Knoxville native doctor reattaches teen's severed arm
By KYLIE HUBBARD
Jul. 29, 2018
When 13-year-old Tyler Hughes was flown to Wake Forest Baptist Medical Center on Jan. 18 with his left arm nearly severed, the odds didn't seem in his favor.
Dr. Matthew Goldman, a vascular surgeon and assistant professor at Wake Forest Baptist in North Carolina, and his fellow surgical teammates rushed Tyler into the operating room with the hopes of saving his arm.
"To be honest with you, my first impression when I saw his arm was that it would not be salvageable," Goldman said. "But we have experts in a lot of different fields that looked at it. We ran through a checklist of things like if this is there, then maybe we can do this and if this is there, then we can try it."
After rushing Tyler into the operating room, Goldman, a Knoxville native, and his team temporarily put a shunt into Tyler's arm to give blood flow to the arm while the orthopedic surgeons fixed his bone. After the bone was fixed, Goldman took a vein from Tyler's leg to reconstruct the artery and two veins in his arm.
Goldman graduated from Webb School of Knoxville in 2000 and went to medical school at East Tennessee State University before heading to Wake Forest Baptist for his surgical training. His father, Dr. Mitchell Goldman, practices at UT Medical Center, and his mom and sister also work as nurses in the area.
The 9.5-hour surgery was the result of a split-second accident. Tyler Hughes and his best friends, Tyler and Jacob Iles, were riding a side-by-side utility terrain vehicle in the snow when it turned over. A safety feature, the roll bar, landed on his arm, severing it above the elbow.
But Goldman said the surgery didn't save Tyler's life — his mom did.
Mom Crystal Hughes and 11-year-old brother Marshall were down the street from the scene of the accident when it occurred, taking pictures of the heavy snowfall in their Clemmons, North Carolina, neighborhood.
Suddenly, Crystal heard her name through the winter breeze. When she found her injured son, Crystal tied her scarf to his arm and kept him calm. Blood had pooled in Tyler's snowsuit, but Crystal couldn't see that.
Her reason for tying the scarf? "I saw it on TV."
"I have no medical training. I credit that to divine intervention and mother's intuition," Crystal said. "I never once thought he could've been bleeding to death, though. It (didn't occur) to me until many hours later when Dr. Goldman was speaking to my husband and I after the initial 9.5 hours of surgery when he found out I tied the scarf."
"He (Goldman) told us that I saved his life," Crystal added. "It hit me like a ton of bricks."
Tyler's recovery has been "a complete roller-coaster ride," Crystal said. He's had seven surgeries, with the latest taking place on July 19. Tyler also needed two hospital stays as well as therapy appointments during his recovery and has had infections in his wound. The seventh surgery's results will determine if the infection is cleared up and if so, his eighth surgery will be scheduled by the end of the month to remove the external stabilizer and replate the bone.
"Whether or not he'll have full function, that's years down the road," Goldman said. "I think our goal in doing what we did was to at least give him the shot of having that."
Tyler can move his left arm at the elbow and shoulder but is unable to lift his hand and fingers without assistance. He has a good grip and can lift small bags and door handles. The current goal is regaining control of his wrist and the tendons in his upper arm and hand.
After being home-schooled for the third quarter because of the accident, Tyler finished the fourth quarter at school. Right-hand dominant, Tyler has done well with the injury and even signed yearbooks with his injured left hand as a joke at the end of the school year.
"Aside from the initial traumatic accident and Tyler's pain, it has been a flood of miracles tripping over themselves to happen," Crystal said. "We have been able to watch this unfold right before our eyes. We are awe-struck by the power of God's love."
For Goldman, Wake Forest Baptist's preparedness makes Tyler's recovery much more special.
"I think that it's a testament to our university (Wake Forest) and our hospital (Wake Forest Baptist) and the training that every person in this hospital does every day to be ready to take care of the sickest of the sick," Goldman said.
"In Tyler's case, our teams were where they needed to be when they needed to be there to give him an outcome that hopefully will long-term be a good one for him," Goldman added.
Looking back on the magnitude of Crystal's actions at the scene, Goldman urged the community to understand the importance of stopping a bleed — whether you see blood or not.
"I would encourage people in the community, wherever they are, to participate in the Stop the Bleed Campaign where people learn how to put on tourniquets and stop bleeding," Goldman said. "His mom (Crystal), who has no medical training, was able to probably save his life."