting activities (8%). In rehab centers located near skiing destinations, staff refer to the two waves of SCIs as the winter season (skiing and weather-related car accidents) and summer season (mountain biking, hiking, diving and distracted/drunk driving accidents).
SCIs are classified as complete or incomplete. A complete SCI, which accounts for 32% of SCIs, means that the patient has lost the ability to move or sense below the area of the spinal cord injury – in short, the spinal cord is completely damaged. For example, a complete SCI in the lower back may leave a patient’s legs paralyzed, while a complete SCI injury in the neck would leave the patient paralyzed in all four limbs and could limit the patient’s ability to breathe on his own.
An incomplete SCI reflects that there is some level of nerve activity being transmitted below the site of the injury. In short, the neural highway is still open in an incomplete SCI, although the level of neural traffic varies widely. Some patients with incomplete SCI will walk again while others will not.
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Emmett had an MRI shortly after he arrived at the hospital that Friday night. The radiology tech told him, “Don’t move” and Emmett replied, “I don’t think that will be a problem.” Despite the incessant banging that accompanies an MRI, Emmett lost consciousness in the middle of it. When he woke a few minutes later, he thought he was drowning. The tech briefly paused the test to comfort Emmett.
Less than an hour later, the ICU doctor shared some good news. The minor sensations he was occasionally feeling in his arms and legs were signs that he had an incomplete SCI, and the MRI confirmed that; while the disc between his third and fourth vertebrae (C3 and C4) was pushed against his spinal cord, there was no indication that the spinal cord had been severed.
When Kristin was allowed to see Emmett later that evening, Emmett immediately told her, “I’m going to walk again.” He had no movement in his limbs but spoke with a certainty that stunned Kristin. She later said, “To be honest, his positivity that night made us all be positive. Despite his injury, he was in complete control of his emotions.”
Near midday Saturday, the ICU doctor was not as optimistic when he met for the first time with Emmett’s parents. His first words to them were delivered with tears: “I’m a parent with kids of my own, so I am sorry to tell you that Emmett is not moving from the neck down.” He explained that a SCI in the high-cervical area – between the C1 and C4 vertebrae – were the most severe SCI in terms of long-term paralysis, bladder/bowel control and the ability to speak. He could guarantee them nothing in terms of Emmett’s recovery, and he discouraged them from making any promises to Emmett.
It was too late for that.
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Over the next three months, Emmett received excellent care at three different hospitals. One of the biggest challenges for paralyzed patients is avoiding pressure (bed) sores due to lack of movement. Pressure sores often develop near the bony areas of the body like the pelvis, heels, shoulder blades and the back of the head, and they can lead to infections, either pain or loss of sensation, Marjolin’s ulcers and, very rarely, sepsis. Pressure sores are so problematic that some rehab hospitals won’t allow patients to engage in physical therapy until their sores are fully healed. For the first 30 days after his accident, Emmett was effectively confined to his bed with his arms and legs elevated to improve circulation, and yet he never developed one pressure sore.
Within a few days of the accident, Emmett’s doctors in Fort Myers recommended watchful waiting. The injury site on spinal cord had significant edema (swelling) and the doctors felt that Emmett would likely begin to regain some movement once the edema receded. The Hassenstabs are not a wait-and-see family. Kristin suggested another option.
Kristin grew up in Scottsbluff, and her best friend from high school – Cara Stanko Dodson, MD – is married to an orthopedic surgeon who is also a team doctor for the Philadelphia 76ers and Eagles. Chris Dodson practices with Dr. Alexander Vaccaro, one of the top spine surgeons on the East Coast. Within 24 hours of Kristin’s text to Cara, Dr. Vacarro was calling Cheri’s cell phone. He thought he could help. The Hassenstabs just had to get Emmett to Philly.
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Everyone knows that the rich and famous fly in Lear jets. However, they’re also used to transport patients like Emmett who are bed-ridden and can’t take on a commercial flight. The cost? You don’t want to know. Was it worth it? Definitely.
Emmett arrived at Thomas Jefferson Hospital in Philadelphia on June 2nd, five days after the accident. Dr. Vaccaro performed surgery on June 4th. Twelve hundred miles away, Emmett’s friends and the Skutt track team met at St. Stephen’s Church to pray the rosary during his 60-minute surgery.
The surgery was a success. Dr. Vaccaro reported that spinal cord had been ‘crushed’ by the disc that was supposed to be sitting between the C3-C4 vertebrae, but he was able remove the disc and fuse C3 and C4 together with titanium. The surgeon told Tom and Cheri that the surgery went as well as he expected, and it was now time for Emmett to focus his attention to regaining movement.
