The devastating consequences of one punch

In 2019, Emma and her husband Tom had enjoyed pre-Christmas drinks with friends in Nottingham, when a vicious attack on their way home led to Tom sustaining a brain injury so severe, he wasn't expected to survive.

Here, Emma recounts the moment their whole world changed.

Victim of a one punch attack

“We had stopped off in Burger King after a nice evening with friends. Before we had a chance to eat our food we were attacked by another couple.

“I heard Tom's skull cracking on the floor. It was clear that something serious had happened as the couple fled, and everyone stopped. It was as if everything went into slow motion. I don't think I realised the severity of the situation, but Tom was out cold and was unresponsive. The police later advised me that it was a one punch attack – and the harrowing CCTV footage later confirmed this in court.”

Lifesaving treatment

“We were lucky that the emergency services responded within minutes, and we were only 10 minutes away from the hospital. This quick action is ultimately what saved so much of my husband. Tom was assessed in the ambulance and was given the lowest possible score on the Glasgow Coma Scale - a 3 - which meant likely surgery.

“Within no time I had to go and say goodbye to Tom as they prepared him for surgery. He had 2 bleeds on the brain, a subdural hematoma, and a subarachnoid haemorrhage. They also found an extradural hematoma whilst in surgery too.”

You can read more about types of brain haemorrhage here.

At 2am I had to make the call to Tom's parents, and our children who were 17 and 15 at that time. We had to be prepared for the worst, Tom wasn't expected to survive the night.

“But he did! Tom had a craniotomy on his left side to allow space for the swelling. He had a significant mid-line shift, and due to this the fear was that he would have right-hand side brain damage, as well as left.

“After a week in ICU, two previous attempts to bring him out his coma, pneumonia and E. coli, the medical team went for it a third time.

“It was so scary. His sedation had been reduced, so we started to see more movement from him. They notched it down again and whilst our two boys and I were visiting Tom started to fight and try and remove the tube from down his throat. Doctors were also present, and one made a split-second decision to take that out and to see what Tom did. Thankfully it paid off. I can't tell you how amazing it was to see him awake!”

But Tom wasn't Tom. No speech, no recognition of who people were, fear, loss, confusion, devastation.

“Whilst in intensive care and the high dependency unit (HDU) Tom was always 2 - 1 care. The medical staff were amazing with me, and I used to do 12 - 14-hour shifts by his bedside.

“Tom was fortunate that his mobility didn't appear to be hugely affected, but this became an issue as he would constantly rip out all his tubes and wires. They had to stitch his central line into his neck and put boxing gloves on him... which made him even more agitated.

“Linden Lodge Neuro-Rehabilitation Unit came to assess him and a bed was offered, but at the same time, he got really sick again due to Sepsis, so the transfer was put back.

“Tom was so determined. He became obsessed with time, with his lessons, he wanted to be doing something all the time to get better quicker and to come home. He really didn't realise how poorly he was and how hard and long the journey would be. We had to apply for a deprivation of liberty order as he was a huge flight risk and had no insight into his injury.”

Coming home and continued care

“Tom came home after just 8 weeks in residential rehab. His recovery has been miraculous. We all worked so hard, and I cannot fault his determination.”

I remember the Occupational Therapist saying “Emma, this just does not happen!"

“I have an incredibly supportive family and employer, which meant I was able to be Tom's rehab team, with the support of professionals over the telephone and via Teams.

“I wasn't able to parent my children for months, but I didn't have to worry because I have a supportive family that took this pressure off me.

“Tom received two and a half years of speech and language therapy and has done amazingly well.”

Our coping strategies for living with brain injury

“We are trying really hard to move forward and have learnt to plan ahead to support all of Tom's everyday needs.

“People ask if he's better, and my response is "no we just get better at it!".”

• Tom has no short-term memory, so we use diaries, wall planners, notepads, lists, alarms, post-it notes etc.
• We write instructions, ingredients, menus, and shopping lists together to help make things easier.
• Tom cannot self-medicate so we have alarms on our phones and a dosette box to ensure we don't miss anything.
• I pace Tom from a fatigue perspective. We now know what he's capable of and the best time of day to do things, mornings are always best.
• If we have a social engagement, or are busier than normal, I ensure that there are full rest days immediately after.
• We take into consideration environments and how busy they will be.
• Tom can't order from a menu, so if we are eating out we choose his food before we go to avoid him getting distressed and frustrated.

“These have been successful for us, but we learn to adjust more and more each day.”

We have no idea what the future holds, we still have very bad days, but the good days make up for these.

Lifelong consequences

“Tom has cranial nerve damage, right side drop, a Cranioplasty, and post-traumatic epilepsy, and this remains a challenge with him still having up to two seizures per week. He has damage to both frontal lobes, his left temporal lobe, and his left parietal lobe. He has mood and emotional difficulties, speech, reading and writing difficulties, no inference, he can be impulsive, he has executive dysfunction, he has no smell or taste... the list goes on.”

“One thing is for sure though, we will continue on this new journey together and we will continue to get better at it!”

Sickening stats

“The Christmas that Tom was assaulted I believe there were approximately five similar incidents in Nottinghamshire alone, and the majority of these ended up in a fatality.”

What we lost, and what we found

“At 41 years old Tom nearly lost his life. Overnight he lost his business of 22 years, he lost his independence, he lost his confidence... But he survived, he still has me, and his children, who are amazing and incredibly supportive of us both."

We now celebrate two birthday celebrations each year, like the monarch. We have the original Tom, who made it to 41, and the new Tom, who is nearly 4.