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Boy, Interrupted

Joe Kay was a math whiz, a two-sport star and an award-winning sax player. One moment after the buzzer, all that changed.

Photo: Michael Chow

TRIBUTE: Players from a rival high school signed a get-well volleyball.

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By Christine Foster

It was the indelible moment of the 2003-04 men’s basketball season. The February 7 Stanford-Arizona game was tied with 24 seconds remaining. The crowd waited breathlessly to see if the No. 2 Cardinal could remain undefeated, not to mention beat the Wildcats at Maples Pavilion for the first time in five years. After Stanford stole the ball near midcourt with two seconds to play, junior forward Nick Robinson took one dribble and launched a 35-footer—swish. Jubilant students poured onto the court and piled on him.

“I was flat on my back; [senior Matt] Lottich was on top of me,” Robinson said after the game. “And a couple of other people were on top of me in places that were rather uncomfortable.” But he emerged unscathed, and played 30 minutes against Cal the following week.

The day before, in an old barn of a gym at an Arizona high school, a postgame dog pile had far different results. Nearly 2,000 spectators had packed into the Tucson High School gym, most hoping to see the home team beat Salpointe, the city’s traditional basketball powerhouse. Senior Joe Kay, a two-sport standout with a volleyball scholarship to Stanford, led Tucson’s charge.

Each time he made a basket, the crowd roared his name: “JOE KAY.” With less than 10 seconds remaining, Tucson was leading by six when Joe capped off the game with an explosive dunk. The crowd stormed the court. Leading the pack were some rowdy young men whose chests were painted with Tucson High’s colors. One apparently tried to hoist Joe into the air. Instead, the 6-foot-6 player was knocked to the ground and trampled.

Tucson High’s basketball coach, Gary Lewis, was headed into the locker room when his brother, Frank, intercepted him. “Gary, we need to get Joe in the locker room,” Frank Lewis said. “He got dazed.” Joe’s father, Fred, also was nearby. He remembers thinking that Joe’s eyes looked wild and that some of his movements seemed strange.

The men helped Joe walk, but by the time they reached the locker room door, he had nearly collapsed. They dragged him into the room and laid him down on a red wooden bench. Most of his teammates continued to celebrate, unaware of what was happening.

“Joe, Joe, what happened?” Gary Lewis asked. No response.

“You all right, Joe?” No response.

Gradually, players began to realize Joe was hurt badly. Some boys began to cry. Some yelled at him, begging him to respond. Still, nothing.

An ambulance arrived and the crew whisked Joe to the University of Arizona’s medical center, just blocks away. The verdict: during the postgame melee, Joe’s carotid artery had torn, causing a devastating stroke. He was hemiparalyzed—unable to move his right arm and leg—and unable to speak. It was the day before his 18th birthday.

Hollywood couldn't have created a golden boy better than Joe Kay. A straight-A student with a perfect 800 on the math portion of the SAT. A gifted saxophonist and poet. A vegetarian since age 4, when he faced down the hamburger on his plate and asked his mother, “They didn’t kill it for me, did they?”

Joe was, his friend Marshane Flanigan once said, the kind of guy who managed to pair swim trunks with a mismatched plaid shirt, name the presidents in order in 10 seconds flat, and not seem like a nerd. The kind of guy, his mother says, who when faced with a schedule conflict between traveling to Reno with the school jazz band and taking the SAT II, did both—winning the festival’s award for musicality and picking up another 800 in math.

He was a nonconformist, eating meatless meals as his friends chowed burgers and, for a time, wearing his hair in raggedy dreadlocks. He chose to attend gritty Tucson High, his neighborhood school, rather than the magnet school that attracted most of the city’s gifted kids. He wasn’t afraid to push back when he disagreed with authority figures. “Teachers don’t always like Joe,” says his mother, Suzanne Rabe. “He always had his own mind.”

And of course, he was a gifted athlete, blessed with height, speed and the ability to jump high. As a junior, Joe led the state in volleyball kills and was named Tucson High’s athlete of the year. “He was just coming into his own,” says Don Shaw, Stanford men’s volleyball coach.

But while this may sound like the first act of a celluloid drama, Joe’s story holds no promise of a perfect ending.

