When Sam Bellett woke up that dark summer morning, his future couldn’t have been much brighter.
He had just turned 16 and was a week away from starting his junior year in a rigorous academic program at Mandarin High School. He had recently earned a spot on the cross-country team and was on his way to becoming an Eagle Scout, the highest rank in Boy Scouts.
At about 6:15 a.m. Aug. 18, 2011, it all came to an abrupt halt.
Sam was struck by an SUV as he rode his bicycle to cross-country practice. His family was told his injuries were life-threatening. He’d been rushed to TraumaOne at Shands Jacksonville Medical Center.
He would spend about three weeks at Shands Jacksonville and another few months in and out of rehabilitation. And Sam would miss that entire first half of his junior year at school.
The worst of Sam’s physical wounds would mostly heal, but he was warned things would be different.
A young man who didn’t settle for anything was facing a future where he’d be forced to settle for less than his original dreams.
But Sam had different plans.
Sam wasn’t the most athletic person in his family, but he enjoyed spending time outdoors—camping, kayaking and rock climbing. By most accounts though, Sam was an academic, a bookworm. He breezed through mysteries, fantasies and other novels at an early age. He volunteered at the local library. And he was a natural with numbers and science.
Still, there was something about cross-country. During his sophomore year in high school, Sam told his parents he wanted to try out for the team. Jim Schmitt, head cross-country coach at Mandarin High, wasn’t confident Sam would take to the sport easily. Usually, runners started at a young age. But Sam was determined, and Schmitt agreed.
“I was impressed with his willingness to keep coming back out at first, and then he started developing,” Schmitt said.
Sam was so happy that it didn’t bother him to get up early during the end of his summer break to practice with his team. That’s where he was heading that August morning, a week before classes were set to begin. He was struck as he was starting to ride his bicycle across Greenland Road in front of the school.
“I went running out to the light at the front of the school,” Schmitt said. “Sam was lying in the street. His bicycle was crushed. It was a very frightening moment to see someone like that.”
The knock on his mother’s door followed a short time later. Maisie Bellett was home that morning with Sam’s three younger brothers and her 2-week-old daughter.
Maisie and Richard Bellett and other family members rushed to Sam’s side. His parents saw scrapes covering his face, a brace on his neck and tubes helping their son breathe, keeping him alive.
“We sort of broke down at that moment, because you don’t know what to do—you see your child lifeless,” Maisie Bellett said.
They were told Sam had suffered a severe brain injury, his skull was fractured, his left leg was broken and he had numerous internal injuries.
“The instant the brain is injured, the injury starts a whole cascade of other things,” said Joseph J. Tepas III, MD, a University of Florida professor and chief of pediatric surgery at Shands Jacksonville. “Our job is to minimize the likelihood that that cascade will go out of control.”
Because Jacksonville Fire and Rescue personnel quickly recognized the severity of Sam’s head injury and got him to TraumaOne, the region’s only adult and pediatric Level I trauma center, his prognosis looked good. Still, his body needed time to heal.
Sam was put into a medically induced coma. His parents and grandparents took turns by his side while his friends, his coach and the principal all came to the hospital to visit. Sam’s family constantly told Sam he would be just fine, and physicians and nurses gave the same reassurance to the family.
After spending time at Shands Jacksonville and Brooks Rehabilitation, he began what would be months of rehabilitation at home. Meanwhile, the start of Sam’s junior year had come and gone. Classes he would need to graduate were well under way. They weren’t easy classes to begin with, so they certainly wouldn’t be easy to make up.
Sam had been in standard classes in middle school and the start of high school. Near the end of his freshmen year at Mandarin, he told school counselor Peggy Adams he wanted to enroll in the Cambridge Advanced International Certificate of Education (AICE) program.
It was the most rigorous academic program Mandarin offered. Adams didn’t encourage Sam to enroll. She didn’t think he was ready. He hadn’t even taken the honors classes most of his peers in the program had already finished and now he wanted to take college-level classes. But Sam kept making the request, so eventually Adams relented and he started his first AICE class.
Then there was the accident. And the brain injury.
“There was an unknown with what his mental ability would be, whether he would be able to handle the rigors of this course,” Adams said.
Sam was devastated when he was told he would be returning to standard classes instead of AICE courses.
