It comes in waves: The fall – and rise – of Josie Dooley

One minute, you are screaming, in the worst pain of your life in a Hawaiian emergency department.

The next thing you remember, you are in a hospital bed, asking to call a friend.

That doesn't sound abnormal until you realise those two memories are 13 days apart, and you have no idea you are in another country.

***

Professional cricketers who love to surf feel deprived in an Australian summer. Which made Hawaii the ideal off-season holiday destination for Josie Dooley and her partner Michael Wegener. Well, maybe not quite ideal for Wegener; the long flight delays, missed connecting flights and arrival to a one-in-30-year flood in Hanalei Bay, did not alleviate any of his pre-existing travel stresses; he is not, Dooley cheekily reveals, exactly known for his composure in transit.

Yet flight delays and torrential rain would become the easier parts of this holiday to navigate.

The pair quickly settled into their accommodation and began planning their first day. While they might have needed to wait a day or two to hit the water, in typical Dooley fashion, she was determined not to allow the brown, log-filled ocean or closed walking trails curb her sense of adventure.

For most of that first evening, Dooley, only 24 but a well-established 'keeper-batter with South Australia and Melbourne Renegades in the WNCL and WBBL respectively, had a headache she describes now as "waves of pressure". It was a feeling she somewhat ignored, attributing it to the lingering effects of a Hen's party the night before they left Australia (Dooley was in the bridal party).

She woke at 3am, her head pounding. The pain was so unbearable she began throwing up.

This wasn't a hangover. Or jetlag.

The small hospital in Kauai was a 30-minute drive from their accommodation. With the flood-affected, foreign roads, Wegener was worried about the drive – but there was no other choice.

Dooley was put on a drip, and medicated. She slept for two hours and woke feeling better. Eventually, she was sent home with a migraine fact sheet. Lethargic, and still a little sore, they returned to their AirBnB, where she fell back to sleep.

If the 3am wake-up was a warning, the 8am wake-up was the alarm.

This time, she was in absolute agony. Uncontrollably vomiting, she could barely walk.

Intuitively, Wegener grabbed everything he could, including their passports, and frantically retraced his journey to the hospital.

Eyes closed, hunched over in pain in the passenger seat, all Dooley could manage was an occasional squint at the car's navigation system, counting the minutes to their destination. Upon arrival, Wegener carried his partner into the same waiting room they had left a matter of hours ago. She was screaming. Delirious. Immediately admitted, she was barely responsive.

A scan diagnosed Dooley with hydrocephalus, defined as a neurological disorder caused by an abnormal buildup of cerebrospinal fluid in the ventricles deep within the brain. She needed an urgent medical transfer to Honolulu for treatment that could not be provided by the small hospital in Kauai.

***

Tuesday, April 16: Day One

While Dooley does not remember being admitted to hospital, those moments could not be more vivid for Wegener. Having contacted his partner's parents – Jon and Leanne, who hastily booked flights from Brisbane – he sat alone, waiting for the next update from doctors. When it came, it was frighteningly simple: Dooley would not survive without a transfer to Honolulu.

An ambulance took them to the airport for what was supposed to be the life-saving flight.

Yet Dooley, intubated and unresponsive, deteriorated dramatically when she was moved onto the plane. In those decisive minutes, she suffered a major cerebellar stroke and takotsubo cardiomyopathy (a form of heart failure), and subsequent pulmonary oedema.

Wegener recalls what happened next with a strange mix of haze and clarity. One moment, he was by her side on the plane. The next, he was ordered off, as the doctor desperately tried to stabilise his partner.

For almost half an hour, he stood alone on the tarmac. He was distraught, and completely helpless.

Yet despite his overwhelming emotion, some form of intuition prompted a more rational voice inside his head.

"It is really hard to describe," he says. "I was a complete mess and it was all a bit of a blur. But there was this voice inside my head telling me it was going to be OK. In that moment. I knew there was no way I was going back to Australia by myself."  

That optimism was quickly tested. Wegener returned to the plane, and the engines even started up, but the medical staff could not stabilise Dooley. By 9pm, the window of opportunity was gone. The plane took off, and they weren't on it. Medical staff had effectively decided Dooley would not survive the flight.

