A friendly game of checkers may seem like play, but for Emmanuel Pavon, the boardgame doubles to engage his mind in a fun, meaningful way.
“In therapy, we always want the skills we practice to carry over into real‑life situations, and tapping into his interests, like familiar games, created a comfortable, motivating environment,” Claire Dowling, MS, CCC-SLP, CBIS, Emmanuel’s speech therapist, said. “These activities help target several areas at once, including attention, problem‑solving, memory, turn‑taking and speech intelligibility, all within a context that resembled being at home or spending time with friends.”
Emmanuel’s best friend is wife, Kasey, who smiles as she watches his competitive side emerge. She says his personality, much like his voice, continues to gain strength after Emmanuel experienced severe brain trauma caused by a serious car crash.
Sunday morning drive results in brain trauma
The couple was enroute to church in mid-November when their car collided with a deer. While both sustained injuries due to the crash, Emmanuel’s were far more severe, resulting in several facial and skull fractures and severe brain trauma.
“He hit his head and got a severe TBI injury. Besides hitting his head … he broke [bones in] the majority of his face,” recalls Kasey.
Emmanuel was taken to Nebraska Medicine and spent three weeks in a coma. Bobby Lopez says during that time, the family heard sobering news regarding his son-in-law’s chance of survival and what his future may hold.
“They told us 33% of patients in my son’s state are not going to make it,” recalls Bobby, Emmanuel’s father-in-law. “And if he does make it, he’ll be in a nursing home the rest of his life.”
Grateful for the doctors’ honesty, Bobby and his daughter chose to focus on their faith and belief in what’s possible.
Building on hope in Madonna Rehabilitation Specialty Hospital
Emmanuel arrived at Madonna’s Specialty Hospital in mid-December for the next stage of his recovery journey. He was unable to walk, talk or follow simple directions. Early on, physical therapy focused on getting him up and moving safely using equipment like the Lite Gait.
“This equipment was instrumental because it allowed us to put him in positions to practice standing, walking, balance and while keeping him safe and free of falls” Ryan Knight, PT, DPT, Emmanuel’s physical therapist, said.
In addition to walking, regaining control of his voice was also a priority as Emmanuel struggled to verbalize his wants or needs despite understanding much of what was happening around him. To assist, speech therapists first helped him to understand how the body produces voice and how much breath support matters.
“We used simple tools, like straws, tissues, whistles and kazoos, to build his respiratory strength and control. We then added tactile feedback so he could feel the vibration needed for voicing,” Dowling said.
What began as a whisper for Emmanuel quickly dialed up into clear words and eventually a strong, confident voice. Meanwhile, Bobby says, as a family, they remained dedicated to prayer and reading the Scripture. Coupled with daily therapy sessions that increased in intensity, Emmanuel transitioned to the Rehabilitation Hospital level of care, where he continued to make steady, hopeful progress and his personality began to emerge.
Military mindset supports progress through Madonna’s continuum of care
Originally from California, the couple lived in Bellevue, Nebraska. An Airman First Class, stationed at Offutt Airforce Base, Emmanuel’s job was to repair and maintain B-22 airplanes, with dreams to one day fly one. His military background played a key role in his recovery. He approached therapy sessions with discipline and a strong work ethic, showing up even on difficult days.
That disciplined approach, combined with strong family support and physician-led care team expertise, helped him make huge gains as he progressed through Madonna’s continuum of care. “Their constant presence was wonderful as they would carry on our therapy efforts between his structured therapy times plus provided him with lots of reassurance and support,” Knight said.
Preparing for a return to home and community
Toward the end of his seven weeks, Emmanuel continued to improve upon his ability to walk and talk. During this time, the team also provided Kasey caregiver training to equip her with the skills to help Emmanuel be successful with daily tasks like teeth brushing, showering and going to the bathroom. Therapy became more intentional on preparing him for life back home and interacting with others through board games and community outings to places like the bowling alley and fast-food restaurants.
“They challenged him to use his communication, problem‑solving, and safety awareness in environments that felt more like everyday life. Being out in the community also boosted his confidence and showed him and his family how far he’d come,” Dowling said.
The couple is now back in California where Emmanuel’s working on the next phase of his recovery. Kasey says she’s so grateful for Madonna’s work in restoring her husband.
The couple is now back in California where Emmanuel’s working on the next phase of his recovery. Kasey says she’s so grateful for Madonna’s work in restoring her husband.
“This is an amazing place. I see how much progress my husband has made with the help of the Lord and the help of these gifted people and what they do” she said.
Bobby says he has much love and respect for Madonna.
“There is hope because as of today, my son is walking, talking, picking up my daughter with two hands. We just went out to Don & Millie’s, we were bowling just the other day. Ultimately, we know it comes from God, but it also comes from good people at Madonna.”
“Thank you for helping me. I appreciate it so much,” Emmanuel said.