Fearless: The girl in the pink tutu
It was Aug. 25, just another scorching San Antonio summer day, when an American bulldog viciously attacked 3-year-old Brooke Brady, inflicting horrific injuries on the tiny, blond-haired girl. Eleven days later, on Sept. 5, Brooke walked out of University Hospital, bandaged but smiling, and wearing a pink tutu. What happened between those two dates is an extraordinary story of one patient’s untiring courage and the incredible expertise of a team of UT Health San Antonio physicians and caregivers.
It’s a remarkable story yet, in a way, remarkably ordinary. It’s one story out of so many.
Brooke’s dad, Justin Brady, was in Washington, D.C., on business, and her mom, Kim, was on a weekend getaway with friends in Port Aransas that sultry Saturday. Brooke and her sister, Riley, age 5, were in the care of a sitter when the attack occurred.
Brooke was rushed by ambulance to University Hospital. She had extensive crush injuries to the torso. Major lacerations. Her left lung was punctured, a rib fractured. Blood filled her lungs. That day, Susannah Nicholson, M.D., the on-call trauma surgeon, took Brooke to surgery for bleeding control. It was the first of four surgeries, performed every other day. Trauma surgeons Lillian Liao, M.D., M.P.H., and Deb Mueller, M.D., and plastic surgeon Amita Shah, M.D., also treated Brooke. She was intubated, cared for in the pediatric ICU and was heavily sedated the first three days.
Her terrified parents rushed home to San Antonio. “I mean, seeing your little 3-year-old, fragile, clumsy daughter with tubes coming out all over her body, it was just … words can’t describe that feeling,” Kim said, fighting back tears. It was only after speaking to one of the doctors who calmly explained and reassured, she added, that she felt she could breathe.
‘Calm and cooperative’
Dr. Liao is a clinical associate professor at UT Health San Antonio and pediatric trauma and burn director at University Hospital. The trauma surgeon remembers Brooke as exceptionally strong.
Most 3 year olds, Dr. Liao said, “have a bit of stranger anxiety. Brooke never had that. She was very cooperative from the very beginning when she was incredibly sick in the pediatric ICU. … She was unlike most of the other children we treat in that she was so calm and cooperative and, really, super-resilient.
“At some point during a child’s illness,” she added, “we’ll see what a mom would call a ‘meltdown.’ And Brooke never really had that. She was really a super-sweet child to care for.”
Parents Kim and Justin described their daughter as tough, stubborn, headstrong and independent. “I think that came across during her stay” in the hospital, Justin said.
Dr. Liao applied a different term. “With Brooke, I think a good word to use would be fearless.”
University Hospital is the only Level I Pediatric Trauma Center in South Texas. UT Health trauma surgeons provide the highest level of care for injured children in partnership with the hospital. The approach is multidisciplinary, Dr. Liao emphasized. Surgeons, pediatricians, residents, psychiatrists, advanced practice nurses, support staff such as Child Life specialists and physical therapy team care for the entire person, not just the physical injuries.
“We realize that while there are visible wounds that we need to treat, there are these invisible wounds as well,” she said. “That’s where the pediatric psychiatry team comes in.”
The first doctor that Brooke communicated with was a psychiatrist, Kim said. He used play therapy and props to elicit dialogue and help Brooke deal with the understandable fear and stress, and haunting memories of the attack.
With each passing day, Kim and Justin said, they grew more impressed with the caregivers’ medical expertise, compassion and communication skills.
“At 5 or 6 in the morning every day,” Kim said, “I’d get awakened by the resident, just to give me a play by play of what’s happening, what her numbers were from the night and here’s our agenda for the day. And the nurses were awesome…. We always knew what was happening, what Brooke’s schedule for the day included.”
Kim had special praise for Dr. Liao. “When something like this happens, trusting someone to fix your child is so difficult. But after the first meeting with Dr. Liao, I was like, I don’t want anybody else to touch her. She just gave us so much information, so clearly, and in such a nonchalant way, like, it’s going to be OK. It wasn’t, ‘Oh don’t worry, there’s nothing to worry about,’ because it was something to worry about. It was her compassion and the way she explained it.”
About Dr. Liao, Justin added, almost incredulously, “She actually thanked us. That last day she thanked us for allowing her to do her job. She’s just a strong, focused woman and doctor.”
Brooke, who will turn 4 years old on Jan. 8, is back in preschool at Will Smith Zoo School. Soon, she’ll be going to physical therapy and occupational therapy for scar management, and she may need some reconstructive surgery. She’s still mentally processing and working through issues, Kim said, but all things considered, it’s a remarkable outcome.
“From what we saw to what we have now, in Brooke, is just incredible,” Justin said. “We can’t believe it. She’s a 3-year-old girl again, which is all we wanted. She has scars and stuff she’s going to have to go through, but she’s Brooke again.”