They were simple words, but they nearly knocked Betsy Scantlin off her feet. "Hi, Mom," said the caller who reached her at the Cheney, Kans., home she shares with her husband, Jim, on Feb. 4. In an instant, the 64-year-old retiree recognized a voice she thought she'd never hear again. "Sarah," asked Betsy. "Is that you?"

Indeed it was. For two decades Sarah has been confined to the Golden Plains Healthcare Center, unable to speak or voluntarily move her limbs. An athletic and popular 18-year-old freshman at Hutchinson Community College, she was struck by a drunk driver and left severely brain damaged. Trapped in what neurologists define as a minimally conscious state, Sarah seemed to recognize loved ones but could only react by "following things with her eyes," says her doctor, Bradley Scheel. Then last month Scantlin said the word "okay" during a therapy session and later, with help, began uttering simple sentences. Cautious about her progress, staff brought in a speech therapist who worked with Sarah until she made her surprise call. "It's miraculous," says Scheel. "Some of her connections for speech have regenerated, but we don't know exactly why."

Regaining speech after such severe brain trauma is rare. "There have only been occasional reports," says Dr. John Kessler, chair of neurology at Northwestern Memorial Hospital in Chicago. "But people would be misplacing hope if they thought it was the same as [coming out of] a permanent vegetative state."

But for Scantlin's family, her recovery is miracle enough. Mute since the Reagan era, it is unclear how much history Sarah gleaned from the TV in her room, but when her brother Jim, 42, asked if she knew her age, she guessed 21. "I told her she was 38, and she looked at me like I was nuts," he says.

Scantlin's prognosis is uncertain: She still eats with a feeding tube and may remain hospitalized for the rest of her life. Yet loved ones are thankful she can manage a simple chat. "We had expected the next phone call to be one saying she had passed away," says her brother. "We just giggle now and think it's unbelievable."