Every step along the way
Sophomore Ian Ricketts is on the path to become a physical therapist, inspired by those working with his father to regain the ability to walk 18 years after a near-fatal brain injury
Story by John F. Trump
Photos by Ben Brown
Ian Ricketts doesn’t remember the day his father was gravely injured. Neither does his father. They remember nothing about the accident. Nothing about the doctors who told Ian’s mother Kim that her husband likely had just hours to live. That — if he did survive — he’d probably never awake from his coma. Or when he did open his eyes 10 days later, that he’d likely be forever paralyzed.
Ian had yet to turn 2 years old on July 21, 2006, when his father Brian Ricketts was helping Kim’s family move a small plane at a private airfield in Fayetteville.
It was raining that day, and as Brian was reaching to grab a handle on the plane, he slipped, falling headfirst on an antenna. The thin metal entered through an orbit in his right eye, through his brain and touched the brainstem.
“No one truly knew what had happened, because they thought he had just hit his head,” Kim recalls. “But when I showed up at the hospital, they had a grief counselor and a chaplain waiting for me. They told me he was going to pass away that night.
“And he lived.”
It’s been nearly 18 years since his father’s accident, and Ian is sitting quietly in a corner room on the second floor of Campbell University’s Tracey F. Smith Hall of Nursing & Health Sciences. He’s thinking about why he chose Campbell for his undergraduate studies. About why Campbell was his first and only choice, despite the opportunity to visit several campuses after high school.
His father is seated to his right. His mother to his left. She’s close to Ian, offering hope, love and support as only a mother can as he talks about his father and their future.
Ian is on a pre-physical therapy track, laying the groundwork for a career that’s been his goal since middle school, around the time he began to fully understand the extent of his father’s injuries.
“I told [people] I’m gonna do physical therapy,” Ian says. “I really want to help people like my dad.”
Brian Ricketts is still working to recover from an accident so freak and so catastrophic, it not only forever altered his family’s lives, but the lives of the people closest to them as well.
When the antenna entered his brain, Brian suffered a stroke of the cerebellum (often referred to as the “little brain), which controls one’s balance and movement. He defied the odds in many ways when he woke from his coma 10 days after the accident, but he remained in intensive care for a month. Another month was spent in the hospital and yet another in inpatient physical therapy.
He was released on Halloween in 2006, just past his 100th day under a doctor’s care.
“It’s amazing,” says Kim. “He had to relearn to do everything — breathe, regulate his body temperature, talk. … His left side is still weak, but it’s definitely not paralyzed. He just … he came from nothing.”
“Looking at the X-ray, I think there’s no way I should have survived,” Brian says. “If I can help one person. …”
He doesn’t quite finish the thought, but it doesn’t matter. The message is clear.
Trips to Campbell’s Health Sciences campus are a regular thing for the Ricketts family. Smith Hall is home to the Doctor of Physical Therapy program, and part of its evidence-supported curriculum (one that centers on the patient and clinical practice in rural health care) is exposing students to cases like Brian Ricketts and providing free regular therapy that not only benefits the patient, but the students as well.
On this day, Brian is working on walking. It takes the work of multiple PT students to help pull his 6-foot, 7-inch, 300-pound frame up from his wheelchair, but when he’s up, the work begins.
Pushing. Walking forward.
Ten steps. Then 20.
It’s a process. Arduous and draining.
But he’s progressing. Slowly … progressing. Step by painful step. Ian is at his side all the while, pushing, challenging and helping his dad on levels emotional as well as physical.
And at the same time, Ian is learning. It’s been this way his whole life — when Ian was learning to talk at a young age, his father was relearning.
“They had their own language,” Kim says. “[Ian] had speech therapy until he was in fourth grade. Brian just tried to get out the important words, and Ian [learning from him], did the same thing.”
Growing up, Ian had plenty of inspiration to motivate and encourage him, whether it was a health sciences teacher at Gray’s Creek High School in Fayetteville or staff at a nursing home, where he met with an occupational therapist and learned about time and money management, scheduling and patient care. There was his grandfather, a Vietnam veteran. The Devault family — Donna, Terry, Nicholas and Addison — who helped raise Ian when Kim spent most of her time with her husband, by his side in the hospital.
“We didn’t leave Brian, not even for a day,” she says. “It was either me, my mom [Cindy], my dad [Dale] or my brother [Scot]. We stayed with him 24 hours a day, seven days a week.”
Terry Devault, who taught Ian to ride a bike, to bowl and to swim, was a graduate of Campbell University. He finished his last classes in the hospital, Kim Ricketts says, and died of cancer soon after. He was 47.
“He was also one of my greatest inspirations to come [to Campbell],” Ian says.
A large, ensemble cast prepared Ian to enter his high school’s Certified Nursing Assistant program as a senior, where he was the only male among its five students. Prior to that, in middle school, Ian remembers completing school projects and developing discussion boards where he shared his burgeoning passion of physical therapy with teachers and fellow students. All the while overcoming the challenges and the uncertainty.
“We’re humans, and we’re always gonna have doubts, no matter what,” Ian says. “But sometimes you just have to overcome that doubt and just keep pushing forward.”
Adds his mother, “During this time we have come to realize how important family is. And not just blood family, but friends who chose to step up and become family.”
The Ricketts are at home in a still-rural part of Fayetteville, about 30 miles south of Fort Liberty, on a hot Friday morning, and Brian is sitting across from Kim at their kitchen table. Ian is nearby, diligently working to extract DNA from a strawberry — a project for a summer biology class.
