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Central Park Jogger's recovery illustrates brain's amazing capabilities

Trisha Meili has returned to good health after rape and assault that nearly killed her

Tuesday, May 13, 2003

By Mackenzie Carpenter, Post-Gazette Staff Writer

The slight blonde woman giving a speech on the stage of the Carnegie Library of Pittsburgh's lecture hall hesitated briefly, trying to find the right word to describe how she reacted to something.

Trisha Meili, with her father, Jack Meili of Bethel Park, listens while he adds his perspectives about her ordeal during her talk last month at the Carnegie Library in Oakland. (Annie O'Neill, Post-Gazette)
"Intuitively," she said. "No, make that instinctively."

It was just a slight distinction, a subtle refinement of language, but still some pretty impressive wordplay for someone who had once had her head bashed in with a brick.

Trisha Meili was here last month talking about her new book, "I Am The Central Park Jogger: A Story of Hope and Possibility," the story of her remarkable recovery from injuries she received in a brutal rape and beating 14 years ago while jogging in Central Park.

Today, the 42-year-old former resident of Upper St. Clair is lithe, limber and clear-eyed. She laughs a lot. At lunch the next day, she puzzled over a dessert menu as any normal person might, then joked with her husband, Jim Schwarz, about the choices. "Our lemon torte was on the cover of Pittsburgh Magazine's June issue," the waitress volunteered helpfully.

"Wait!" Meili said with a smile. "It's only April."

After being assured that she was not about to eat a nine-month-old cake, Meili dug right in. While she is tiny, the anorexia she wrote about in her book is long gone, vanished soon after the attack, when, at Gaylord Hospital in Connecticut, she was presented with a menu and asked to choose.

"I remember thinking, well, I treated my body pretty badly so I'm going to have to eat right," she says, a surprising thought given that she had never consciously acknowledged her anorexia before. She's not sure why it suddenly occurred to her then.

"I'm just amazed I had that insight."

Not perfect, but pretty good

On this particular spring afternoon, all the hoopla over her internationally publicized story faded as Meili talked calmly and carefully about her journey over the past 14 years toward the good health she enjoys today.

To be sure, life isn't perfect. When she's tired, she has double vision. She occasionally stumbles and loses her balance, and she has to pause briefly to collect her thoughts before answering complicated questions.

Overall, though, Meili's story is a remarkable tale of how the body can, under the right conditions, heal itself of the most punishing trauma.

"Of all our patients, she would be in the top 5 or 10 percent" in terms of how closely they've come to regaining their previous functions," said Nelson Carvallo, who oversaw Meili's rehabilitation at Gaylord, a long-term acute care center in Wallingford, Conn.

After spending seven weeks at New York's Metropolitan hospital, this once-driven Wall Street investment banker was sent to Gaylord to learn to walk, talk and care for herself.

"We really see a gamut of people coming in here," Carvallo said. "Some of them, from day one, make no progress at all either because of the severity of the injury or how the brain is affected. But when she came in, even though she had many difficulties, we saw her potential."

"I was told -- not by people at Gaylord, but I heard this from medical experts on television -- that it was common for people with brain injuries to improve for maybe two or three years, and then I would plateau out and that would be it," said Meili. "But I am still improving 14 years later."

Indeed, much more is known today about the brain's capacity to heal than was known in 1989. Not a static organ whose functions are hard-wired by age 2 or 3, the brain is always growing and responding to stimuli, scientists believe. When it's injured, it is much more flexible about shifting functions to undamaged areas -- called plasticity -- than was previously thought.

More also is known about the ability of the brain's 100 billion nerve cells, called neurons, to regenerate themselves.

Just why, though, does a Trisha Meili recover so much of her previous functions, while others don't?

While there are some predictors like age, disease and pre-existing neurologic disorders, recent research shows that genes also play a role, said Dr. Greg Oshanik, national medical director for the Brain Injury Association of America.

Not only that, he said, "women generally have a poorer recovery than men, according to the statistics. Trisha is obviously an exception to that rule."

Massive trauma

Trisha Meili was close to death when she was brought into the Metropolitan Hospital emergency room after the attack on April 19, 1989, and remained in a coma for 12 days. Besides massive brain damage, Meili's eye socket was crushed, and she lost almost all of her blood.

And she was frantically thrashing about, a manifestation of her damaged brain's inability to control her movements. People with brain damage will very often exhibit what doctors call "primitive posturing," said Dr. Robert S. Kurtz, who then directed the hospital's surgical intensive care unit. "Their arms straighten out and snap down at their sides, or fly up to their chin."