“I worked so hard to be able to go into it and do it, I just wanted to get back to it,” Sam said.
So while he learned to walk again, while his fractured skull healed and while the swelling in his head subsided, Sam enrolled in virtual classes from home. He even attended homecoming that fall with his girlfriend and other friends.
By the time classes started again at the end of January 2012, Sam was back at Mandarin and back in his AICE classes. He’s set to graduate from Mandarin with his AICE degree in June 2013.
“I knew I learned my lesson: you can’t tell the young man no,” Adams said.
Though Sam is doing well in his classes, studying doesn’t come as easily to him now. And physically, he is still healing. He runs some, but his leg hurts when he runs too much. He’s ridden his bike, but he tires if he’s on it too long. Still, he goofs around with his brothers, plays with his little sister and jokes with his friends at school.
Sam still plans to become an Eagle Scout, though he must first complete a community service project before he turns 18 this summer. Then he will enroll at The Ohio State University, where he plans to study science.
Sam was accepted to the university in January, not that he had any doubt he’d get in. He has shown he has the will to make his dreams come true.
“The name of the game right now is determination, and Sam’s got determination,” Tepas said. “Sam will succeed.”
Matt Giannini doesn't remember what caused his motorcycle to go off A.C. Skinner Parkway that August night in 2010, and the police report gives no indication.
He doesn't remember his motorcycle hitting the first tree, throwing him into the air and then his head, in a helmet, ramming into the second tree.
Giannini, now 25, remembers coming to in a wooded area and hearing the cars on the nearby road, but knowing no one could see him.
He dragged himself to the side of the road, but he couldn't feel his right arm. So Giannini lifted his cell phone into the air with his left arm, in hopes someone would see the light coming from the phone. Someone did.
Giannini was taken to the TraumaOne Trauma Center at Shands Jacksonville and treated for his injuries, including broken ribs, broken bones in his right arm and left leg, a collapsed lung and three fractured vertebrae. It was mostly a blur to Giannini, except for the mango frozen yogurt his friends brought by a few days after the accident.
But his full recovery would take months. Giannini had lost the use of his right hand, which he couldn't move because three nerves were pulled out of his spinal cord during the accident.
Those nerves controlled Giannini's right hand and arm, and because they were ripped out from the root, they couldn't be repaired. He could use his shoulder and bend his elbow, but the rest of Giannini's arm and hand wouldn't move.
Life as Giannini knew it had changed. He couldn't open jars, play video games or even tie his shoes. His parents helped in the beginning. So did his girlfriend. But he wanted to regain the use of his right arm.
Within weeks after the accident, Giannini began working with a team of therapists at Shands Jacksonville Rehabilitation Services. Occupational and physical therapist Elisabeth McGee began helping Giannini recover the use of his hand.
In the beginning, the focus was on decreasing the swelling in his fingers, which were twice their normal size. Range of motion exercises, stretches and special splints were used to loosen his stiff joints. He also learned how to function in adapted or modified ways as he awaited his follow-up surgery in November.
McGee, a certified hand therapist, helped Giannini strengthen the muscles in his right arm.
Then the muscles from his elbow and wrist were rerouted in the November surgery to replace the tendons in his fingers. When the surgery was over, Giannini began working with McGee to regain the use of his hand.
From the first day, McGee said Giannini always had a smile on his face. He didn't complain. He just kept working harder.
"Matt has always had a good spirit," McGee said.
And the hard work has paid off. He can tie his own shoelaces. He can button his shirts. And he can open a jar without the help of an automatic jar opener.
By spring, Giannini quickly picked up small screws, pens and other objects with little effort. A business card or a penny took a little more time, but Giannini didn't give up.
"Compared to what I had, I think it's like a new hand," Giannini said. "I'm able to do most anything, except heavy lifting."
Giannini has continued to get treatment on his left leg. But now he's done with therapy sessions for his hand. His thoughts are about his long-term career goals.
Giannini once thought he wanted to be a teacher. He received his associate's degree while he was in the hospital and plans to head back to college soon. But his plans have changed some.
Now he's thinking he may want to go into physical therapy so he can help others– just as the people at Shands Jacksonville Rehabilitation Services helped him.
