Best Doctors: Fight Of Their Lives

For more than a week, Kim Jaworski lay in MetroHealth Medical Center’s intensive care unit in a coma. 

The 58-year-old father from Westlake had been stabbed 14 times with a kitchen knife. When he arrived at the hospital via medical helicopter, his chest had been cut open, the result of an emergency effort to drain the blood pooling around his heart. 

It took five hours of surgery for doctors to stop all the bleeding. But Kim was alive. 

Normally, the hospital’s survivor recovery services team would work to support the family. In this case, they didn’t quite know how to respond. 

Kim’s wife, Carol, was also recovering from surgery at MetroHealth, after 14 stab wounds in the back, legs and arms during the same attack. Their youngest son, Scott, alternated between rooms worried his mother and father might not survive. 

Their oldest son, Robert, was in jail, the primary suspect in the attempted murder of his parents. He’d been apprehended by Westlake Police a little more than an hour after Carol called 911. 

It had been a tumultuous few years leading up to that moment. 

Robert had been diagnosed with schizoaffective disorder, a condition that includes symptoms of both schizophrenia and bipolar disorder. When taking his medication, he functioned normally. But when he wasn’t, Robert could be unpredictable. He heard voices and believed his parents were trying to kill him. 

Although Robert had been committed to hospital psychiatric units three times, he had been discharged once the hospital determined he wasn’t a threat to himself or others.

Then, on Aug. 18, 2014, while the family prepared to watch a Cleveland Browns preseason football game, Robert attacked his parents in their bedroom with a chef’s knife. In an effort to subdue his son, Kim took the worst of it with lacerations to his liver and diaphragm.

He’d been in a coma ever since. Doctors didn’t know when he might regain consciousness or how he would react if he did. 

Then on the eleventh day, Kim awoke groggy and sore. As hospital staff and his family rushed to his side, Kim wanted to know one thing: “Where’s Robert?” he asked. 

When they told him his son was alive and safe, Kim sank back into his pillows. “Thank God,” he recalls thinking. “Now he can finally get the help he needs.”

For the Jaworski family, the evening started out like any other — or at least not unlike any other night, of late. 

Carol, a blonde-haired, blue-eyed eastern Tennessee native who still speaks with a soft, southern lilt, greeted her family when she arrived home around 8 p.m. from her job as a speech language pathologist. Scott, 21, was on his way home from church. Robert, 23, was just hanging around the house. 

The family traditionally watched Browns football together, and a preseason game against the Washington Redskins was on Monday Night Football. 

Because their downstairs TV was broken, Carol and Kim decided to watch the game in their bedroom. They asked Robert if he wanted to watch with them.

Since Robert had been diagnosed with schizoaffective disorder a few years earlier, medication helped him, but he didn’t always take it. During those times, he had called the police accusing Kim and Carol of being pedophiles who were trying to kill him. He threw his brother’s $1,400 Apple computer in a creek. He tried to run his father’s car off the highway. He heard voices in his head and went for barefoot runs at 3 a.m.

Carol and Kim had forced Robert to take a leave from the University of Kentucky, where he had been acting moody and impulsive. He got into fights and had once been caught trying to enter a sorority house naked. 

Recently, Robert had terrified his parents by running off to New York City without telling anyone. While there, he was detained for trespassing on city property, but had been released without charges.

Three times, Robert had been involuntarily committed to psychiatric units for treatment. But in less than two weeks, once the hospital determined he wasn’t a threat to himself or to others, he was discharged. 

After his most recent hospital stay in July 2014, Robert seemed particularly distressed. He wouldn’t touch his food because he thought his parents had poisoned it. He wasn’t sleeping and walked around with a vacant look on his face.

Kim didn’t know where to turn. So he twice dropped Robert off at the 2100 Lakeside Men’s Shelter, believing that he might get help there if he was regarded as homeless. But Robert turned around each time and walked the 15 miles — a more than five hour trip — home. 

Carol had allowed him to return, and things had been quiet for a few days. No arguments, outbursts or aggression. Carol was hopeful that Robert had turned a corner and his condition had begun to stabilize.   

“Sure, I’ll watch,” Robert told his parents that night, Carol recalls.

But rather than sitting on the edge of the bed, Robert came over to Carol’s side. Without saying a word, he raised a knife above her. “Kim, he’s got a knife,” Carol screamed. 

