The last thing Betsy Williams remembers before she was hit by a car on the morning of Oct. 25, 2022, is walking through the Bicentennial Mall park after leaving her home in Germantown. She was on her way to a breakfast meeting of the Nashville Area Chamber of Commerce at a downtown hotel and planned to cross James Robertson Parkway at the crosswalk to climb the Capitol steps on the way — something she’d done “a thousand times” over the past 16 years.
“I lived on Second Avenue from 2006 to 2020 and moved to Germantown after the Christmas Day bombing,” said Williams, who worked with the Chamber as a member of the Partnership 2030 team and served on the Transportation Licensing Commission and Nashville Downtown Partnership Board of Directors. “No matter where I lived, my regular route was walking Bicentennial Park and climbing the Capitol steps — the first set of 144 when you come out of the park and another set of 100 around the side of the Capitol — multiple times until I was just under 1,000 stairs every day. It was a good workout.”
Williams was halfway through the crosswalk when she was struck. A park ranger, likely alerted by the sound of the car skidding 70 feet, called emergency services and sat with her until first responders took her to Vanderbilt.
“From that day forward, Vanderbilt’s trauma team and various specialists in orthopaedics, neurology, physical therapy and every specialty I could have needed devoted their skills to helping me get better,” Williams said. “The list of miracles is long.”
Picture of health
Williams had a traumatic brain injury, multiple broken bones, including a compound fracture in her leg, and a break in the second vertebra of the neck that forms a ring around the spinal cord. The situation was so dire that Williams’ wife, Kim Madlom, a medical receptionist in the pediatric medicine acute care unit at Monroe Carell Children’s Hospital at Vanderbilt, agreed to sign a do-not-resuscitate order shortly after she arrived. But she wasn’t ready to give up.
Within 24 hours, Madlom had printed 30 8×10 photos of Williams in happier times and posted them around the room.
“I wanted people to see her. The person in the bed was so terribly broken and couldn’t speak. Those photos showed a happy, energetic, joy-filled person,” Madlom said. “The trauma team would’ve worked as hard, but every single time someone would come in, I’d say, ‘This is who she is, and this is who I want back. Please give her back to me.’”
The photos made an impression on Michael Derickson, MD, assistant professor of Clinical Surgery, who was on call for trauma the day Williams was brought to Vanderbilt.
“We see people on the worst day of their life. They’re injured, may have a bloody face or broken bones. They’re in splints and casts and fixation devices, and it can be dehumanizing,” he said. “But seeing photos of our patients in their normal state reemphasizes to our team that we’re taking care of people, and the goal is to get them back to living their life.”
Though Williams remembers very little from the eight weeks she spent at Vanderbilt, Derickson’s compassion and communication made a big impression on Madlom.
“He was always there, so open and patient with me about what was happening and what to expect next,” she said. “He even took the time to speak to our family friend, who’s a renowned vascular surgeon. Not everyone would be comfortable with that.”
Derickson said it’s wonderful to see patients with family members who care for and act as advocates for them.
“It’s just as important to communicate with and take care of the family members as it is the patient in ICU,” he said. “They’re the surrogate decision-makers and need to be as informed as possible so they can do what’s best and what they think the patient would want for themselves.”
‘Vanderbilt never gave up on her’
Williams’ first few weeks were touch and go; she developed pneumonia and sepsis.
“Vanderbilt never gave up on her,” Madlom said. “The respiratory therapist kept her breathing before and after she was trached. I don’t think I recognized respiratory therapy until I sat there and stared at that machine when Betsy was on the edge of life and death, and the respiratory therapist was keeping her airway open. And the people in the speech unit who helped her swallow. You don’t think of all that until you’re in the midst of it — how many people it takes to keep one person alive and progressing.”
Madlom didn’t “relax enough to believe she’d make it” until three weeks after Williams was hit by a car. Even then, she didn’t know if she’d walk or if she’d “be herself” again until Williams had been at Vanderbilt for seven weeks.
“I downloaded a brain exercise for people with trauma injuries, and she couldn’t do it,” Williams said. “It was as simple as those ‘Sesame Street’ games of ‘which one of these doesn’t belong.’”
