When Jake Bontekoe took his son to the hospital after the boy and his brother collided on their motorcycles in a cornfield, it was precautionary.
Or so he thought. Bontekoe had no idea 12-year-old Max was bleeding internally, or that the only hope to save his life would be a radical procedure where surgeons removed his liver, repaired the damage and reattached the organ.
The surgery had never been done successfully before – not in a trauma situation.
Bontekoe also didn't know his son’s heart would stop both during and after surgery, or that they'd both spend the next six months in the hospital as Max, in a medically induced coma for the first eight weeks, encountered one dangerous complication after another.
Today, the zipper-like scar running from neck to navel is the only indication his life nearly ended a few days before he was to begin seventh grade.
In June, Max graduated on time with the Hartland High School Class of 2017.
‘He’s hurt really bad’
In late August 2011, Jake and Betsy Bontekoe were preparing to host a “summer’s last hurrah” cookout with friends at their Deerfield Township home.
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Max and his brother Harrison, then 14, asked if they could go riding with Jack near the cornfield, about a quarter-mile from the house, before the rest of the guests arrived.
An avid motorcyclist himself, Jake Bontekoe had allowed his sons to buy the bikes with money they’d earned raising 4-H pigs and working on the family’s 1,000 acre dairy farm, with one caveat: the motorcycles had to remain untouched until the end of the school year.
“I was encouraging my boys to have straight As in school, so I…put the bikes in the office in my house. They couldn’t touch them until...they brought home report cards for that year with all As.”
It was an intense school year, but ultimately the boys succeeded.
They had been riding the motorcycles all summer, and, like always, strapped on helmets before heading out.
Bontekoe turned on the grill and was slapping hamburger into patties when he realized he could no longer hear the motorcycles.
A few moments later, Jack called from the cornfield. The brothers had crashed into one another. Max was hurt.
Bontekoe jumped in his truck and drove to the site, where he found Max’s Honda CRV 150 bent and tangled with his brother’s bike.
“Harrison is dazed, he’s just walking around in a circle,” Bontekoe said. “Max is standing there holding his stomach. Jack keeps saying ‘Max is hurt. He’s hurt really bad.’”
Max doesn’t remember much after the crash, but he does remember how it happened: he and Jack went to find his brother, who’d split from the group during the ride.
“He just kind of disappeared,” Max said. “When we were going around the corner of the field, we couldn’t see over the corn, and here comes Harry coming the other way. We hit head on.”
He remembers terrible pain in his shoulder and abdomen, a tire mark across his chest, and climbing into his dad’s truck to go to the hospital.
And he remembers briefly waking up in the helicopter.
‘Something’s not right’
On the way to St. Joseph Mercy Livingston Hospital in Howell, Bontekoe was concerned, but not overly worried. After he and the boys’ mother divorced, and before he and Betsy married, he'd spent the larger part of the last dozen years as a single father. Bumps and bruises for the boys were part of the process.
But at the hospital, Bontekoe recalls hearing someone say his son’s blood pressure was dangerously low; that he needed blood product. Another staff member shouted for a CT scan.
“I’m thinking ‘What is all this about?” Bontekoe said. “’A boy fell off his motorcycle, got the wind knocked out of him and everything’s going to be fine. I've fallen off motorcycles as many times as I’ve gotten on. Something's not right here.’”
The CT scan revealed internal bleeding, perhaps from his spleen, and doctors told Bontekoe his son needed to be airlifted immediately to Ann Arbor.
At home, with a yard full of guests waiting on news, Betsy's phone rang, and she thought Jake was calling to say Max was fine and they were on the way home.
Instead, she grabbed her keys and rushed to the University of Michigan C.S Mott Children's Hospital in Ann Arbor.
Minutes after climbing out of the helicopter alongside Max, Bontekoe found himself running down the hallway – running, he emphasizes – alongside a doctor who explained they’d be opening Max's abdomen to repair his spleen, a fairly common injury, and to look for other potential damage.
It was a long time before the surgeon came out of the operating room.
“He sat down and took off his mask and he was like ‘This is bad. This is bad.’”
In an Adirondack chair under a shade tree in his yard last week, Bontekoe pauses for a moment in his story. He looks across the distance of his property and blinks hard.
“It was horrible," he said of the hospital experience. "I could hear another parent in another room, screaming and wailing because her child didn’t make it.”
