Close up , cropped picture of a man in a suit. He is white, wears wire-framed glasses and has a reeding heairine with salt-and-pepper hair and a full, trimmed beard.
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It’s Thanksgiving week.  This is now my 15th Thanksgiving without my father.  Fifteen years ago, the Saturday before Thanksgiving, my life was irrevocably changed by my father’s traumatic brain injury(TBI).  

What happened

He slipped.  While climbing a ladder.  He fell less than 10 feet, but just landed on the back of his head.  The ladder also fell and hit the side of his head. Twice. Once as it fell, and a second time as it bounced up after hitting the concrete. 

At least that’s what the police deduced, given the position of his body and the ladder.

A cropped closeup picture of a metal ladder in a white room.
an innocuous cause of death, and a huge emotional trigger for me.

He was clearing the leaves out of the gutter on the back of the house.  It was an addition, put on long before we moved in when I was six, with a huge picture window looking out into our deep and beautiful backyard.

Since then, the house has been sold and rebuilt.  The roof, the patio, the picture window, all of them are gone.  I can still picture the space, though. 

My dad wasn’t alone. Mom was there, but in the back part of the yard, taking care of the rabbits.  When she started walking down the yard, dad was climbing the ladder.

When she turned around, he was on his back, on the ground.

She did all the right things.  She called 911, listened for breathing, and waited for the police and ambulance to arrive.  She stayed on the phone, relaying all she could about the situation.

There was no blood.

He had a bruise on the side of his head from the ladder.  

He wasn’t conscious. He didn’t respond. His breathing was erratic, and irregular, it sounded a little like snoring, but more uneven.

Mom didn’t know it then, but Dad was probably already brain-dead – the fall had shattered his skull.  

That uneven breathing? Agonal respiration, his brain stem trying desperately to get some oxygen into his dying body.

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Fears being recognized and realized

Mom called me after the ambulance and police arrived.  

We knew it was bad. We knew that he would never be the same again, no matter what.

The EMTs talked about whether to airlift dad to the nearest trauma 1 center or to drive him to the nearest trauma 2 center.

The reality was it didn’t matter, but nobody was sure of that at the time.  I don’t know what precisely decided them, but they decided to drive Dad.

a city street corner.  The focus is on an ambulance, lights flashing, turning the corner on a red light.  A police car is right behind it, lights flashing.
I still often have movement symptoms when I see or hear an ambulance.

Mom rode in the ambulance, and Dad’s body was rushed to the second closest hospital since it was better equipped to handle the severity of his injury.

The ambulance had a police escort, and police stopped the traffic at every intersection so that nothing would slow the ambulance down.  

I met up with mom at the hospital within the hour, a lazy Saturday suddenly transformed into a traumatic nightmare.

Mom and I ended up waiting about six hours before they gave us the news.  

We weren’t alone.  My boyfriend at the time had brought me to the hospital and stayed.  

One of my sisters was away at college and out watching her track teammates compete, and wouldn’t be returning to her campus until late Sunday.

Her twin, who lived at home(and had experienced a mild TBI in her late teens), had gone to visit friends near Philadelphia.  

This was 2003, and while there were cell phones, not that many people had them. My sister in Philadelphia had dad’s phone, which she mostly kept off to conserve batteries.

Of course, she couldn’t access the voicemail because she didn’t have his password.  

Much of our wait was spent telling friends and family members where we were and what was happening – and trying to reach my more geographically available sister.

Mom had worked at the NJ brain injury association(now known as the Brain Injury Alliance) as lobbyist years ago(prior to my sister’s injury), so she knew intellectually that the fact that dad had been unconscious that long meant that the damage was severe.

Dad would never be himself again, and we had lost the man we knew.

The priest at mom’s church came to offer his support. My uncle and some family friends arrived.

It was four or so in the afternoon, the accident had been around noon or 12:30, mom and dad were at the hospital by 1, and still, nobody in the hospital staff talked to us.  

We finally reached my sister, told her what was happening, and she took the train home, with my uncle volunteering to get her at the train station.

Still, we waited.

picture is of a white open space with beige tiles.  There are three gray metal chairs lined against the wall, with a gray door visible against the wall near the chairs.
I don’t much like waiting rooms, either.

