Doctor, heal thyself: How one woman did
This article first appeared in the St. Louis Beacon: June 10, 2008 - Dr. Emily Storch still doesn't remember the highway accident that nearly took her life.
She does recall coming out of her coma a month later, overcoming amnesia and discovering that some doctors thought she would never walk again.
Now, more than 16 months later, after repeated surgeries and determined physical training, she's in good shape. On June 12, she will begin a Yale University internal-medicine residency, working in two New Haven hospitals.
As a result of her recovery, Storch thinks she's made an important medical discovery: that patients who have suffered traumas like hers, can get back to normal – or better – through regular weight training and conditioning.
Here's her story:
Emily Kathleen Storch, now 31, was brought up in University City and graduated from John Burroughs School. She was an accomplished teenage violinist who played in the St. Louis Youth Orchestra, among other ensembles. She earned her bachelor's degree from Harvard.
In January 2007, she had only four months left before getting her medical degree from the University of Pittsburgh.
As a physician, she aspired to specialize in critical care. She didn't expect to get there so soon.
On Jan. 22, 2007, around 9 p.m. Storch drove her Jeep Cherokee along the Pennsylvania Turnpike toward Pittsburgh, almost back home from a residency interview in Virginia. Her car hit a patch of black ice, skidded crazily and hit the median before coming to a stop on the highway. Storch, dazed, either was thrown from the car or got out. Then, she was hit by an oncoming tractor-trailer.
With incredible luck, she got some treatment at the scene from medically trained passersby before being airlifted to a Pittsburgh hospital.
Storch suffered bleeding and swelling in the brain, punctures to both lungs and a ruptured bladder. She had numerous shattered bones in both legs and thighs, her ribs and her right wrist.
Doctors immediately performed the surgeries essential to saving her life; they had to create a large hole in her abdomen to get internal access. Storch remained in a coma for about a month. In February, she woke up and gradually regained memory. After nearly six weeks in Pittsburgh's UMPC Presbyterian Hospital, Storch was flown to St. Louis, where she entered the Rehabilitation Institute of St. Louis at 4455 Duncan Street.
In residence there for two weeks, Storch underwent physical, occupational and speech therapy.
Emerging from the institute in a wheelchair, Storch lived with a cousin, who had an accessible ranch-style house, before moving into her father's house several weeks later. Gradually she eased back into work, first doing chart reviews at Children's Hospital. In June, she began courses at Washington University Medical School to finish the work she needed to get her medical degree from Pitt. She finally got that M.D. degree in May of this year.
Back in May 2007, Storch still had severely limited mobility, when she received a bureaucratic blow: Her insurance coverage for physical therapy had expired. Without therapy, Storch couldn't progress. She and others wrote letters seeking an extension for this crucial service.
A solution came from Dr. Tim Buchman, chief of the Section of Acute and Critical Care Surgery at Washington University Medical Center, who had been managing her abdominal wound.
Buchman recommended that she work out with Diane Kruszynski, an advanced exercise specialist.
Having a personal trainer of this sort would be expensive. Unlike physical therapy, training wouldn't be covered by insurance. But Storch and her family felt it would be worth it, so they decided to proceed. Once Storch started the workouts, Kruszynski told her that the training bill would be covered by an anonymous donor.
By the time an insurance letter came granting an extension for Storch's rehab, she didn't need it anymore.
When she began with Kruszynski – in July 2007 – Storch could barely shuffle along with the aid of a cane. One of Kruszynski's first goals was to get rid of that device. When they took walks together, Kruszynski carried the cane.
In Storch's mind, it was that training – lasting through May of this year – that allowed her to make a full recovery. Storch has done extensive reading on the topic of rehab.
"In research," she says, "paper after paper assumes that if you have a major trauma, you'll have lasting disability; that people don't have full recovery from this type of trauma, that they can't go back to work."
Storch and Kruszynski are coauthoring a medical-journal article contending that this doesn't have to be true. They think that trauma patients can achieve full recovery in much greater numbers than previously believed. Their research focuses on Storch and four other cases.
Although limited to just the five examples, the paper invites further research – perhaps a randomized prospective controlled study – on the costs-versus-benefits of more intense training.
Comparing physical therapy with her eventual training regimen, Storch said, "Some of the specific exercises are the same, and they both share goals of increased balance, flexibility, strength. Where they diverge, as we see it, is in the level of intensity pursued, and the degree of disabililty considered acceptable."
Physical therapy, she said, tries to get patients to the point where they are considered "safe," and capable of daily living -- dressing, and bathing, for example. Training attempts to return patients to the life they were able to pursue prior to the accident, including returning to work or school and social activities.
"Ideally," she said, "training takes up where physical therapy leaves off."
Asked whether she has achieved full recovery, Storch didn't hesitate, saying, "I'm probably stronger now. I didn't work out before."
Now in New Haven, the fledgling Dr. Storch's professional goals remain essentially the same. She plans to specialize in critical care – on her own terms.