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‘It was very extreme’
Dr. Ronald Hirschl, a pediatric surgeon at C.S. Mott Children’s Hospital, was at Max’s bedside moments after he arrived in the helicopter, and quickly decided Max needed to go surgery immediately.
There, he discovered what he later described as a surgeon’s nightmare: two of three veins connecting Max’s liver to his body were torn off, and the third was partially torn.
Max was bleeding to death, and quickly.
Hirschl summoned a transplant surgeon and a radical idea quickly took shape: remove the liver, fix the veins and replace the organ.
“Transplant surgeons do that all the time as a liver transplant,” Hirschl said. “But not in a trauma situation like this; it has been tried in a few instances, but no one ever survived more than a few days.”
It worked. It took 12 hours of surgery, and Max had a mountain of challenges ahead, but his liver was reconnected to his body.
Hirschl credits several factors for the success of the surgery,
“We thought of it early,” he said, noting the hospital’s academic setting led to discussion of a better approach when other patients with similar injuries did not survive.
“In medicine and surgery, sometimes we…have to innovate to save someone’s life," he said. "It was very extreme, but we had no choice. We knew if we didn’t do something very innovative, he was going to die. That was clear.”
A long road back
The surgery saved Max’s life, but it was only the beginning of his grueling road to recovery.
All told, he went through more than 100 units of blood during his stay at the hospital, and over the next several months underwent some 30 additional surgeries. He required dialysis, developed a clot in his heart, infections, had problems with nutrition and more.
And he needed rehabilitation once he was finally brought out from sedation; two months of lying in bed meant he was weak and debilitated.
As a farmer, Bontekoe depended on his mother to help care for the boys while he, his brothers, father and sister tended to the duties of maintaining 180 dairy cows
But when Max was hospitalized, he rarely left the boy’s side.
“I lived at the hospital,” he said. “I came home when he came home. I tried to help as much as I could while staying out of the way and not to be irritating.”
After 100 days in the old C.S. Mott Children’s Hospital, Max was moved to the new hospital. It was around that time doctors began letting him emerge from the sedation, and Bontekoe began to feel they were on a path home.
Max couldn’t talk, so they used an iPad to communicate.
“It kind of felt like ‘All right, we’re going to get home,’” Bontekoe said. “He’s not out of the woods yet – that was a term everyone kept using – but there was a definite pathway leading us out of the hospital.”
Videos he made during Max’s recovery offer a glimpse of the long road as therapists helped a weak boy shuffle through his first steps and slowly become stronger with the support of friends and family.
Meanwhile, Betsy, a teacher at Farms Intermediate School in Hartland, drove back and forth to the hospital every day, usually with Harrison, to visit, help with Max's therapy and make sure Jake was eating and getting out of the hospital room occasional, if only for a few minutes.
Slowly, as Max got stronger, Bontekoe was persuaded to go home every other weekend.
He didn’t like it, and was always eager to get back, but realized he needed a break to refocus.
“He was always there when the doctors rounded in the morning, always asking questions and doing research,” Besty said “He didn’t allow himself to get emotional like he does now; it was all about making sure Max got better."
When Max finally did come home, he came home with a breathing machine, slept in a hospital bed and continued on a liquid diet.
Although he missed his entire seventh grade year, a teacher brought lessons and he was able to start eighth grade the following year. At Hartland High School, he played trumpet for four years in the school's marching band and continued to develop a passion for cars and engineering through the shop program.
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Gratitude and caution
Bontekoe said he’s forever grateful to the hospital.
"There's no question about the nursing staff, surgeons, doctors, and therapists, and the amount of love and care they giving their patients," he said. "They loved Max. They wanted everything for Max. Everyone there saved his life.”
The message he’d send to others?
“I’d want more people to donate blood. If that blood was not available for him, he would have passed," he said. "Be aware that you could have an internal injury…If you're in an accident, seek help. If you're on a motorcycle, wear a helmet."
"Without the helmet, Max most definitely he would have had a head injury," he added. "That could have been the determining factor whether he lived or died."
Today, Max says the accident has little lasting impact on his life. He's focused on the 1977 Trans Am he and his dad restored – he sold his bike to pay for the car – and the Jeep they also worked on together.
Last month he began a mechanical engineering program at Kettering University in Flint. He likes living away from home for the first time, he said, and plans, ultimately to work for General Motors.
He still rides his dad's motorcycle occasionally, and Besty admits she's threatened to sink it it the pond.
Bontekoe is also more hesitant to climb on the bike.
"We don't ride as much as we used to."
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