All of this time, we were in this little waiting room by the ER.

One other person came in around when we did, and left to see her husband an hour or two later.

We waited, knowing the news wasn’t good, knowing there was nothing we could do.  

Finally, somebody came in.  

The nurse couldn’t give us an update, but she had been told to bring us up to the waiting room for the ICU.  

Mom reached out to friends from the Brain Injury Association to get suggestions on the right hospitals or right treatments  -what was important to ask about, what could wait in his treatment – what could she do? 

Being in the ICU, maybe there was hope, maybe it wasn’t as bad as we knew it was. 

Going into the ICU stirred mom into thinking that there might be more to Dad’s story. 

If he wasn’t dead, there was going to be a long road with painful decisions ahead, and she would likely have to make most of them. 

She and I both knew that a severe TBI was guaranteed to severely debilitate dad, no matter which symptoms he had.


Fearful and hopeful.  

Grieving and bracing for the bad news.  

Nobody came to tell us anything.

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Finally getting the news

An eternity later, a doctor came in, grim-faced.  

Dad’s skull had shattered, the damage was too severe.  He was brain-dead.

Agonal breathing, he might not have been aware of anything that had happened.

So many hours of waiting, to be told what we feared and suspected, and, strangely, hoped for.  

The worst was over.

Dad was gone.

There was no shell to care for, no pieces of him to support. In a moment, in a misstep, my father had gone from a vibrant happy, healthy, loving person, to a flesh-sack on a ventilator.  

top-down picture of a wooden floor by a Christmas tree.  A red ball ornament lies shattered on the floor.

I think the doctor was surprised how we responded.  Mom nodded and asked about next steps.

I was crying, we all were crying, but we understood – there was nothing left to bring back, Dad was gone, permanently and forever, so it was time to mourn.  We didn’t question ‘brain dead’ we got it.  

Mom couldn’t face going in alone, so she had me come in with her.  Soon the whole crowd was in there, with the priest saying a prayer for dad’s soul.  

The most uncomfortable thing, what stood out the most, was dad’s foot.  

His body was still on multiple support machines and so there were lots of beeps and noises and occasional alarms going off. He was lying in a hospital bed, the bruise on the side of his head visible, machines all around, and he was covered in blankets, except for his right foot.  

I have no idea why his foot wasn’t covered, and probably if it had been covered, something else likely would have struck me with its unreality.

Dad never went barefoot, and I have no clue when or why they took off his shoes and socks, but there was this naked foot, sticking out from under the covers.  

We didn’t know if we could or should touch him – I mean, we knew that we were there to say goodbye and that he couldn’t feel anything anymore, so he wasn’t cold – but there it was. 

I didn’t dare reach out.  

Dad was brain-dead, kept alive by a machine, and we were saying goodbye to him with his pale foot sticking out from under the covers.

The most surreal Thanksgiving Ever

He died the weekend before Thanksgiving. His fall was on Saturday, but they didn’t remove him from life support until Sunday morning. Monday was spent planning his funeral, which was on Thanksgiving eve. Dad’s father and siblings were with us for Thanksgiving the only time in our lives.

That was the most surreal thanksgiving I ever had, made worse by many family members leaving that day to go home to their spouses and children.

We started with a very full table(family friends prepared the meal for us!), and every few hours, somebody else would get their ride to the airport, and we’d be a smaller group, with fewer people around the table.  Each time somebody left, the fact that Dad was gone just felt more and more irrevocable.

I’ll never forget that Thanksgiving, and I never want to experience one like that again. It haunts me, though the pain is quieter each year.

What I am grateful for

As weird as it may sound, I am grateful that dad died that day.  Brain injuries are rough, and even mild ones can cause severe and permanent damage.  

a  blue-gray wrapped package sits on a white surface. Two heads of grain are beside the package. The package is wrapped with beige twine, about the same shade as the grain.

The brain is such a fragile organ and can even be bruised by being shaken up in a car accident, sports game, or a fall from a relatively low height.  

Damage that doesn’t even show on any scan can still have life-altering and personality-altering effects, leaving a person more drastically changed than most other injuries.

With how severe the damage was, if they had somehow been able to keep some part of his brain alive, he would have been a completely different and likely extremely limited person.  

