Triumph out of tragedy

Former college catcher Jon Wilhite closes his eyes and teeters slightly, balancing first on his left leg, then on his right in the exam room at UC Irvine Medical Center. For the battery of neurological tests, he also names months of the year backward and taps the fingers of each hand against his thumbs in quick succession.

It has been just 14 weeks since Wilhite arrived unconscious in the hospital’s emergency room after a car crash that killed Angels rookie pitcher Nick Adenhart and two other friends. The doctors at Orange County’s only Level I trauma center soon discovered that the impact had torn neck ligaments and fractured the bone connecting the 24-year-old’s spine and skull. The only things holding his head in place were skin, muscle and a rigid collar Fullerton paramedics had put on as a precaution.

Ninety-five percent of people with this kind of dislocation, sometimes called internal decapitation, die immediately. The rest are gravely impaired. Yet here was Wilhite, parrying questions with sly humor and describing the miles he logs on the family treadmill. A few days earlier, Fox Sports had broadcast him throwing the opening pitch at a baseball game at Cal State Fullerton’s Goodwin Field with barely a hint of unsteadiness or stiffness from the metal rods that now connect his head and spine.

Dr. Suzy Kim is impressed by his progress. “I’m sure I’m not the first to tell you, Jon, but your recovery is just amazing – in so many ways,” says the director of UC Irvine’s Acute Spinal Cord Injury Program and survivor of a surfing accident during medical school.

Crowded into the exam room, his father, mother and younger brother are visibly relieved. Wilhite, however, lets a flicker of impatience show, wishing that his body would cooperate more, that his speech were a little faster, that he didn’t feel so exhausted.

“This has been – what? – three months’ recovery?” Kim responds. “Most patients don’t recover that quickly even after a simple orthopaedic injury.”

Defying the odds

Only four other people are known to have recovered from atlanto-occipital dislocation, says UC Irvine spine surgery chief Dr. Nitin Bhatia, who fused Wilhite’s head and neck together with a titanium plate, rods and screws in a delicate five-hour operation.

“He should have died, like everyone else in the car,” Bhatia says. The early morning crash claimed the lives of Adenhart, 22; Cal State Fullerton student Courtney Stewart, 20; and Wilhite’s childhood friend Henry Pearson, 25.

“Everything had to go just right – from the paramedics and firefighters who pulled Jon from the car to our ER team and the UC Irvine trauma surgeons and neurosurgeons who kept him alive,” Bhatia says. “If he’d been pulled a centimeter in any direction, his spinal cord would have been damaged. If any one of the links in our chain weren’t as strong, he might not be alive today.”

As UC Irvine’s experienced trauma team quickly learned, internal decapitation was just one of many life-threatening hurdles the 2008 Cal State Fullerton graduate would have to overcome.

April 9, 2009

12:10 a.m.: Fullerton emergency officials get a report of a high-speed collision at Lemon Street and Orangethorpe Avenue. Adenhart, who pitched six scoreless innings for the Angels a few hours earlier, had been headed with his friends to a local dance club when the driver of a red minivan ran a red light and broadsided their silver sports coupe.

12:17 a.m.: The first fire engine arrives at the scene. Pearson, in the right rear seat, is found to have no pulse.

12:19 a.m.: The first ambulance arrives as the fire crew prepares to cut away the car’s roof to get to Stewart, in the driver’s seat; Wilhite, seated behind her; and a badly injured Adenhart, in the front passenger seat. Stewart dies moments later.

The unconscious Wilhite appears to have only minor cuts. Still, paramedics follow protocol, placing a rigid collar around his neck and sliding a board behind him to stabilize his back. Slowly and carefully, several firefighters lift him out of the mangled car.

12:34 a.m.: The ambulance speeds toward the medical center in Orange. With Wilhite strapped to the fiberglass board in “full spinal precaution,” paramedics cut away his shirt and jeans to check for injuries. En route, Fullerton firefighter Rich Zeller notices that his unidentified patient’s pupils have become unequal, suggesting pressure building in the brain.