The family’s dog, Sam, patters across the kitchen to a pet bed near the front door.
Brian recalls being released from intensive care and meeting a physical therapist who worked at the time with Cape Fear Valley Health in Fayetteville. That therapist, Dr. Michelle Green, is today an associate professor and the assistant director of Campbell’s DPT program.
Green stayed in touch with the family and ultimately suggested Brian come to Campbell for his physical therapy in 2014.
“I’m highly thankful I met Michelle,” he says.
Campbell’s DPT program offers pro bono physical therapy, which Green says is a typical outpatient clinic run by students. Residents can sign up and receive an evaluation. They then work with the students, with faculty supervision, to get better.
The Community Wellness Program, in which Brian is a patient, is a required course for DPT students and continues throughout their second year, embedded within the neuro assessment class. In summer, it’s embedded within the pediatric and the neuro curriculum.
The course is on-the-job training, as students put into practice what they’ve learned in the classroom. Students also develop what Green calls “soft skills,” such as building relationships and talking with and teaching patients and family members.
On this day, as the group of students gather around Brian — helping him to walk up the hallway and down again — rooms on the health sciences campus are filled with patients and groups of student physical therapists.
Patients learning from students. Students learning from patients. Patients with cerebral palsy, Down syndrome and autoimmune disorders. People recovering from a stroke or from injuries incurred in falls or accidents. One child, treated earlier that day, was paralyzed from the waist down when a car crossed the centerline and struck the car carrying him, his mother and brother. All survived, although his mother has had multiple surgeries.
Sometimes, in physical therapy, the care doesn’t meet the needs of the patient, or a patient’s insurance fails to cover this procedure or that.
“This program really helps bridge that gap, at the same time helping the students evolve and grow and gain a lot of confidence,” Green says. “We always say that we want to build clinicians who can treat a patient anywhere, anytime, anyplace … across their lifespan.”
Caring for patients, she says, transcends their diagnoses. Patients are dealing with issues, often internal and not apparent to others, resulting from or precipitated by their initial injury.
“They are not just their diagnosis, but they have problems within all of the systems of the body,” Green says. “Our students can’t be just trained in pediatrics, or just trained in neuro, or just trained in musculoskeletal.”
It’s about looking at the whole person, she says. Holistically, osteopathically.
For assistant professor Dr. T.R. Goins, physical therapy is often about becoming comfortable with the uncomfortable. Treating patients with compassion and humility, regardless of their initial or subsequent injuries. An adult patient with a pediatric diagnosis who, for example, suffers a knee injury.
“I want you to not run away from that,” Goins says. “I want you to treat that person, no matter what. That’s one of my objectives. The students don’t know what they don’t know, but the hands-on approach, to me, develops a more well-rounded clinician. … They aren’t seeing just a knee; they’re seeing the whole body.”
A physical therapist is a movement specialist, Goins and Green say, agreeing on the concept. Physical therapy is about helping the individual return to pursue their passion, even if that isn’t quite to the level before the accident, injury or disease.
“We hope to provide a path forward,” Goins says. Joining the conversation with other specialists. Learning to contribute, to help.
One small step at a time.
Movement is taken for granted by so many, says Erin Carter, one of the dozen-plus students working with patients on this day.
“It can be really difficult but extremely rewarding … seeing someone for more than just their abilities,” Carter says. “Giving them their independence back and seeing [them] as human, despite whatever might have happened to them, is what pulls me in.”
For the wellness program, third-year students spend four weeks with the second-year students, orienting them to patients whom they worked with over the past year. It’s not part of the curriculum, but rather done on a sort of voluntary basis.
“They show up to make sure that these people get good transitional care as the second years start,” Green says.
Andy Sartain, one of those second-year students, “for a very long time” has known he would make a career in physical therapy.
“One of my skills is that I love people,” he says. “And I love helping people. And so, I think it’s important for me to work in a field I know that I’m gonna love for a long time. If you love what you do, you won’t work a day in your life.”
Above and beyond the inherent challenges.
“I’ve worked in different clinics where I’ve seen patients go from not walking to walking. And even one step is just as rewarding as running a marathon,” Sartain said. “Just seeing the people’s experience is well worth it.”
Brian Ricketts is still outside, in that hallway. Talking, listening, working. Stretching and pausing for a deep breath. Wiping beads of sweat off his forward. Sitting patiently as students, with the help of an orthotics professor, carefully working on a brace to stabilize his left foot, which tends to turn inward. He has since received the finished brace.
A bit later, he strains to rise from his chair, the one with a “Campbell Dad” sticker on the headrest. The sweat on Brian’s forehead is now more prominent. The breaths deeper. He stares straight ahead. Determined, strong.
“We’re going to grind,” says Cole Kuhnel, also a second-year DPT student. “We’re all incredibly excited to be working with Brian.”
For Ian, his father’s rehabilitation has always been a part of his life. And it will probably continue for the rest of Brian’s life.
“I really push hard for Ian so he can see that there is a good outcome and that people do take advantage of what’s being offered,” Brian says.
Ian has found his passion, and he, too, is working hard to realize that dream. Becoming a physical therapist, getting his degree and eventually his doctorate from Campbell University. He also plans to try to earn a spot on the basketball team.
“We are so proud of Ian and the person he has always been and continues to be,” his mother says. “He has the biggest heart and wears it on his sleeve. Ian has chosen the perfect career to showcase just how big his heart is. His dad and I could not have asked for a better kid, and we love him so much.”