PEPPERELL -- Less than two years ago, after suffering a traumatic accident, John Gubernat of Pepperell was rushed to the hospital via ambulance as Pepperell EMTs did everything in their power to keep him clinging to life. His wife Kathy feared it would be the last trip her husband would ever take. These days, John is still regularly riding the Pepperell ambulances. But now, it's as a member of the Pepperell emergency medical response team, and he's administering the same life-saving care that he received that bitter winter morning.
It was Feb. 3, 2011. John has no recollection of the day's events, but Kathy will carry the memories forever.
A blizzard had come through the night before, blanketing the Gubernats' house and yard in a thick layer of snow several feet deep, with the exception of the stone patio that John had shoveled out the night before.
That day was declared a snow day, so John and Kathy's then-17-year-old daughter Kelsey was still in bed when she heard her dad on the roof towards the back of the house at 8 a.m., shovel in hand. Meanwhile, Kathy was clearing out the front porch.
All of a sudden, Kelsey, still in her pajamas, burst through the door, the color drained from her face. It took a minute for the meaning of her words to resonate:
"It didn't register to me at first," said Kathy. "John is Superman. Nothing ever happens to him.
Dialing 911, Kathy ran to the back of the house, where John had fallen onto the only piece of the backyard not cushioned by snow: The patio he had shoveled the evening before.
"You could see he was just broken," said Kathy. "If Kelsey did not find him, he would not have survived."
Kelsey, who was a first responder, scooped the slush away from John's face while Kathy tried to keep him still.
"Kelsey and I literally at one point were holding him down because he kept trying to get up," said Kathy. "You knew that he wasn't going to be here for too long."
Fearing that her husband would slip away before her eyes, Kathy sent Kelsey to the end of the driveway to flag down the ambulance when it arrived.
"I didn't want her to be here when he died," she said.
Minutes later, Fire Chief Toby Tyler was the first to arrive on the scene.
"I remember thinking, 'Okay, Toby's here, everything is going to be okay,' but I could see the look on his face that he knew this was bad. But I knew that if anybody could help him, he could."
Tyler said although it was not the worst scene he's ever responded to, it was "right up there."
Then, said Kathy, the cavalry came.
"It was probably only six or seven minutes, but it truly felt like he was going to die before they got here," she said.
John was transported to the nearest trauma center: Southern New Hampshire Medical Center in Nashua, N.H. The doctors were not optimistic, informing Kathy that John would not make it and handing her the forms to have him removed from life support.
"The doctors said, 'You need to get kids in here, they need to say goodbye,'" she said. "I'm just thinking, 'This isn't what I planned for today.'"
Horrified by the idea of being asked to sign her husband's death warrant, Kathy had John transferred to the Massachusetts General Hospital SICU.
"By 6 that night, he was finally in his home away from home," she said. "They weren't sure if he was going to make it, but they told us they would do the very best they could."
The medical staff put a shunt in John's brain and provided him with two nurses around the clock. He was hooked up to 39 machines and 28 tubes. He had fractured his temporal bone, severed his ear canal, broken his jaw and pulverized his collar bone in the fall. He also had six fractured vertebrae, 11 fractured ribs, a punctured lung and water around his heart. John had sustained four different types of traumatic brain injury, including shearing the protective sheath over his brain, seven brain bleeds, significant bruising and swelling of his left and right temporal lobes.
"That's where your personality, cognitive functions, motor skills, executive functions -- all the higher functions you use your brain for -- just about everything are," said Kathy. "What saved his life, no doubt, is when he fractured his temporal bone. It gave his brain room to swell. If not for that, he would not have made it to the hospital."
While John was in a medically-induced coma, the doctors warned Kathy that he might not recognize his family, be able to communicate or live independently. Little did they know what was to come. The medical team would take John out of his coma every eight hours or so to see how his brain was functioning. Some days, he was able to respond with a shake of the head; other days, which Kathy called the most devastating, he was unreachable.
"But you get through it. You just do it. You've got your kids watching you, so you just do it," said Kathy.
After about two weeks, John was transfered out of the SICU into the trauma center, and from there to Spaulding Rehabilitation Center. He had a surgery to remove his gastrointestinal tube. That was a defining moment in his recovery, said Kathy.