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You’ve stuck with this article for this long, but by now you have to be asking the question: “Will Emmett ever walk again?” Tom and Cheri had that same question, but they never dared to ask it. They didn’t want to hear the answer if it was ‘no,’ so they moved forward with the steadfast assumption that it was ‘yes.’
The ASIA (American Spinal Injury Association) test is routinely used to assess patients with SCIs. Graded on a scale of A (complete SCI and permanent paralysis) to E (normal), the clinician performs a series of pin pricks and light touches on 56 points on the body to assess which are sensed by the patient. Emmett was tested at Fort Myers, before and after surgery in Philadelphia, and upon arrival at the Craig rehab hospital. He scored a ‘C’ each time.
A hospital resident in Philadelphia performed the ASIA test a few days after Emmett’s surgery, and then spoke to the Emmett and his parents. “I know you’re going to ask,” he began. A ‘C’ score, he explained, meant that there was a 60% chance that Emmett would walk again. Emmett could do the math; there was a 40% chance that he wouldn’t walk. He was devastated. Cheri was furious that the resident introduced the prospect of not walking again. Later in the day, she gave clear orders to the nursing staff that the resident was no longer welcome in Emmett’s room.
Tom’s role throughout the ordeal was to build Emmett back up by having him focus on future goals. With the 60% estimate now on the table, Tom chose to embrace it. After a physical therapist (PT) finished a session that involved manipulation of Emmett’s still-paralyzed limbs, Tom quipped, “You’re up to 61%.” When Emmett was able to apply a minor amount of resistance against the therapist’s palm, Tom proclaimed that Emmett’s chances had just improved to 64%.
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Emmett took a second Lear jet ride on June 15th, moving from Philadelphia to Craig Hospital in Englewood, a suburb of Denver. The Hassenstabs had evaluated a number of highly-ranked rehab hospitals where Emmett could focus on recovery, and they chose Craig due to its proximity to Cheri’s family and its expertise in dealing with paralyzed teenagers.
Surgery may have taken the pressure off Emmett’s spinal cord but it did not fix everything. He had debilitating neck and nerve pain throughout June, and his limbs would unexpectedly spasm or jerk as nerves slowly regained function. However, the pain was only slightly worse than the humiliation of not being able to care for himself. Once teenagers hit puberty, most have a heightened need for privacy, but all that is stripped away when a teenager is paralyzed. He had to be fed, clothed and bathed. He had a catheter because transiting to a bathroom was out of the question. Emmett could talk, breathe and chew, but the nursing staff and his family were on the hook for everything else.
The family celebrated every minor improvement. Feeling something in his right leg before he left Fort Myers. Having an involuntary twitch in his finger. Flexing his ankle. Holding a spoon, gripping a water bottle.
Unfortunately, recovery from a SCI does not follow a linear path. Tomorrow’s therapy session could be worse than today’s. Pain levels fluctuate. Panic attacks arrive without warning.
It would have been easy to give up.
What a time it was to be Emmett Hassenstab.
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The Craig hospital staff weighed Emmett every day. He was sure they made a mistake on his first day there, but they reported the same number the next day. One hundred forty-three pounds. Emmett had lost 42 pounds in less than three weeks.
Emmett had the same care team during his 70-day stay at Craig: a rehab physician, physical therapist, occupational therapist, mental health counselor and nutritionist. The nutritionist explained that patients recovering from a SCI could burn as many as 8,000 calories per day, so Emmett was placed on a high-caloric diet. If physical therapy was his first job, then eating was clearly his second.
Emmett was engaged in some type of therapy from 8:00 to 5:00 every weekday, with one-on-one or two-on-one attention during that time. In addition, the care team gave him exercises to perform during the evening, and Cheri was given an exhaustive therapy plan for Emmett to perform on the weekends. His therapy never stops; when I was speaking with Tom or Cheri during the family’s interview, Emmett used the down time to perform wrist rolls and neck rolls.
Like the families of most of Craig’s SCI patients, Cheri and Tom were living in a Craig-provided apartment on campus so they could be fully involved in Emmett’s daily care. In the month prior to the accident, with track season and prom and graduation parties, Emmett had rarely seen his parents. Once he was hospitalized, he told Cheri that he didn’t want her to leave him. She didn’t. For 90 days, she lived out of a suitcase.
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Emmett was measured for his own wheelchair on June 17th. On that day, the rebab doctor told the family that anything that was moving slightly as of that day would most likely be functional again; if a body part hadn’t moved yet, she could not provide any guarantees. She promised to give a full analysis after a few more weeks of work.
