Three-year-old Xavier Njemanze knows he has owies on his tummy, chest and back, but he doesn’t seem to remember how he got them.
Unfortunately, his mother, Chika Njemanze, and his 5-year-old brother, Malik, remember all too well that early morning March 1, 2012, when Antonio Roebuck broke into their Rochester, Minn., duplex and stabbed little Xavier five times before they could flee for help.
Xavier spent his second birthday, just six days later, in a medically induced coma. Few believed the toddler could survive the vicious injuries that sliced his liver, kidney, lung and intestines. And if he survived, no one dared to guess in what capacity -- massive blood loss from the stab wounds had caused parts of his brain to die.
But Xavier is a tough little guy.
And as determinedly independent as any “terrible twos” toddler.
Ten months ago, he arrived at Madonna Rehabilitation Hospital unable to walk, feed or dress himself, and talking very little.
Today, you have to move pretty fast to keep up with him.
He’s come a long way, says his mom. But he still has a long way to go.
Thanks to Madonna’s nearly one-of-a-kind pediatric rehabilitation program, 25-year-old Chika Njemanze is confident he will get there.
* * *
6 a.m., March 1, 2012.
Chika Njemanze is sound asleep. She hears Xavier cry and waits to see if it will pass. She and the boys have just moved into the Rochester duplex, and she has been working to get them used to sleeping by themselves in the new surroundings.
Xavier cries out a second time.
The cry is different. Pain? Fear? She can’t place it. She runs to the boys’ bedroom. She sees a shadow over Xavier’s bed. She runs to Xavier and is slammed backward into the wall. She reaches for the light switch. Nothing happens.
Then the boys’ father, Thomas Manning, runs in. He tackles the shadow. There is fighting. Screaming.
He has a knife, Manning yells. Get the kids out.
Njemanze picks up Xavier, grabs Malik by the hand and runs downstairs.
Something is wrong with Xavier. He’s not holding on to her. His head hangs loose. He’s like a rag doll.
She yells to her brother downstairs to call 911. She flicks on a light and lays Xavier on the couch.
She still can see how they dangled outside his body.
The fighting men fall down the stairs. The attacker, Roebuck, turns his rage on Chika Njemanze and her brother. He follows her into the kitchen, frantically opening drawers looking for another knife.
“I only had two knives,” she recalled. “I had just moved in.”
Roebuck is momentarily distracted.
Njemanze runs and grabs her sons, racing down to the landlord’s side of the duplex. She runs in, not even bothering to knock.
The landlord’s wife offers them shelter.
The police arrive.
Paramedics race to Xavier.
There is so much blood.
“I thought he was gone. His breathing was extremely weak. He wasn’t even gasping for air,” she recalls. “If the ambulance had come any later, it would have been too late.”
Xavier is taken straight to Mayo Clinic. Doctors count five stab wounds: a large laceration to his abdomen, two to his chest, one in his back and the other near his armpit.
They rush Xavier into surgery.
“Before he was even out of the operating room, they had to go back in,” Njemanze said.
Before the day ends, Xavier will return to surgery for a third time, to stop bleeding from his left lung.
* * *
Xavier is placed in a coma so his body can heal.
Njemanze holds vigil at his bedside, rarely leaving the hospital.
He spends nearly two weeks in intensive care, another month in the pediatric unit. He will have two more surgeries before he transfers to a Minnesota rehabilitation hospital.
Alive and healing, Xavier faces a long road to recovery.
Brain damage from blood loss has affected his vision -- while he responds to light, he doesn’t indicate he can see much more. Signals to the left side of his body are weak, leaving him with limited movement and function. He cannot sit up by himself, feed himself, chew or even swallow. He no longer talks.
“He was really like an infant again,” Njemanze said.
* * *
Xavier is ready to come home.
But Njemanze has no home.
She has not been back to the duplex since the attack.
“I couldn’t go back to that house after what happened,” she said. “Malik saw a lot of violence and blood. It wouldn’t be healthy for Malik.”
Malik has been staying with his father in Lincoln. Manning’s family encourages Njemanze to move to Lincoln. Although Njemanze and Manning are no longer a couple, they are united in their devotion to raise the boys together.
Njemanze tells Xavier’s doctor about the offer, and the doctor is ecstatic. Lincoln is home to Madonna Rehabilitation Hospital and the renowned Alexis Verzal Children’s Rehabilitation Hospital. It is one of only seven rehab hospitals in the country accredited in brain injury and pediatrics. The doctor ensures the transfer of all of Xavier’s records to Lincoln, so he can resume his rehabilitation upon arrival.