One gruesome example of this can be seen in the famous Zapruder film of President John F. Kennedy's assassination. When the bullet shattered his brain, his arms snapped up to his chin, as if he was fending something off. "He wasn't. It was the outward sign of irreversible brain damage.

"Ironically, patients who are agitated in this manner, and whose brain damage isn't irreversible, tend to do better because the reflexive movements increase the level of norepinephrine, a substance that assists in improving brain function," Oshanik added.

The prognosis for Meili wasn't promising, though. Tests found that "at a mid-brain level where her cerebral cortex is located, she wasn't doing very much other than existing vegetatively," Kurtz said.

But there were some good signs. While there was substantial brain swelling, the cold temperatures in the park had helped keep the swelling from reaching catastrophic levels.

Another plus: Meili had suffered no penetrating injuries, like a gun-shot or stab wound to any of her organs. Her eye injury smashed the bones around her eyeball without penetrating the eye itself.

And her heart was strong from her running. "My running almost killed me," she says. "It saved my life, too."

A few weeks later on Memorial Day Weekend, she started remembering things. She snapped at her boyfriend ("Nothing like a gracious re-entry into human society," she would write, amused, later). Frank Sinatra sent roses, and, Kurtz said, "she said, 'I don't know him.' That's when she realized, I think, that something major had happened."

Indeed, the knowledge that so many people were praying and rooting for her helped immeasurably. The power of prayer, she says, does matter. There was something else, too, that can't be found on a CAT scan -- a strong survival instinct, what so many people have called her "indomitable spirit."

Mentally, too, Meili was spared. The brain injury destroyed the cells that temporarily store memory before it is committed permanently, sparing her the agonizing flashbacks other rape victims suffer.

Most important, perhaps, Meili's survival could be tied to her instinctive (not intuitive!) determination while at Gaylord to live in the moment and not dwell on what had happened. To relearn how to walk and talk, she had to focus on what her body was doing every minute.

That sense of "mindfulness," of being aware at every moment of the mind-body connection, is something she continues to live by every day.

Very good care

Meili had the best medical care money could buy, paid for by her former employer Salomon Brothers.

In today's era of managed care, though, a patient like Meili could probably not spend six months in rehabilitation at Gaylord. "They're coming in and out the door a lot quicker than they used to. Trisha was here for six months, but today most insurance doesn't cover stays beyond 30 to 40 days" and on average it's much less, Carvallo said. "They'll say, 'OK, you're functional, so that's good enough.' "

The therapy she received -- speech, object recognition, an emphasis on mathematics and reading skills -- is still relatively unchanged, although "there's more concentration on things visual," he said.

"Now we're finding that these types of injuries affect ambient vision and depth perception more than we thought, so we do more testing for these kinds of problems than we did, perhaps, when Trisha was here."

Meili will always have what she and her doctors call her "deficits." But she likes to focus on how far she has come, contrary to what those medical experts predicted for her on television so many years ago.

"It made me so mad, because the experts didn't know me."

"We're seeing recovery and positive changes 10 to 20 years post-injury," said Karen Flippo, a spokeswoman for the Brain Injury Association. "Because of the kinds of treatment we have now we're not seeing the kinds of devastation as we did 10 to 15 years ago. We have a lot more hope than we did in 1989."

Therapeutic sharing

Today, Meili runs only once or twice a week, but does yoga, meditates, lifts weights and rides a stationary bike. She is finding her newfound public identity to be much more rewarding than she had expected. Not only is it therapeutic for her to discuss her story, it seems to be inspiring others, and maybe, she muses, she'll build a career speaking to audiences about brain injury research after her book tour ends.

She has plenty of support, not only from her husband, but from her father, Jack Meili, a retired Westinghouse executive who lives in Bethel Park. Meili sat in the front row during his daughter's speech. He stood up frequently during the question-and-answer period to add his own perspectives on her ordeal, obviously proud of his daughter's strength and tenacity. But he could scarcely contain himself when a woman, sitting in the balcony, commented to his daughter that she looked "frail."

"Not true! Not true!" Meili said loudly from his seat.

Everywhere she goes, people reach out to her. Three times during last month's lunch Trisha Meili was interrupted by well-wishers, virtually all of whom could have been reading from the same passionate script: I admire you, I followed your story so carefully, you're a hero and an inspiration.

"Thank you," she says, with a huge smile.

And in the end, she listens to her body -- the one she got back against all odds.

Mackenzie Carpenter can be reached at mcarpenter@post-gazette.com or 412-263-1949.

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