The ambulance returned to take her to a medical centre closer to the airport, where she and Wegener remained for a further three hours. The essence of the doctor's message still rings in Wegener's ears. Dooley was unlikely to survive the flight but was almost certain to die if she stayed on the island. According to the doctor, her survival rested on the hope she could ultimately make it to Honolulu, where neurosurgeons could "work their magic".

If not for Dr Spencer Smith – one of the heroes in this story – who refused to conform when met with this life-or-death situation, Dooley's story ends on a runway in Kauai. Smith did not accept that she was done fighting. And nor was he. This young Australian, fit and healthy only hours earlier, was not dying on his watch.

And as the longest day of their lives blurred into the next, it finally happened. At around 1.30am, Dooley was successfully transferred to the Queen's Medical Center in Honolulu. An external ventricular drain (EVD) was immediately inserted to relieve some of the pressure that had triggered the alarm bells almost 24 hours earlier. Unresponsive, with signs of quadriplegia, her life was in the balance.

As Wegener resumed his bedside vigil, all he could do was sit and watch the clock, awaiting the arrival of Jon and Leanne Dooley.

***

Dooley's parents were hurriedly making plans to fly to Honolulu when they received a call from Dr Smith.

"He seemed distraught," Leanne recalls, "and just kept apologising to me."

The conversation was the last the Dooleys heard from Hawaii before they boarded the nine-hour flight from Sydney to Honolulu – without Wi-Fi. For a parent, there can be few more harrowing scenarios.

Josie's father Jon – stoic, matter-of-fact, loyal – describes his emotions at the time as "all over the place"; perhaps an empathic response to what his wife of 34 years was experiencing, as she sat in tears beside him for all but the final 60 minutes of the flight. Leanne recalls that last stretch, as the plane approached the Pacific paradise, as surreal. As with Wegener standing on the tarmac, she too felt an intuitive wave come over her.

"I somehow just knew it wasn't her time," she says. "Josie has a bigger story to come."

As they made their way to the hospital, their knowledge was limited to the barest facts: their daughter was alive, and a drain had been successfully inserted. They willed themselves to prepare for the real possibility she had significant brain damage.

When they rushed into the ICU, they saw eyebrow movements. Then, a slightly raised 'thumbs up'. Dooley recognised her parents. The relief was palpable.

***

Dooley puts it like this. While she is the one with the physical trauma, it is Michael, Jon and Leanne who carry it emotionally. Particularly from the two weeks that followed her hospital admission.

After an initial misdiagnosis, scans soon revealed the cause of hydrocephalus that led to her stroke was a benign, tectal glioma – a rare tumour that had been growing very slowly above her brain stem for years.

With the tumour inoperable, Dooley underwent her second neurosurgical procedure inside a week – an endoscopic third ventriculostomy. This procedure brought significant stress for her support crew, which was faced with a confronting reality that it could be weeks until an outcome was known. In the meantime, Dooley remained one "bad turn'" away from irreversible damage, or worse.  

Amid this maelstrom of anxiousness and fear, Leanne took it upon herself to provide daily updates for extended family and friends around the world via a 300-strong WhatsApp group. As she distracted the crowd with a 'Day 7' report that focused on the acquisition of three pairs of vintage beach towel pants, her daughter was quietly wheeled in for life-determining surgery. It was one of many examples where that loving trio drew on the sort of humour and determination for which Dooley is renowned. It was a means of finding some light in the darkness.

Despite a successful procedure, the days that followed were not nearly as bright as the Dooleys' new favourite pants.

Every spike in Josie's unstable intracranial pressure prompted a reciprocal response in Michael, Jon and Leanne's heart rate. There was not a moment where at least one of them was not by her bedside – eyes flitting between their girl and her monitors. Struggling to eat or sleep themselves, Dooley's loyal trio were attuned to every noise, movement and eyebrow raise, and did their best to make sense of the lip movements around her endotracheal tube.

Perhaps the most traumatic day of their rollercoaster ride came when doctors made an attempt to extubate. An all-too familiar feeling of helplessness crept back over Wegener, as the three of them stood in the corridor and watched one nurse turn into nine expert medical staff as Dooley went into severe respiratory distress. It was yet another near-death experience, narrowly avoided.

In the 24 hours that followed, Dooley was again fighting for her life. And despite this, her sense of humour remained. Having regained consciousness after the ordeal, through hand signals, letter boards and a few frustrated eye rolls, she conveyed the message: "I came on holiday, and it is a shit show!".

It was a small moment of humour among ICU delirium.