"It was like a light just switched on," she said.
John began talking again; the only thing he could say at first was Kelsey's name.
Then, two weeks later, came his first sentence since the accident: "What I do affects all of you."
Soon, he began walking on his own. Three weeks later, he was having conversations. But it was still a struggle. His memory was on a three-minute loop, the entirety of which consisted of his asking to be taken home. He would be soon enough; between the accident and being allowed to go home, the elapsed time span was five weeks and one day, though he still works closely with Dr. Seth Herman, a psychiatrist at Spaulding.
"His doctors are still blown away," said Kathy. "Dr. Herman told John that John is truly his hero. He gives John a majority of the credit because of his drive and his willingness to keep going."
Strangers who meet John on the street today are unlikely to perceive the trauma he has suffered. Still, that doesn't mean his recovery was easy. John had to relearn everything, down to the ability to swallow and breathe properly.
"What I tell people is that it's very difficult from the inside looking out because you don't necessarily perceive either your deficits or the inability to do different things. Whether at a physical level or interpersonal level or cognitive level, you think you're fine, but you've got no clue," said John. "Luckily for me, most of the the gross physical stuff came back over time, and then it was a matter of rebuilding stamina, balance, all of those types of coordination."
Soon, John had far surpassed anyone's expectations of his recovery. Because of his rapid and profound progress, doctors were at a loss of what treatment to continue to prescribe.
"They don't have protocol for patients like this because they don't have patients like this," said Kathy.
Doctors suggested John enroll in a college course in order to exercise his brain. John, who had been a neuro-psychology PhD candidate and had always had an interest in the science of medicine, decided to enroll in an EMT course offered through Townsend. The doctors were initially apprehensive about John trying something so demanding, but John has never shied away from a challenge.
"My basic philosophy in life now is what's the worst that can happen? I fail and I find out I can't do it, or the best case, which is where I like to hedge my bets, is I succeed and I can do it and I can actually give back to some of what's been given to me," he said. "If it wasn't for the people in Pepperell Fire and EMS on that scene, things could be really different."
The course was not without its challenges. Where John could breeze through an entire book in virtually no time at all before his accident, he found himself studying and restudying every word on every page and transcribing pages of notes several times, a difference he is still adjusting to.
"My wife likes to joke with me that now I'm a mere mortal," he said.
Still, despite the hurdles, John passed his class with flying colors, completing his workload in May and graduating at the top of his class. From there, he began third-riding with the Pepperell EMTs and continued for three months, passing his state practical exam in June and the state written exam in July. Once all of his paperwork was completed in September, he began riding as a certified EMT. The job requires a minimum of 40 hours a month, a number which John exceeds regularly.
"Even when he's not on call, he's on call," said Kathy.
When it comes to the workload, said Tyler, John is a natural. To this day, he said he is awe-inspired by John's incredible journey from the day he saw him on the stone patio.
"To see him even after (the accident) getting around and talking and stuff like that I would call a miracle in itself. Then for him to even go further and become an EMT and be really good at it is beyond all expectations," he said.
But the ever-ambitious John doesn't plan to stop here: His aspirations are to take his EMT education to the next level and one day become a certified paramedic.
"It's just so rewarding to him to be able to help people," said Kathy. "He feels like he owes this huge debt and he's just trying to pay it back."
Kathy said she continues to be blown away by her husband on a daily basis.
"Every single little thing he does is awe-inspiring to me because he shouldn't be able to do it," she said.
As for his daily life, John said the biggest change since the accident has been a readjustment of priorities.
"If you asked me why I'm still here, I'd say there was a whole lot of good medicine involved and an equal amount of divine intervention. You're not as in control as you think you are, and maybe there are some things that you could give back to your society and fellow man," he said. "My prognosis was not to sit here talking to you about this. Being a member of the 'last-rites club' and now being able to sit here and talk to you about it is pretty overwhelming sometimes. Sometimes it takes a knock in the head to give you an appreciation of some of this balance."
"Whenever a family goes through something that changes them, they can look it as either a gift or a challenge," she said. "The kids and I and John are now so incredibly grateful for the day. We don't take anything for granted. You honestly do not know when you're going to fall off a roof."