Victim of train finally bids hospital bittersweet farewell

Bri Mullinger gives nurse Sarah Schwen and her mother Teri Mullinger, an update from her bed in Toledo Children's Hospital. THE BLADE/AMY E. VOIGT Enlarge | Photo Reprints

Spending the better part of eight months at Toledo Children's Hospital hasn't been all bad for Bri Mullinger, the teenager who survived being struck by an Amtrak train as she and her best friend tried to dart across the tracks near Springfield High School.

Although the hospital has been the site of painful medical procedures she's endured since the day in December she lost her best friend and her left leg, her fifth-floor room slowly became comfortable, almost like home. It became a place to be silly with old friends and make some new ones, spend time with family, do homework, eat, and sleep.

Although the hospital has been the site of painful medical procedures she's endured since the day in December she lost her best friend and her left leg, her fifth-floor room slowly became comfortable, almost like home. It became a place to be silly with old friends and make some new ones, spend time with family, do homework, eat, and sleep.

"It hasn't been horrible

'cause I have friends here. And I just do the same thing here that I do at home. It's not bad. I don't enjoy it, but … " she said with a shrug.

Well, she might have enjoyed some of it. Just a little. There was the friendly battle with a younger neighbor on the floor who couldn't walk past Bri's room without pelting her with a marshmallow fired from his arsenal of toy weapons.

Although a family friend bought Bri her own shooter and shield, she was no match for the kid's bow and arrow, rifle, and, of course, bazooka - which shot giant marshmallows.

For the month she was hospitalized with a staph infection, both hospital rooms became littered with the sugary puffs whenever the two thought the nurses weren't looking.

Bri, 17, left all that behind Thursday when she was discharged after what her family hopes will be her last major surgery - a reversal of the colostomy her doctors performed the day of the accident to redirect her bowel movements into a palm-sized pouch out of her body to prevent infection during her initial 16-hour surgery.

Bri's mother, Teri Mullinger, is thrilled to have her daughter home after what she considers to be the milestone procedure that signals an end to frequent overnights at the hospital and a living room crowded with medical supplies. Bri isn't quite ready to celebrate. She continues to struggle with memories of Dec. 16 - the day her life changed forever.

"I just try to make her laugh," Ms. Mullinger said. "There's nothing that we can do, you know? There's nothing. I can't turn back the clock for her. For her, or the Browns. I would in a heartbeat."

Bri, then 16, and her best friend, Cody Brown, 15, always walked to school together. Snow and rain never stopped them, and the brisk chill that December day didn't stop them either.

They were about 10 minutes late after stopping at the gas station between their homes for a cappuccino. Cody spilled coffee on his shoes. Bri told him to "quit whining" and they picked up the pace. They looked up to see the railroad crossing gates descending. They clasped hands, and darted across anyway.

The train that usually interrupted their walk was a slower-moving freight that could make kids late for school, Bri said, not an Amtrak passenger train moving nearly 80 miles per hour.

Cody, just steps ahead of her, was killed instantly.

Bri said "everything" still reminds her of her lost friend. She sleeps on a pillow wrapped with his school baseball jersey, No. 18, and keeps a picture of him hanging above her bed at home.

The impact of the train shattered Bri's pelvis and broke her collar bone, two ribs, and her nose. Her left leg was crushed from the knee down, and her right elbow was shattered when she landed on it.

Dr. Gregory Georgiadis, director of orthopedic trauma at Toledo Hospital, led the team that put Bri back together during nearly 16 hours of surgery that started about 9 a.m. the day she was injured.

The colostomy was the necessary first step for the exploratory surgery to assess her injuries. She had no major damage to her organs, despite a large open wound caused by the impact.

Still, doctors worried that she would have a higher risk of infection if she defecated naturally during her recovery and pelvic surgery, he said.

Next, the team tackled her pelvic injuries - counted among the orthopedic community as "very rare" and among the most critical of injuries, Dr. Georgiadis said.

Dr. Georgiadis displayed a model of what Bri's shattered pelvis looked like after the crash - with so many fractures that her pelvic cage fell out of shape. A few inches of her upper left pelvis, a bone called the iliac crest, remains missing. It took dozens of stainless steel screws to reform her pelvis, and doctors recommended that the metal stay put even after her bones healed.

"She's very lucky, and again, she could be, you know, hit in a variety of ways," Dr. Georgiadis said. "Just a couple inches more, maybe she would have torn her bowel off or ripped her urethra. This was pretty close. Or she could have torn all the nerves to her leg, giving her chronic, disabling pain. So, you know she's really lucky that it wasn't worse."

The third surgery repaired her shattered right elbow, with various pins and plates that may be removed surgically if Bri feels uncomfortable with them later, Dr. Georgiadis said.

The final surgery that first day was to try to repair her badly damaged left leg. Days later, it would be amputated.

"It was very obvious early on that was not going to make it," Dr. Georgiadis said, adding that surgeons attempted to save it anyway.

Her leg could not be fixed because a major artery was destroyed in the accident. A failed procedure attempted to harvest a vein from Bri's other leg to repair or rebuild the artery.

