Safe at Home
When a traumatic brain injury placed a promising young baseball player’s life in jeopardy, Dr. Seth Joseffer of Princeton Brain & Spine helped turn a tragic story into one of triumph
by Bill Donahue

On the evening of December 5, 2013, Christopher Iazzetta was playing the game he loved. It was also the night a series of events nearly brought his life to an abrupt halt.

The 16-year-old high school student was taking batting practice at an indoor facility in Flemington, N.J. Having just finished hitting, he was pitching to a friend when the worst possible scenario became reality: His friend connected, and the ball rocketed off the bat, coming straight for Chris’ head. The ball hit Chris on the right side of the skull and sent him sprawling to the ground, dazed. Chris’ friend ran to his side and tested his awareness by asking simple questions such as, “What year is it?” and “Who is the president of the United States?” Chris answered the questions correctly but thought he just likely had a concussion, so he declared to his friend, “I’m done for the night.”

Although he didn’t yet know it, Chris was in serious trouble. The impact had cracked Chris’ skull and caused a blood clot to form in his brain. Soon he would develop a medical condition called herniation, in which internal pressure moves the brain tissue away from its normal position in the skull. If not treated in time, brain herniation can cause permanent and significant neurologic problems and, quite possibly, brain death.

Chris’ condition deteriorated rapidly, as he was overcome by severe headache, profuse sweating and waves of nausea. He called his mother, Mary, to come pick him up, and by the time she arrived within a few minutes, Chris was near the point of collapse. Alarmed by her son’s altered state, Mary drove him to the nearby Hunterdon Medical Center. Once in the car, a disoriented Chris started vomiting and began to lose command of his speech and motor skills.

At the hospital, a CT-scan revealed the full extent of Chris’ injury.

“I was outside the CT-scan room, but the door was open and I could see the screen,” Mary says. “I was looking at the screen, saying to myself, ‘So that’s his brain, and the big black area on the right side must be his ear.’ Then I realized there was no black area on the left side. I remember staring at that black area and thinking: This is not good.”

Before long Chris was unconscious and on life support.

The gravity of Chris’ condition dictated that he be transported by medical chopper to a dedicated pediatric trauma center, but a heavy fog had grounded all helicopters from northern New Jersey all the way down to Philadelphia. Chris’ prognosis got grimmer with each passing minute.

With few good options and the clock ticking, the decision was made to call Seth S. Joseffer, M.D., FACS, an attending neurosurgeon at Hunterdon Medical Center with Princeton Brain & Spine, to operate on Chris. After a “harrowing” 30-minute drive through dense fog, from his home in Princeton to Hunterdon Medical Center, Dr. Joseffer arrived on the scene and quickly took control.

“[Chris] was basically as close to being beyond the point of recovery as possible,” Dr. Joseffer says. “What he had was a rapidly fatal problem, and he was going downhill very quickly.”
 
To this day Mary and her husband and Chris’ dad, Carmen, recall the speed and confidence with which Dr. Joseffer orchestrated the staff to prepare Chris for emergency surgery.

“For us it was sheer terror and chaos, but for Dr. Joseffer, he was so calm, like he had done this a thousand times before,” says Carmen. “There was absolutely no hesitation.”

Besides Dr. Joseffer’s matter-of-fact demeanor, Mary remembers another unique attribute about the surgeon: his hands.

“When I shook Dr. Joseffer’s hand, I told him, ‘You look really young, but you have a very strong handshake, so I guess we’re good,’” she says. “I remember looking down at his hands, and I knew those hands were going to save my son’s life. Thirty seconds later, off he went, and I had an unbelievably peaceful feeling that everything would be OK.”

She had good reason to feel this way. Dr. Joseffer is a board-certified neurosurgeon with advanced training and experience in cranial and spinal surgery. He earned his medical degree from New York University Medical School, where he graduated with honors. He completed his residency at NYU Medical School’s department of neurosurgery in 2005. Today, as a neurosurgeon with Princeton Brain & Spine, he handles the full range of brain and spine procedures, including the surgical removal of complex brain tumors.

In addition to his practice with Princeton Brain & Spine, Dr. Joseffer is the chief of neurosurgery at the prestigious University Medical Center of Princeton at Plainsboro, N.J. Also, in May 2014, Dr. Joseffer was recommended to receive “Gold DOC” recognition, an initiative of the Arnold P. Gold Foundation intended to honor physicians who show “exemplary skill, sensitivity, caring and compassion.”

Approximately two hours after leaving Mary and Carmen’s sides to remove the clot in their son’s brain, Dr. Joseffer emerged from the operating room with news: Chris was stable and recovering—in other words, he would survive. Almost immediately afterward, Chris was transferred to a regional hospital that was well equipped to provide the pediatric intensive care that would aid in his recovery.

“It was very dramatic, and in a situation like that you’re just trying to get things done correctly but in the swiftest possible manner—kind of the opposite of what we do in the office [at Princeton Brain & Spine], where we try to spend a long time with each patient,” Dr. Joseffer says. “These are the kinds of cases in which you have a very tangible effect and see the impact of what you’ve done for someone.”

Chris spent the next five days in the hospital, and from then on he would fight a day-by-day battle to recover a sense of normalcy. He dealt with the aftereffects of the accident for the next several months: headaches; not being able to think straight; and “a lot of long, boring days” in which he could do, quite literally, nothing. After years of leading such an active, sports-oriented lifestyle, it was a harsh adjustment.

Thanks to Dr. Joseffer’s life-saving efforts, Chris returned to school and, eventually, to the game he loves, baseball. He still remembers his first day back on the field, how something as simple as having a catch with a teammate had become suddenly alien after being away from the game he loved for so long. More than anything, however, he feels gratitude—to the staff at Hunterdon Medical Center and, of course, to Dr. Joseffer—for having been granted an opportunity to do anything at all, let alone be back on the baseball field, after having come so close to the unthinkable.

“When people ask me about the experience, I can’t say anything negative,” says Chris, who has chosen to repeat his junior year at a new school, The Hun School of Princeton. “I made a commitment to myself, with my work ethic, with my schooling, to go 100 percent and not have any regrets, because you never know when it’s going to be your last day. I was minutes from dying and God gave me a second chance. I’m not going to let Him regret it.”

About Princeton Brain & Spine
With New Jersey offices in Flemington, Freehold and Princeton, as well as one in Langhorne, Princeton Brain & Spine provides expert care in various areas of treatment relating to the brain and spine. This includes everything from complex spine surgery to the treatment of concussions to relief for chronic back and neck pain. The practice is staffed by a team of highly skilled neurosurgeons—Seth S. Joseffer, M.D., FACS; Mark R. McLaughlin, M.D., FACS; Nirav K. Shah, M.D., FACS; and Matthew Tormenti, M.D.—each of whom has received subspecialty training in specific areas of neurosurgery.

Princeton Brain & Spine
www.princetonbrainandspine.com

Five Area Campuses:
Flemington
Hunterdon Medical Pavillion (behind CVS Pharmacy)
190 State Hwy. 31, Suite 300B
Flemington, NJ 08822
Phone: 908-229-6627

Freehold
901 W. Main Street
CentraState Medical Center, Ambulatory Campus, Suite 267
Freehold, NJ  07728
Phone: 732-333-8702

Princeton
731 Alexander Road, Suite 200
Princeton, NJ 08540
Phone: 609-921-9001

Langhorne
St. Clare Medical Building
1203 Langhorne-Newtown Road, Suite 138
Langhorne, PA 19047
Phone: 215-741-3141

Photograph by Rob Hall