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At the prime of his career, Jim Faulkner was infallible. This self-described workaholic who ascended through the ranks as a lawyer had what most would perceive as the ideal life — until July 14, 2006, when a massive stroke rendered him helpless.
“I would wake up at 2 in the morning and just cry,” says Jim’s wife, Bettina Faulkner. “I didn’t know how we were going to handle this.”
Jim suffered both an intracerebral and a ventricular hemorrhage stroke that caused a large volume of blood to leak into his brain. Typically with these types of strokes, there’s little chance of survival and no likelihood of achieving any functional or meaningful recovery.
But by coincidence — or as Bettina would attest, “the intervention of angels” — Issam Awad, MD, an internationally respected neurosurgeon who’s performed more than 100 procedures of this magnitude, was on call that morning when Jim arrived at the ER.
“When Mr. Faulkner came to my care, he had three things in his favor,” says Awad, professor of surgery and director of neurovascular surgery at the University of Chicago Medicine. “One was the fact that he was relatively young; two, he was not in a deep coma; and three, he had a very supportive family.”
Six years later, Jim has progressed far more than what was initially expected and has reason to be excited about the future.
“He doesn’t walk independently but can do so with assistance, which is an index of his improvement, and similarly his cognitive ability to interact and understand his surroundings, despite speech problems, is phenomenal,” Awad says. “There is no question that this man has a quality of life he treasures and his family very much values.”
In gratitude of Awad’s life saving efforts, the Faulkners have contributed more than $100,000 over the last four years to Awad’s research efforts in neurovascular disease and stroke.
At the time Jim suffered his stroke, Awad had been focused on refining a groundbreaking procedure called minimally invasive surgery with thrombolysis in intracerebral hemorrhage evacuation or MISTIE. This procedure involves a clot-busting drug that thins the hematoma so it can be evacuated from the brain through a catheter. The University of Chicago Medicine is one of only a few hospitals nationally participating in the recently completed MISTIE Phase II clinical trial, funded by the National Institutes of Health (NIH).
Previously, there had been no effective treatment for intracerebral hemorrhage with the exception of open brain surgery, which often does just as much harm as good. “The brain is brittle,” Awad says. “It’s already damaged and then to perform brain surgery on top of that is not usually helpful.”
In addition to MISTIE, Awad and his team were enhancing another procedure called CLEAR — where the clot-busting agent is distributed through a catheter in the ventricle of the brain to allow faster unclogging of the circulation of cerebrospinal fluid through the cerebral ventricles. Over the past 10 years, that procedure has advanced through Phase II trials and has shown significant promise.
Housed at the University of Chicago, the Hemorrhagic Stroke Trials Surgical Center monitors every catheter placement at more than 60 institutions around the world and is overseen by Awad, who is co-principal investigator of the CLEAR III trial currently underway (also funded by the NIH).
Jim was not eligible for either trial because he had severe bleeds simultaneously in the brain and in the cerebral ventricles. Although the risk was great, Awad — at the encouragement of Bettina and their three children — performed both the MISTIE and CLEAR procedures separate from the clinical trials.
“We cleared Jim’s bleeding, and he amazed us by waking up and becoming responsive within a week,” Awad says. “He is in some ways an extreme example where heroic intervention like this can work, but also a living legacy for this approach because if it works in a man with such a severe condition, it will work in the hundreds of cases that are milder with an even greater likelihood of succeeding.”
Now Dr. Awad sees Jim just once a year and occasionally for tea at the Faulkners’ home in Kenilworth, Illinois. For Jim, bustling work meetings have been replaced with weekly physical and speech therapy, occasional lunch and dinner outings, and lots of laughter with his family.
“To get through something like this, you definitely need a sense of humor,” jokes Bettina. “We still have a lot of laughter here. It’s also an enormous spiritual experience and definitely strengthens your belief in God.”
The precious moments she now embraces with her husband are a direct result of Awad’s care — a doctor whom they both say always made himself available and exuded the best bedside manner.
“Dr. Awad would come in every single day and would speak to us in normal English language, not huge medical terms, so that we could understand what was going on and we knew things were going to be okay,” Bettina says. “I think it’s wonderful when a human being can be that dedicated to what he loves to do. What he’s doing is just amazing.”