My wife almost died in mid-October. She is only alive today because of the phenomenal care she received at your hospital. We are not out of the woods yet, but I am so grateful for the care she has received at Nebraska Medicine. From top to bottom, everyone has treated us with the utmost respect, professionalism, and kindness since we got here. I really feel like so many people have gone above and beyond for her. However, there are a handful of individuals who I think deserve a special shout-out for their medical care, as well as for their personal care of my wife and our entire family during this incredibly scary time. I would like to provide a brief summary of the events as I remember them and then highlight the team members who got us to where we are today, almost a week later.

My wife and I live in Nashville, Tennessee, where I am a resident physician at Vanderbilt. She was 31 weeks pregnant when she drove from Nashville to Omaha with her parents on a Saturday to start preparing for our baby shower in Omaha the following Saturday. I stayed in Nashville to work and prepare our nursery.

My has been struggling with chronic but progressive hip and back pain for years, and over the last few weeks her symptoms have progressed to increasingly severe headaches as well. She called me early Wednesday morning with the worst headache of her life. I told her to go to the ED with her parents and booked a flight for Omaha that day. Over the next 48 hours, the headaches and back pain progressed to signs of brain herniation, a life-threatening medical emergency. The cause was increased pressure in her brain.

She received a lumbar puncture early in the morning, which temporarily relieved her symptoms until about 4 hours later, when she developed rapidly progressive signs of brain herniation requiring an emergency brain surgery to insert an External Ventricular Drain (EVD) to relieve the pressure in her brain. Her symptoms were so severe and rapidly progressive that the procedure needed to be performed in her ICU room because there was no time to take her down to the operating room. The procedure went flawlessly, and she made a full recovery.

Since undergoing the procedure to insert the EVD six days ago, she has had no headaches, back pain, or signs of brain herniation anymore. We are still in the process of figuring out what caused the severely increased pressure in her brain, but we are getting closer to finding an answer every day, and based on our experiences so far working with all of the various consultants and caretakers here at Nebraska Medicine, I have the utmost confidence that we are exactly where we need to be.

Susan Greni (PGY2 Neurosurgery Resident)
She emergently put the EVD in my wife's brain while she was herniating. She was in the room within minutes of the nurse paging her that my wife's neuro exam and mental status had changed. She confidently walked up to me and told me that we had to put the EVD in at the bedside; there was no time to go to the OR. She told me this was a lifesaving procedure and had me sign the consent form.

She looked me square in the eyes and quickly said I will use landmarks to guide my approach; 11cm back and 3cm over, mid-pupillary line. I trusted her so much in that situation. She let me say my last words to my wife ("I love you so much") and started setting everything up for the procedure. When I walked out of that room, I thought that was the last time I would see my wife alive.

Best-case scenario, I thought she'd have lifelong neurologic deficits. Susan came to the waiting room about 20 agonizing minutes later and told us the procedure went well, and my wife was alive and talking to them. They weren't ready for us to come back yet, and they would give us the full update soon. She then sat with us in the waiting room with her attending and a maternal-fetal medicine consultant to explain what the next few days might look like.

We walked back into the room, and my wife looked like her normal self again. I immediately started crying in relief. Susan's quick actions, her calm demeanor, and her skill saved my wife's life, and I will never be able to repay the debt we owe to her. As a fellow resident physician, I cannot imagine being as controlled and confident as she was as just a second-year resident; Susan is truly unbelievable to me. My wife's first memory after the EVD placement is coming to while Susan was putting staples into her scalp. Susan said to her, "You are such a badass." Well, Susan, you are such a badass, too.

Stephenie Grenfell (RN who took over Jen's care)
Stephenie's contributions were two-fold: first and foremost, outstanding medical care, and second, a personal connection with her patient on a human and emotional level. Stephenie was the first person I alerted when I noticed my wife's headache had gone from excruciating pain to her pupil not working anymore. Stephanie quickly paged the neurosurgery team and grabbed a member of the primary team to come look at her. Stephenie stayed in our room the whole time, ready to assist the doctors with anything they needed to stabilize her.

I was not in the room during the procedure, but I was told she was the primary nurse helping the team during the EVD placement. She was my wife's nurse for the next 3 days, and she consistently provided Jen with focused and attentive nursing care and was extremely attentive to our needs (especially because I fear I may have been overly neurotic those first few days after EVD placement). She never made us feel like a burden for asking to go to the bathroom, get extra blankets, reposition her in bed, wash her arms, etc.

Personally, I especially appreciated how she walked me through step-by-step how the EVD worked and what precautions we needed to take with it. However, here is where the story takes a turn. The first day, while making small talk, Stephenie learned that we were traveling to Omaha for our baby shower, which we obviously had to cancel. She also learned that my wife's only pregnancy craving was orange juice. Well, after working her 12-hour shift (with 3 kids at home), Stephenie took the time to make homemade baby shower decorations for our room and brought good orange juice from the grocery store for my wife to enjoy with breakfast. We both cried. But it doesn't stop there.