Kim jumped up to tackle his son. 

“He had no expression,” Kim recalls. “He was just zombie-like.” 

A marathon runner and warehouse manager, Kim was a strong guy with a body like a steel drum. Robert, on the other hand, was emaciated from lack of eating and sleeping. Yet, as they were tussling, “I remember thinking, This guy is strong as hell,” Kim says.

Kim tugged the comforter off the bed as a shield. But Robert sliced through it with the blade, stabbing Kim 14 times in the torso. Carol, meanwhile, fled to the hallway, cradling their phone and hurriedly dialing 911. Robert followed, stabbing Carol 14 times, mainly in her back and legs, before fleeing out the door.

“My son has a knife,” she screamed to the 911 dispatcher. “Send an ambulance. I’m bleeding really badly. We’re hurt really badly. My husband is passing out. Please help him — hang in there Kim, hang in there, honey.”

Before college, Robert had exhibited no obvious signs of mental illness, Kim and Carol say.

As a child, Robert was gregarious, witty and a bit of a charmer. With big blue eyes, he could pour on the sweetness like a ladle of syrup. 

Robert would often visit his paternal grandmother in Bay Village and fawn over her German-Danish cooking, which earned him heaping covered dishes of sausages, pierogies and potatoes. “He knew how to butter her up,” Kim laughs. 

The charm might have been compensation for other insecurities. 

As a toddler, Robert had been diagnosed with Tourette’s syndrome. Medicine helped suppress many of the compulsive movements, but kids can be cruel. Robert got into at least one fight with a classmate who had made fun of him over it, his parents recall.

In high school, Robert played lacrosse but was far from a star. “I did it mostly for exercise,” he says. At night, he hung out with his friends and smoked too much weed, he admits. Popular, he always had girls over, his brother Scott recalls.

During his sophomore year, Robert participated in a German exchange program and fell in love with the country and its language. He wanted to study international business in college and applied to the University of Toledo and University of Kentucky. “When I got into Kentucky, I thought, Great, guess I will be going there,” Robert recalls.

He was excited for his freshman year — for the freedom, for the classes, for the parties. But during the fall semester, things began to feel off, he says.

“I started hearing these voices,” Robert says. “I wasn’t sure whether they were coming through the walls or in my head.” 

He also developed an intense case of paranoia. “I was convinced my friends were talking about me in negative ways,” he recalls.

Fearful of himself, Robert didn’t know what to think. “It just kept getting worse and worse,” he says.

His parents noticed something was wrong too. 

After an appendectomy during his sophomore year at Kentucky, Robert accused the doctors of changing his sex organs. His thoughts grew disorganized. He began insisting to anyone who would listen that his parents weren’t his biological parents and he’d been adopted. 

Worried, Kim and Carol took Robert to Dr. David Chaiffetz, a psychiatrist at the Cleveland Clinic who would later diagnose Robert with schizoaffective disorder. 

“I didn’t want to accept the diagnosis,” Robert says. Crazy people were schizophrenics — not him. And before then, nothing had seemed wrong. So how could it be true?

According to Dr. Ewald Horwath, chairman of MetroHealth’s department of psychiatry, the most common age of onset for schizoaffective disorder is actually late adolescence. Although early signs such as depression or behavioral issues often present themselves earlier, they are often easily mistaken for the normal moodiness of a teenager, Horwath explains.

A history of mental illness in the Jaworski family (Kim’s aunt was placed in a mental health facility in Denmark) and Robert’s marijuana use may have also put him at risk. “Heavy marijuana use is a known risk factor for the onset of psychosis,” Horwath says.

Chaiffetz prescribed medication for Robert. But the dosages made his brain feel cloudy, Robert says, which made it “hard for me to think and rationalize.” 

As a side effect to his medication, Robert lacked the energy to exercise. So he stopped taking them intermittently, which is when the problems really began. 

“I really wish we had known what was going on earlier,” Kim says. “We were worried as hell.”

In early December 2012, Robert was involved in an accident while driving home from Kentucky. He had been up for 36 hours, he told his parents, and had fallen asleep at the wheel. His car had drifted into the passing lane, where it had been hit by a tractor-trailer. Robert was lucky to be alive.  

When Kim arrived in suburban Columbus to pick Robert up, he immediately knew something more was wrong. His son was angry, defiant and jittery.

