On Oct. 5, 2021, Adam Daniels, a special agent of the Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF), was shot in the head during the attempted apprehension of a federal drug suspect in Nashville.
His fellow agents rushed him from the scene to the Emergency Department (ED) at Vanderbilt University Medical Center. He entered the doors less than nine minutes after he was critically wounded, a factor that played a significant role in reducing damage to his brain.
In those same moments, his then-girlfriend, now his wife, Krystyna Barnard Daniels, was notified of his traumatic injury. Krystyna’s name is likely familiar to many at VUMC as she’s the assistant director of communications for the Department of Medicine.
ATF agents notified Adam’s family in Virginia and escorted them to his side when they arrived to the ED. Federal, state and local law enforcement agency vehicles lined the streets at the Medical Center as officers kept vigil for Adam.
A single, high-velocity bullet had struck him just left of the center of his forehead, traveling through his skull and into his brain. It impacted Adam’s frontal lobe, subcortical regions and occipital lobe.
Dario Englot, MD, PhD, the attending neurosurgeon on call, directed his neurosurgical care.
“We were concerned because it was a severe gunshot wound injury that impacted the dominant hemisphere of his brain and, importantly, impacted the subcortical motor system that controls movement on the right side of his body,” he said.
An emergency external ventricular drain was placed to reduce and continually monitor the pressure in Adam’s brain. A cerebral angiogram was also performed to determine if there were any injuries to his brain’s major blood vessels. Miraculously, there were not.
“It’s important with this type of brain injury to quickly get the drain in to determine if the brain pressure is elevated, as prolonged periods of increased pressure in the brain from swelling can lead to further brain damage,” Englot said. “From the pressure, we decide whether we need medications or even a larger brain surgery to lower the pressure. Also, the drain allows us to release spinal fluid and help lower brain pressure, so it is both a diagnostic and therapeutic procedure.”
“This is not a good injury”
Adam was admitted to the Trauma Intensive Care Unit where around-the-clock monitoring continued. Adam’s injury occurred during the COVID-19 pandemic when visitors were limited, which made the experience even more challenging for everyone.
“In those early days, the conversations we were having with his doctors were that this is not a good injury,” Krystyna remembered. “We were told Adam may never walk or use his right arm and hand again. There were a lot of unknowns. As he passed each milestone, there would be a sigh of relief. He’s continued to defy all the odds.”
“I was intubated for 26 hours, and then I was breathing on my own. For that first week, my vital signs were being watched like a hawk.”
Adam Daniels
Adam spent three weeks at VUMC before he was transported by ambulance to Shepherd Center in Atlanta for rehabilitation of his traumatic brain injury (TBI).
“I don’t have any memory of Tuesday, October 5th,” Adam said. “The last memory I have is of going to bed on Saturday night, and then at some point, I’m at Shepherd Center. I pieced together that I had been shot and that it was my head. The bullet is still in there because they felt there was too much risk to go in there and get it.”
Adam was at Shepherd Center for 16 weeks where he completed an intensive program of physical, occupational and speech therapy. When he left the center, his speech had greatly improved, and he was walking slowly with a cane.
Adam then went to Virginia Commonwealth University for an additional nine months of outpatient therapy. Adam is now back in Nashville and has returned to VUMC for weekly outpatient occupational and physical therapy (he graduated from speech therapy) at the Pi Beta Phi Rehabilitation Institute at Vanderbilt Bill Wilkerson Center. He’s still working to improve some movement limitations on his right side.
“Whatever I have to do, I’m up for it”
“I’ve had some great teams everywhere I’ve been,” Adam said. “I’m glad I’m where I’m at now, but I’m not done! I want to be back to what I was doing before, so whatever I have to do, I’m up for it.”
“He is doing his therapy and always wants more homework,” Krystyna added. “I think that speaks to his resiliency.”
Adam has returned to the ATF to resume the law enforcement career he is incredibly passionate about and was determined to continue. And one more significant milestone: On Nov. 4, 2023, he and Krystyna were married in a Nashville ceremony. Adam was completely without his cane on the day of the wedding.
The Daniels are incredibly grateful for the lifesaving care Adam received at VUMC. They recently met with Englot and with Reid Thompson, MD, William F. Meacham Professor of Neurological Surgery and chair of the Department of Neurological Surgery, to say thank you and to ask more questions about his injury and the treatment he received.
“Because it’s been so difficult for me to wrap my mind around the severity of my injury, one of my questions was how often do people survive these types of injuries,” Adam said. “They weren’t able to give us an exact data point, but they did tell us that if the bullet had been a millimeter to the left or right it likely would have been fatal.”
“We wanted to give something back”
The Daniels have made a financial gift to the Department of Neurological Surgery as a token of their appreciation to Englot and the others who saved Adam’s life and for the work this group does every day to save the lives of persons with TBI.
“The work that Vanderbilt does is so important, and we wanted to give something back to them for all they’ve done for me,” Adam said.
“It is a great joy to bear witness to Adam’s miraculous recovery,” said Thompson. “Indeed, it is a direct reflection of Adam’s tenacity, inner strength and deep resolve. It is also a function of love: the love of his wife, Krystyna, his family and Adam’s amazing team members at the ATF who kept vigil at his side. It is also the loving kindness and exceptional skill of the Vanderbilt trauma team including all the amazing surgeons, trauma ICU nurses and therapists who cared for Adam during the critical moments after his injury.
“We are honored by the gift made by Adam and Krystyna in generous support of our traumatic brain injury research efforts. I could not be more proud of our Vanderbilt trauma team’s care for Adam. It is why we do what we do. And it is our passion.”