RESILIENCE IN RECOVERY by Ellen Donker
A local doctor gets a second chance.
As a general practitioner, Hugh Snyder is accustomed to giving and caring. He’s the type of doctor who thrives on getting to know his patients and seeing them in the same community he calls home. But recently, the roles were reversed and he learned the beauty of receiving care and concern from others.
It all started on March 27, 2018, on what should have been an average morning. Snyder said good-bye to his wife and children who always left together for school. Although his speech was slurred, they thought he was just being funny.
It wasn’t until he rolled over to silence his alarm that he noticed something was wrong. He couldn’t turn it off, nor could he roll out of bed. In short order Snyder realized that his right side was paralyzed and that he had suffered a stroke in his sleep. He was 47 years old.
Ironically, this is what his mother imagined would happen to her. Her mother had died from a stroke at the age of 48 and Snyder’s mother made it known to the family that she expected the same would happen to her. Instead her son was the one to have the stroke.
Managing to pull himself out of bed and clumsily pulling on sweat pants, Snyder called 911 and, with a doctor’s precision, explained his condition, requesting an ambulance to take him to Overlook Hospital. He also called his partner at their practice in South Orange, Samantha Pozner, and said simply, “I had a stroke. I’m not going to come in to work today.” As if it were a one-day problem. Clearly, the enormity of his situation hadn’t sunk in.
Snyder is used to being in control. A self-professed Type-A personality, he admits in retrospect that “I thought I was managing my stress, because I had these distractions,” such as competitive sailboat racing, skiing, coaching lacrosse – a competitive sport – and playing snare drum in a competition bagpipe marching band. On top of that, he was medical director of Seton Hall University Student Health Center as well as the South Orange health department, and he taught physician assistants at Seton Hall. The result, he says, is that “there wasn’t any time where I was just ‘being.’”
Somehow Snyder got himself downstairs to wait for EMS to arrive, not realizing that his family had just walked out the door. In fact, it was when they were backing out of the driveway that his wife, Caroline Toman Snyder, saw the ambulance pull up to their house. That’s when Snyder calmly told her and their kids – 11-year-old Logan and 13-year-old Brodie – that he had had a stroke and they didn’t need to come to the hospital just then since he’d be undergoing a series of tests. Still in control, he didn’t stop to think what it would be like for his children to go to school after seeing their father half paralyzed.
In the ambulance, Snyder wracked his brain for details on the last eight hours, wondering if he was a candidate for TPa, a clot-busting drug that can stop a stroke or reduce its severity. He quickly concluded that he was, in all likelihood, already past the time when the drug could be safely administered. (As testing would later reveal, his was a lacunar stroke and he would not have benefitted from TPa anyway.)
After spending one day in the hospital, Snyder was transferred to a rehabilitation facility where he remained for a month, working on his speech, regaining use of his right arm and hand and learning to walk again. Since his stroke was a “motor only” presentation that paralyzed his right and dominant side, he had no vision, perceptual, or cognitive problems. Still, his appearance was shocking. Snyder’s friend Ted Westhelle recalls seeing him in rehab when he was at his lowest. “I was hoping he’d be able to walk again and I wondered if he’d ever be able to drive or get back to work.”
Snyder adds, “My first concern was knowing that my brain was okay. Making sure I sounded like I was still competent.” He worked very hard to speak clearly, over-enunciating so his speech wouldn’t be slurred. He also scheduled a cognitive psychological evaluation. He felt that “whether or not I pass this is whether or not I can be a doctor.” His score was favorable – in fact, literally off the charts.
Once he was home, Snyder continued with physical therapy once a week, determined to rehab himself the rest of the time. Snyder is an old-school type of guy favoring bowties and little round eyeglasses. He found that he had to devise adaptive schemes to do simple things he had taken for granted. Without the dexterity to tie a bowtie he had to buy some that were pre-tied. And those light switches that he had converted to old-fashioned push buttons made the simple act of turning on the lights difficult.
Three months after his stroke, the family travelled to Italy on a previously planned trip. Clockwise from top left: Hugh in Rome; the family in Tuscany; Hugh with Brodie and Logan on the back of a water taxi in Venice; At a wedding in Tuscany where Caroline was a bridesmaid.
He starts to cry when he describes the many acts of kindness people bestowed on him: the meal train organized by his wife’s school, the phone calls, prayers, and cards. He wasn’t used to being on the receiving end and he said it has changed him and made him understand what it means to be vulnerable.
About this time, he and Caroline had to make a decision. Before the stroke, they had planned a family trip to Italy in late June to attend a destination wedding. In his present condition, Snyder wasn’t sure he’d have the stamina or mobility to get around. In the end, they took the trip, bringing a collapsible wheelchair in case he got tired. But ancient Rome didn’t prove to be handicap-accessible, so Snyder walked everywhere. The trip turned out to be the best rehab he could’ve gotten.
Focused on easing his way back to work, Snyder returned to his job at the Seton Hall Health Center. Next, he started seeing patients one day a week. To prepare, he had to master some basics in order to do his job. Pozner marvels at his ingenuity for workarounds. Pulling a rubber glove off of his left hand, for instance, required an adaptive technique – he slips a reflex hammer into it to take it off. Being able to wash his hands in a hygienically-acceptable manner took practice. And he had to learn to write, type, and do most everything left-handed. Snyder says, “I do think I brought a very Type-A drive to my recovery. And in that case, I think I benefited from it.”
Another milestone that Snyder passed at the end of February, exactly 11 months after the stroke, was to be able to ski again. An expert skier, he was used to taking annual trips with a group of local friends. After the stroke he hesitated joining them at Big Sky, Montana – afraid he’d slow them down – but they insisted.
Snyder reasoned that, “Italy is where I learned to walk. And you know, maybe these are opportunities that I need to take and force the issue. Because if I don’t try anything I’m not going to discover what I can do.” Of course, he couldn’t ski on the double black diamond slopes like he used to do, but practiced instead on the beginner trail. A video that Westhelle took of him skiing documents one of his proudest moments.
As a family, the Snyders had to adjust to a new normal that is ever-evolving. Caroline says, “I am and have been in awe of Hugh’s resilience and perseverance this past year. His unshakable optimism has kept the whole family afloat, and he has made all of us see how important it is to maintain a sense of pragmatism as well as a sense of humor when faced with a setback. We are all so proud of him.”
On the year anniversary of his stroke, Snyder was surprised at St. James’s Gate with a gathering of his family and close friends. It was an acknowledgment of his comeback and a reminder of the many people who care about him.
During that same time, he also started working full time at his new office in Summit, thrilled to finally be back. There in the waiting room hangs a painting of a schooner (remember, Snyder is a sailor). His partner, Samantha Pozner, says it’s a metaphor for how they support each other, because when a boat capsizes, the first rule is to stay with the boat.
Remarkably, Snyder says, “I haven’t shed a tear for myself. The tears are about how pleasant it’s been having people care for me. What I say now is, the worst part about the stroke is being paralyzed. But the best part is the people. I’ve gotten so [many] positive wishes, goodbyes, people’s prayers, offers to help [from] the entire community and everyone I know.”
In the end Snyder says the experience has been “almost net neutral or maybe net positive. That’s pretty crazy…but there’s been a lot of good parts to it.”
Ellen Donker feels fortunate to be able to tell Hugh Snyder’s inspiring story and spread the word that he’s back.