Five months ago, Kellen Smith was on the eve of his junior football season at Upper Lake High School.
In the best shape of his life, strong and fit, he was prepped and ready to play backup quarterback on the Cougars’ eight-man squad. But a late-night car crash ended his high school football season before it started.
He’s no longer learning plays and staying fit through weights and workouts. Today, Kellen Smith is relearning how to use his body. He’s improving his speech. He’s working on his balance. His workouts are less about fitness and more about reintroducing his muscles to the memory of movement and coordination.
“To walk, to get out of this thing,” he said, glancing at the wheelchair he sits in. “I hate it so much.”
But Smith’s ability to complain about the wheelchair, his ability to razz his mom, Shannon Walker-Smith, as she waits through another hour of his physical therapy, and his ability to clown around with fake money as he relearns making change in his head is nothing short of amazing.
Smith was grievously injured when he lost control of his car late at night on Aug. 14. He sustained a traumatic brain injury and had part of his skull removed in the hours following the crash. In those early hours, Shannon and Kellen’s dad, Mike Smith, couldn’t know how bad it was or what their son’s world would look like as he recovered.
When he arrived at Santa Clara Valley Medical Center’s “Journey to Recovery” program in September, he was “unable to speak, unable to verbalize, his hand gestures were inconsistent at that time as well,” according to Dr. Henry Huie, chief of brain injury rehabilitation and Smith’s primary attending physician during his stay in Santa Clara.
He had a tracheostomy tube to help him breathe. He was fed through another tube connected to his stomach. Much of his left side, the side that bore the brunt of the impact in the crash, was largely unresponsive. The surgeon who performed one of his initial emergency brain surgeries told Smith’s parents that their son would have brain damage — it was just a matter of how much.
“He was so significantly impacted early on,” Huie said.
But Kellen worked his way back. After days and nights of never leaving their son’s side, his parents began to read his eyes. Then he started snapping his fingers. He would point. When he was frustrated? He’d pretend to sleep through therapy or pull at the tubes coming in and out of his body.
It was all good, even the irritation, Huie said. “It’s a big milestone when a patient can start expressing what they are feeling.”
Smith’s tracheostomy tube was removed Oct. 23. The gastronomy tube through which nutrients were pumped into his body was taken out Nov. 13.
On Thanksgiving, the family rented a house near the Santa Clara Valley Medical Center, took Kellen on a day pass from the facility and celebrated.
It was a day of both highs and lows. After months of not tasting any food, and then more than a week of institutional meals, Smith ate turkey, stuffing and berry pie — enough to make him feel ill. He got to hang around with family. He also had to learn how to cope when his young cousins expressed confusion about what was happening with him.
“He said ‘They don’t want to come around me because I’m weird right now,’” Mike Smith remembered. “He handled it well and just believes he’s getting better every day and improving every day.”
Kellen’s focus on getting back what he lost is unwavering, according to his mom. He goes to hours of physical and occupational therapy sessions each week at St. Joseph Health Outpatient Therapy in Santa Rosa.
At a recent therapy session, Smith wore a significant brace on his left ankle to help keep his foot at the correct angle. Sitting in a recumbent bike, his left foot was strapped to the machine because he was not able to keep pressure on the pedal on his own.
But when the therapist said go, Kellen pedaled away, moving his arms in coordination with his legs. His breathing was heavy — not because of weakness, but because of strength. He was working hard. He then used a walker, with a therapist’s hand holding a belt around his midsection for support, to move to a room down the hall where he worked to make change with phony money. Then he practiced his cursive, his face close to the paper because his vision is still somewhat blurred.
“He never complains about it,” Walker-Smith said. “He has stayed positive. His spirit is good. He can see his progress. He talks about it all the time.”
Kellen’s gains have been tremendous.
In a video message to his grandfather less than a month ago, he sounds winded and his voice is raspy. By mid-December, his voice still sounds ragged, but his communication is clear and flowing. Conversation is easy.
“He’s a joy to talk to,” Huie said. “He’s upbeat, he’s got a good sense of humor, he’s motivated.”
And he comes back around to that word again.
“Kellen is very strong,” Huie said.
But Huie said he is careful to talk with families about what the road ahead may or may not look like.
“With these traumatic brain injuries, you want to be realistic and let them know what to expect,” he said.
Some of the struggles are obvious — the balance, the coordination. Others are less clear. A patient’s judgment can be impaired.
“It is sometimes an invisible disease where others don’t know the difficulties a person is going through,” Huie said.
“It gets better over time but you want to prepare family members, those caregivers, for what that is going to be like,” he said.
Kellen is living at his mom’s house in Lakeport. Walker-Smith now has baby monitors set up so she can hear if he needs her in the night or if she is elsewhere in the house. On a recent night, she didn’t hear Kellen awaken. She thinks he might have been dreaming, because he tried to get out of bed and walk. He crashed into his glass-top desk.
“I have a fat bruise right here,” he said, running his hand across his chest. “It was bad.”
“Coordination is still an issue,” Huie said.
