By Brian Carroll
Irish Daily Mail
ENNIS, England — It was a single unprovoked punch - a brutal assault that left Brian Hogan in a coma, brain-damaged and blind. A consultant neurologist told his family to expect the worst; that there was a 95 per cent chance that Brian would die. If he did survive the coma, they were told that he would live out the rest of his days in a vegetative state.
Almost three and a half years later, the Limerick man is wheelchair-bound, with his left arm and left leg paralysed, but an extraordinary story is unfolding.
Thanks to, his family say, stem cell treatment he underwent in China earlier this year, unbelievably he is slowly regaining his ability to walk.
Although his lucrative career as a quantity surveyor - he had been overseeing the construction of Tesco outlets in England - is finished, the 35-year-old is now taking the first steps towards a new life that recently was unimaginable.
When we meet in Ennis, he stands out of his wheelchair. Aided by a physio, he can now walk more than 20 metres. Two weeks ago, he walked for the first time without the aid of the splints used to keep his left leg from curling in on itself. His leg used to be ice-cold to the touch, now it’s warm. And although his speech can sometimes be slurred, Brian’s intelligence is unmistakable and, much like his humour, wholly intact.
‘Since coming back from China my balance is much better,’ he says. ‘Your photographer asked me to stand up - I wouldn’t have attempted that before. He asked me to sit on the wall but I wasn’t in the mood for tightrope tricks.
‘I said, “You know the Humpty Dumpty story? Well, I had a great fall once and banged my head, and I don’t want to go there again”.’
He breaks into uproarious laughter. His sister Siobhan, 42, laughs too. Understandably, she can remember that ‘great fall’ in unforgettable detail. In the early hours of Sunday, July 19, 2009, Brian invited friends back to the three-storey Edwardian property he owned in Nottingham.
He had spent three years restoring the property, furnishing it with antiques, and converting the cellar into a party room, complete with bar, black and white tiles and Fifties Kitsch furniture, replicating the design of a Paris club he’d once visited.
‘I was drinking in a club on a Saturday evening and I said to my mates: “Let’s go back to my place.” There was a park adjacent to my property and we were walking through it when I noticed a stranger walking in my group and I turned and said: “Who are you and where are you going?”
‘He said: “My name is Martin and I’m coming to your house.” I replied: “I don’t know you, you’ll have to go home.” Then he drew his fist back and punched me hard into the face, I fell back and hit my head on the edge of the footpath.
‘I was unconscious. The people in my company called an ambulance but unfortunately by the time the ambulance arrived I had come around and insisted I was fine. ‘I was dazed but I said I wanted to go home. It was about 1.30am. I went to bed but, unknown to myself, my brain was bleeding.’
Discovered unconscious the next morning, an ambulance crew resuscitated Brian en route to Nottingham University Hospital, where he underwent five hours of brain surgery.
A hole was cut in his skull to relieve the pressure from the brain bleed, but it was too late. Extensive, seemingly irreparable, damage was done to the neural pathways instructing the left side of his body. The nerve carrying messages from his eyes to his brain was destroyed and, though surgeons didn’t know it yet, Brian was blind and paralysed. He then slipped into a coma for three months.
His retired parents were contacted in Spanish Point in Co. Clare, where they were on holiday, and told to prepare for the worst.
This week in Ennis, Siobhan was Brian’s driver for the day, taking him to our interview and then on to meet a Belgian physiotherapist in Ennis General Hospital.
Brian now lives in assisted living accommodation provided by Acquired Brain Injury Ireland in Clarecastle, 3km south of Ennis. He shares a house with two men, one of whom suffered a brain injury in a car crash, the other falling off a bicycle.
Brian knows the layout of the house instinctively, meaning he can whizz from room to room in his wheelchair despite being blind. He jokes that his biggest worry now is that someone will install speed cameras in the hall.
He’s learning a new language - German - and he also makes sure to do crosswords and listen to music, all of which is proven to regenerate brain activity. Not that the reality of what he has lost ever goes away.
‘If I was a stupid man, I think I could grin and bear this a little bit easier but I’ve always had an active mind and I’m fully aware of what’s happened to me,’ he says.
Siobhan remembers days of much greater concern. She remembers sitting by Brian’s bedside in the summer of 2009 and hearing the consultant’s awful prognosis.
‘He looked perfect, like he was going to just wake up like in the movies. When the consultant said there’s a 95 per cent chance Brian is going to die and if he doesn’t he’s going to be in a vegetative state, everybody was just wailing.’
Brian had intravenous lines in his arms feeding him morphine and saline, and a tracheostomy tube inserted in his neck to help him breathe. His legs were in plaster to keep the muscles straight and his family used a sponge to place droplets of water in his mouth.
His parents and siblings weren’t sure then if he could hear them or not, but they made sure that at least one family member was always there, reading to him, singing to him, telling him jokes.
Brian’s parents, Brian Snr and Phil, now 68, travelled over from Ireland every week, while weekend visits were rotated among sisters Siobhan, Grainne, 41, Nevis, 39, or twin brothers Shane and Jonathan, 29. One day, after two months in a coma, his face suddenly started heaving with laughter, even though he couldn’t actually make the sound of laughing.
‘That day was one of the biggest breakthroughs,’ Siobhan says. ‘Myself and Nevis were there and we’d brought over the Limerick Post and we were reading out something and we inserted a different name about someone Brian knew. Even though he was in a coma, he was laughing his head off. There was no sound but you could see he was laughing. We kept it up and slowly it just got better.’