“This isn’t a fairy tale. People want it to be, but it isn’t,” Suzanne says. “People say, ‘I’m sure he’ll be 100 percent.’ I want to say, ‘So look at the MRI and see. See what it looks like,’” thinking of the obvious signs of damage in her son’s brain.

Joe Kay’s story is a real one about the power—and the limits—of love, medicine and hard work. It is about how even those who are very blessed can have their lives changed in an instant. And it is about a young man who will make it, if anyone in his situation can.

When joe suffered his stroke, the blood flow to part of his brain was cut off. Brain tissue, robbed of crucial oxygen, began to die. The neural pathways that allowed him to move his arm and leg were gone—or at least disabled. Gone, too, were the roads that led to speech and to the academic skills that had always been his gift. There was one piece of good news: his receptive language, or ability to understand what others said, was intact.

After a stroke, brain tissue can regenerate at the margins, but there is nearly always some permanent damage. Similarly, as the inflammation caused by the stroke subsides, some injured neurons recover on their own. But most patients need to create new pathways to perform old tasks—and fast, before the brain tissue containing the relevant instructions atrophies from lack of use. Each day that Joe isn’t able to connect with the part of the brain that controls movement in his right hand, for example, it becomes harder to regain that ability.

During the first week after his stroke, Joe began to sit up in his intensive-care bed. He ate voraciously—mostly tortillas and soup. His vision seemed fine. He was conscious and aware, but he couldn’t respond. “There was no voice,” says his father, Fred.

Finally, about a week after the injury, Joe spoke his first complete sentence. His big brother Alec, who had flown in from Alaska, said, “It’s really great to see you.” Joe replied, “It’s nice to see you, too.” His words were slurred, his face and tongue contorted, but he had said something. “It was such a great relief,” Fred remembers.

Although Joe’s injury was serious, he had a couple of things going for him. First, he is an unusually young stroke victim. Young brains rebuild faster and more completely than older ones. Second, he had his own in-family team of specialists who worked right away to find him the best treatment options. Alec and his wife, Laurie Macchello, are both physical therapists, and Laurie specializes in neurological injuries. Between them, the two flew to Arizona eight times in the first seven months after Joe’s stroke.

A week after the accident, at Alec and Laurie’s suggestion, Joe was taken by ambulance to Barrow Neurological Institute at St. Joseph’s Hospital in Phoenix. He spent more than a month there, first learning to use a wheelchair, then learning to stand again, then—gradually—learning to walk. He walked awkwardly, with an obvious limp, but it was huge progress. On March 29, Joe was discharged from the hospital. Ahead of him lay eight months of full-time outpatient rehabilitation.

Joe arrives for a rehabilitation session in late May wearing black shorts and a neat white polo shirt with “Stanford Volleyball” embroidered in Cardinal red. With his limp right arm immobilized in a black nylon sling, he juggles his belongings, struggling to put his backpack into a locker. He walks slowly, limping, to join one other patient and a speech therapist at a table in Barrow’s makeshift kitchen.

In this session, Joe is practicing cognitive-retrieval skills, trying to build up speed at simple tasks. Right-handed for 18 years, he must now write his name on his worksheet with his left hand. He looks uncomfortable, as if he is wearing a giant mitten. Each letter is a struggle: J-O-E. He stretches out his lanky frame, trying to get comfortable in the cramped chair.

The exercise, a simple word search, is timed and Joe works quickly. When he is finished, the therapist checks his work. She asks if he usually crosses off each word once he has found it. “Yeah.” he says. “Yeah, and you forgot?” she says, her voice gentle. “Yeah,” he says.

Next, Joe works on symbol recognition, something that would have been tediously basic before the stroke. He is given a sheet of paper with 10 numbered pictures—a star, an elaborate circle, etc. His goal is to label at least 85 of the 100 symbols on a second sheet with the correct numbers. He again works quickly, but not fast enough. When the timer goes off, he has finished identifying just 74, and one is wrong. He drops his pencil on the desk and shakes his head in dismay.

Joe’s frustration is evident, but he doesn’t express it verbally. The culprit: aphasia, a language impairment that makes it hard to understand or produce speech; it affects about one-third of people with severe head injuries. Initially, Joe’s aphasia was so pronounced that he generally responded to every question affirmatively. Now, much of the language is there, but it takes more time to retrieve. As Joe’s father puts it, “It’s difficult to throw it back out.”