On the drive up Interstate 71, Kim recalls, Robert kept trying to take the key out of the ignition. “You son of a bitch, you assaulted me my whole life,” Kim recalls him saying, as Robert tried to get out of the car. 

Kim pulled the car onto the median and hurriedly called 911. Police arrived and took Robert to Marion General Hospital about an hour outside Columbus, where he stayed until Christmas Eve. 

It was the first of three long-term involuntary hospital stays: Marion in 2012, Windsor Laurelwood Center for Behavioral Medicine in August 2013, and Lutheran Hospital in July 2014. In an effort to get help, Robert also spent several overnights at other hospitals. 

“Every time, every single time, we told the doctors he was sick,” Kim says. “We explained to them all the things he was doing when he was off his medication. We told them we wanted him to be committed long-term and have a chance to get better.”

But if the patient is over 18, Ohio law gives parents very little control over their child’s care. And hospitals can only hold patients against their will if they are generally a physical danger to themselves or to others, are unable to care for themselves and are likely to benefit from treatment.  

“A parent can let the doctor know their concerns,” says Dr. Phillip Resnick, professor of psychiatry at Case Western Reserve University. “The hospital staff weighs that along with their own observations. If they reach the opinion that a patient isn’t a harm to themselves or others, they would have to release.” 

In addition, financial and legal pressures work against parents. Nonstate hospitals must meet the criteria of third-party payers in order to be reimbursed for care and could face lawsuits for keeping a patient beyond what’s necessary. 

In addition, Cuyahoga County is under pressure for beds. Before deinstitutionalization in the late 1950s, four state hospitals in Cleveland offered approximately 1,500 to 2,000 beds, Resnick estimates. Now the only state psychiatric hospital, Northcoast Behavioral Healthcare, has about 250 beds.

“The lengths of stay are way down,” Resnick says. “There are efforts to treat people in the community [as outpatients] and only reserve beds for the most dangerous.”

The shorter stays mean doctors don’t have time to get to know the patients or determine whether the prescribed medications are working. 

“People are discharged when they are considered no longer a danger to themselves or to others,” says Rick Oliver, the director of crisis services at FrontLine Service in Cleveland, an organization that provides mental health and supportive services to county residents. “It’s not because they are necessarily better.”

Unlike other medical specialists, psychiatrists don’t have X-rays, MRIs or blood tests to help in their diagnosis. “That’s the tricky part,” says Oliver. “These brain issues are tough. If someone wants you to believe they are not suicidal, for instance, they can take steps to hide it. Violence is very difficult to predict.”

Robert, for his part, was always good at telling doctors the things he knew would get him released, his parents say. And even if Carol and Kim had gotten through to the doctors, Robert wouldn’t have willingly submitted to his parents’ care, he says. 

“Anything my parents said, I did not accept as the truth,” he says today. “I thought they were trying to harm me.” 

Outside the hospital, Kim and Carol could do even less to make sure Robert was taking his medication or getting mental health support. “They are such awesome parents,” says the couple’s good friend Mary Ellen Brock. “They tried so hard to get him help.”

Between 2012 and 2014, records show the couple called the Westlake police to assist with their son more than a half-dozen times. By summer 2014, Robert’s psychiatrist had become extremely concerned as well. 

Robert says he felt he was part of a Chinese military government spy program. If he had not tried to kill his parents, he believed that they would try to kill him. 

“It didn’t feel like I was making my own decisions,” he says now. “It felt robotic, like I was being operated by someone else.”

On July 3, Chaiffetz called the Westlake police to tell them Robert had stopped taking his medication and needed to be hospitalized, according to the call log. The court order him admitted to Lutheran later that day.

Chaiffetz advised Kim to seek guardianship over Robert. Four days later, Kim filed paperwork with the court arguing Robert was unable to make rational decisions over his own treatment or the care of himself. “We hoped it would be able to give us power over his medication,” Kim says.

But weeks before the guardianship process was complete, Robert was discharged from the hospital. Carol recalls being distraught during a meeting with Robert’s psychiatrist at Lutheran. “I said, ‘He’s still ill,’ ” she says. “ ‘What are we supposed to do now?’ ” 

Kim was just as worried. “For months now, we had been watching Robert get worse and worse. We were deathly afraid of what would happen.”

Kim lost more than a liter of blood. 

The knife had perforated his liver. But despite the deep chest wounds, luckily none of the blows had nicked the aorta. 