The doctor scheduled a meeting with the Hassenstabs on July 1st. Tom had a habit of attending daily Mass whenever he could, and July 1st was no exception. Early that morning he jogged six blocks to St. Louis Catholic Church in Englewood. That day’s gospel reading was Matthew 9:
For which is easier, to say, ‘Your sins are forgiven,’ or to say, ‘Stand up and walk’? But so that you may know that the Son of Man has authority on earth to forgive sins” - he then said to the paralytic – “Stand up, take your bed and go to your home.” And he stood up and went to his home. When the crowds saw it, they were filled with awe, and they glorified God, who had given such authority to human beings.
Later than morning, Emmett’s physician told him that he was her best-case scenario for recovery. If he could fully commit to the rehab process, she was confident he could walk again.
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Tom had made three promises to Emmett the morning after his accident, and competing in the 2021 Cornhusker State Games was the third. The Hassenstabs had competed in a number of events at the 2018 and 2019 Games, highlighted by victories in the family 4x100 race in both years. In 2021, the 4x100 was scheduled for Saturday, July 17. There was a problem. As July began, Emmett couldn’t walk. Tom told Emmett that he planned to keep his promise.
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It is difficult to overstate Emmett’s dedication to rehab. He was engaged in some type of therapy for a minimum of 10 hours a day for over two months, performing passive or active stretches, strength/resistance exercises, range of motion work, gait training and anything else that helped rebuild his muscle memory. When he wasn’t in the middle of an exercise, he was often encouraging one of the other patients in the rehab gym. Gains were often followed by losses, but his strength and his weight slowly rebounded.
On July 6, with therapists holding onto his gait belt to prevent him from falling, he took his first unassisted steps. His steps were unsteady and he tired quickly, but he had pushed well beyond 60%. Tom later told his friends, “Seeing your toddler walk for the first time is memorable; seeing your 17-year-old walk for the second time is emotionally indescribable.”
A key part of SCI rehab is pool therapy. However, Emmett struggled with that recommendation given his last experience in a swimming pool. He overcame his fear on July 12th, and the pool eventually became his favorite mode of therapy.
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Craig Hospital invests a tremendous amount of time in their patients, and they request that patients stay on campus during their stay in order to ensure their safety. Family members are allowed to take patients outside, and that’s what happened on Saturday, July 17th. However, Emmett’s wheelchair didn’t stop at the edge of the campus.
Englewood High School is six blocks from the Craig campus, and Tom pushed Emmett’s wheelchair as quickly as he could. Emmett’s brothers Jack and George had flown to Denver to spend the weekend with Emmett but also to help Tom fulfill his promise. Jack scaled the fence and unlocked the gate so that Emmett could be wheeled onto the track. George was the lead-off leg. He tagged Jack for the second 100-meter leg and then Tom ran the third leg. All three ran to Emmett, who sat in his wheelchair at the final exchange zone. Jack and Tom pulled Emmett to a stand, and the four of them walked the final 100 meters arm-in-arm. It was Emmett’s longest walk since May 28th.
Emmett’s athletic.net profile reflects a DNS – a ‘Did Not Start’ – for the 2021 Cornhusker State Games. That couldn’t be farther from the truth.
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Is Emmett Hassenstab lucky? After everything he’s endured over the last ten months, it doesn’t seem that way, but Emmett would argue otherwise.
· He was lucky he didn’t push off the pool deck with just a little more force – simulating one of those 21-foot long jumps – since just a few more pounds of force could have easily resulted in a complete SCI and permanent paralysis.
· He was lucky his injury wasn’t amplified when Jake pulled him off the pool bottom and lifted him onto the pool deck.
· He was lucky that a former ER nurse and a physician’s assistant were at the pool.
· He was lucky that he had great care at all three hospitals, that Kristin was two degrees separated from a top spine doctor, and that Craig had one – just one – open bed.
Once he was settled into his bed on his first day at Craig, a teenager in a wheelchair rolled into his room. And then another. And another. Four teenagers, most followed by parents, were there to welcome Emmett, Tom and Cheri to the hospital. The parents were ushered outside and the teenagers got to know one another. In the hallway, spoken and unspoken, was this message to Tom and Cheri: “We know what you’re feeling. Sixty days ago we were in your shoes. We’re going to help you get through it.”
Emmett became fast friends with those kids, and at one point over the summer there were six teenagers in Craig’s teenager SCI program. In early August, three of the six were walking. No one at Craig could remember having three SCI patients walking at the same time.
Of course, they were the lucky ones. Three of the six teenagers have not walked. One boy fell off a 60-foot cliff while mountain biking. Another was in a car accident and is still trying to walk. A third boy, a victim of a drunk driver, arrived at Craig with pressure sores and had not been cleared for physical therapy as of Emmett’s discharge date.