The aphasia has caused a change in personality, too. Joe used to be at ease in large groups, adding sharp and humorous insight, his family and friends say. Now, he is more shy and withdrawn. “He still has the same witty thoughts, but he can’t interject them into the conversation at the same speed,” Alec says. “That’s really frustrating for him.”

In a one-on-one conversation in May, Joe’s speech was slow and deliberate, but completely coherent. A bit of that answering-everything-in-the-affirmative remained, but he spoke clearly about finishing his first book since the stroke (Bill Bradley and Phil Jackson’s Values of the Game), his increased interest in the science of the brain and visiting the Phoenix Suns locker room with former Stanford star Casey Jacobsen, ’03.

Joe remembers being knocked down on the court that day in February. He remembers opening his eyes and seeing the crowd around him in the locker room, but being unable to respond. Later, he became unnerved by the experience of the remaining paralysis. “I can’t even feel my arm or move it.” Joe said in May. “It’s weird, one side is fine, but on the other I can’t feel a thing.”

The hardest part of being injured, Joe said in the spring, is not being able to do simple, normal, teenage stuff. “I miss being with my friends and playing basketball and volleyball and going outside and sweating out all my frustrations.”

Instead, at the end of each day of therapy, Joe returned to his family’s rented apartment, just five minutes away, and napped. He seemed like a giant puppy, somewhat unsure of how his body worked and worn out by a day of hard work. Fatigue is common in stroke patients. What Joe calls his “fog” probably also was a factor. “I felt like I wasn’t in the right place in time,” he says. “I noticed it about two months after my stroke. Up till then, I was on so much medication I hadn’t really had the chance to think about it—what will be the aftereffects of my stroke.”

Keeping players, fans and personnel safe during postgame celebrations is something many schools struggle with. Carl Reed, Stanford’s assistant athletic director for facilities operations and events, reviews tapes of postgame activities and attends seminars to learn to better handle big crowds. He plans to establish a committee in the spring, including members of men’s basketball’s boisterous Sixth Man Club, to help educate students about the dangers of storming the court after games. “It’s a constant struggle,” he says. “You could put up barricades and have police in riot gear, but the flip side is do we want to look like it’s a police state?” And, Reed adds, even the presence of armed police won’t stop some fans from jumping onto the court.

Nick Robinson, who lay flat on his back after his buzzer-beater, says he became a bit scared as the pile of people atop of him got heavier and heavier. When he later heard about Joe Kay’s injury, Robinson’s first thought was, “That’s the last time I am at the bottom of a dog pile.” Still, he doesn’t think there is a simple way to prevent a serious injury like Joe’s. “How could you predict that? There’s nothing you can do to predict that.”

Maybe not, but families of such accident victims don’t always see it that way, often filing lawsuits immediately. Joe’s parents—both attorneys (Fred spent his career in the federal public defender’s office; Suzanne teaches at the University of Arizona)—have not. “We are not bitter or angry,” Suzanne explains. “The one who leads us in this is Joe. We wish the people who tackled him would come forward. We feel like they owe it to Joe. He would be gracious and he would be their friend.” The Kays do hope that more might be done to prevent future on-court accidents, and met with officials from the school district last spring to discuss how postgame celebrations might be tempered. And they have asked the district to help pay Joe’s mounting medical bills, because neither his family’s nor the district’s insurance fully covers his outpatient therapy.

Primarily, the family focuses on getting Joe better. “We haven’t had the time or energy to do anything but support him and support one another,” Suzanne says. They have kept out of the media spotlight, turning down interview requests from dozens of reporters, including Today host Katie Couric. They agreed to speak with STANFORD, they say, because of the attention and affection the University community showed Joe before and after his accident.

Soon after his injury, Stanford administrators assured the family they would honor his partial scholarship even though he likely will never play Cardinal volleyball. His offer of admission will remain open until he can enroll (this fall, if all goes well). Don Shaw and an assistant coach call regularly to check in. University President John Hennessy sent a letter wishing Joe his best. Casey Jacobsen and his wife, Brittney (Blunt, ’01), visited him in the hospital in Phoenix. A group of incoming freshmen, the kids who would have been Joe’s classmates if he had entered last fall, set up a website to send their support. “Out of the woodwork, these Stanford people keep coming,” Fred says. “It’s like, ‘You are in Stanford. You are part of the family.’”