12:42 a.m.: They arrive in the hospital’s ER bay. Fullerton paramedic Capt. Ben Garrett recites the patient’s vital signs and symptoms as UC Irvine’s waiting trauma team takes over. “It was like a pit crew in a stock car race,” Garrett relates. “All 10 or 20 of them had a job, and they were all doing it at once.”

12:44 a.m.: Another ambulance leaves the crash scene for the medical center with Adenhart on a backboard. A second UC Irvine trauma team scrambles into place as the first team tends to an unresponsive Wilhite.

12:50 a.m.: An ultrasound and X-ray find no bleeding in his lungs or abdomen, and his blood pressure is good. But his body temperature has plummeted to hypothermia level.

1:01 a.m.: A CAT scan of Wilhite’s brain, spine and vital organs reveals the break in the bony joint linking his skull and neck. He also has broken ribs, a broken shoulder blade and collapsed lungs. The base of his skull is fractured, and he has serious internal hemorrhaging above his left ear along with diffuse micro-bleeds, evidence that the brain was jolted against the skull and sheered back on itself.

Wilhite is rushed to the intensive care unit. Paged at his residence, spine surgeon Dr. Douglas P. Kiester takes one look at the CAT scan on his home computer and orders that a cagelike device called a halo be put on the patient to immobilize his head and neck. The ICU and trauma teams race to treat Wilhite’s other life-threatening injuries.

A few hours later, ICU surgical director Dr. Darren J. Malinoski and his team lose the battle to save Adenhart, and police arrest the suspected drunk driver of the van, who fled on foot.

1:15 p.m.: Wilhite’s breathing and other vital signs are sufficiently stabilized that he’s given an MRI scan, which lets doctors view soft tissue inside his body. It confirms extensive swelling in the brain and around the spinal cord, which must recede before surgery to reconnect the head and neck. A grave-faced Kiester meets with Wilhite’s parents, Tony and Betsy Wilhite, who didn’t learn of the accident until they awoke that morning.

“Dr. Kiester had tears in his eyes,” Betsy Wilhite recalls. “You could tell he was sympathetic to us. He said he was going with his gut and telling us they needed to put off the surgery to reattach Jon’s head and neck – he and Dr. Bhatia both. We trusted them.”

‘Exceptional recovery’

In the hours and days that followed, the ICU and trauma teams worked to keep Wilhite’s brain suffused with oxygen-rich blood and his lungs infection-free while a ventilator breathed for him. Surgeons inserted a filter in his abdomen to trap blood clots before they could cause damage. Family members took shifts at Wilhite’s bedside.

Finally, on April 15, Bhatia performed the surgery to fuse the head and spine, leaving Wilhite with an 8-inch vertical scar. Now it was time to let his athletic young body begin to heal. By the time he left the hospital for inpatient rehabilitation on April 30, the 10-pound protective halo was long gone and he was walking, albeit with help.

“That’s when we knew his was a really exceptional recovery,” Kim says. “And not just from the internal decapitation. He was able to speak a few words, swallow and initiate some walking. That’s absolutely extraordinary.”

When Wilhite and his family visited the trauma team about two months later, it was clear he had recovered all his mental faculties. He joked that he was not only recovering but taller, thanks to the spine straightening. “Expressing himself may have been a challenge speechwise,” Malinoski says, “but making a room full of doctors laugh takes intelligence and wit.”

The future

For now, Wilhite is busy with speech, vision and physical therapy. Kim has also suggested stacking pennies to hone his fine motor skills and computer games to improve his eye-hand coordination and acuity. “See, Jon, come to me and I give you a prescription for money and games,” she jokes.

He’s been invited to toss the first pitch at a number of Major League Baseball games, including the Aug. 29 Angels’ home game, which coincides with a blood drive in memory of Adenhart.

Wilhite is eager for things to “get back to normal, to be able to run, work out, go to batting practice.” Down the line, when Bhatia gives the go-ahead, he wants to try surfing and snowboarding, sports that were off limits to a competitive baseball player lest he hurt himself.

In his heart of hearts, Wilhite says, “I at least want to coach kids. I want to somehow be involved in baseball.”

Michael Greenlee, Cal State Fullerton’s media director for baseball, says he’s “already seen too many miracles from Jon, so I wouldn’t count him out.”