One moment, Jacksonville Sheriff’s Office Patrolman Michael Pickering was in pursuit of a suspect. A few minutes later, he was in the back of an ambulance, on his way to Shands Jacksonville Medical Center.
It was Jan. 20, when Pickering felt a pain in the center of his chest during the chase and called for paramedics.
Now on the stretcher, Pickering, 50, felt tired. He wanted to close his eyes—just for a minute.
“Clear! Hit him again,” the rescue worker yelled.
In the time between feeling tired and hearing those words, Pickering was going into cardiac sudden death. As he would later find out, his heart was beating irregularly and then stopped beating effectively.
After paramedics resuscitated him, Pickering picked up his cell phone to call his wife, a communications director at the Clay County Sheriff’s Office.
They had an agreement. If one of them got hurt and was able, he or she needed to call the other person. The couple, married 10 years, didn’t want to find out through a knock on the door that something was wrong.
Pickering wasn’t going to break that agreement—not even because of a heart attack. Though someone else had gotten to his wife before he was able to, Pickering was able to talk to her coworkers to explain what was happening.
“He was still on his cell phone when he was wheeled into the emergency department. He was taken for tests that showed he was in the process of having a heart attack,” said Theodore Bass, MD, chief of the division of cardiology at the University of Florida College of Medicine–Jacksonville and medical director of the Shands Jacksonville Cardiovascular Center.
Both of Pickering’s parents died after having heart attacks, but they had been heavy smokers.
But Pickering didn’t smoke, he wasn’t a drinker and he was in good shape. And during his 29 years as a member of the sheriff’s office, Pickering was given annual exams. He’d passed the latest exam just a few months earlier.
Then in January, Pickering was working an assignment on Jacksonville’s Northside when another officer asked for backup. Pickering responded.
He was chasing a shoplifting subject into a wooded area when he started to feel the pain in his chest.
It must have been the Mexican food he’d eaten earlier that day, he thought. But just to be safe, as other officers continued to chase the suspect, he headed back to his truck, parked alongside Lem Turner Road.
He called for an ambulance, though he never said it was for himself. He took off his vest, locked his gun away and waited.
“I thought for sure rescue was going to get there, check me out and say it was nothing,” he said. But it was something.
Just a few minutes after Pickering’s wife got to the hospital, Bass came out to speak with her.
Pickering had a heart attack in the bottom wall of his heart. Through a radial artery entry in his right wrist, doctors were able to thread catheters in to take pictures, open the completely blocked right coronary vessel and put in a stent, Bass said.
“His symptoms got better,” Bass said later. “We were fortunately able to significantly limit the size of his heart attack.”
At Shands Jacksonville, doctors routinely use the radial approach instead of the traditional femoral approach, which goes through an artery in the groin. Bass said the radial approach is preferred because there aren’t as many bleeding complications, but not all doctors in Northeast Florida have been trained to use it.
Within a few weeks, doctors put a stent in another of Pickering’s arteries to fix a light blockage in the front wall of his heart.
He was so happy with his care that when workers’ compensation officials asked him to switch to a different doctor at a different hospital, he declined.
“Dr. Bass, I love that guy,” Pickering said. “He puts it in layman’s terms.”
He said he owes a debt of gratitude to the Jacksonville Fire and Rescue personnel, Shands Jacksonville employees and UF doctors who saved his life and took care of him during his recovery.
It isn’t clear what caused Pickering’s heart problems. Middle age men in the United States often have risk factors because of their diet and lifestyle. But for Pickering, it was his history that likely played a bigger role.
“No matter what he did, he was born with a gene pool that put him at increased risk,” Bass said.
Bass stressed that all people should be careful to control such risk factors as hypertension, diabetes, high cholesterol and stress and stay away from tobacco.
Today, Pickering is done with cardiac rehabilitation. He was back at work on April 12.
And then eight days later—three months to the day of his heart attack—the father of three had another important job.
He gave his daughter Kerri away at her wedding.
“I had tears in my eyes as we were walking down the aisle,” he said.
It was a day he told himself he’d never miss. And he didn’t.
I've been fighting an overactive bladder for about two years, and previously my primary care doctor had tried all sorts of pills. I went from one pill to the other and some made me swell, some would work for a week, others for only a day or so and then it was back to normal.