Njemanze and the boys arrive in Lincoln in late May. Red Lobster, where she was working, offers her a transfer to the Lincoln restaurant. She enrolls at Southeast Community College.
By early June, Xavier is attending Madonna’s Rehab Day program -- an all-day program featuring intensive physical, occupational and speech therapy five days a week.
April Lieb, an occupational therapist, worked with Xavier at the beginning. He was weak. He had trouble using a walker, she recalled.
And while most of us consider toddlers, by nature, to be very dependent and helpless with their care, Lieb knows otherwise.
By age 2 we expect kids to feed and help dress themselves, to play, move around independently, pick up and carry things, and get into all sorts of exploratory mischief.
For Xavier, all that was gone -- lost in the physical recovery and amid the dead spots in his brain that no longer sent messages to his muscles and nerves.
He has thrived at Madonna, Njemanze said.
He now has therapy two days a week, down from five.
The kid-friendly approach makes therapy more of a game, Lieb said. He learns to dress himself by playing fireman and farmer. He builds muscle strength in his legs, arms and midsection by doing the wheelbarrow walk, riding a scooter, swimming, lifting balls, blocks and toys.
“A lot of our goals focused around improving fine motor skills -- getting control with his hand, picking up things,” Lieb said. “He was able to grasp things, but not able to use his finger tips to pick up small things. Now he is able to. We’ve been working on strengthening that.”
Make no mistake, rehab is hard work. For the able-bodied, pushing buttons on toys, throwing balls, grabbing a cookie and putting it into your mouth, and walking on different surfaces takes no effort and little thought. For a brain-injured person, it can be a monumental, perspiration-inducing, painful, exhausting task -- even for a toddler.
Mandi Weiner became Xavier’s physical therapist when he graduated to outpatient therapy.
“When I started seeing him, he was using a walker a lot. He was falling a lot. He was not safe to walk by himself at all,” Weiner said.
Not long ago, Weiner introduced Xavier to a WalkAide, an electronic device he wears around his calf. The WalkAide sends an electrical impulse to his leg muscle, causing it to reflexively lift the toes and ball of his left foot when he walks.
It scared him at first. It felt weird. Xavier wanted it off. Slowly he adjusted. Just recently he has become able to wear the WalkAide for the entire 45-minute therapy session.
The changes over the past 10 months are nothing short of remarkable, Weiner said.
Xavier no longer uses a walker. He not only walks with confidence, but trots at a good clip. Even with the WalkAide, his left leg has a telltale limp. His foot and hip are not functioning completely normal -- yet, Weiner said.
But many other issues are gone. Xavier talks -- quite well -- and quite a lot. His eyes reveal the toddler teeter-totter of emotions -- happy, sad, mad and sassy.
Njemanze chuckles as Xavier spouts out the ever-favorite word of toddlers: No!
“He’s got a lot of personality,” Weiner said with a laugh. He likes to show off, which makes the therapists’ job easier.
How long Xavier will continue therapy is unknown.
The long-term goal is to have him at an age-appropriate level physically, socially and developmentally, Njemanze said.
“He’s very smart,” she said. One can almost see the wheels turning behind those twinkling brown eyes. But the losses still are apparent. He can see a picture, know what it is, but can’t say the word right away, Njemanze said.
Doctors have prepared her that Xavier never may regain fully everything he has lost.
“Some adaptations are to be expected,” Lieb said of Xavier’s long-term prognosis. Just how many remains unknown.
Njemanze cannot hide her frustration.
The attacker, Roebuck, took a plea bargain in July -- pleading guilty to attempted first-degree murder in exchange for the dismissal of all other charges. He was sentenced to 27 years in prison and will be eligible for parole in 18.
During the sentencing, the lawyers talked about the “accommodations” Roebuck needed in prison.
It baffles Njemanze. He stabbed Xavier five times, and Manning three times.
“He never said why he went after Xavier. He never apologized. He said he wanted to receive the death penalty,” Njemanze said.
She takes a deep breath. Her children will always have scars -- physical reminders on Xavier’s torso, emotional wounds to Malik who fears the "bad man." His counselor at McPhee Elementary School helps him. His mother reassures him he is safe.
But one day the “bad man” will be out of prison. By then Xavier will know how he got those "owies."
Njemanze can only hope the smiling, giggling and tenacious youngster upon her lap, who is vigorously munching his post-therapy reward of vanilla sandwich cookies, will remain just as strong and determined as he has been in his fight back to health.