“We only see the lucky ones,” says Dr. John Como, the MetroHealth surgeon who treated Kim. The ones who aren’t so fortunate never make it to the operating room.

When Kim finally awoke from his coma, he had no doubt that he would survive. “I knew if I didn’t, Robert would be in a much worse place,” he says.

Kim’s injuries required three surgeries and six weeks of recovery in the intensive care unit. But through it all, Kim had only one thought: When can I see Robert? 

After the attack, Westlake police apprehended Robert a few blocks from his house. During questioning, Robert admitted he was in custody because he “committed a crime.” 

“It was clear that something was wrong with him mentally,” recalls Westlake police Capt. Jerry Vogel. 

In October 2014, Robert’s case was transferred to the Cuyahoga County Mental Health and Developmental Disabilities Court.

In spring 2015, Kim visited Robert at Northcoast Behavioral Healthcare, where he was being held before the trial. In the visitation area, Kim sat with Robert at a round table and looked his son in the eyes. “You don’t have to apologize,” Kim told him. “I know you didn’t do this. Your illness did.” 

“I had been anxious to say that for a long time,” Kim says. “I knew it would take a major burden off of his shoulders.” 

Kim recognized that some people, even friends, couldn’t understand why he would forgive Robert or how he could invite him back into his life. But to Kim, it was always very simple. 

“You don’t disown a sick kid,” he says. “You just continue to love him.”

On July 9, 2015, Robert stood before Judge Hollie Gallagher with his attorney, Frank Cavallo, at his side. In the courtroom, Robert’s father, grandfather and aunts sat in support of him.

“Are you feeling OK today?” Gallagher began.

“Yes,” replied Robert, who had spent much of the last year at Northcoast Behavioral. 

He had been taking his medication regularly and had regained the expression on his face, depth in his eyes and weight on his frame. The voices in his head no longer tormented him. 

Two days before, Robert’s attorney had submitted a plea, asking that the court declare Robert not guilty by reason of insanity. 

Cavallo read aloud from a report by Dr. Cortney Kohberger, a forensic psychologist at Northcoast Behavioral who had examined Robert. At the time of his parents’ stabbing, Robert “was in a paranoid delusion believing that he was in a computer simulation” and “was of the belief that his parents were not biological beings.”

She concluded there had been no argument or anything to precipitate the attack, and Robert had “no rational basis for engaging in any of the behaviors that he did.”

Gallagher found him not guilty by reason of insanity. 

Robert was committed to a mental hospital for 11 years, the maximum jail time he would have served had he been found guilty of the charges. Part of his treatment included mandatory counseling, constant monitoring of his medication and periodic check-ins with the judge. 

The Jaworski family was happy with the verdict. It was exactly the care Robert’s parents had been hoping for. 

“But I had to get freaking stabbed for Robert to access it,” Kim says.

Almost two years after the attack, Kim arrived back at MetroHealth’s intensive care unit — not as a patient but as a volunteer. 

On that first day, the constant beeping and whirring of the unit’s machines and alarms gave him goose bumps. 

“It’s one of my PTSD triggers,” Kim says. “I can’t stand hearing those alarms go off.” 

But he pushed through the fear, because there were patients to help. 

After leaving MetroHealth, Kim had been recruited into the hospitals’ survivors network, a program that trains trauma survivors to support and motivate current trauma patients.

“We try to flip the switch to get patients from ‘Here is thing that happened to me,’ to now ‘How am I going to do something about it?’ ” explains Sarah Hendrickson, manager of Survivor Recovery Services. 

Few things motivate patients more than talking with someone who has been through a similar situation.

“The worst part about being in the hospital, for me, was not knowing how long I would be there,” Kim says. “All these doctors and family members would come into the room and they would say, ‘We know how you feel.’ And I thought, You don’t know what it’s like at all.”

About five weeks into Kim’s recovery, Pete Soto, a former cop and the first survivors network volunteer, came to meet with him. 

In 2010, Soto’s police motorcycle collided with a pickup truck. He was pinned underneath it with a shattered pelvis for hours. 

“He walked in and he said to me, ‘You know, I was in a bed just like this one for three months, too,’ ” Kim recalls. “It just gave me so much hope.”

Today, Kim meets regularly with trauma survivors — from 20-year-olds with gunshot wounds to 75-year-old fall victims. 

