ST. LOUIS — Richard Wessbecher doesn't remember being hit by a car while jogging in 2002 on the campus of St. Louis Community College at Florissant Valley. He was knocked out.
From the looks of the skid marks and the spot on the side of the road where her son landed on his head and neck, Joyce Wessbecher estimates he was thrown about 35 feet.
"They didn't write up a police report or file one, and nobody was arrested or called on the carpet for it," his stepfather, Paul Schattgen, added.
Richard Wessbecher, a 45-year-old airline mechanic and marathon runner, was pronounced dead that day at St. Luke's Hospital emergency room, then resuscitated. He spent a week in a coma and another two weeks in the hospital.
His parents remember how he struggled. How he'd stutter to verbalize simple thoughts. How his short-term memory was shot and he couldn't calculate numbers.
Focusing his eyes on things around him was a constant struggle, they said. So was standing without falling. His balance was practically nil, and his brain was sending scrambled signals to the left side of his body so he walked with a funny gait. He often relied on a wheelchair or walker to get around.
Fast forward to January 2005.
Missouri legislators were trying to balance the state budget in Jefferson City. So they cut Medicaid funding for a program at the Center for Head Injury Services in Maryland Heights called Comprehensive Day Rehabilitation. The program is still available for children, the blind, pregnant women and those whose private insurance will pay for it.
The holistic program combines specialized therapies including physical, occupational, speech, neuropsychological and counseling.
Wessbecher, now 52, was one of the last Medicaid clients to benefit from it. And administrators at the Center for Head Injury Services point to him as a shining example of what it can do for brain-injured clients.
Today, Wessbecher walks with a normal gait and carries on intelligent conversations with almost no stuttering.
He works part-time behind the deli counter at the Schnucks in Dorsett Village. He lives on his own in a tidy, three-bedroom ranch house in Chesterfield and drives a shiny red Grand Am that he paid for himself.
He loves helping others more than himself, said his mother. His neighbors ask to borrow a shovel, and Wessbecher does one better: He does the shoveling with a broken shovel no less.
He also bakes bundt cakes from scratch for friends and co-workers. Name a flavor, and Wessbecher will bake it.
"He's always been such a good boy," Joyce Wessbecher said. "It's so good to see him showing himself again."
Said Richard Wessbecher: "I still have trouble with numbers and remembering where I put stuff. But I keep things well organized."
The Centers for Disease Control and Prevention estimates that 14,000 Missourians suffer traumatic brain injuries each year, and many of them are between the ages of 18 and 30 and are uninsured or underinsured. Two-thirds of those who survive live a normal span of life. They often require such services as round-the-clock care, vocational rehabilitation and physical therapy that can easily exceed $4 million during their lifetime.
State Sen. Bill Stouffer, R-Napton, whose wife had a traumatic brain injury, has tried every year since 2005 to get Medicaid funding for the Comprehensive Day Program restored.
"I'm not pointing fingers at anybody," Stouffer said. "They had to balance a budget (in 2005). And when they went to restore it, it got lost on the cutting room floor. It survived up to the end, and I'm not sure it wasn't a copy room error."
Wessbecher's private insurance paid for a few weeks of therapy at a hospital. The state picked up the tab for about 10 months of the Comprehensive Day Program at the Center for Head Injuries, and the center provided a couple more months for free.
Wessbecher has appeared before the state legislature several times, appealing for the funds and standing as an example of what the program can do.
Each year the state legislature votes down restoring the money on the premise that they're not expanding funding for such services. No one seems to outright oppose it, Stouffer said. But no one's advocating for it, either.
"I've been able to shepherd it through the Senate, but it tends to get lost on other end of building," he said.
This frustrates Donna Gunning, executive director of the Center for Head Injury Services.
She feels it's wrong morally and economically for legislators to invest in medical technology to keep people with traumatic brain injuries alive but not to improve their quality of life afterward.
"There are a lot of people in nursing homes who don't need to be there but are because of those cuts," she said.
Stouffer points out that a high percentage of people who suffer traumatic brain injuries are between the ages of 21 and 30 and don't have insurance. He knows a young woman who incurred traumatic brain injuries in an auto accident the week before she went to college.
At first, she was in a fetal state and couldn't do anything, he said. But within six months, rehabilitation had her back on her feet, communicating with friends.
"She wasn't 100 percent, but her life was immeasurably better than it would have been without rehabilitation," Stouffer said. "Otherwise you put them in a nursing home; they have a normal life span, so you're taking care of those folks from age 21 to 78 on the state's dollar. It's good public policy to bring those people back to highest level of functioning."
When he arrived at the center, Wessbecher told the staff he had three goals: to walk on his own, to work and to drive a car.
Physical therapist Sarah Richter helped him break them down into small steps.
First, she had to figure out what the injury had changed in Wessbecher's brain. Then she taught him ways to rearrange his environment to fit his new needs and to adapt himself to environments he couldn't alter.
For instance, Wessbecher's brain no longer processed information it was receiving from his ear's vestibular systems, making it hard for him to maintain posture and balance, she said. He'd sway his hips in an exaggerated fashion to stay balanced and stare at the floor to avoid vertigo.
"And getting him to put weight on his left leg so his gait would normalize was a project all by itself," Richter said. "He was just trying to stay upright in this world."
Walking while talking was especially difficult, but there's no need to do both at the same time. So Richter taught him to stop walking, face the other person squarely and then talk.
Bathing, dressing and just about every activity took longer initially. So Richter helped him learn to account for this when planning to go somewhere.
He'd also forget stuff, like where he put his shoes or that he'd made a doctor's appointment for next Tuesday. So she helped him to use a day planner, keep notes and always put things in specific places.
Wessbecher couldn't return to his job at Thunder Air. So the center helped him find other skills and interests and develop them.
The goal of the program, Richter said, is to get clients out of their homes and functioning in their communities.
Wessbecher, one of the center's most tenacious clients, worked at the therapy six hours a day, five days a week for a year. Then, with the center's help, he found the job at Schnucks. Today, he's a motivational speaker at the center.
Dr. Grant Hoekzema, his family physician, thinks he's made his biggest improvements since starting the job two years ago.
"Getting out and being in a social setting and using the things he'd been taught really helped boost his self-confidence," Hoekzema said. "And that's really to Richard's credit. He didn't want to hang around his house and collect a disability check for the rest of his life."
Peggy Barco, administrative director of medical services at the Center for Head Injury Services, said she gets calls all the time from people trying to get services for uninsured or underinsured family members. The center provides about $500,000 in services free of charge each year to many of them. But it has to turn a lot away.
It's heartbreaking, Barco said. In those cases, someone — a parent or spouse — often has to quit his or her job to care for the loved one.
"Then," she said, "they fall into a cycle where the family can't support themselves, and they are on state funds."