At one point, Williams told her, “Kim, you have to let me go.”
“What I was seeing all around Kim was stars, light, peacefulness, warmth and comfort, and it was such a pull to go that way,” Williams said. “Kim said, ‘I can’t keep you here, but please don’t go. Please try.’ When I agreed to try, all the stars and light disappeared, and I knew it meant an incredible amount of work, pain, frustration and all the things that go along with recovery — but also the celebration of passing milestones on my way.”
When Williams was finally stabilized enough for surgery, Manish Sethi, MD, professor of Orthopaedic Surgery, was able to save Williams’ leg — her muscles were strong, and her blood flow was good as a result of walking the Capitol steps for years.
Her left arm, which hung limply by her side for months after Williams was released from the hospital,was a different story.
“I’d written off Betsy’s left arm. I’d already come to the conclusion that it wasn’t going to work again, and we weren’t going to worry about it,” Madlom said. “She’d never be able to cut up vegetables — she loves to cook — and that would be OK.”
Williams and Peggy Haase, OTR/L, CHT, never gave up on it. When they started working together in February 2023, Williams couldn’t move her fingers, use her hand or lift her arm.
“Peggy was able to guide me to bring both my hand and arm back to life, which has restored so much of my independence and abilities,” Williams said.
“I can’t say enough about therapists and how critical they are to recovery. I still have weakness and probably always will, but it’s not for the lack of Peggy trying.”
Steps to recovery
Williams’ eight-week stay at VUMC wasn’t her first: In January 2018 she was diagnosed with HPV-linked head and neck cancer and had a tumor removed from the base of her tongue plus 30 lymph nodes from her neck, followed by radiation and chemotherapy.
Two years later, the Christmas Day bomb destroyed her home in the Rhea Building on Second Avenue and a short-term rental business she and Madlom had focused on properties in that area.
Two years after that, she was hit by a car.
Those experiences might dampen the spirits of some, but not Williams.
“If you want to be miserable, those are pretty good reasons, but I personally don’t want to be miserable,” Williams said. “So I’m going to therapy. And I’m going to work out with my personal trainer three days a week. And I’m going to work with my vestibular therapist every week.”
She brought that same energy to a video she was asked to participate in for Vision Zero, Metro Nashville’s initiative to cut down on traffic fatalities and pedestrian accidents. She made the video inApril 2024 and saw it at a Nashville Department of Transportation meeting earlier this fall.
“In my interview, I said I was going to climb the Capitol steps again in 2024, and I have to tell you, I had forgotten I said that,” Williams said with a laugh.
“Mayor Freddie O’Connell, who was a speaker at that meeting, came up to me and said, ‘When you walk the Capitol steps, I want to walk them with you.’ I was so touched. We set a date and invited the first responders and everyone at Vanderbilt who helped save my life.”
Walking has been a challenge for Williams, 68, who has lingering dizziness and balance issues due to cervical issues with her neck, eye damage, head trauma, brain bleeds and dislodged crystals in her ear that are responsible for balance. Thanks to her continuing work with vestibular therapist Holly Cauthen, PT, DPT, she no longer needs a rollator or walker and doesn’t use her cane if she can hold onto someone’s arm or a banister.
“Holly has been incredible. She researches, then helps me implement exercises to help with my balance,” she said. “She’s worked on my dizziness like a puzzle that she will solve.”
Surprising no one, Williams made good on her goal to walk the Capitol steps with the mayor at her side on Nov. 22, surrounded by a crowd of friends and supporters.
For Madlom, it was a full-circle moment.
“It’s a perfect completion of what she started out to do that morning two years ago,” she said. “We’re forever grateful to Vanderbilt as an institution, but it’s really all the people. That’s not just talk for us: We’ve witnessed it in two big aspects of our lives. Every person has pushed her a little further forward or encouraged her to take her own steps forward.
“After she was hit, the goal was to keep her alive and hope that she’d be herself again. When she was herself again, I thought, that’s great. That’s all I ever wanted because my person is still here. Then she was more independent, and that was great. There have been steps back but mostly steps forward. She’s exceeded my expectations repeatedly. And I think everyone else’s. Everyone’s but her own.”