“Kim just sort of fails to see the disease or the damage,” Hendrickson explains. “It’s sort of the theme of their family story. He doesn’t think any of these people are any less capable than they were the day before they got injured.”

It’s amazing, Carol adds, to watch Kim in action. “Before the accident, Kim was not very touchy-feely at all,” she says. “I think this program has just been tremendous for his healing. It’s opened him up to new friendships and given him back a lot of his confidence.”

That includes Deena Palmer. In November 2017, her 20-year-old son Hunter, who had been suffering from paranoia and delusions, allegedly walked into his beloved grandmother’s kitchen in Ashtabula, picked up a knife and cut her throat while she was making pork chops. 

The grandmother was taken to MetroHealth for treatment. She and Deena were connected to Kim through the hospital. 

“I’ve called him so many different times,” Deena says. “I’m not always able to discuss this with anyone else for fear they wouldn’t understand what I’m saying. I feel very fortunate that’s he come into my life.”

Today, Hunter awaits trial in a maximum-security facility in Columbus. Deena lives in Florida, but Kim calls often, and even met her there on a trip. Together, they talk about the problems of the mental health system, about the criminal justice system and about their children. 

“Kim was able to get his son back mentally,” she says. “We are still working toward that.” 

After struggling so much himself, it feels good to be a part of other people’s healing, Kim says. “Doctors and nurses can help you physically,” he explains. “But they can’t help you mentally.” 

On a recent June morning, Robert is feeling bored. 

“I’ve just been watching a lot of the World Cup and looking forward to meals,” he says on the phone from his room at Northcoast Behavioral. He’d like to return soon to the halfway home where he had been living before a small psychological setback in April. Gallagher had Robert returned to the hospital to stabilize his treatment. 

He’s feeling less manic now, and everyone hopes he’ll be back living and sleeping there soon. Life is more normal there, he says. 

Robert is scheduled to be released in eight years. “I want to go back to school, and finish my bachelor’s degree,” he says. “I’d love to move to Europe and live there for a while.” Maybe he’d be an interpreter or a teacher, he says. “I really like my language studies a lot.” 

Carol just wants Robert to find something that will give him a sense of purpose and worth. And hopefully find a few close friends again.

The family is anxious about what will happen when no one is enforcing Robert’s medication schedule any more. 

“I do worry about something like that ever happening again,” Robert admits. “I deal with the consequence of my actions every day. It’s something I have to live with.”

It is clear to Kim and Carol — and to Gallagher — that there is something wrong with our mental health system in the U.S. “In a perfect system, Robert wouldn’t have ended up in court,” Gallagher says. “We would have gotten him help in the community beforehand. There would have been ways to make sure he was taking medication. We need to improve on what we provide for people with mental illness in our community.”

But, Gallagher adds, there’s no reason why Robert can’t go on and live a long and full life. “The family support he has — especially from his dad — has been amazing,” she says. 

The family says they have never been closer. “Our relationship now is much better than it ever was before,” Robert says. 

On a recent Tuesday night, Carol, Kim and Scott sat in their Westlake backyard drinking lemonade and picking at strawberries, crackers and cheese as they recounted their journey. 

Scott, who has had the longest road to forgiveness, says he has a new sense of the situation. “I understand it wasn’t Robert,” he says. “It was the disease that did it.” 

After a few years of being unsure about his career path, Scott plans to become a nurse, largely as a result of the care his parents received while at Metro, he says. Carol beams with pride when he announces this. 

Since the “incident,” as they have come to call it, the family has made a few changes to the house. The flooring and bedding have been replaced in Carol and Kim’s bedroom. They are currently redoing the kitchen, where there will be no butcher blocks. All the knives will be enclosed in a drawer. 

“Butcher blocks and knives are another trigger,” Kim explains. 

But Kim forces himself to use them anyway. “My wife can’t cook to save her life,” he jokes. “So I’ve got to pull through.” Carol, who is back at work as a speech language pathologist, laughs and doesn’t disagree. 

When a jarring, whirring noise of a medical helicopter halts their conversation, Kim crosses himself. Every time he sees one of these flights, Kim says, he can’t help but reflect briefly back on his own. 

“I thank God they are helping someone else,” he says about the medics onboard. “I just really hope that that person makes it.” 

There is a lot, he knows, to live for on the other end of that flight.