There has been similar goodwill from the Kays’ community in Tucson. When both parents were accompanying Joe to Phoenix, they returned home each weekend to a clean house and a refrigerator full of meals. Dozens of teenagers, even opponents from other high schools who knew Joe from summer-league teams, made regular visits. “If love could heal, Joe would be running marathons right now,” Suzanne says.

Over the summer, Joe did go running for the first time—two miles. He wasn’t as fast as he used to be, he told Don Shaw. “That’s okay,” Shaw assured him. “It’s just great that you are doing that.” He also began to regain some movement in the fingers of his right hand.

By fall, he could lift a water bottle to his mouth, but couldn’t release his grip on it without the aid of a spring-loaded device. At press time, he was entering a three-week constraint-induced therapy program at the University of Alabama, where he would have his left arm bound so he would be forced to use his right. Eating a meal was expected to take hours.

It was difficult to watch his friends go off to college, and to be somewhat recovered but still dependent on his parents. “He started to chafe against everyone telling him what to do,” Suzanne says. Before the accident, “the apron strings were completely untied. He was ready to fly. Now, we’re running his whole life for him.”

Many things that would once have been simple for Joe remain out of reach. He is desperate to drive again, Suzanne says: to regain that measure of independence, to stop asking his parents for rides to parties. But he failed a driving test when he rolled through a stop sign, unable to get his right foot to cooperate. He could get licensed to drive a car with a left pedal, but he doesn’t want to give up or settle. In the fall, he enrolled in a basic calculus course at Phoenix College. The high-level math that was once second nature now requires significant effort, and some aspects—like word problems—leave him flummoxed. “It’s just really slow. He has to plug in the numbers. It’s like, ‘Welcome to the real world, Joe,’” Suzanne says, laughing gently.

Suzanne is wryly witty, but also honest and direct. Seeing her gifted son hurt has been wrenching. The day after Joe’s stroke, Suzanne dropped out of everything, resigning as an elder in her Presbyterian church and as a leader of a group that opposes the death penalty. She has spent hundreds of hours online researching treatments and read every book for laypeople on the subject of strokes. For weeks, she could force down only crackers, cheese and sips of 7-Up. The well-meaning but worn-out phrases people offered in sympathy didn’t help. “God never gives you more than you can handle,” some friends assured her. “I don’t think God had a hand in this,” she says. “Platitudes—I have not appreciated platitudes.”

The final act of joe's script, of course, is still being written. When Alec first saw Joe in the intensive care unit, his hope was simple: that his little brother would live independently someday. That hope is already being realized: in January, Joe will move into the honors dormitory at the University of Arizona. He will take more calculus, plus a class on communication and its disorders. It focuses on aphasia and apraxia, another speech impairment.

“I do not see any real cognitive issues,” says Kay Swan, who oversees Joe’s physical rehabilitation. She points to his recently developed interest in politics, sparked in part by concern for his own health-insurance prospects once he turns 19. Joe engages fellow patients in discussions of abortion and Iraq, and even snagged an invitation from Arizona Gov. Janet Napolitano to attend the final presidential debate in Tempe in October. “The fact that he is discussing these issues is a miracle,” Swan says.

As Alec sees how Joe is always working, checking his gait in store windows so he can refine it, his hopes have grown. He believes Joe might someday walk with a barely noticeable limp, regain more use of his right hand and become nearly anything he wants to be.

“I expect him to be a successful professional. It will be a lot more work and it may take longer, but I just don’t think he is going to let anyone get in the way of that,” Alec says. “He’s come really far, but I’m still not satisfied because he’s not satisfied.”

Joe himself dreams bigger than anyone. He won’t even accept that the Cardinal volleyball team may be beyond his reach. “Never say never. There may be a small chance—one in 100, one in 1 million; there is a small chance.” Is there anything he is sure won’t be possible? “Pretty much nothing,” Joe said during a phone conversation in the fall, sounding strong and confident. “I don’t know if I will be able to jump as high as I could or have the dexterity I once had or compute math problems in my head, but I think I will be able to do almost anything.” One sign: he can again name all the presidents in order. He’s just a bit slower, at 13 seconds.

CHRISTINE FOSTER is a Stanford contributing writer living in Mountain View.

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