Two hours into her Jamaican honeymoon, Lauren Esper was kneeling over her unconscious husband and screaming for help.
Gabe Brown, 26, had fallen while walking around a sunken bathtub in the newlywed couples' resort room in Montego Bay on Sept. 25. He likely had been unpacking the Pennsylvania couples' clothes, Esper said.
"I was dozing when I heard a gasp and then a loud boom," she said. "It was horrific. He was seizing and probably bit his tongue or lip because he was bleeding from his mouth. His hands were clenched and he was just shaking."
Brown had struck the left side of his head on the room's tile-and-stone floor and was bleeding between his skull and brain. Doctors call it an epidural hematoma and it can become life threatening if left untreated as blood collects and, with nowhere else to go, damages nearby brain tissue.
If the couple had been in the United States, Esper would have called 911 for an ambulance to transport Brown to the nearest trauma center for prompt emergency treatment.
Instead, the 25-year-old newlywed spent the next seven-and-a-half hours battling — first to get an ambulance to the resort, then to convince two Jamaican hospitals to treat her seriously injured husband.
"They don't have 911 in Jamaica," said Esper, referring to the fact that the island country has separate emergency numbers for police, fire and ambulances. "I couldn't figure it out, so I'm just screaming bloody murder, 'Please help me!'"
Other resort guests, including a doctor, arrived at the couple's room. They stayed with Brown while Esper found two staff members, who called for an ambulance.
Brown soon regained consciousness, though he was groggy.
"He was disoriented but did ask, 'What happened?'" Esper said.
An ambulance arrived and transported Brown to a nearby private hospital, where he was wheeled into an emergency room.
But hospital staff wouldn't treat Brown, or even provide a diagnostic brain scan, without a $3,000 payment up front because they didn't accept his health insurance or travel insurance.
"So, I'm on the phone with my bank, trying to convince them that the $3,000 charge on my credit card is legitimate," Esper said. "Three hours after Gabe arrived at the hospital, I finally got the payment approved and they took him for a CT scan."
The scan showed significant bleeding on the left side of Brown's brain. A neurosurgeon told Esper that her husband needed immediate surgery to relieve the pressure on his brain but that it would take hours to assemble the surgical team.
Instead, he recommended transferring Brown to a nearby public hospital where they could perform the surgery, Esper said.
"This neurosurgeon told me that he talked with his counterpart at the public hospital and that they were ready to perform the surgery," Esper said. "Based on his recommendation, I signed the forms to release Gabe to the public hospital."
An ambulance arrived about two hours later and transported Brown to the other hospital, where they told Esper they had no idea that he needed brain surgery. Hospital staff had to call their neurosurgeon.
Meanwhile, Brown's condition worsened and he slipped into a coma.
"I really felt at that point that my husband was dying right in front of me," Esper said. "I had depended on this (first) hospital to save his life and they let me down."
Esper stayed with Brown as the public hospital scrambled to prepare for his surgery. The neurosurgeon and staff arrived, and Brown was taken to surgery around 1:30 a.m.
The surgery didn't start until seven-and-a-half hours after Brown fell and more than three hours after his CT scan showed serious brain bleeding.
It took more than four hours but doctors told Esper they were able to stop the bleeding, reduce the pressure on his brain, remove blood clots and maintain his blood pressure.
"Then they tell me that Gabe has to go back to the private hospital because they don't have an intensive care unit at this one," Esper said. "We get ahold of the private hospital and they want a five-figure payment, up front again, to care for him."
Esper made the payment and Brown was transferred back to the private hospital, where he remained while his wife arranged for a medical flight to the United States.
The effects of Hurricane Helene made it difficult, but Esper was able to schedule a flight to Fort Lauderdale, Florida, where Brown was then taken to Broward Health Medical Center.
Before they could leave, the Jamaican private hospital demanded one last, five-figure payment. Esper estimated she spent $25,000 for Brown's care at the hospital.
In an effort to help cover Brown's medical bills, a friend has set up a GoFundMe account. People had donated nearly $90,000 by Friday.
Brown stayed about a week at the Fort Lauderdale hospital before being flown home to Erie, Pennsylvania, and transferred to UPMC Hamot medical center.
"They did an MRI and thought there was an infection in his brain," Esper said. "So they scheduled a second brain surgery. They didn't find any infection but they took out more clots, removed more blood, and placed mesh between his brain and his scalp where they had removed part of his skull for the first surgery."
Doctors were able to wean Brown off a ventilator during his three-week stay, though he remained in a coma. At times, he would respond physically to what neurologist Dr. Dan Kinem called "irritating stimulation."
It was a subtle sign of progress, said Kinem, who believes Brown can recover, though perhaps slowly, from his injury.
"I tell my residents, never underestimate the power of youth and its remarkable ability to heal," Kinem said. "While we haven't seen many signs of progress on exams, his scans don't show anything that would prohibit him from making a good recovery."
A "good recovery" means that Brown would live a relatively normal life by retaining his speech, personality and ability to use his body, Kinem said.
But first he needs wake from his month-long coma.
On Oct. 23, Esper made the difficult decision to transfer Brown to Select Specialty Hospital — Pittsburgh for long-term acute care.
"I considered moving him to the Select Specialty Hospital here in Erie, but the one down in Pittsburgh is connected to a UPMC Hospital," Esper said. "They are in constant contact with UPMC doctors there."
Meanwhile, Esper is back at the couple's home when she isn't visiting Brown in Pittsburgh. She stashed their luggage in Brown's home office until, many days later, Esper was ready to unpack their unused honeymoon clothes.
"And the whole house is decorated for Halloween. We did it before we left because it's our favorite holiday," Esper said a few days beforehand. "He was so excited to have trick-or-treating at our house.
"We were going to have a Halloween party, but I can't see that happening. I want to pass out treats, though. I want to tell Gabe about it when he wakes up."
Contact David Bruce at [email protected]. Follow him on X @ETNBruce.