Perspective: Understanding Brain Injury
by Dr. Bryan S. Weinstein
Imagine that you wake up one morning to discover that you are in a foreign country. Everyone – including your friends and family – speaks a different language. Their language is as incomprehensible to you as yours is to them.
Now imagine that you just enjoyed a dinner with friends and had one too many drinks. You wake up in the morning and realize that not only did you fail to sober up – you never will. You will continue to be disoriented, dizzy and off-balance; impulsivity and dis-inhibition will define your behavior; your affect will alternate between inappropriately jovial and incongruously aggressive. Absent your normal inhibitions, you say and do things with no insight into your own behavior.
Take a moment to mentally fuse both scenarios. Now picture this state lasting for a minimum of two years. Or even for the rest of your life. Your loved ones may attempt to care for you, but it isn’t long before your behavior alienates both family and friends. Maybe even your children. You can no more hold a job than you could wish yourself better. You find yourself isolated, inconsolable and without immediate access to your usual emotions, memories and coping skills.
This may sound like a nightmare, but the reality is that there is a very real possibility of a head injury turning into a lifelong disability. How often have you heard the phrase, “I never thought it could happen to me?” I hear it dozens of times each week. As long as you drive a motor vehicle, you and your loved ones stand a chance of becoming victims.
You don’t have to suffer a catastrophic accident to acquire a brain injury. Experiencing rapid deceleration can cause your brain to slam into the front and back of your skull – this is called a contrecoup event and is one of the most common injuries resulting from an auto accident. Even minor injuries can damage billions of neurons and effect large parts of your brain. Unlike most physical injuries, a trauma to the brain is invisible – which makes it extremely unlikely that you will be afforded any sympathy for the behaviors we discussed earlier.
Instead, you will be held responsible for your behavior. You will become a victim of your brain’s inability to function properly. You may become a pariah, a social outcast unable to relate and unable to have other people relate to you. Soon, you enter into a world of pervasive loneliness. What’s more, the brain does not heal in a predictable fashion. Symptoms may vanish within six months or last a lifetime. The severity of a brain injury bears no correlation to the length of recovery time. Even a minor fender bender or fall with no visible physical injury can result in behavioral and cognitive deficits that have profound social and occupational consequences.
I was taught that the best moral compass for compassionate care was to treat patients as I would members of my own family. When we’re able to step into the shoes of a survivor, some things become very clear. People with brain injuries want:
· The basic respect afforded to anyone
· To be treated like an individual, not an injury or constellation of
symptoms
· The dignity of being allowed input into a treatment plan
· Acknowledgement that they still have goals and ambitions
· To socialize with family, friends and to meet others
· A chance to be happy, fulfilled and find purpose
· A chance to realize true independence
We should all do our best to acknowledge their humanity, as well as their wants and needs.
Now imagine that you just enjoyed a dinner with friends and had one too many drinks. You wake up in the morning and realize that not only did you fail to sober up – you never will. You will continue to be disoriented, dizzy and off-balance; impulsivity and dis-inhibition will define your behavior; your affect will alternate between inappropriately jovial and incongruously aggressive. Absent your normal inhibitions, you say and do things with no insight into your own behavior.
Take a moment to mentally fuse both scenarios. Now picture this state lasting for a minimum of two years. Or even for the rest of your life. Your loved ones may attempt to care for you, but it isn’t long before your behavior alienates both family and friends. Maybe even your children. You can no more hold a job than you could wish yourself better. You find yourself isolated, inconsolable and without immediate access to your usual emotions, memories and coping skills.
This may sound like a nightmare, but the reality is that there is a very real possibility of a head injury turning into a lifelong disability. How often have you heard the phrase, “I never thought it could happen to me?” I hear it dozens of times each week. As long as you drive a motor vehicle, you and your loved ones stand a chance of becoming victims.
You don’t have to suffer a catastrophic accident to acquire a brain injury. Experiencing rapid deceleration can cause your brain to slam into the front and back of your skull – this is called a contrecoup event and is one of the most common injuries resulting from an auto accident. Even minor injuries can damage billions of neurons and effect large parts of your brain. Unlike most physical injuries, a trauma to the brain is invisible – which makes it extremely unlikely that you will be afforded any sympathy for the behaviors we discussed earlier.
Instead, you will be held responsible for your behavior. You will become a victim of your brain’s inability to function properly. You may become a pariah, a social outcast unable to relate and unable to have other people relate to you. Soon, you enter into a world of pervasive loneliness. What’s more, the brain does not heal in a predictable fashion. Symptoms may vanish within six months or last a lifetime. The severity of a brain injury bears no correlation to the length of recovery time. Even a minor fender bender or fall with no visible physical injury can result in behavioral and cognitive deficits that have profound social and occupational consequences.
I was taught that the best moral compass for compassionate care was to treat patients as I would members of my own family. When we’re able to step into the shoes of a survivor, some things become very clear. People with brain injuries want:
· The basic respect afforded to anyone
· To be treated like an individual, not an injury or constellation of
symptoms
· The dignity of being allowed input into a treatment plan
· Acknowledgement that they still have goals and ambitions
· To socialize with family, friends and to meet others
· A chance to be happy, fulfilled and find purpose
· A chance to realize true independence
We should all do our best to acknowledge their humanity, as well as their wants and needs.