Persevering Through the Worst Day

As a full-time education consultant, Allison Zmuda works with educators to grow ideas on how to make learning for students challenging, possible and worthy of the attempt. Over the past 19 years, Zmuda has shared curricular, assessment, and instructional ideas, shown illustrative examples, and offered practical strategies of how to get started.

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What would you do the next day and on subsequent days after the worst day of your life?

The emergency doctor was already waiting for me as the paramedics navigated me into a room.

Uh oh. No lines, no waiting. This is serious.

As the doctor simultaneously did an initial exam and gave an explanation of the protocol she was going to follow, I focused on the face of a nurse who I would remember long after my hospital stay. She exuded sympathy, compassion, and strength when she looked at me. I tried to express both my gratitude and my insistence that she stay by my side with the only language I had left at my disposal. I made eye contact and squeezed her hand.

I was wheeled to a CT-scanning machine down the hall to confirm that I had had a stroke and then wheeled back in to administer the first dose of tPA. Just under an hour after falling down on the soccer field, I was what “winning” looks like from a stroke victim’s point of view: quick paramedic response, instant diagnosis, confirmation of stroke in a timely manner, and tPA coursing through an IV to break up the blood clot in my brain.

Meeting Dr. Agola

zmuda-agola-071216What I didn’t know was that they were making plans to move me to Norfolk General Hospital to be examined by one of the greatest interventional radiologists on the East Coast. Dr. John Agola describes himself as a “brain plumber.” When a blood clot gets stuck in the brain, he has an arsenal of tools at his disposal to loosen it. The first weapon was the tPA.

They wheeled me back into an ambulance to take me to the next emergency room to meet Dr. Agola. This was standard protocol for him. He was paged whenever there was a potential stroke in the Sentara Family of hospitals. He then examined the scans and either recommended treatment or instructed the doctor to transport the patient to him for immediate intervention. He fields several dozen calls per month on average, but only a handful of such patients require brain surgery.

I instantly liked him.

He spoke in an authoritative but kind manner with a clear undertone of urgency. He ordered a second CT-Scan and, based on the results, made it clear that we needed to take action immediately. The doctor explained the options: a second dose of TPA or brain surgery to remove the blood clot.

Without question, I said “Do it.” Actually, it came out painfully slow again, but I was adamant. I want the surgery. For the love of God, I want the surgery.

“Are you sure honey? Because we can …”


I implicitly trusted that Dr. Agola would get me whole again. I believed in him. Exhausted by my outburst, I laid back, depleted but hopeful. I can get through this and then back to my life again.

Knowing the Stakes

A minister walked in just as the preparations were being made. This is serious. Ministers don’t come to people’s bedsides when they are doing a run of the mill procedure. I looked into his eyes, pleading for counsel, for understanding, but he delivered a stump speech about how God would give the doctors the wisdom for the surgery.

Need my own pep talk. I believe in God, I believe in the universe. I repeated that over and over again to myself as I was wheeled down the hall and ushered into the operating room. I believe in God, I believe in the universe.

Tom was adamant that he would see me after surgery and that we would do whatever we needed to do together to get me better.

“I’ll see you after you wake up, I promise,” he said.

The nurse removed my wedding rings for safe-keeping and gave them to him. He was left standing in the hallway, clutching a tangible reminder of the stakes as they made final preparations to put me under. He kept saying to himself over and over again, “I am not prepared to do this alone. I am not ready to be a single father.”

Back in the operating room, Dr. Agola explained the surgery one more time and that I was going to be put under general anesthesia for it. The anesthesiologist said, “Don’t worry, you should only feel a pinch. Count backwards from 10 to 1.”

I believe in God, I believe in the universe. I believe … The room faded to black. Maybe I saw myself looking down, maybe I didn’t. But after six hours of surgery I opened my eyes and looked up. I didn’t see God anymore.


The surgery itself was quite an ordeal. Because the TPA (thrombolysis) was unsuccessful, I underwent the endovascular procedure to try and remove the clot from the left middle cerebral artery. Dr. Agola made two attempts to snag it with a MERCI basket but was unsuccessful. After a third attempt at retrieving the clot, he considered concluding the procedure because it was a long time for me to be under anesthesia and he was concerned about causing more damage if he continued trying to pull it out.

Thankfully for me, they persevered.

The blood clot that lodged in the left hemisphere of my brain was flushed out, but so too was my language, my memory, my livelihood, my ambition, my pride.

Around 10:00 pm, six hours after the surgery began, I woke up to see Dr. Agola’s worried eyes staring down at me. “Hey there. You had me a little worried, young lady,” Dr Agola said. “Are you up for some company?” I nodded.

Tom rushed in and I could see the sense of relief, worry, and love on his face. I wanted to comfort him, to tell him that I was a fighter, that I would conquer the world once again, that I wanted to go home and give the kids a hug. But the pictures in my head could not be translated into language.

That first night I only had yes, no, please, thank you and I love you to draw from. The good news is that at least my good manners were still in tact. The bad news is that it became instantly clear what the stakes were — the life of my family was on the line.

One Step Closer to Freedom

The next morning, Tom came to visit. He held my left hand and stroked it gently, not wanting to make eye contact with the tubes and contraptions that were prevalent on my right side. He had a bad hospital experience when he was a teenager and he resolved never to enter one again (other than the birth of our two children).

When the doctors came into my room for rounds, they did the standard neurological tests, explained what the day’s plan would be, and then they asked if anyone had any questions. I paused and then slowly asked mine. “Howwww (pause) yyyyou doooing?”

Tom burst out with laughter. “How you doing?” he quipped back to me, with appropriate inflection like a mafioso from New Jersey would say. That was the first time I genuinely smiled. It became our long-standing joke: I asked how he was and he would come back with that rejoinder. On the rehab floor, he trained the kids to come into my room the same way.

“Rise and shine!” the nurse greeted me cheerily, as she opened up the curtains to the outside world. As my eyes adjusted to the early morning sun, I looked out across the horizon to the water. One step closer to freedom.

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