The slow healing of the brain
To the medical staff, the signs of Father Tim's reawakening were a bit more ambiguous. They knew that he appeared alert and responsive at times, especially around family and friends. But like many brain-injured patients, he had good days and bad days. The changes weren't consistent. Often, on long days in the hospital's extended care unit, there was little sign that he knew what was going on around him.
Nurses tried to read his moods in the squeeze of a hand. Officially, doctors classified him in a "minimally responsive state."
Once, scientists thought that a damaged brain could never heal. Now, they know that it can in certain circumstances, said Dr. Gregory O'Shanick, medical director of the Brain Injury Association of America. But a lot depends on the extent of the injury. If part of the brain is destroyed, no amount of time will bring it back.
Typically, the most dramatic improvements occur in the first six months, he said. But not always. If someone is fighting for his life, for example, the amount of brain damage may be hard to assess. "It's [like] trying to tell somebody what color the walls are when the room's full of smoke," he said. You have to wait until the smoke clears.
With brain injuries, people often reach plateaus and go for months without any change.
"What I basically tell families is that there is no absolute rule," said O'Shanick, of Richmond, Va. "We can talk about statistics in terms of recovery patterns, but we certainly can see people that recover in amazing ways."
The uncertainty can be extremely difficult, especially for families. "You suffer every little setback with him," said Phyllis Vakoc. "But I think maybe you just hope and trust in God."
In October, Father Tim sat in the front row of the hospital chapel, as Brother Conrad led a small group in prayer. "Hail Mary, full of grace," they chanted. Father Tim didn't stir. His mother wrapped a rosary around his left hand, as his father, Henry, 83, prayed a few seats away. She lifted her son's hand to make the sign of the cross.
"I go day by day," she said. "He goes inch by inch."
The priest speaks
Two months ago, doctors thought Father Tim had reached another plateau. They got ready to stop therapy.
And then Father Tim spoke.
His voice was rusty, and the words were halting. Mostly, he repeated what others said to him. "I love you."Goodbye." But for the first time in two and a half years, there were no subtle movements or ambiguous signals.
He was speaking for himself.
Just three days before, a cardinal from Rome had paid a visit, bearing a set of rosaries blessed by Pope Benedict. Family and friends called it a miracle, or something close. His mother started to dream of the day when he might say mass again.
The doctors say that removing the tracheotomy tube from his throat in August was probably a factor. But they were awed nonetheless. "I don't think we can say with any certainty what's going on, other than he is very slowly improving," said his speech therapist, Jim Schumacher.
Since then, he has been practicing speaking almost daily.