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BlueCare CHOICES member Brett Smith clearly remembers the events that led up to a life-changing moment on Dec. 6, 2012.  More than that, he regrets them.

At the time, Brett was struggling with drug addiction. On that day, an attempted robbery of an abandoned Knoxville home led to an altercation with the property owner, a gunshot wound to the head, and an escape by automobile.

Law enforcement caught up with Brett’s car three miles away, after he’d passed out from blood loss and run off the road. He was rushed to the hospital and into emergency surgery for head trauma.

Today, Brett has one word to sum up that period of his life: lost.

“I wasn’t happy,” he says. “I didn’t like my life. That was my problem.”

“After his surgery, he fell into a coma and was on a feeding tube,” adds Brett’s mother, Robbie. “Ten days in he got stage 4 bed sores all the way to the bone. The trauma doctor said to me, ‘He’s worse than critical.’”

“He wasn’t expected to make it.”

But Brett had brain activity, so Robbie and Brett’s father, Perry, never gave up hope. They spent every day in the hospital with him, and then in the nursing home where he was transferred, telling him how much they missed and loved him, playing his favorite music, and most importantly, praying. He eventually awoke from his coma, but was in a vegetative state.

CHOICES steps in

Brett had no health insurance, and because of the severity of traumatic brain injury, he didn’t receive the physical therapy he needed. Severe contractures of his hands and feet resulted.

Though most every medical professional seemed convinced Brett would die in that nursing home, his parents were committed to taking him home. More than that, they were committed to ensuring he received the care he needed.

Through TennCare, Brett obtained health insurance and services as part of the CHOICES program for the elderly and physically or cognitively disabled. CHOICES provides long-term services and support for members to remain in their homes and communities for as long as possible, as opposed to having to go into a nursing facility for long-term care. It also provides in-home assistance to help these members bathe, do their grocery shopping, attend doctor visits with them, and coordinate unique services like pest control, assistant technology and minor home modifications.

“When I first laid eyes on Brett in the hospital, I admit I was one of those people who did not expect him to live,” says Karen Baker, CHOICES care coordinator manager and Brett’s first care coordinator when he transferred from the nursing home to his home in 2013. “I met with Robbie and Perry, and we discussed services Brett could receive at home. We submitted a request to TennCare, and Brett was approved to go home with CHOICES services in place. I also advised his parents to accept hospice services.”

A Hoyer lift was installed in Brett’s bedroom so that he could rest in familiar surroundings. Robbie and Brett continued their prayers, and wheeled Brett outside on the back porch to see the sunshine and hear the birds sing.

Another fighter in the corner

For the last five years, the Smiths have had another devoted ally. Rhoda Tummel, a registered nurse and Brett’s current CHOICES care coordinator, has been caring for others since she was a hospital volunteer in middle school.

“I’ve always been passionate about helping the sick feel better and just taking care of people in general,” she says. “I especially enjoy caring for senior members and those with disabilities.”

Rhoda worked as a hospital floor nurse for six years, but found the grueling schedule incompatible with raising a family. She joined the CHOICES program in 2011 not long after it launched. The focus on helping those in need of consistent care live their best life appealed to her.

“CHOICES is an awesome way to keep folks out of a facility by bringing in professional caregivers,” Rhoda says. “My family was one of those who said, ‘We’ll never put Granny in a nursing home,’ but then we had to. My mom took care of my grandmother for two years, but it aged my mom 10. CHOICES didn’t exist when we were going through that.”

Rhoda connected with Brett in 2013 after Karen was promoted. They were an ideal match since they were from the same area of Knox County and Rhoda had experience in critical care and a background in an acute care setting.

When Rhoda met the Smith family, Brett was still in a total vegetative state. She was in awe of how he could even still be alive, as literally half of his brain was gone  due to the traumatic brain injury.

“Perry and Robbie had been told how they needed to see Brett’s future – that he was going to die at a young age,” Rhoda says.