The next day, she (along with my wife's mom and lead nurse, Lexi Lindermann) planned a surprise baby shower for my wife. Stephenie spent the afternoon cleaning the blood out of her hair with her mother and braiding the hair to make it look nice for the baby shower. A handful of our closest friends and family were waiting in the lobby to celebrate the mom-to-be, who was miraculously still alive and able to enjoy the event. We got to open gifts, eat pizza, and joke around with our loved ones in the lobby of the hospital, and it felt like old times again. All the while, Stephanie watched my wife's monitors and made sure the event was safe for her to attend. Stephenie's compassion, empathy, and strong work ethic have served us well, and we will cherish our relationship with her for a long time.

Lexi Linderman (Lead Nurse who helped plan the baby shower)
See Stephenie's story above. Lexi was the lead nurse when Stephenie proposed the idea for the baby shower. It would have been very easy to deny the request outright, given my wife was 2 days out from almost dying and had an EVD still in her brain. However, Lexi took her nurse's idea seriously and explored ways to make it happen. She did not promise anything, but she would see what it would entail to make something like that happen.

She coordinated coverage of the floor so Stephenie could stay downstairs with us for an hour throughout the party. She helped coordinate with the neurosurgery and infectious disease teams to make sure we were taking all necessary precautions to ensure the event was safe. Lead nurses often go unseen to the patients, but I believe her willingness to support her staff (i.e., Stephenie) - even when their ideas may seem far-fetched - is likely very much appreciated by the nurses who work with her.

Nicholas Borg (Neurosurgery Attending)
I think this one is obvious. He is the attending who oversaw her EVD placement and all of her care post-op. He has the best bedside manners, and we all hold him in very high regard. He is blunt and honest (and a little cheeky at times). He spends time explaining the complexities of her care and the options for moving forward, while also providing clear, direct, and logical recommendations based on what he thinks would be the best next course of action. We trust him wholeheartedly.

One story that made us smile was when he was reviewing her MRI images in the room with us. He got to the lesion in question, but it was a slightly blurry image. He said in a monotone, "You moved." My wife apologetically said, "I'm sorry; I tried to stay so still." To which he replied, "well you have to breathe." It made us both chuckle. My wife really appreciates his communication style, and I really appreciate his medical expertise and deep understanding of the nuances of her case. My wife sometimes calls him Dr. House behind his back.

Alexander Shearin (PGY4 Neurosurgery Resident)
Alex basically spent all night with us, our first night in the ED/neuro ICU. He basically never left her side from the moment he met her until his shift ended. He was explaining everything to me in real time to help me understand what was happening to her when things were changing on an hour-by-hour basis. I never felt alone or in the dark because of Alex. I was so scared, but I knew that she was in good hands with him.

He reviewed her images overnight (before the final read) and made the decision that a lumbar puncture was safe based on the images. She probably wouldn't have made it until rounds to get the EVD without that lumbar puncture temporarily relieving her pressure. Before he did the lumbar puncture, she was having waxing and waning cranial nerve 3 palsy, altered mental status, unresponsiveness, and incoherent speech. After Alex performed her lumbar puncture overnight (which must have been challenging on a semi-altered patient), she was completely back to normal for a few hours until her symptoms returned on rounds the next morning.

Without the overnight lumbar puncture, I don't think she would be alive. He even took the time to draw the brain/spinal cord anatomy on her whiteboard to help illustrate what was happening and the concerns the teams had about determining the best next steps overnight. My wife doesn't remember a lot of that first night, but she remembers the kind male doctor who kept saying to her, "Hey, it’s me, I'm going to shine a light in your eye." Alex still checks in on us at the beginning of each of his night shifts (even though we are not actively ill anymore), and I sleep better knowing he is in the building.

He is a very special physician and compassionate person, and I don't totally understand how he was able to spend so much time taking care of us that first night, but I am so grateful that he did.

Jeffrey Cooper (Emergency Department Physician, overnight)
Dr. Cooper was the attending in the Emergency Department the night my wife's symptoms went from bad to worse. He calmly managed many emergent and diverse situations while caring for her (getting her to the trauma bay for a potential crash C section when they were briefly concerned for eclampsia, getting her to the CT scanner when they were concerned for stroke, getting supplies ready to intubate her when she started posturing and stopped following commands but astutely holding off when she miraculously improved on her own and started asking why people were so concerned). He navigated her disposition with grace as there were conflicting interests (go to the neuro ICU, which is more familiar with increased intracranial pressure, vs go to cardiac ICU, which is closer to the labor and delivery suite in case she needs a crash C-section).

Luckily, he decided to send us to the neuro ICU because the staff is so familiar with EVDs and they relayed to us that it is not unheard of to place them at bedside and that neurosurgery is very comfortable with doing that procedure on this floor because they know where all the equipment is and all the nurses they will be working with to perform the procedure. He has come to check in on us multiple times in our ICU room since Thursday, and he is always so kind. We are grateful for his compassion.

There are so many others to highlight, given the phenomenal care here, but I fear this is already quite lengthy. Suffice it to say that I cannot accurately put into words how much this hospital now means to us. Every morning, I get emotional watching the sunrise from this ICU room because it is one more sunrise with my wife in this world.