Dad was a brilliant man and a creative mind. He created computer networks in our home, starting with a 512K mac he’d bought at the Apple Store when that was the pinnacle of achievement.  

He taught me to count in binary for fun while waiting for my flight to college.

He was a computer engineer before that was a field, and he consistently did everything he could to nurture and support our family.

I see his death as a final gift to us – sudden, sharp, and painful, but leaving us with all memories of him as the vibrant man he was, rather than that complete and painful change followed by lingering and slow death as his brain and body found more and more ways to fail him.  

I am glad that he likely didn’t suffer, and if he felt or knew much of anything, his awareness ended very quickly.

I am grateful for the time I had with him(the first 24 years of my life), and that his gentleness, love, and joy is still echoed in my life.

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Where I am now with my father’s passing

To this day, especially on days when I am more symptomatic or sensitive, I have a strong physical reaction to both ladders and ambulances.

The worse I am the stronger the reaction – it sometimes is as mild as missing a step or a hand clench, and at its worst, I would spend maybe 10 minutes or so trying to get my body to stop thrashing and shaking. 

Those two things are some of my deepest emotional/physical triggers – my Functional Neurological Disorder(FND) symptoms were diagnosed about four months before his death, so the trauma of losing him had a huge effect on my symptoms and made processing and expressing my grief extremely difficult.

I have had many conversations with therapists about losing him, and the shock of losing him, and I have worked hard to come to terms with his death.

  The regrets I feel are about lost opportunities, times I would have loved his advice or presence after his death, participating in joyful events that I wish he could have attended, new family members that I wish he could have met.

 He never met his grandchildren, died before any of his daughters got married(even before any of us were with our current partners), and he didn’t even get to retire.

I wouldn’t be who I am without him and his influence and am so grateful that I had him in my life as long as I did.

Father’s day and the Thanksgiving-through-New Year’s season are when I connect most with my feelings of loss.

picture of a family of 5 - father, mother, and three daughters.  All the women have dark brown hair of various lengths, the father has  salt and pepper hair and a  full beard Mother, father, and one daughter wear glasses.
Christmas picture, 2002 – Dad’s last Christmas

Father’s day, my partner and I enjoy time with his father, but I find myself occasionally tearing up as he plays with his grandchildren and enjoys his family. 

Dad now has four grandchildren, but he died even before my sister started dating her now-husband and father of her children.

At mom’s, we make the food we made when Dad was alive, but now it’s mom’s husband making the turkey, not dad. 

My sister makes Dad’s stuffing, and mom makes her cranberry sauce. The rest varies.

We eat pie and celebrate being together – but there’s usually some reminiscing about Thanksgivings growing up.

The pall of losing him really sticks through Christmas since the holidays are so close together, especially in the warped perspective that trauma and grief tend to bring on. 

It’s just easier to fall into a bit of a funk, so I do my best to focus on the positive and hopeful things in my life.

Our Christmas celebration is now so very different from what it had been when he was alive that it also doesn’t sting as much – growing up, Christmas usually was just the five of us – now my family’s Christmas celebration involves a lot more people!

People gathered around a large table with others sitting on chairs and couch nearby.  A man at the table uses a wheelchair, and everybody is holding a Christmas Cracker up in the air.  A toddler stands beside the couch, his back to the camera.  Smiles are on all visible faces
2014 family Christmas celebration!

Mom’s husband has two children of his own that also come up for the holidays, and all but his son(who had a moderate brain injury from a car accident in college) have partners, and of course, one of my sisters has kids!

It’s usually all the adult children, except the sister with kids, for Christmas day, and she and her family come by either in the late afternoon or the next day – those lucky kids get at least 3 rounds of presents – they are the only grandchildren on both sides of the family!

I wish Dad could have met them – I can imagine him thoughtfully finding the best gadget or game for each of the kids, carrying the younger ones on his shoulders, gently and patiently soothing the baby, or just hugging them and telling them how much he loves them.

I am grateful for all the time I had with him, and it’s just human nature to just wish you could have a little more of everything good.

I do my best to continue to honor his memory, and to make him proud. 

He would want me to be happy, and to enjoy my life – so even when my tears fall, I do my best to find my happiness and hope in his honor.

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