Kelly Bouldin Darmofal never imagined that a single moment could rob her of everything — her past, her present and her future.
Until Sept. 17, 1992.
It was a mere five days after her 15th birthday and Kelly Bouldin — as the freshman at Reynolds High School was known then — was headed to Burger King for a celebratory chicken sandwich after cheerleading at her first high school football game.
While on a winding road, the driver turned his head away for just a moment. The car crumpled against a telephone pole, propelling Darmofal headfirst into the dashboard — despite the hug of her seatbelt — and causing a severe closed-head brain injury. The driver of the car and one other passenger sustained only minor injuries.
After weeks in a medically induced coma, Darmofal became one of the 5.3 million survivors who would suffer a disability or other consequences of a traumatic brain injury.
A traumatic brain injury (TBI) is caused by a blow to the head or a penetrating head injury that disrupts the normal function of the brain, according to the Centers for Disease Control and Prevention (CDC). Injuries can range from mild — in which a brief change in consciousness occurs — to severe, such as Darmofal’s injury, where an extended period of unconsciousness or amnesia is experienced.
The accident stole many of Darmofal’s childhood memories and the use of her short-term memory, as well. Gone were the days when making straight A’s and cheerleading had come easily.
“I knew the Pythagorean theorem, but forgot how to multiply. I knew the names of most friends, but forgot my feelings toward them,” Darmofal, a Winston-Salem native, said. “It was hard to recall my own personality, and thus I felt quite isolated and confused for many years.”
Darmofal has spent the past 22 years coping with the loss of her memory and learning how to overcome the frustrations related to TBI in her daily life. She recorded her extensive rehabilitation process in a memoir, “Lost in My Mind: Recovering from TBI,” which was published in November 2014.
The book was intended to help other TBI survivors and caretakers and to bring awareness to TBI, especially among young students, Darmofal said.
“Most people … do not recognize TBI and those who do often think of soldiers and athletes — not students,” Darmofal, 37, said. “However, TBI is the leading cause of death for America’s children, and the leading cause of disability in the young. Awareness is crucial, yet slow in coming.”
Had to relearn ‘basics’
Every day, about 138 Americans die from TBI, and those who survive often face effects lasting a few days to the rest of their lives, according to the Brain Trauma Foundation, an organization whose mission is to improve TBI patient outcomes worldwide.
Symptoms differ from person to person, depending on such variables as the type of accident and where on the head the injury occurred. The foundation has developed guidelines for managing TBI. About 2 percent of the U.S. population suffers daily from the effects of TBI.
Darmofal is well acquainted with many of those. Tasks that had once been simple seemed impossible after her accident and she had to relearn the “basics” — how to read and write from left to right and dress herself based on the season. Each night she would go to bed wondering what she had already forgotten that day.
Her memoir explores her path to “normalcy,” in hopes that her experiences can help survivors, and is supplemented by clips from her mother’s diaries to fill in the gaps in her memory.
“Any parent can imagine the pain and anguish that stole our daughter’s childhood,” her mother, Carolyn Bouldin, said. “At first her new memories held only a few hours, then a few days, and she didn’t have time for the social activities of her peers. Her life was work.”
Bouldin, a learning disability resource teacher at Summit School at the time, tutored her daughter in the spring after the accident. She was well acquainted with finding creative teaching methods and made sure her daughter didn’t fall behind.
But when Darmofal returned to Reynolds in the fall — a full year after her accident — she still suffered from memory problems, had difficulty speaking, was limping and was legally blind. She often fell down stairs, lost her personal belongings and couldn’t recall the names of teachers or where to go next.
“Doctors wanted Kelly back in a familiar environment so that her memories would trigger back more quickly,” her mother said. “I had to trust those at school to help her, although I probably knew more about TBI than her teachers did. I knew I could not protect her as I did at home.”
Long road to recovery
But her return was far from easy.
Kids made fun of her and her friends avoided her. Worst of all, she couldn’t remember who she was. Unlike before the accident, she was now left-handed, an introvert and couldn’t participate in the activities — such as cheerleading, horseback riding and art — that had once brought her great joy.
“I wished to die, not because I disliked therapies, but because I remembered the excellence I had lost,” Darmofal said. “Few friends knew how to respond to my changed persona; they wanted ‘old Kelly.’ Rejection isn’t easy to live with.”
Although she may have appeared a bit different to many, her close friends knew she was still the “same old Kelly” they had always known and loved, longtime friend Nicole Londono said.