“I gained their trust because I didn’t come in with defeatist attitude or tell them no. I said, ‘I’m here for you. What do you want to do? What do you need?’ I tried to just be there for them.”

Then, something changed.

Hope pays off

After months in a vegetative state, Brett started showing signs of awareness of his surroundings.

“We noticed that Brett was starting to look at us, and follow us with his eyes,” Rhoda recalls. “I thought, ‘OK, this is not normal.’ That’s when I realized this was a person who was fighting his way back from the brink.  And I was just as committed to that fight.”

“Brett is nothing short of a miracle.”

The miracle came to fruition, fittingly, on Christmas Day 2013.

“I couldn’t talk for a year, but I remember everything that happened, and I heard everything people said to me during that time,” Brett remembers. “I finally woke up on Christmas.”

Not only did he wake up – he spoke. Clearly.

“My dog, Abby, got up in my bed with me and I couldn’t get her off of me,” Brett says. “And all of a sudden I looked at her, and said, ‘Abby!’ And I looked at Mom, and said, ‘Mom.’ I looked at Dad and said, ‘Dad.’ And then everybody started crying.”

“It was the best Christmas ever,” Robbie tearfully adds. “The best.”

Brett obtained additional services and resources through TennCare. A baclofen pump helped stimulate his nerves and muscles and prompted limited movement – and helped him form complete sentences.

“I can clearly remember the day Robbie called and passed the phone to Brett, and he started singing ‘America the Beautiful,’” Rhoda says. “We just sat there and cried.”

Brett also found yet another advocate within BlueCross to join his team.

“I had seen Brett’s casework come through, and what’s on paper is that he’s had a traumatic brain injury and he’s bedridden, and he had this injury so long ago that there’s no hope of rehab or recovery,” says Dr. Catherine Payne, BlueCare medical director. “What I saw in person was something very different.”

“When I met with Brett and talked with him, it was very obvious that he was still mentally intact. He was fighting, and he needed help with his fight to get his life back.”

Rhoda and Karen were instrumental in getting Dr. Payne to visit Brett in his home and getting him in an inpatient rehab facility. Karen gives all credit to her team member.

“Rhoda has been a fierce advocate and coordinator for care and services, working with Brett and his parents, his physicians, BlueCare providers, medical directors and supporting departments to ensure he gets what he needs,” she says. “She was a vital part of the process in getting Brett approved for intensive rehab at Patricia Neal Rehabilitation Center, which was a huge stepping stone in restoring a great deal of his functional status.”

Brett wants to use his voice to speak out and reach others who have faced similar adversity, and assure them that life goes on and is worth living.

Though his functions have improved, he still has only limited use of his hands and feet and requires assistance with everyday activities – but that’s not slowing him down a bit. He’s planning to start a foundation for people who have gone through an experience similar to his, and he’s joined the BlueCare CHOICES advisory council, where he’s able to give feedback and suggestions for improvement to the program.

“This journey has not been an easy one, but CHOICES has provided so much help along the way,” Robbie says. “Brett was initially given no hope whatsoever, yet God carried him through hospice to live and have a purpose in life.”

“I’m a fighter,” Brett adds. “If you tell me I won’t do this, I won’t do that, I’ll prove you wrong. That’s the kind of person I am.” 

All in the family

Though Rhoda and her husband, Travis, have two boys – Lincoln and Waylon, ages 8 and 9 – who keep them busy with basketball and competitive 4-wheel ATV racing, she considers Brett another member of her family.

“They say you’ve got to distance yourself and make it a professional relationship, but seeing what all Brett’s gone through, how far he’s come, and how he committed he is to going farther, I will say he is like another son to me,” she says.

Despite that closeness, Rhoda considers her advocacy on behalf of Brett as part of her role as a CHOICES care coordinator.

“I’m just doing my job,” she insists. “Brett’s faith and determination are what continues to get them through all of this.  When they need something, I go and get it for them. If I can’t, I fight tooth and nail to get whatever they need.”