But cognitively, Kellen is largely back. Just months ago, he was unable to communicate at all, but now he speaks in steady streams. His voice remains raspy from having a trach tube connected to his throat for months, but his communication is clear. And nearly constant.
At a recent session at St. Joseph Health Outpatient Therapy, one meant to build strength back into his damaged voice box, he was instructed to stretch his vocal chords by hitting different notes and holding them.
Given free range to say whatever he wanted to say, so long as he pumped certain words and held them, the Dallas Cowboys fan went loud and long: “The 49ers suck!” There was heavy emphasis on “suck.”
“His wit is definitely back,” Mike Smith said.
Physically, Smith is thinner than he was at his preseason football fitness best. He has grown two inches taller since the crash, making more obvious the 40 pounds that he has lost.
But Smith, wearing a black Upper Lake Cougars basketball shirt and gray sweatpants, cruised through a recent workout session, seemingly struggling only when he was tasked with walking on his knees across a padded surface. Even with his therapist there to guide him, his balance was off.
But when asked about the session and what was the most difficult part, Kellen wasn’t having it.
“It’s all easy,” he said. “I’m used to it.”
“When we do PT, I’m like, ‘Seriously? I do that all the time,’” he said.
Once disdainful of something like Pilates, Smith is now into it so long as he thinks it helps him on his road back.
“That took some convincing,” Walker-Smith said, smiling.
That drive has been there throughout and was clear even in those early days after his arrival in Santa Clara, Huie said.
“But even early on, when we first started, he was asking for more classes, more therapy,” he said. “I think his determination, his will, shined through early on.”
He flies through some activities but gets stumped by others.
In one therapy session with Kim Jacobs, his speech language pathologist at St. Joseph, he was asked to give three examples of something hot. He said “Rice.” There was a confused pause. Rice? Then he pointed at his mom.
“She knows what that means,” he said.
“I spilled hot rice on him at the hospital,” she said.
In another drill, he listened to audio recordings of scripted phone messages before Jacobs quizzed him on the details. It was a test of both memory and comprehension. When he couldn’t remember a certain detail, Jacobs told him to guess. He paused.
“Oh. The 49ers suck. Go Cowboys,” he said.
But it’s not all easy. When Jacobs asks him to listen to words that have two distinct meanings and use each in a sentence, he rattles off a series successfully: Point. Ruler. But when he gets to “fly” he can’t use the word to show two meanings.
Jacobs pressed on.
According to doctors, and his parents, this is a crucial time for Smith.
“Within that first year is when you get the most bang for your buck on recovery,” Mike Smith said. “Not that you don’t recover after a year, it’s just a slower, gradual process. We have nine more months to really pack it in and gain as much as you can.”
Both Shannon and Mike, who are no longer married, have been granted significant time off from their jobs — Mike Smith as principal at Upper Lake Middle School and Shannon Walker-Smith as director of Sonoma State’s Upward Bound programs in Lake County — to drive Kellen to hourslong therapy sessions in Santa Rosa, to exercise classes, and to work with him themselves.
It’s hard to imagine how the family would navigate this time without the support of their employers. Walker-Smith called it a blessing.
It’s also crucial. In Santa Clara, Kellen was undergoing six days a week of near-constant therapy. Now that Kellen is home in Lakeport, Shannon and Mike are working together to make sure Kellen’s recovery does not plateau.
“We have to find something on our own to maintain that consistency,” Mike Smith said.
So mom and dad take Kellen to therapy and exercise and do some of the routines themselves. They are all learning a new way forward.
They do it hoping and working for the best result. But what that may be for Kellen remains unclear.
“It’s hard to predict exactly what the future is going to hold,” Huie said.
But it’s Huie, who works with patients with traumatic brain injuries every day, who called Kellen’s recovery “remarkable.”
Brain injuries can mean long-term deficits, Huie said, but “it’s hard to predict. He is getting better very quickly.”
So when Kellen says that he wants to walk, that he wants to go back to Upper Lake High, that he wants to play football next fall and that he wants to graduate from high school on time in 2020, it’s hard to doubt him.
But it’s easy to worry. Especially when the young quarterback talks football.
“I’m definitely doing football, don’t even,” he said, pointing a finger at his mom.
I asked Walker-Smith if his resolve to play again, with all that his body and brain have been through, makes her nervous.
“Yes,” she said.
“I’m more of a, 'Cross that bridge when we get to it,'” she said.
But there is also the motivation that team and sport give Kellen. Goals are powerful tools in recovery. His mom knows that and wrestles with it.
“If he’s to the point where he’s physically capable of being out there next year, that’ll be amazing progress,” Walker-Smith said. “If that pushes him? Then …”
Her voice trails off.
I asked Kellen what the football team means to him. What it meant to him to return to Upper Lake High recently to be greeted and cheered and high-fived by teammates, friends and teachers.
He used that same word Huie used to describe the young man who came to him just a few months ago, startlingly broken, but with a will to survive.
“It gives me strength,” he said.
You can reach staff columnist Kerry Benefield at 707-526-8671 or email@example.com, on Twitter @benefield and on Instagram at kerry.benefield. Podcasting on iTunes and SoundCloud “Overtime with Kerry Benefield.”