Twelve-year-old Noah Rybak, of Oradell, New Jersey, was sledding with friends one February 2021 day when his sled suddenly ran headfirst into a tree at the bottom of a hill. His friend called 911 right away—an action that likely saved his life.

When Noah’s parents, Chaim and Jodi, arrived at Joseph M. Sanzari Children’s Hospital at Hackensack University Medical Center, they quickly realized something more serious had happened beyond just a broken bone.

“We went back to the room where Noah was and there were so many people,” says Jodi. “There were like 20 doctors and nurses, and officers from the Bergen County Sheriff’s Department who were with the ambulance that brought Noah. Our heads were spinning.”

Doctors discovered that Noah had a depressed skull fracture with life-threatening brain bleeding.

When Time Is of the Essence

Noah’s care involved a multidisciplinary team, including pediatric neurosurgeon Catherine Mazzola, M.D., pediatric plastic surgeon Robert Morin, M.D. and surgeon and trauma medicine specialist Jyoti Sharma, M.D.

The team quickly scheduled surgery to elevate and repair the depressed skull fracture and remove the blood clot from Noah’s brain. “Time was of the essence,” says Dr. Mazzola.

The surgery was successful, but Noah needed to be placed in an induced coma to help his brain heal. “With an injury like this, the patient is put under sedation with a breathing tube after the surgery,” says Amy Chirico, M.D., pediatric critical care medicine specialist in the pediatric intensive care unit (PICU) at the Children’s Hospital, who treated Noah during the five days he was in an induced coma. “That helps keep the brain as inactive as possible to allow it to heal. Families want to know how the patient is doing, but until they wake up, we don’t really know.”

An Unforgettable Moment

No one, including Dr. Chirico, was prepared for what happened when Noah first came out of the coma.

“I will never forget it,” she says, adding that patients are often tired and confused when they are brought out of a coma. “When we were finally able to wake him up, his eyes were closed and I was saying, ‘Noah, squeeze my hand.’ Noah responded, ‘How strong?’ He did remarkably well for the extent of his injury. It was really wonderful.”

Jodi adds: “You sit there for days wondering if he is going to talk when he comes out or if he will know who we are. When he said, ‘How strong?’ I knew he was going to be exactly the same, because that’s something Noah would say.”

A little more than a week later, Noah was transferred to a rehabilitation center. “[Noah’s rehab] started slow with many long nights, but then it just took off,” says Chaim. “By the end of his therapy in March, he was playing basketball with the therapist.”

Support Through Recovery

Just four months after the accident, Noah graduated from sixth grade with the rest of his class. He danced the night away at his Spring Fling dance and today is back to his favorite activities, like playing sports. It’s hard for Chaim and Jodi to believe the incredible turnaround they’ve had since that harrowing experience in February.

The Rybaks see Noah’s story as an opportunity to start a conversation about winter sports safety. “We’re going to make a video to be shown at the schools and PTA about our story and what happened to raise awareness,” Jodi says.

Beyond the lifesaving work from Noah’s care team, the Rybaks point to their community as a huge factor in keeping them going through this traumatic experience. Friends and family created #TeamNoah signs and spread them around everywhere: front lawns, windows, schools and community centers.

“It really lifts your spirits and shows that people care,” says Chaim. “I’ll never forget one night I came home, and I had to take the dog for a walk. Every house I walked past had a Team Noah sign, and it hit me: That’s for my son.”

Next Steps & Resources:

Meet our sources: Catherine Mazzola, M.D. and Amy Chirico, M.D. To make an appointment with a doctor near you, call 800-822-8905 or visit our website.

Learn how our pediatric intensive care unit (PICU) teams work to return children to health as quickly as possible.

How parents can prepare their kids for surgery

Common myths about kids and concussion

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.