Surgeons also sent for a vein graft from the University of Toledo Medical Center, the former Medical College of Ohio, but that attempt didn't work either, Dr. Georgiadis said.

The amputation was done because Bri was struck in such a way that all the ligaments, veins, nerves, and bones were torn or crushed at her knee.

Her leg was removed at that level, which still allows her to bear weight at her thigh and thus become mobile with a prosthesis.

Ms. Mullinger praises the care her daughter received at Toledo Children's Hospital and gushes that Dr. Georgiadis is "next to Jesus" for his work with Bri.

Although the cost of prosthetic legs start at about $15,000, an appropriate one for Bri probably will cost between $50,000 and $75,000 because she'll need a computerized knee to resume her active lifestyle - which included playing softball and drumming in the high school marching band before the crash.

A good Samaritan donated a gently used prosthesis with a computerized knee, but the device seems to be at least an inch too long for Bri. It is unclear whether it can be modified for her use.

Several community fund-raisers have been held for Bri this year at restaurants and a golf course. A fund of donations to defray medical bills and the cost of the prosthesis was established at Huntington Bank, the Bri Mullinger and Cody Brown fund.

No matter how painful the procedure or how difficult the news, Bri and her family have forced themselves to laugh a lot this year. Bri refuses to call her amputation a stump - it's a "nugget." The large, lingering scab on her injured hand was her "beef jerky" until it healed.

When Bri was first released from the hospital in January, she came home with a portable version of a device known as a "wound vac," a medical innovation now widely used in wound care rather than frequent dressing changes, which can be painful, Dr. Georgiadis said. The device extracted fluid and encouraged cell growth to help heal a massive wound on her back that couldn't be covered with a skin graft.

During the several weeks the device was home, it was dubbed "the juicer" by the Mullingers - "Because, it's, like, juicing you," Bri explained - and the fluid it produced looked like a beverage.

Ms. Mullinger jokes about how she's going to use the hundreds of sterile colostomy bags she still has around the house - filling them with treats and handing them off to youngsters on Halloween.

Bri's return to school in March lasted just about two months because she developed a nasty bacterial infection known as MRSA in her left hip.

Her open wound was swabbed to test for the infection during a routine visit with her pediatrician for a cough on a Friday in May. By the following Monday, she was ordered into the emergency room by her doctor, who "told us to drive fast and wear our seat belts," Bri recalled.

She was in and out of the hospital with the infection for five weeks - returning twice after having allergic reactions at home to the powerful antibiotics she was taking intravenously.

She spent a few days at the hospital in July with a kidney infection, and several days in August there with a painful bout against E. coli.

After the reversal of her colostomy, something that usually happens behind the privacy of a bathroom door became the hot topic in Bri's room because she couldn't be discharged from her hospital stay until she had a bowel movement. Bri used two words to announce to her friends on Facebook.com that she would be coming from the hospital Thursday: "I pooped!"

"This is huge," Ms. Mullinger said in her daughter's hospital room. "She's healed now. She's as healed as she's going to be. This is a big milestone."

Bri didn't expect to spend her summer cooped up at the hospital. She planned to be behind the wheel learning to drive but instead studied for the written portion of the driver's test.

She won't return to school this year until weeks into the school year.

Bri's room felt like a raucous sleepover during her bout with MRSA, with giggling high school pals crowded onto her couch and hospital bed.

Her latest stay was quieter, although not quite lonesome with a new friend at her side.

Stevie Beale, 21, who was paralyzed in a 2006 Bedford Township crash that killed her best friend, became a nearly constant companion to Bri when the Springfield Township teen was first hospitalized in December. Ms. Beale often spent the night during Bri's recent hospital stays when Ms. Mullinger was away caring for Bri's great-grandmother, who died of lung cancer at Hospice of Northwest Ohio last week .

Bri's friendship with Ms. Beale has grown as relationships with high school peers have faded, Ms. Mullinger said.

"A lot of people, it feels like for her, that they've just moved on. But it's not going to be like that for us, or for the Browns. We can't move on. Ever. Not one day," she said. "Bri will never have both legs. She's never going to forget about Cody. He was a huge part of our family every day, so we're always going to feel the loss of him."

At an age when some teenage girls are having knock-down, drag-out fights with their mothers, Bri and hers have become "almost best friends," Bri insisted.

"My Mom is definitely my hero," she said.

Bri doesn't take for granted the support she's had from her family during what has become the most difficult year of her life - a year in which she's had a lot of growing up to do - but could do without some of the attention she's had in the process. News coverage of Bri's accident has turned her into a recognizable figure who is often approached by strangers in public. Bri sometimes tries to avoid the attention by hiding under the hoods of her sweatshirts, although she said, "the whole one-leg thing kind of gives it away."

Ms. Mullinger tries to convince her daughter to accept the local fame.

"People are noticing her [because] she's a miracle. And I want them to always remember that she's a miracle," Ms. Mullinger said. "She's not going to get it until she's older and can get past the loss of her best friend. She won't get how lucky she is, you know?"

Contact Bridget Tharp at:

btharp@theblade.com

or 419-724-6086.