MUSC neurosurgeons save mother and unborn child after domestic violence shooting

For Haleigh Rae Startin, the first serious red flag went up in November 2019, shortly after she found out she was pregnant. “It was the first time he’d really assaulted me. I was a manager at Firehouse Subs, and I was on my way to work. He basically kidnapped me and threw my phone out the window,” said Startin. “Then he blacked both my eyes and busted my lip. When he drove off, I went to a gas station and called 911.” 

The police took her statement and issued a warrant for her boyfriend for first-degree domestic violence.

But things seemed to settle down after that. They spent Christmas with his family in North Carolina and had a gender-reveal party where friends popped a balloon filled with light-blue confetti. They were excited to welcome a son into the world. Still, the arguments continued to simmer.

In January 2020, four months into her pregnancy, Startin decided that she’d had enough. “It was two months since he beat me up, and I thought it was a safe time to tell him that I was done,” she said. “I took the ring off my finger and said I didn’t want it anymore, and he got furious.”

As they drove through a rural area near Green Sea, South Carolina, he pulled out a gun and shot her in the head, stopping to push her out of the car and leaving her and their unborn child for dead in the middle of the road. “A sweet older woman named Carolyn found her. It’s a miracle she came by because it’s not a highly traveled road. She thought Haleigh had been hit by a car,” said Sue, Haleigh’s mom.

 

Startin was airlifted to MUSC Health where Alejandro Spiotta, M.D., led the team of neurosurgeons and critical care specialists who worked to save her life. “Based on the gunshot injury alone, a lot of hospitals would have given up on her because her chance of making a meaningful recovery was so low,” Spiotta said. “The CAT scan showed a very deep bullet trajectory that stopped just one centimeter from the center of her brain. If it had gone any further, she’d have been in a coma.”

They rushed her into emergency surgery. “Her odds weren’t good, but it wasn’t impossible. We just saw this young pregnant woman who deserved every chance we could possibly give her,” Spiotta said. “The first thing was to reduce her brain swelling and prevent more damage. We removed a large piece of her skull and parts of her brain that were damaged, but we had to leave multiple bullet fragments because it was too risky to get them out,” he explained.

Fortunately, the swelling did abate and Startin survived. Over the next several months, she underwent two more brain surgeries and multiple complications, including an aneurysm, seizures, preeclampsia and a pulmonary embolism. It has now been a year and a half since the rainy day in January that could have been her last, and she is back home raising her son.

“He made it full term,” she said proudly. “Born at the MUSC Shawn Jenkins Children’s Hospital – a healthy baby boy at 9 pounds and 19 inches long. We worried about all the medications I was on and everything I went through while I was pregnant, but he’s doing great.” Although she still uses a wheelchair, she is determined to regain independent mobility. “I’m working hard at my therapy and doing everything I can to get better, because I won’t let him win. My goal is to get out of this chair and walk again on my own,” she said.

 

For Spiotta, it’s a joy to see how far she has come. “Considering her injury, she’s made remarkable progress. She still has challenges with left-side weakness and occasional seizures, but I believe she’ll regain her ability to walk with aid. Her syncing is spot on, and she’s young,” Spiotta said. “It’s so rewarding to see her in the clinic; her mom is always by her side, and her son is thriving.”

He credits Startin’s positive outcome to MUSC Health’s multidisciplinary team approach, which brings multiple areas of expertise together to manage difficult cases. Specialists in trauma, critical care, neuroendovascular surgery, neurology, intensive care, neurology nursing, physical therapy and occupational therapy all collaborated to bring Startin through her ordeal. Spiotta also credits a unique MUSC culture. “Other hospitals call us when they have a scary case. Dozens of feeder hospitals send us their most challenging patients, and we’re very aware that we are often these patients’ last hope. Knowing that makes us push ourselves to do everything we can for them. It’s our culture not to give up on anyone.”

MUSC Health also has specialists who deal exclusively with cases of intimate partner violence. The MUSC Advocacy Program (MAP) features a social work response team available 24 hours a day, seven days a week to respond to calls from any staff member who suspects a patient has been the victim of domestic violence, child abuse or neglect, elder abuse or neglect or human trafficking. Licensed master social worker Abby Steere-Williams is the Map Social Work coordinator.

“Honestly, I thought we were OK when he shot me. I really didn’t think he would try to kill me – until he did.”
Haleigh Rae Startin

No one deserves to be hurt by their partner. If you need help, resources are available.

MUSC Advocacy Program: 843-792-2123

MUSC Women’s Health has statewide resources available, by county.

My Sisters House: 843-744-3242

SC Legal Services: 888-346-5592

Charleston Area Consolidated Dispatch (Non-Emergency): 843-743-7200

MUSC National Crime Victim Center (NCVC): 843-792-8209

National Domestic Violence Hotline:
1-800-799-7233

“We’re a round-the-clock social work response team for any MUSC inpatient or outpatient. We do a safety and danger assessment with them and provide resources for whatever they need – shelter, counseling, medical care, food, clothes – whether they’re ready to leave the situation they’re in or not,” explained Steere-Williams. “We follow up after discharge to make sure they know they’re not alone, and that support is available in their local community to help them.”

Steere-Williams emphasizes that self-determination is one of the program’s core values, and they do not pressure victims to leave before they’re ready.

“When a provider is concerned that something is going on, we meet with the patient one-on-one and talk about the prevalence of intimate partner violence,” Steere-Williams said. “We educate them about domestic violence and the help that’s available. We let them know that this type of violence affects one in four women, so it’s very common, and if they or anyone they know is in this situation, they can call us when they’re ready.”

The MAP team works closely with MUSC Health’s forensic nurse specialists like Karen Hughes, R.N., who is a certified sexual assault nurse examiner. “We see them at the same time as MAP so the person doesn’t have to retell their story, which is traumatizing,” Hughes said. “Our job as nurses is to examine them from head to toe and ask questions about their medical history. We do a body map where we measure, describe and document their injuries with photographs so they have those if they need them later in a legal case.”

While many victims do not initiate legal action for quite some time after an assault, they know that there is forensic documentation in their MUSC medical file should they ever need it. In cases of severe injuries, like those suffered by Startin, the police can step in and start criminal proceedings based on the medical record alone.

Hughes and Steere-Williams work with both male and female victims of intimate partner violence and said most victims return to their abusers after discharge. Their goal is to ensure that victims know how they can reach out and where to go for help and understand the level of danger they face in choosing to stay or leave. “Victims don’t always understand how much danger they’re in,” Steere-Williams said.

In fact, that is what motivated Startin to tell her story. “Honestly, I thought we were OK when he shot me. I really didn’t think he would try to kill me – until he did,” she said, offering the following advice to others: “Please leave before it’s too late. You might not be as lucky as I was. I wouldn’t wish what I’ve been through on anyone. If he verbally abuses you, he will physically abuse you, and he will try to kill you. That’s what I’ve learned. At the first sign of disrespect, just go ahead and leave because it’s not worth it at the end of the day. I know what it feels like to love someone so much that you feel like you can fix them, but you can’t fix people.”

She also hopes that sharing her story will help to create more open conversations about intimate partner violence. “Domestic violence is so hush-hush and taboo. But it should be talked about more openly. I feel like that would help people who are feeling alone and trapped.”

For now, she’s happy to be at home, working to reach her goal of walking again and raising her son in a home filled with love and gratitude. “He’s doing so well! I just want all good things for him. I want him to always be kind and to look up to me the same way I look up to my mom. So, I’m going to be the best that I can be for him.”