SIOUX CITY -- After having melanoma removed from her back three years ago, Mari Beth Jackson received nothing but good reports about her health.
On Oct. 3, after a full day's work at Great West Casualty, the 54-year-old Sioux City attorney went to see her dermatologist for a three-month checkup. After that appointment, Jackson appeared dazed and confused.
"I don't recall driving home or talking to my husband," said Jackson, who reported experiencing headaches a few weeks prior. "He said I was out in the kitchen like I was going to be sick, but I didn't get sick."
Jay Jackson drove his wife to Mercy Medical Center, where a scan revealed bleeding in her brain caused by tumors located between her eyes, near her forehead and the left side of her head. Although earlier testing didn't detect it, the melanoma had spread.
A neurosurgeon performed a procedure to remove the pressure in Jackson's brain. She was placed in a medically induced coma for 10 days.
"It was a shock to my family and the dermatologist. He came up to the hospital a couple times and was just flabbergasted. I think it happens in just 3 percent (of cases)," said Jackson, who has no memory of the two weeks she spent at Mercy or a portion of the month-long stint at Madonna Rehabilitation Hospitals' Omaha Campus.
Jay Jackson said his wife showed very little improvement her first week at Madonna. She had to be moved with a Hoyer lift and a wheelchair. She responded to questions with a smile, but wouldn't speak. Her muscle movement was limited to a simple wave of her hand while lying in bed. She repeatedly failed tests that gauged her ability to swallow.
"I don't know if it's instinctual or just something inside of Mari. Even during that three-week period of time, where she's almost non-responsive for the most part, as she was slowly getting to the point where there's some response, that response was always positive to the doctor or the nurses," Jay Jackson said. "When they asked her to do the smallest of tasks, she would smile to them."
Jackson's first memory at Madonna is sitting at the lunch table with therapists and other patients eating mashed-up food and drinking thickened liquid.
"I was looking at another patient who was having difficulties and I remember thinking, 'Why am I here? What is going on? Who's that person?'" she recalled. "Then, I could hear my therapist saying, 'You need to take a drink. You need to take a bite.'"
Jackson responded, "I'm fine. I'm not really hungry."
"She just kind of had a look on her face like, 'Oh my god! You're talking to me,'" Jackson said of the therapist. "I think she was just amazed that I had started talking."
Jay Jackson said his wife's progress was "steady" and "remarkable." Daily, Jackson participated in a regimen of physical, occupational and speech therapy. She said she spent time in a gym doing specific exercises to rehabilitate her right side, which she described as "lazy" and "not really working very well."
"She really wanted to get back to work and driving, so we used our driving simulator to do different assessments and to increase her reaction time," said Jena Roeber, an occupational therapist who worked with Jackson at Madonna. "Mari was basically simulating driving in different environments -- night driving, rural driving, city driving."
Roeber said Jackson, one of the most motivated patients she has ever encountered, spent time in a therapy kitchen, where she baked cookies, and a therapy bedroom, where she practiced hanging up clothes. She said staff also worked with Jackson on problem-solving and decision-making, high level skills needed to help her return to work.
"She was really realistic about wanting to manage her daily activities when she went home," Roeber said. "We would really educate her about energy conservation, because once you go back home, you can't always just jump right into what you were doing before."
Through it all, Jackson received supportive cards, texts and emails from friends and family members. Her children, Blake, 24, and Spencer, 22, took turns spending the night in her room on the couch.
"I think they liked it there, because I wasn't running around doing stuff. Here, I'd be putting laundry in or doing something. There, we were just in the room visiting," she said. "It was quiet. It was calm."
Before Jackson was discharged on Nov. 21, she received the Madonna Spirit Award, an honor bestowed on a select number of patients. When Jackson hears the story about her positive attitude and comments from members of her care team about how she was such a joy to work with, she can't help but chuckle.
"I just felt like I was being how people should treat each other," she said. "Why would I be mad at them? They're trying to help me."
Jackson completed radiation treatments in Omaha and recently started receiving immunotherapy treatments to help her body fight the cancer. Two weeks before Christmas, Jackson was looking forward to spending a normal holiday with her family.
"It's definitely a hard time of year to go through this -- traveling to Omaha and trying to find time to shop and do the normal holiday things," she said. "It's just all really strange, so I just keep trying to tell myself to keep things as normal as possible."