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November 3, 2009

STEPHANIE SALTER: A boy is gravely injured and his mother learns her capacity for love

By Stephanie Salter

Among the many truths Joan Ryan shares in her new book, “The Water Giver,” is this:

“You don’t need to go to a monastery in Tibet to learn about living in the moment. Just spend a month in an ICU.”

Ryan’s book (Simon and Schuster) is subtitled, “The Story of a Mother, a Son, and Their Second Chance.” A slim volume (260 pages), it details an unlikely and beautiful purification that was born of the kind of horrible accident every parent fears.

Not that Ryan realized in August 2006 how horribly her 16-year-old son was hurt when a call informed her he had wiped out on his skateboard.

“There was no blood. No obvious injury,” she writes of the scene that awaited her a few blocks from home. “… My stomach didn’t lurch. My heart didn’t stop. I didn’t feel what I had always heard you felt in the moment that your life changes.”

Sitting in the waiting area of the hospital’s ER, Ryan and her husband, Fox sportscaster Barry Tompkins, figured their only child was in for a few stitches, a bad headache and a good scolding for not wearing his helmet. That was until the first person to come out and speak to them was the hospital chaplain.

Ryan is a career journalist, who began covering sports in Florida, continued in that vein when she moved to the San Francisco Bay Area, then expanded her horizons to the world at-large as a columnist and reporter for the San Francisco Chronicle.

Her 1995 book, “Little Girls in Pretty Boxes,” was the first in-depth revelation of the pressurized, sometimes bizarre world of elite young gymnasts and figure skaters. In 2007, she received a top national reporting award from the White House Correspondents’ Association for a five-part series about Iraq War veterans trying to cope with catastrophic injuries.

Capable, accomplished, happily married and living in the upscale village of Ross, north of San Francisco, Ryan admits in “The Water Giver” that she had long harbored a secret few of her readers or even friends had ever suspected: She had doubted her worth as a mother.

Ryan and Tompkins adopted their son, who they named Ryan, as an infant in June 1990. From the time he began walking, “Ryan didn’t seem to respond to consequences.”

Struggling with what eventually would be diagnosed as ADHD — attention-deficit hyperactivity disorder — Ryan was often sweet, wistful, curious and intellectually creative. (When he was 4, he asked his mother if only God is real and people are “just his dream.”) But he was much bigger than kids his age, clumsy, and he had anger issues.

Joan Ryan’s initial reaction: “What was wrong with this kid? And how do we fix him? I went into research mode. I had come to believe through my career in journalism that diligence and smarts could solve any problem.”

Her son’s problems, which expanded and morphed as he grew older, would put her research mode, diligence and smarts in their place. Like many parents of special needs children, Ryan’s mom had to accept that the primary lesson she needed to practice was letting go in a way she says her husband “has always known: How to love people for who they are, without fear or reservation.”

For her, the lesson came with her son’s massive head injury.

Whatever challenges Joan and Barry had faced and met in Ryan’s first 16 years, the boy’s severely traumatized brain would dwarf them all. From her reporting on wounded Iraq soldiers, Joan knew that about 60,000 people in the United States die each year from traumatic brain injuries. Some 70,000 to 90,000 “emerge with significant disabilities,” accounting for an estimated 5.3 Americans who live with a disability caused by such severe brain trauma.

The statistics for children are grim, as Ryan and Tompkins learned.

In one particularly significant study, only 10 percent of children with a severe brain injury had normal neurological exams a year later. Less than 30 percent had a normal IQ, about half experience considerable behavioral problems and 75 percent required special education services.

Ryan and Tompkins knew none of this as their son fought for his life, first in Marin General Hospital, then in a special brain trauma unit at the University of California, San Francisco, medical center.

The setbacks and emergency surgeries came at them like the Four Horsemen of the Apocalypse — only there were four times four times four. Drains, shunts, temporary removal of sections of skull, pinpointed medications calibrated and recalibrated. Every step forward seemed to ensure two or three back. The mantra of both mother and father became:

“Today is just today. It is what it is.”

And it went on for months and months.

The miraculous thing about “The Water Giver” is that, as the author describes her little family’s grueling journey, the details do not repulse or numb. Years of newspaper writing have honed Joan Ryan into an expert storyteller who is spare with her adjectives but rich with facts and observations that matter. Along with its poignancy, the account of her son’s cataclysmic accident and its aftermath is a medical thriller.

It is also deeply moving in its intimate candor. As her iron-fisted, reform-minded judgmentalism drops away in the face of her boy’s prolonged fragility, Ryan drags her personal demons from their hiding places, calls them by name and shoves them out of her realm.

Perhaps the most important quality of Ryan’s book, though, is its redefinition of a happy ending. Ryan Tompkins has survived his traumatic brain injury and regained much of his life, but he will be forever affected by the literal and figurative scars he carries.

Joan Ryan’s embrace of all of that is the “happy,” believable ending. That embrace does not look like a made-for-television movie with a swell of music as the final credits roll. What it looks like is a comatose son’s answer to his mother’s early plea in an ICU room:

“‘You can’t do this,’ I whispered in my son’s ear. I was crying. ‘I can handle anything. But I can’t handle losing you, Ryan. I can’t survive that.’”



Stephanie Salter can be reached at (812) 231-4229 or stephanie.salter@tribstar.com.

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