I just couldn’t control it. I'd get up seven or eight times a night. When I went shopping, I would have to make sure I knew where the restrooms were. Sometimes I’d take a change of clothes along with me when I was away from home. It was one of those things I knew I had to do something about, but I didn’t know what.
My primary doctor sent me to a specialist, who then referred me to Dr. Joseph Costa at Shands Jacksonville. That’s where we’ve had good luck.
Dr. Costa recommended I have a special device implanted to stimulate the nerves going to my bladder. I really had no idea what this whole procedure would be like. I was very naive but the nurses there are very knowledgeable. Dr. Costa warned me it might not work, but I was willing to try anything.
In June, 2011, I went in for the outpatient procedure to have the implant. So far, it's been great and I haven't had any problems. I'm starting to feel like my old self again.
I have great respect for Dr. Costa and the nurses and staff at Shands Jacksonville. They are the most pleasant individuals to be around and I thank them all because I am back to normal.
Orange Park, Fla.
Video: Overactive Bladder: Ellen's Story
The mammograms every six months wore on Blair Trikardos.
The anxiety, the waiting, finding time to squeeze visits to the doctor between work and everything else - only to hear the same thing every time.
The doctor can feel the lump, there is something that shows up in the mammogram, but it's tough to see what it is, please come in every six months for the next two years so we can keep an eye on it.
Then there was the physical pain Trikardos felt when technicians tried to get the compressed images that would help doctors get a closer look inside her breast.
So she quit going.
But she knew she needed to go back. The lump in her breast wasn't just going to go away. Three years later, when Trikardos was 34, the Shands Jacksonville Breast Health Center had its brand new tomosynthesis machine - the only one in Northeast Florida.
Trikardos, a neonatal nurse at Shands, went in December and her exam was done with the 3D imaging that allows doctors to look at the breast in separate images just one millimeter apart.
This time, there was a conclusive result: You're fine, the nurse told her. Come back when you're 40. There was something about her having dense breast tissue which made it harder to read the earlier exams.
"The only words I really heard at that moment were that it was OK," Trikardos said. "That's what I needed to know."
And that's the beauty of tomosynthesis, said Martha C. Wasserman, M.D., chief of the women's imaging division at the Shands Jacksonville Breast Health Center.
The technology allows physicians to better diagnose problems and - just as important - to rule out tumors when they are not there, said Wasserman, an assistant professor of radiology at the University of Florida College of Medicine–Jacksonville.
Unlike a traditional 2D mammogram which takes digital images from two dimensions or views, 3D tomosynthesis takes multiple images from a camera located in an arm above the patient which sweeps from side to side during the exam. This additional imaging takes place in the same amount of time as a traditional mammogram, splicing together all the images like pages of a book, giving the radiologist a clearer view of all the layers in the breast.
Tomosynthesis is particularly effective for women with dense breast tissue which on a 2D mammogram could be difficult to distinguish out abnormalities over simply a build-up of natural tissue. This new imaging view not only rules out these abnormalities for the patient giving them piece of mind, but also significantly decreases the potential of call backs or additional mammograms saving the patient time and additional visits.
Patients are often expecting a high-tech looking machine, but the technology is in the camera.
"We've had patients say, 'When are you going to do that special mammogram?'" Wasserman said. "But it's already done."
Tomosynthesis can help avoid some of the compression images which may be painful for the patient.
With a traditional 2D mammogram, if doctors want to get a closer look at a particular part of the breast, they will do what is called a spot compression. That presses the breast more to spread it out and can be painful for women, Wasserman said. The tomosynthesis often eliminates many of the spot compression views, Wasserman said.
Every year, Lexus hosts the Champions for Charity Golf tournament with the Research is the Answer (RITA) Foundation to benefit the Shands Jacksonville Breast Health Center. Shands used money raised from the tournaments to purchase the machine last year and started performing the 3D imaging on patients in August. About 5 to 10 mammograms are done daily on the machine - which is just being used for diagnostic exams, meaning a doctor saw or felt something that warranted a closer look. The goal is to eventually get more machines so all mammograms can be done on them, Wasserman said. And fewer women will experience the fear and uncertainty that Trikardos went through.
"When you have to go through something like that every six months for two years, the waiting, the not knowing …," Trikardos said, "… I just had to put it in God's hands."