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The Atlanta Journal-Constitution
By Fiza Pirani
February 4, 2018
Richard Blackwell of Tucker is advocating for headgear and more restrictions on headers in youth soccer after his 16-year-old daughter Alex committed suicide last September. Photos by Alyssa Pointerfirstname.lastname@example.org, except where indicated
It’s going to be OK.
Those were the last words 16-year-old Alex Blackwell mumbled to her boyfriend on video chat around 2 a.m. one Wednesday morning last September, moments before she fell into a listless trance.
Seth panicked as he watched her striking blue eyes turn milky white.
An hour later, a police officer responded to his frantic 9-1-1 call, pounding on the Blackwells’ Colonial-style home tucked in a quiet cul-de-sac in Tucker.
By the time Richard and Kim Blackwell made it upstairs to their first-born’s bedroom, Alex had given up her last breath.
Inside the Emory University Hospital emergency room, medical personnel performed chest compressions in rotation. Just as one reached a point of exhaustion, another stepped up to the plate. Over and over and over.
Every now and then, Alex’s heart would tease them with a heartbeat or two, the deafening silence between each beat more insufferable than the last.
Alex lost her battle with mental illness, her final act fueled by a calculated concoction of medications.
A natural athlete
Babies typically take their first steps between 9 and 12 months of age. Alex conquered that physical feat when she was just 7 months old.
As the only seasoned pedestrian in her day care age group, Alex took charge. She’d often walk around the room, swapping out the other babies’ bottles for no good reason. It drove the employees nuts, her father, Richard Blackwell, said.
When Alex was 2, Richard and his wife, Kim, both Georgia Tech-educated engineers, noticed Alex’s toes pointed inward and her legs bowed outward. She was diagnosed with Blount disease.
More common among African-American or obese children, Blount disease is also associated with early walking. The condition causes uneven growth of the shinbone and it is progressive. If left untreated, it can result in deformity and disability.
When Alex was diagnosed, Richard and Kim were given two choices: Either put their infant daughter through extensive leg surgery or have her bones temporarily adjusted with leg braces and then operate when she was older.
They opted for the latter.
Customized metal braces helped support Alex’s legs from her thighs to her toes. She wore them day and night for 18 months. Every few months the braces were adjusted and her legs began to slowly straighten out.
When the braces finally came off, Alex was the fastest kid on the block. Just like Forrest Gump, Richard said, she ran like the wind.
By the time she was a freshman in high school, Alex was one of the best ball strikers on the Greater Atlanta Christian School’s varsity girls soccer team.
“If she got the ball, anything could happen,” said coach Mike Giuliano.
In soccer, a dominant striker is not only a master scorer but someone who brings lethal instinct and speed to the game. There were better overall forwards on the team, Giuliano said, but Alex brought the umph. She didn’t shy away from a physical game.
“Her pain threshold was unspeakably high,” Giuliano recalled. “And people often respected her for it.”
One of the things that made Alex such a good player, said Richard, was her willingness to take a risk.
Life of the party
Alex didn’t just shine on the field. She was a bright light behind the scenes, too.
In the locker rooms, she was famous for sharing her massive stash of pre- and post-game junk food: Cheez-Its, Fruit Roll-Ups, Chester’s Hot Fries, Snickers, Reese’s Peanut Butter Cups — you name it. She came prepared with the essentials, too: tampons, Advil, Band-Aids and extra soccer gear to share.
“She was like the nurse of the locker room,” said teammate Caitlin Elmore.
But it was her outrageous, impulsive sense of humor that friends mention most often when talking about her.
“Alex didn’t care what anyone thought,” said teammate Amanda Stigaard. “She wanted to keep everyone laughing. She was her most vibrant self in that locker room.”
Before games she would cue up tunes over the locker room speaker system and bust out in absurdly awkward dance moves that her friends lovingly described as “spazzy” and “tragic.”
When Richard turned down the music to give the pregame announcements before a soccer game, Alex would shout at him: Hey Richard, turn up the music! Her friends would erupt in laughter.
“If a guy was walking by, she’d just yell: ‘Hey, you’re cute!’” said best friend Annie Kilpatrick.
Her humor was never more apparent than when she was joking around with her dad, with whom she was especially close.
“Even when her parents weren’t around, she’d talk about how close she was with her dad,” said Amanda. One night she was at the Blackwell home when Alex and Richard were making gluten-free pizza.
“They could not stop laughing about how gross it was,” she recalled.
“I remember once telling my dad I’d never met a family that liked each other so much,” said Alex’s cousin Kristin Fair Ethridge, who lived with the Blackwells off and on in recent years.
That bond has helped sustain Richard in his grief.
“We had the opportunity to spend twice the amount of time a typical kid has with their parents,” Richard said. “So in a way, it’s like I had 30 years with her.”
Alex’s impulsive, high-energy side was apparent in other ways, too. Kristin said Alex would get an idea in her head and nothing could get in her way. She recalled more than one impromptu Dairy Queen run late at night.
Unfortunately, when things started to go wrong with Alex, that impulsive behavior took a dark turn.
Alex loved soccer so much, she played on the Greater Atlanta Christian School team in the spring and on a club league team through Georgia Soccer in the fall.
During the 2016 club league season, Alex unknowingly suffered back-to-back concussions in two games one week apart.
A mild traumatic brain injury caused by a blow to the head, concussions are not easy to identify. The initial pain of a blow may fade fairly quickly, but it can leave contusions on the brain that, over time, can lead to significant long-term effects, including brain damage, behavioral changes, cognitive deficits and more, according to the American Osteopathic Association.