Brain injuries are measured on the Glasgow Coma Scale, descending in severity from 15 to three - if you fall to three, you are categorised as brain-dead. Brian had reached four. After entering hospital trim and fit at 160lbs, he had also lost a lot of weight.
‘I would register my laughter by waggling my foot,’ he recalls. ‘The doctors told my family to keep going because it would stimulate my brain.
‘I think it was my sense of humour that kept me alive. My mum used to sing a song to me, and even though I was in a coma when she sang it, I would cry.
‘Now when she sings that particular song - it’s called That’s An Irish Lullaby - I still burst into tears. The song registers with me now as just a bad time.’
And it was a bad time - devastatingly so. He went from a prosperous career as a senior quantity surveyor for Bowmer & Kirkland - one of Europe’s biggest construction firms - to being incontinent, paralysed and blind.
His sisters used to play his favourite film, Willie Wonka and the Chocolate Factory, and soul music by Aretha Franklin, Gladys Knight and Sam Cooke. But for a long time, he couldn’t even comprehend where he was.
‘I started to hear my family’s voices and I got confused wondering why were they in England,’ Brian says.
‘I’d think: “Why is Grainne’s voice here, she should be in America?” It was scary because I couldn’t see what was going on.
‘When I put my hand out I could feel the cot rails at the side of the bed and I’d think: “Where am I? Am I in some kind of a sheep pen?”’
Even after he emerged from the coma, the family didn’t immediately know that he was blind. Indeed, he appeared to have some vision in the early stages.
Siobhan explains: ‘Our friend Rose came over to visit and her son Colin went up to Brian and never said anything and Brian opened his eyes and said: “Colin Churchill”.’
When his sister turns to him and asks if he remembers that day, Brian beings to cry at the recollection. Clearly, it’s the loss of his sight that pains him most.
‘I had suffered optic nerve atrophy, where the nerve that carries the message from your eyes to your brain, because of the pressure of the brain bleed, had snapped or atrophied,’ he explains. ‘That’s why I went to China to try and regenerate that nerve, to get both sets of that snapped nerve to meet up.’
Stem cell treatment remains deeply controversial among medics, who remain divided over its validity. The cells used during treatment were initially sourced from embryos but more recently they are extracted from umbilical cords, placentas, bone marrow and body fat.
Some scientists are hopeful that the method can eventually help those who have experienced stroke, arthritis, cerebral palsy, Parkinson’s and Alzheimer’s.
But groups such as the Irish Patients’ Association have warned people that vulnerable families hoping for miracle cures could be scammed by clinics abroad offering miracle cures at a huge cost.
Brian’s treatment in China in July was just one aspect of his rehabilitation. He’s also had three long years of rehab, including seven months in Linden Lodge on the grounds of Nottingham University Hospital, three months at the National Rehabilitation Centre in Dun Laoghaire, and two years working with Headway, a support group for people with brain injuries, in Limerick.
In February 2010, while Brian was still in Linden Lodge learning to talk and eat solid food again, his attacker Martin Slack, a 33-year-old British national, was sentenced to two years and three months for causing grievous bodily harm. He had a previous conviction for assault, during which he’d punched a woman in the face in a bar.
‘Being punched in a social setting is just not me,’ says Brian. ‘I worked hard and went out at the weekend to socialise. I don’t have a violent bone in my body.
‘It was very undignified at the age of 35 to re-learn to walk and talk like a baby. I remember the first time they gave me Petits Filous [prior to that he was fed through a tube] and I thought it was delicious.
‘I had to work very hard on not becoming bitter towards the person who attacked me. I could very well go into a corner and feel sorry for myself but I know bitterness will just consume me. I won’t allow him to rent any more space in my brain. He’s taken enough from me.’
Brian lived in Nottingham for nine years before the attack, having qualified from the Limerick Institute Of Technology, and later the University Of Limerick.
Understandably, some old friends drifted away but Brian knows that more than enough have stayed to help.
‘The ones that don’t stick around, they are the ones that weren’t worth hanging on to anyway,’ he insists.
The impact of the assault has been deeply felt by Brian’s family too.
Brian Snr, a retired ESB linesman, had to take over the mortgage on Brian’s Nottingham house. He paid it up until recently, when it was finally rented out.
As well as paying for weekly flights to England, he also had to buy a car there. And when his eldest son returned to Ireland, he would drive 180km a day ferrying Brian between his assisted living and rehab clinics in Limerick.
Brian’s parents built an extension on their house, having been promised enough home help hours to allow Brian to live with them. However, the home help hours were cut to just two a day, meaning that until Brian gains more independence, he can’t go home.
The family raised (EURO)40,000 for him to go to Beijing in the summer, where Beike Biotech injected donor adult stem cells into his central nervous system. He was told it would take six to eight months to see any advancement. His sight hasn’t improved as yet, but nearly five months on, his left leg appears to be coming back to life. His family have posted videos of his progress on YouTube.
‘Once you get over the initial mourning of losing who you used to be, and acquaint yourself with who you are now, you can build on that and use that as a foundation and go from there,’ says Brian. ‘Since coming back from China my motor control is better, my balance is better and I’m starting to use my left arm a lot more.
‘I’d always slept on my tummy, but the last few years in hospital and care institutions I’ve slept on my back. Now since coming back from China I’m able to turn myself over and sleep on my tummy again - it’s nice to feel your body stretched out.’
It’s a long road, and he’s only at the beginning, but Brian’s focus now is spending three days at home in Russell Court, Co. Limerick, with his parents at Christmas.
‘Me and my dad, our big thing is, “don’t look back, you’re not going that way, drive on”,’ he reveals.
And certainly, Brian is only headed in one direction - forward.
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