At its peak, she went three days without sleep, experiencing extensive terrors and paranoia. Despite her heavy sedation, she even required restraints to ensure she did not dislodge vital medical equipment. And if that wasn't enough, there were another two procedures – a tracheotomy and PEG line insertion.

For Wegener and her parents, it was a gut-wrenching challenge of watching a fiercely independent, capable and kind person, experience sheer suffering.

Still, in a bid to match Dooley's wit, the WhatsApp group of loyal followers erupted with WWE (World Wrestling Entertainment) references and more than a few sledges about the lack of 'oomph' in the right cross she had (unknowingly) directed at an ICU nurse.

She might not have fully grasped it, but in the fight of her life, Dooley had an army behind her.

***

There were three reasons Jon, Leanne and Michael felt optimistic on the morning of Day 13: Dooley woke significantly more alert and energised; she requested to re-watch her beloved Seinfeld as a family; and when given a five-minute goal of sitting in her bed with back support, she politely rejected the limitation, instead sitting for 15 minutes.

In all the important ways, the girl they knew was back. As it happens, Day 13 is also the first Dooley can remember.

From there, she continued to make steady, positive progress.

Her night terrors settled. The IV drugs were being weaned. She was spending multiple hours off the ventilator.

And finally, after two weeks that felt more like months, the EVD was removed, and the surgery was officially deemed a success.

For weeks, her body had been out of her control. It is a difficult reality to imagine for someone so independent and capable, let alone a professional athlete. On her sixteenth day in ICU, Dooley set the goal for that day. The whiteboard said, "Shave my head".

And so began the Dooley family shave.

Dooley's instigation prompted an act of solidarity by her brothers – Paddy, Louis and Will (Josie is second youngest of the four) – who had been relying on FaceTime to connect with their sister, as they navigated the ordeal together from across the Pacific.

Jon took a little more convincing. Unwavering with her own courage and positivity, Leanne led them to an unsuspecting Hawaiian barbershop. One can imagine the influx of GI Jane, Sinead O'Connor and bald middle-aged white male content streaming through the global WhatsApp chat. All inspired by Dooley's bold move.

After 18 days, Dooley transitioned from ICU to the general neurosurgical ward. In that time, she and her family had won the hearts of not only the ICU staff, but many throughout the hospital. If you ask Dooley, the reason is obvious: "Of course everyone felt sorry for me – I'm a 24-year-old Australian who's had a stroke!". Others might point to the daily supply of French pastries provided by the Dooleys. But if you ask those with a front-row seat to Dooley's progression from a life-threatening condition on arrival, to standing assisted beside her bed, they will tell you it was her sense of humour, courage and kindness that had hospital staff captivated. It takes a remarkable person to build such a human connection without being able to speak a single word.

With plenty of tears, hugs and one last box of pastries, Dooley farewelled her ICU team to begin the next chapter of her recovery. As Jon and Leanne watched their daughter being rolled down the corridor of Queen's Medical Center, their simultaneous sighs were accompanied by the thought that maybe, just maybe, they could dare to believe everything might be OK.

***

Throughout her ICU stay, Dooley had worked her way into the 'presidential suite' (the room with the best view), amassed a pillow collection that was the envy of the entire hospital, and even convinced one of her nurses to immerse a mouth swab in coffee because she was missing her daily caffeine hit. The move to the neurosurgical ward and an upgrade from her trusty whiteboard to a Magna-doodle (thoughtfully sent by a friend from home) gave Dooley a renewed sense of energy. Instead of her S&C coach in South Australia holding her to account with pre-season numbers, it was Dooley turning the tables on her doctors. Cross-questioning of her latest bloods, ECG results, updated CT/chest X-rays, even urine samples. No-one was safe.

She was also working towards a bigger plan – an outdoor excursion. Having witnessed the impact of fresh pastries with ICU staff, Dooley attempted the same leverage with her neurosurgical ward team. Whilst the ocean waves intended for this Hawaiian holiday would continue to elude her, fresh air and sunshine from the balcony had become a worthy substitute.

With kindness and diligence from staff – and less expenditure on pastries than she anticipated – Dooley was signed off for her balcony visit. After 22 days inside the four walls of a hospital room, the 90 minutes it took to arrange the machinery seemed only a minor hassle. For 15 whole minutes, Dooley had sunshine, fresh air and freedom. It didn't matter that she couldn't express herself in words. In that moment, her smile said it all.

