Extraordinary Recovery: Brain Injury Expertise-Unique Extended Recovery Unit

Brain Trauma Injury Unit, Extended Recovery Unit and Individualized Recovery Plan in Acute Care Hospital–key to advancing independence for patients with traumatic brain injuries

On April 20, 2022, 19-year-old college student Malachi Gaddy sustained life-threatening injuries after being struck by a vehicle while changing a tire, requiring months of intensive medical and rehabilitation care.

But despite having multiple broken bones, a collapsed lung, a fractured skull, a traumatic brain injury and a crushed right leg that required amputation, nearly two years later Malachi is thriving—a direct result of his drive and determination to recover from his rare combination of injuries with the help of his multidisciplinary team and personalized recovery plan at JFK Johnson Rehabilitation Institute at Hackensack Meridian Health.

With an individualized treatment plan to help achieve his recovery goals, Malachi received treatment from experts in brain injury medicine, prosthetic/orthotic care, ophthalmology, neuropsychology, speech and swallowing care, and physical/occupational/cognitive therapy.

“Our objective was not only to help Malachi regain the highest possible level of function, but also to help him thrive,” said Brian Greenwald, MD, medical director of the Center for Brain Injuries at JFK Johnson Rehabilitation Institute, who coordinated Malachi’s rehabilitative care. “As a result, we were able to get him back to work and help him to live his life in a way that initially—given the extent of his injuries—seemed difficult to achieve.”

A Pathway to Recovery

After Malachi’s accident, he was in a coma from April 20, 2022, until early June 2022. When he emerged from the coma, in addition to his other injuries, Malachi had a breathing tube, a feeding tube and was unable to see.

After his condition was stabilized in the acute care hospital, Malachi was transferred for his rehabilitation to JFK Johnson Rehabilitation Institute, which offers a continuum of care tailored to the unique needs of patients with traumatic brain injuries. Malachi started his journey to recovery in the institute’s inpatient Brain Trauma Unit (BTU) on June 9, 2022.

“When I first met Malachi, he had severe injuries. In addition to having multiple surgeries, he was missing part of his skull, was blind in both eyes, lost his right leg above the knee, was unable to swallow and required breathing support,” said Dr. Greenwald. “We knew we needed to make a head-to-toe plan to help him get better, so we focused on what would help him most in the short term while also considering his long-term care needs.”

Under the leadership of Dr. Greenwald, Malachi and his care team got to work. His care team performed a complete assessment of his condition, looking at everything from his cognitive function to his strength and range of motion to his eyesight and his ability to speak and swallow.

Malachi’s vision was severely impacted after the accident due to the presence of hemorrhages in both eyes. While Malachi was a patient in the BTU, he was given a comprehensive work-up by an ophthalmologist, Benjamin Spirn, MD. Dr. Spirn performed two surgeries on Malachi that enabled him to regain his vision.

“The fact that JFK Johnson Rehabilitation Institute is attached to an acute care hospital, JFK University Medical Center, affords our patients the benefit of having highly trained specialists available and ready to help care for the most complex patients. This allows us to maximize our patients’ functional recovery in a medically safe and quality-driven way,” stated Sara Cuccurullo MD, medical director and VP of the JFK Johnson Rehabilitation Institute, physician in chief, Hackensack Meridian Rehabilitation Services

“My team assessed where I was and what help I needed,” said Malachi. “I received speech, physical and occupational therapy that was personalized to my condition.”

After spending several months in the BTU, Malachi’s condition improved and he was transferred to the Extended Recovery Unit (ERU) at the Center for Brain Injuries, JFK Hartwyck at Oak Tree—the only specialized sub-acute brain injury unit in New Jersey, and one of only a few in the nation.

“Malachi’s care required the expertise of specialized physicians, nurses, therapists, neuropsychologists, amputation experts, prosthetists and more—and our comprehensive, compassionate care combined with Malachi’s resilience enabled him to regain his independence,” said Dr. Greenwald. “The continuum of brain injury care we offer at JFK Johnson really is the secret sauce to helping people get better.”

And, Malachi said the team always found innovative and enjoyable ways to help him practice his skills.

“I love to cook and my mom is a chef, so I did cooking therapy as part of my occupational therapy,” said Malachi. “I was able to cook whatever I wanted, and I learned to navigate the kitchen using my wheelchair so I would be prepared to cook for myself when it was time to go home.”

He also said the team at JFK Hartwyck always prioritized his safety and well-being while creating a home-like environment where he could thrive.

“Everyone took the time to learn about me and always treated me as a person — not just a collection of injuries,” said Malachi. “And even though I had to follow the rules that were there to keep me safe, I always felt like I had the chance to be as independent as possible, practice my skills in a safe environment, and take initiative to do things on my own. I was able to be myself, and that helped me to feel comfortable and confident.”

Excited for the Future

Malachi received his temporary prosthetic leg in 2022 and was discharged from the ERU in November 2022 — equipped with the confidence he needed to live independently at home and navigate his changed lifestyle. He continues to receive outpatient physical, occupational and speech therapy through JFK’s Outpatient Cognitive Rehabilitation Program.

During his time at JFK, Malachi worked in the hospital’s concession stand for patients and visitors as part of his vocational rehabilitation—which proved to be a perfect fit for his entrepreneurial nature and helped him get a job running the snack shop and assisting in the kitchen at Plainfield High School.

“I ran the hospital concession stand for an hour, and that helped me build endurance for standing on my prosthetic and get my job at the high school,” said Malachi. “It was perfect for me because I’ve been selling things all my life. I shoveled snow and cut grass as a kid, and I even sold candy in high school. I enjoy talking to customers and making them happy.”

In addition to his day job, Malachi is using his skills in photography and knowledge of exclusive sneakers to run two businesses.

“Malachi’s positive attitude, motivation and work ethic are an inspiration,” said Dr. Greenwald. “It’s a miracle for someone to come so far in such a short time, and we continue to give Malachi the tools he needs to maximize his success.”

Team members meeting him now can’t really see what he’s been through–the rare recovery journey given his combination of injuries. He is full of energy, walking effortlessly, offering to help carry equipment–and is just completing his driving assessment–less than two years after he first came to JFK Johnson Rehabilitation Institute.

But Malachi’s not stopping there: In 2024, he hopes to obtain his substitute teacher certification and use the knowledge and skills he gained during his high school basketball career to serve as a basketball coach. He will also receive his permanent prosthetic limb in the coming months.

For Malachi, achieving his goals and staying positive—even when faced with adversity—comes down to mindset and faith.

“I believe everyone is bigger than their situation, and God won’t give you a situation you can’t handle,” said Malachi. “With a great mindset, you can overcome anything, and I’m excited for what the future holds. I told everyone at JFK that they made a huge impact on my life, and I will never forget what they did for me. They are changing people’s lives for the better every day.”

Learn more about innovative rehabilitation care at JFK Johnson Rehabilitation Institute.