It was Aug. 25, 2018, just another scorching San Antonio summer day, when an American bulldog attacked 3-year-old Brooke Brady, inflicting horrific injuries on the tiny, blond-haired girl. Eleven days later, on Sept. 5, Brooke walked out of University Hospital, bandaged but smiling, and wearing a pink tutu. What happened between those two dates is an extraordinary story of one patient’s untiring courage and the incredible expertise of a team of UT Health San Antonio physicians and caregivers.
It’s a remarkable story yet, in a way, remarkably ordinary. It’s one story out of so many.
Brooke’s dad, Justin Brady, was in Washington, D.C., on business, and her mom, Kim, was on a weekend getaway with friends in Port Aransas that sultry Saturday. Brooke and her sister, Riley, 5, were in the care of a sitter when the attack occurred.
Brooke was rushed by ambulance to University Hospital. She had extensive crush injuries to the torso and major lacerations. Her left lung was punctured and filled with blood. Eight ribs were fractured. That day, Susannah Nicholson, M.D., the on-call trauma surgeon, took Brooke to surgery for bleeding control. It was the first of four surgeries, performed every other day. Trauma surgeons Lillian Liao, M.D., M.P.H., and Deb Mueller, M.D., and plastic surgeon Amita Shah, M.D., also treated Brooke. She was intubated, cared for in the pediatric intensive care unit and was heavily sedated the first three days.
Her terrified parents rushed home to San Antonio. “I mean, seeing your little 3-year-old, fragile, clumsy daughter with tubes coming out all over her body, it was just … words can’t describe that feeling,” Kim Brady said, fighting back tears. It was only after speaking to one of the doctors who calmly explained her treatment and reassured them, she added, that she felt she could breathe.
‘Calm and cooperative’
Dr. Liao is a clinical associate professor at UT Health San Antonio and pediatric trauma and burn director at University Hospital. The surgeon remembers Brooke as exceptionally strong.
Most 3-year-olds, Dr. Liao said, “have a bit of stranger anxiety. Brooke never had that. She was very cooperative from the very beginning when she was incredibly sick in the pediatric ICU. She was unlike most of the other children we treat in that she was so calm and cooperative and, really, super-resilient.
“At some point during a child’s illness,” she added, “we’ll see what a mom would call a ‘meltdown.’ And Brooke never really had that. She was really a super-sweet child to care for.”
Her parents described Brooke as tough, stubborn, headstrong and independent. “I think that came across during her stay” in the hospital, Justin Brady said.
Dr. Liao applied a different term. “With Brooke, I think a good word to use would be fearless.”
Caring for the whole person
University Hospital is the only Level 1 Pediatric Trauma Center in South Texas. UT Health San Antonio trauma surgeons provide the highest level of care for injured children in partnership with the hospital. The approach is multidisciplinary, Dr. Liao emphasized. Surgeons, pediatricians, residents, psychiatrists, advanced practice nurses, support staff such as Child Life specialists and the physical therapy team care for the entire person, not just the physical injuries.
“We realize that while there are visible wounds that we need to treat, there are these invisible wounds as well,” she said. “That’s where the pediatric psychiatry team comes in.”
The first doctor that Brooke communicated with was a psychiatrist, Kim Brady said. He used play therapy and props to elicit dialogue and help Brooke deal with the understandable fear and stress, and haunting memories of
With each passing day in the hospital, Kim and Justin Brady said, they grew more impressed with the caregivers’ medical expertise, compassion and communication skills.
“At 5 or 6 a.m. every day,” Kim Brady said, “I’d get awakened by the resident, just to give me a play-by-play of what’s happening, what her numbers were from the night and our agenda for the day. And the nurses were awesome. We always knew what was happening, what Brooke’s schedule for the day included.”
When something like this happens, she said, it’s difficult trusting someone to treat your child.
“But after the first meeting with Dr. Liao, I was like, ‘I don’t want anybody else to touch her.’ She just gave us so much information, so clearly, and in such a nonchalant way, like, it’s going to be OK. It wasn’t, ‘Oh don’t worry, there’s nothing to worry about,’ because it was something to worry about. It was her compassion and the way she explained it.”
“She actually thanked us,” Justin Brady said. “That last day she thanked us for allowing her to do her job. She’s just a strong, focused woman and doctor.”
A fearless future
Brooke, who turned 4 years old on Jan. 8, is back in her San Antonio preschool. She goes to physical and occupational therapy each week, and still sees Dr. Shah, the plastic surgeon, for scar management. She’s still mentally processing and working through issues, Kim Brady said, but all things considered, it’s a remarkable outcome.
“From what we saw to what we have now, in Brooke, is just incredible,” Justin Brady said. “We can’t believe it. She’s a little girl again, which is all we wanted. She has scars and stuff she’s going to have to go through, but she’s Brooke again.”
And one more thing, Kim added. Brooke has decided she wants to be a doctor when she grows up so she can help people in the same way her doctors helped her.