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Tuesday, February 14, 2017

True Believer

Posted By: Advancing Care

When a car accident left him with severe brain trauma, quick thinking and quick action gave a police officer a second chance at life.

By Melissa Pheterson

As a New York City police officer, Alex Penate has faced his share of life-threatening ordeals, but nothing compared to what he faced the evening of November 1, 2015.

Penate was driving to his home in Orange County when his Jeep Wrangler collided with another vehicle, flipping four times and ejecting him onto the New York State Thruway, according to eyewitnesses.

“Apparently, I struck that highway face down,” Penate says. “As the traffic built up, a nurse [who was in a car behind me] ran over to check my pulse, roll me over and open up my airway. I was coughing up blood — but I was breathing, and she knew I was alive. She was my first angel.”

Noticing ejected items from the car, onlookers ran to check his vehicle. They found baby clothes and an NYPD uniform, which they draped outside the Jeep. First responders arrived on the scene — among them, Penate’s next-door neighbor, another “angel,” who recognized the severity of the trauma. A helicopter was summoned to airlift Penate to Westchester Medical Center (WMC), the flagship of the Westchester Medical Center Health Network (WMCHealth), saving 32 critical minutes.

“My wife (Ivy) was putting our daughter to sleep,” Penate says. “She saw two police cars pull up with lights flashing and sirens, and her heart dropped. As the wife of a cop, that’s the last thing she wanted to see.”

The state troopers who drove her to WMC deliberately silenced the radio and took a detour from the wreckage of the accident. In the hospital, doctors were already conferring on how to save Penate’s life.

“From a neurological standpoint, he was showing very little brain function,” says Adesh Tandon, MD, Penate’s neurosurgeon at WMC. “The CAT scan showed acute hemorrhage due to trauma and significant pressure in the cranial cavity, between the skull and the brain. We needed to relieve the pressure right away,” otherwise the damage could quickly progress to brain death.

“In many cases like this, an operation would be futile,” Dr. Tandon adds, “but given his age [32] and examination, we decided to do it.” The neurosurgery team performed a hemicraniectomy, removing half of the skull to allow the swelling to resolve and pressure to subside. Typically, that portion of the skull is not reimplanted for months, but in Penate’s case, it was reimplanted after several weeks.

“Alex started to develop extra fluid in the brain,” Dr. Tandon explains, “so we made the decision to reimplant the bone sooner, so his brain could reaccommodate and reabsorb the fluid.”

On November 15, Penate turned 33. He woke up to a cake, a birthday greeting scrawled on a chalkboard and a family anxiously waiting to see if he’d recognize them.

“His family was here constantly,” says Terry Rattigan-Davis, the Nurse Manager of WMC’s Trauma Intensive Care Unit. “The staff knows how hard things can be on the family when they’re waiting, feeling like they want to do something, but they can’t. We make them feel involved — explain things, hold their hands, even pray with them.”

While his brain and body recovered, Penate worked frantically to communicate with his wife. “I made our private gesture of affection, tracing my finger on her palm,” he says. “I spelled my son’s and daughter’s names, incorrectly, but to show I knew who they were.” His wife was both shocked and relieved.

The next step was intensive rehab, which Penate tackled with determination. “If they said, ‘Do 20 pushups,’ I’d do 30,” he says. “I’d keep pushing myself forward.”

Forty-nine days after his airlift to the hospital, Penate was ready to go home. “He was so motivated and exceptional,” says Rattigan-Davis.

Penate agrees. “I had fractured ribs, a fractured foot and shoulder, two brain surgeries, and I still walked out on December 19 to be home for Christmas. I am a miracle.”

Dr. Tandon calls Penate’s outcome “remarkable.” “He’s regained function, almost to baseline.”

Penate also credits his recovery to the support of his wife, Ivy (far left), as well as his intense workout regimen.

BELIEVE in miracles

Penate struggles with short-term memory loss, migraines and anxiety. He’s lost his sense of smell and taste, and he doesn’t remember his youngest child’s birth. Yet each day, Penate says, he feels “the shock of being alive.”

“My father instilled a positive attitude in me from early on,” he says. “‘Believe you can do better. Strive for greatness.’ When you feel down and discouraged, you have to push forward and believe you can do it.”

Reflecting on this mindset inspired Penate to create the acronym BELIEVE: Beyond Everyone’s Limitations Is Empowerment, Vitality and Exuberance. He has the word tattooed on his arm, along with the infinity sign and butterflies, which testify to the power of change. Family, friends and neighbors have also embraced the mantra, wearing BELIEVE sweatshirts in his honor.

Rattigan-Davis says the best part of her job is when former patients like Penate stop in to say hello.

“He comes back regularly to visit us and bring our patients’ spirits up,” she says. “I recently heard him tell a 19-year-old: ‘Look at me: I’m walking. I’m talking.’”

Penate’s children are now 9, 6 and 2. “I’m grateful I get to wake up with my family in the morning and put them to sleep each night,” he says.

Although he can no longer serve in the NYPD, Penate says he believes the rapid response and advanced care he received that November evening were karmic payback from his days in the line of duty.

“If you put good out there, you receive good in return,” he says. “I’ll keep pushing myself to do good, to do better. Most people are timid. Most are afraid. But nothing can or will stop me.”

Trauma Care At WMCHEALTH

Westchester Medical Center Health Network is home to Level I trauma centers at Westchester Medical Center and Maria Fareri Children’s Hospital and a Level 2 trauma center at MidHudson Regional Hospital.