“Best friends are those who make your problems their problems, just so you don't go through them alone,” said Londono, who met Darmofal at age 3 in preschool. “Kelly had a long road to recovery ahead of her and there was never a question about being a part of that journey with her.”
As a way of showing support for Darmofal, Londono and a few friends vowed to partially shave their heads to match the look of Darmofal’s head, which had been shaved at the hospital after her accident for medical testing.
Londono was one of the handful of people allowed to see Darmofal in the intensive care unit at the hospital. It’s something that she will never forget, a reminder of just how precious life is, she said.
“Seeing your best friend, who had been cheering with you the night before, lying there with tubes to monitor brain activity and assist with breathing, not knowing if she would wake up, was absolutely terrifying,” Londono said. “I remember holding her delicate hand, talking to her and watching the numbers changing on the machine, which indicated that she was listening to me. That’s when I knew she was going to make it.”
Darmofal’s injury was more serious than most, Frank Wood, her neuropsychologist, said.
The doctors had warned her parents that she might not recover from the accident. Best-case scenario, she would recover up to 90 percent.
“Her depth and length of coma put it in the serious category,” said Wood, who has been working with TBI for 40 years. “I thought it was serious, but still something she could make good improvements from with the right effort.”
Intensive physical therapy — coupled with her determination — helped Darmofal improve steadily, although slowly.
Yet even years after the accident, she said, she felt TBI infringing on her life and her education.
Chief among her struggles was that her teachers weren’t equipped to meet her academic needs. None of them had dealt with a student with TBI.
Darmofal taught herself the material, studying constantly, and vowed to one day redefine the education system to help students with TBI.
“My teachers were not trained to help me, though many tried,” she said. “By the time I finished high school, I could still write no more than one full page without a laptop. Reading was difficult as I forgot chapter one before completing chapter three, but I persevered in order to show my friends I was normal.”
After high school, Darmofal attended Salem College — drawn to the school because one of the faculty members had experience with TBI — and graduated with a bachelor’s in communication.
She refused to let anything stand in her way, traveling with groups to Europe and Mexico and even briefly working on the set of the film “Patch Adams” with Robin Williams.
In 2006 — 14 years after her accident — she met the love of her life, Brad, who said he never would have guessed her history with TBI upon meeting her.
“My initial impressions were that she was a very kind, sweet and caring person, and I see that in her every day,” Brad Darmofal said. “I didn't know anything about her accident at first. That’s something I learned about her with time.”
The two were married in 2008, and now have a 3-year-old son, Alex. Darmofal said her TBI has not affected her roles as a mother or a wife.
‘All things are possible’
Besides her family, Kelly Darmofal has dedicated her time to raising awareness for TBI.
She earned a master’s in special education at Salem College. A paper she wrote, “TBI: Our Teachers are Not Prepared,” won an award after publication in the English Journal and inspired her book.
“It was extremely difficult for me to read her book and everything she has gone through,” her husband said. “But it is Kelly's story, and I think it is important for people to hear.”
Each year, about half a million students between the ages of 5 and 15 incur a TBI and reenter the school system with disabilities related to TBI, according to the CDC.
Darmofal has recently begun working with Salem College to design a unique course focused on educating teachers on TBI that would use her book as a jumping-off point.
“A black hole exists in America’s educational system, and this is TBI,” said Kelly Darmofal, who tutors students with special needs at the Triad Academy at Summit School part time. “Currently, there are no programs in America which provide training solely for the instruction of the TBI. It is time for education to wake up.”
Her focus on TBI and the education system is unprecedented and insightful, said Wood, a professor of neurology and neuropsychology at Wake Forest University.
Something else that sets her book apart is the use of poems she wrote after her accident to make sense of the world and understand metaphorical language, Wood said. After her accident, Kelly Darmofal often took such phrases as “hot girl” literally, and used poetry to express herself and heal.
“Kelly Darmofal’s account is unique, yet widely applicable,” Wood said. “She teaches any who have suffered TBI — and all who love, care for and teach them — insights that are not only novel but revolutionary.”
For that reason, the book — “the best of its kind,” Wood said — should be required reading for all TBI patients, teachers and poets. But beyond that, her experiences can apply to everyone.
What makes her book so special, he said, is that it not only offers tips for those affected by TBI, but also sends a message from a girl who wasn’t expected to survive: a message of hope and to make the most of life’s moments.
“A survivor must believe that recovery is possible,” Kelly Darmofal said. “Only with hope, coupled with hard work and determination, all things are possible.”