As her Hawaiian holiday "shit show" ticked into its fourth week, Dooley's repatriation was in sight but frustratingly delayed by her persistent pneumonia. Her main men had returned to Australia. She was still feeding through a tube in her stomach and unable to speak. But why dwell on things you cannot control, when you can chase PBs in your rehab? Optimism and humour remained her superpowers.

Taking inspiration from the playlist ("Josie's Head***k Hits") co-constructed via her 300+ strong WhatsApp chat, Dooley took her first (assisted) steps outside her room, with Fatboy Slim's Praise You echoing through the hospital corridors.

During speech therapy sessions, with the help of a speaking valve on her tracheostomy, she capitalised on the opportunity to practice her cricket appealing, lamenting she may not actually get the deeper voice she assumed would arrive with her new haircut.

Then, to the great surprise of her loyal followers back home, a voice message landed in the group chat, some 26 days since she was admitted to hospital in Honolulu. Fourteen glorious seconds of Josie's whispering voice – a thank you to everyone for their love and support. Typically, this came after several explicit takes and the personalised voice note to her 'A Team' of ICU nurses, notifying them she had finally "peed on her own!"   

***

Tuesday, May 14: Day 28

With a handpicked LifeFlight crew confirmed, and donning her well-worn hospital gown – she'd have preferred the pants – it was time for Dooley to bid farewell to the team at Queen's Medical Center.

A steady stream of doctors, nurses and hospital staff flowed through the ward to say teary farewells.

When they met Dooley, she was paralysed from the neck down and critically ill. She had been close to death a handful of times while in their care. And remarkably, despite her inability to speak for the duration of her stay, those same staff describe Dooley as witty and funny, a fighter and an inspiration.

Leanne's daily update was aptly entitled, Mahalo (a Hawaiian expression of gratitude).

Suffice to say many of the Hawaiian medical profession were now considered family.

Cue Angus and Julia Stone on Josie's Head***k Hits playlist.

Josie and Leanne boarded their small jet plane. Finally, they were going home.

On return to Brisbane, Dooley was admitted to the Royal Brisbane and Women's Hospital (RBWH).

There, during her 10-day stay, some significant medical milestones included the removal of her trache, catheter and PICC line. After not being able to swallow for 36 days, she promptly smashed her first meal – an entrée of Hungry Jack's chips followed by chicken schnitzel and mash potato.

The move from RBWH to STARS (rehabilitation hospital) allowed Dooley's regimen to intensify.

It was a steady progression from harness walking and a stationary bike to coordination games like 'Bop it' where she almost doubled the existing record. Harnesses were removed, and stair walking was added. These activities were not without challenges. Dooley struggled with severe dizziness, vertigo, nystagmus (eye condition) and lacking control of her left arm and leg. Yet just days after walking independently for the first time, she was balancing on a Bosu and requesting a cricket bat.

Determined to turn an 'if' into a 'when' as far as cricket and surfing are concerned. Her Dad Jon meanwhile, is vowing only to return to his surfboard when she does.

***

Instead of her beloved Gray Nic, Dooley raised her walking stick as she made her way out of STARS on day 93.

It was another milestone in a journey that started more than three months earlier with a flight delay and a sense of excitement.

With ongoing assistance from a number of the South Australian Cricket Assocation support staff, Dooley continues to challenge herself physically and mentally as she works towards her ultimate goals of returning to cricket and surfing. And it is as important to her she helps others in the process; earlier this month she walked 5km in the Bridge to Brisbane to raise awareness and funds for the Stroke Foundation.

Amid almost six months of uncertainty, two things are clear: Dooley's inherent optimism, humour, wit, kindness and courage will continue to serve her well; and $250 on travel insurance will remain the best money she ever spent.

Dooley has always been a stats girl. She loves analysing the game of cricket. Team results, individual scores, strength and conditioning PBs, player match-ups. Just ask her, and she will tell you anything you want to know.

In the last six months, the scorecard looks a little different:

• 13 days she cannot remember
• 18 days in the ICU of a foreign hospital
• 26 days without speaking
• 35 days without eating
• 36 days with a trache
• 52 days without walking independently
• 93 days in hospital

One inspiring human being, with the best yet to come.

Follow Josie Dooley's journey via the Instagram account @wave2recovery