Alex’s blows, most likely received during tackles, seemed so insignificant at the time that Richard doesn’t even remember the incidents that caused them. A referee for Georgia Soccer for 10 years, Richard said they’re trained to respond to monster blows, not smaller ones typical of a contact sport.
But hours after the second blow, Alex began experiencing a severe headache, brain fog, nausea and irritability. When Richard and Kim realized over-the-counter pain relievers weren’t doing the trick that evening, they immediately sought medical attention.
That’s when doctors found evidence of the concussion she’d received the week before.
“What the data tells us is that there’s something unique about being hit in the head more than once,” said Dr. Russell Gore, a neurologist at Shepherd Complex Concussion Clinic in Atlanta, who did not treat Alex. “The risk for secondary symptoms automatically goes up and gets exacerbated after the injury.”
These secondary symptoms can include behavioral and mood changes, including depression, anxiety, disinterest and energy loss.
Alex’s doctor, Stephen Kroll of Children’s Orthopaedic, advised Alex to stay home from school for seven to 10 days and avoid her cellphone, laptop or any other source of light stimulation. He also banned sports for three months.
From bad to worse
When Alex returned to school, she had a long list of missed classwork and homework assignments to catch up on.
“I knew she was stressed,” said Amanda. “Even if she put on a happy face for everyone else.”
Alex became less social, often telling friends she was too exhausted to hang out. She told Richard that large gatherings made her especially miserable.
As her Greater Atlanta Christian School teammates began gearing up for soccer season, symptoms of Alex’s Blount disease returned. She began to experience sharp pains below her kneecaps that grew increasingly worse day after day.
The doctor gave Alex two options: Undergo extensive leg surgeries on her ankles, which came with a prolonged recovery period, or give up playing soccer entirely. Surgery it was.
To correct Blount disease, doctors typically cut the tibia and realign it using a metal plate and screws. Most teens are able to fully recover and return to competitive sports.
Alex had the surgery in January 2017 and spent several months having to use a wheelchair and eventually crutches to get around. Painful shin splints during physical therapy prolonged the already tedious rehabilitation period.
In the months following her concussions and surgery, Alex would wake up in the middle of the night feeling inexplicably sad. She began seeing a therapist for depression and social anxiety. She expressed a lack of will to live.
“There was a total shift in who Alex became,” Kristin said. “She was not her normal self.”
But to those not privy to her intimate moments, Alex projected an image of general optimism.
Although she was not cleared to play soccer, she hardly missed a game and often helped the coaching staff or worked the concessions stand.
“If our character is revealed in our most difficult times, your daughter’s a rock star,” coach Giuliano wrote in a letter to Richard and Kim last spring.
When the team won a regional championship, Alex was rolled out to the middle of the field for the team photo.
She often joined the team in the locker room, even though friends had to carry her up the stairs to get there.
But sometimes the cracks in her facade showed, revealing the darker side of Alex’s reality.
One time, instead of allowing her friends to help her get to the locker room, she tried to pull herself up the stairs on her own.
“I opened the door and saw she was struggling to get in,” said teammate Titilayoni “TiTi” Abioduin. “When I tried to help, she wasn’t having it.”
Last summer, friend Annie Kilpatrick noticed Alex was cutting herself.
“That’s when I knew something was really wrong,” she said.
Richard was determined to help Alex, who had begun to resist therapy.
“But we were going to do everything within our power to find out what was causing this and try to fix it,” Richard said.
It wasn’t until 16-year-old Seth Masters came into the picture that Alex showed signs of improvement.
Seth and Alex first met in eighth grade at Greater Atlanta Christian School. The attraction was instant for him, but Alex barely noticed him.
But this school year, Seth mustered up the courage to make his move.
On the first day of school last fall, he switched his assigned seat to one next to Alex. It worked. By the end of the week, they’d paired up.
The two would meet before, during and after school, and frequented a park near her house where they’d sit together for hours at a time. Their first official date started at a Waffle House and ended on the rooftop of a school building, where they watched the sunset before driving wildly around the empty campus.
Just a few weeks later, she would be dead.
“She was the best adventure of my life,” he said.
Hours after Alex died, Richard sat down at his desk, where family photos rotated on his computer screensaver.
For the next 10 minutes, he penned a hauntingly personal warning to parents of girls everywhere.
He revealed details of his daughter’s yearlong war with social anxiety and depression, citing her concussions as the spark in a chain of events that drove her further into the shadows of mental illness.
As survivors of suicide often do, Richard tried to make sense of his family’s loss.
He titled his essay, “Is Your Daughter OK? Check Again.”
“They let us sit with Alex for a long while afterward and we held her hand and kissed her cheeks until it was time to go,” he wrote. “We went home and were surrounded by all our friends and family with more arriving every hour. Everyone tries to say some words to help but really just their presence is all we need because there is nothing to say. The last entry into her diary said, ‘I’m just tired.’”
Then he listed nine things he thought parents should know. They ranged from warnings about concussions and bullies to the dangers of putting too much pressure on grades and watching the Netflix series “13 Reasons Why.”
It felt like Alex was there in the room with him, feeding him the strength to tell her story, Richard said.
“I remember staring at the post and thinking, am I really going to do this? Put this all out there in the highly judgmental world?”
Then he felt Alex’s hand on his shoulder and hit publish on his LinkedIn account.
Moments later, Kim ran into Richard’s office.
You know, the strangest thing just happened, she said. I just felt this big kiss on my cheek.
Within hours, Richard’s post went viral. Millions of people read it, and it was picked up by multiple news stations.
Days after publishing the note, Richard’s brother came to visit. He broke down in tears as he told Richard that his friend, a father in Gulf Shores, Alabama, read the post and ran to wake up his daughter in the middle of the night. When he asked her if she ever thought of killing herself, she said she had.