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The family attributes Emmett’s dramatic recovery to trusting in God’s plan, and there was no shortage of signs from God. The day before Emmett’s surgery, Tom attended Mass at St. John’s the Evangelist Church in Philadelphia. Tom noticed a statue of St. Padre Pio, a relatively obscure saint that Emmett had chosen for his confirmation name in 8th grade, that was prominently displayed in the church basement where Mass was held. During one of Tom’s runs near Englewood High School, he picked up a strip of blue fabric on which was written, “IM thankful.” And, of course, the Matthew 9:1-8 gospel reading on July 1st – the paralytic was cured.
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In times of crisis, many people are forced to take on new roles. On May 27th, Jake Hegge was simply Emmett’s best friend; the next day he saved Emmett’s life. If that wasn’t enough, Jake made five trips to Philadelphia and Denver over the summer to support Emmett. On the first trip, he brought pictures from all of Emmett’s friends but quickly realized that Emmett couldn’t look at them while he was flat on his back. Jake fixed that problem; he taped the pictures to Emmett’s ceiling. When Jake and Emmett wanted to watch movies together, Jake figured out how to use the Hoyer lift above Emmett’s bed to hold the iPad. On most days he visited, Jake would wheel Emmett around the hospital searching for a window where Emmett could confirm for himself that the real world was still out there. Jake was just being a good friend to Emmett, but he was also giving Cheri respite to stitch herself back together.
Emmett's girlfriend, Lynn McGill, supported him at his lowest moments and Face-timed Emmett every night to give him a daily dose of teenage normalcy. She visited Emmett four times at Craig, and they would post Tik Tok videos to pass the time. Since his return home, she has continued to be source of encouragement and strength for Emmett.
Tom has always been Cheri’s rock, but even more so during the summer of 2021. In preparation for this article, she reviewed her meticulous notes from last summer, and she now realizes how badly she suffered through every one of Emmett’s setbacks. Tom was always there reminding Emmett and Cheri of how far Emmett had already progressed.
If Cheri was the MVP of Emmett’s time away, Clara was a close second. While Cheri and Tom were in Philadelphia and Englewood, Clara took over household responsibilities while enrolled full-time in an accelerated nursing program. When Cheri was giving every bit of herself to Emmett, Clara became the mother to everyone else.
There were no shortage of heroes. George and Jack became caregivers. His Skutt coaches became cheerleaders. His private jump coach, Wisdom Loh (pictured above), has mentored Emmett since his freshman year, and that support increased after Emmett’s accident.
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On August 13th, Emmett left Craig’s inpatient hospital and relocated to his parents’ on-campus apartment to adjust to independent living. Satisfied with his improvement, the hospital staff discharged Emmett on August 26th. He walked out of the hospital without any assistance. It had been exactly 90 days since his accident, but he could finally return to Omaha.
He flew coach.
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Twelve months ago, with personal bests of 45-5.75 (TJ) and 21-9.75 (LJ), it was almost a certainty that Emmett would join a collegiate track team. Heck, maybe he’d even play receiver on the football team. Contact sports are now out of the question but track and field is not.
I’d like to tell you that Emmett is back to his old self, physically and mentally, but spinal cord injuries just don’t work that way. From a daily living perspective, Emmett says he’s at about 90% and doing well except for some coordination issues. From an athletic standpoint, he may be closer to 75%. He goes to track practice three days a week, has sports-focused physical therapy sessions twice a week and does strength training every day.
His right leg, which was the first limb to regain feeling back in Fort Myers, drags a little when he tires from running. Yes, as his dad promised on that first Saturday morning, Emmett is running again. He ran for the first time on August 6th on an anti-gravity treadmill, and he’s made great improvement in his sprinting over the past three months.
As of today, Emmett’s return to the jump runway is uncertain. It could be this season, or it might have to wait for another year while he continues to rehab during his freshman year of college. His doctors were quite clear that his recovery could take all of two years, and he’s playing the long game.
After a 90-minute interview that flew by, I finished the session with what I thought would be an easy question: “Do you have any idea how far you could triple jump right now?”
“I honestly don’t know. I haven’t attempted a real jump in practice and I suppose there’s a little fear there. The last time I took a big jump…” He pauses. “Well, it didn’t turn out so well.”
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Ten months ago Emmett was paralyzed.
The paralytic was cured. He stood up and went home.
What a time it is to be Emmett Hassenstab.
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Originally written for and posted at www.preprunningnerd.com by Jay Slagle. Photos and videos provided by the Hassenstab family.
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If this article touched a nerve, you may enjoy our article, "The Runner with the Broken Heart" that we published in October 2018 at https://www.preprunningnerd.com/post/the-broken-heart.