What’s your mission?

Source: Aaron Escobar (the spaniard)

Disclaimer: This may turn out to be a clumsy post. I don’t want to insult anyone with any inappropriate references or seeming to make light of or diminish anyone’s career or calling or history of service. If I get clumsy with my terminology and come across sounding like an idiot, please accept my apologies. But I think what I’m about to say is important, so I’m going to take a shot.

I’ve been thinking a lot about what I’ve read about the movie Restrepo, a feature-length documentary that chronicles the deployment of a platoon of US soldiers in Afghanistans Korengal Valley. I’ve been thinking about one brief scene that someone described — a soldier being asked what he was going to do when he gets home and doesn’t have the constant adrenaline rush of war anymore.

He said, “I don’t know.”

See, this is the thing — with soldiers returning from the front, as well as TBI survivors who once lived fast-paced, action-packed lives. Logistically and qualitatively, there’s really no comparison between the constant life-and-death struggles of active-duty soldiers and, say, an acqusitions and mergers attorney. But biochemically, they’re much more similar to each other than to folk who aren’t bathed in a daily biochemical wash of super-amped-up stress hormones.

When you get bumped out of the front, thanks to TBI (or PTSD), what do you do?

We don’t know.

When it comes to addressing the issues of TBI/PTSD survivors who come from prolonged exposure to biochemical fight-flight extremes — especially when that exposure was in service to a larger-than-life, well-defined structure (in the case of m&a attorneys, the firm(s) handling the transactions and the rules of the game played… in the case of soldiers, the military culture and the rules of engagement). You have a very well-defined structure around you, you’re bound by that structure to follow certain rules, and the structure also defines for you what it is you’re supposed to do within very well-established parameters. And within those parameters, you participate in some of the most taxing and harrowing experiences the human system can endure. The structure, the order, the machine… it all makes it possible for you to do more than you ever dreamed you could — both for good and for ill.

It’s the highest of the highs. It’s the lowest of the lows. And over time, if your system is exposed to enough of those fluctuations without a chance to balance it out — the parasympathetic (rest and digest) nervous system gets out of practice, since it’s constantly pushed out of the way by the sympathetic (fight-flight-fake-it) nervous system — you get stuck in gear. Like the cable of your clutch goes on you when you’re in the fast lane hauling ass out of Los Angeles.

And then you get hurt. Or you get sent home. Or your tour ends.

And then what?

You get out of the hospital/rehab. You try to settle in at home. You look for something to fill the void left by the absence of your colleagues or comrades in arms. Everyone is telling you, “Relax… Take it easy… Calm down…” But the very things that kept you going all those months/years, the very things that made you who and what you ARE… well, they’re gone.

And how does a ghost relax? How does a shadow take it easy? How does a shell calm down?

Getting injured, getting hurt, getting fired/discharged… There’s more to it than just losing your place in the rank and file. You actually lose yourself. Who are you, if you aren’t doing the things you’ve strived to do, month after month, year after year? Who are you, if you don’t have that structure to work in, the rules to define you, the culture to tell you you’re needed?

This, to me, is the most debilitating aspect of TBI — and probably PTSD, too. It’s not just some hurt that needs to be healed or some biochemical imbalance that needs to be righted. It’s a crushing, diminishing, awful loss of the very essence of who you’ve become. And the rest of the “civilian” world — unless they’ve been in that life — cannot possibly understand how insulting it is when they tell you to relax, calm down, take it easy.

Who you are and what you are is about doing and being the exact opposite. Because that’s what you do. You don’t relax. You don’t calm down and mellow out. You don’t take it easy. Because you have a job to do. You have a mission to accomplish. And because you are who you are, you cannot and will not rest, till you finish the job.

So there.

Some of us need missions. We need a structure, a higher purpose, a job to do. We need someone to tell us This Is The Priority, so we can pitch in and do our part. We need to be part of something bigger (and badder) than ourselves, and lose ourselves in service. Some of us are not part of the cult of personality, but part of the brother-/sister-hood of service, whose very essence is refined and shaped by our selfless dedication to the Higher Good. We dedicate our lives and our whole selves to duty and to making a difference in the world — not for the sake of our own glory, but because that’s who we are.

And we need a mission.

Coming home — whether from the front or the hospital — or getting up after a fall, climbing out of a wrecked car, or waking up after being knocked out, we are not the same people as we were before the events that re-shaped our lives. But we still need direction and purpose. In the absence of the larger structures (which no longer have need of our broken selves), it’s up to us to find in ourselves where we want to serve, how we wish to contribute. I firmly believe that each and every one of us, no matter how damaged, has a role to play and a place to fill. If we haven’t got the coordination or the cognitive ability we had before, there are other ways we can pitch in and help out. If we haven’t got the old skills we once had, we have the ability to develop new ones, perhaps ones we never thought we’d have/need.

Once injured, once hurt, once damaged by the world we once participated so fully in, it can be all too easy to get lost in the shuffle.

But if we step up, we can make a fresh start, with a new mission, with a new way, a new dedication. We may not have the old structures around us, but we can find and/or create new ones. This is something we can do.

For some ofย  us, it’s something we have to do.

What’s your mission?

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Cooking up my recovery

Source: momsrecipesandmore.blogspot.com

Some time back, I announced I was going to start cooking as a conscious way to deal with my TBI symptoms. And then I forgot about it ๐Ÿ˜‰

Well, I’ve remembered my resolution intermittently over the past couple of months, and I realize that — intentionally or not, I’ve become the official cook of my household. My spouse has been having health issues that prevent them from standing and walking around much, so it’s been pretty much on me to get dinner on the table when it needs to be there. On top of that, they have been working a lot of jobs lately, so I’m the only one in the house with a predictable schedule.

So, I’ve been cooking. I don’t do fancy meals — mostly things that just need to be cut up and put in a pan and turned on low for an hour or so. Most of my work is preparation of vegetables to go in the pan — peeling and slicing and what-not. Oh, and keeping an eye on the clock, so I don’t burn it.

And I have to say, it’s actually been helping me. Not only is it good to eat food that I’ve prepared (I know what’s in it), but it’s really good for my timing and my coordination. Things like chopping or peeling used to be a real problem for me, when my spouse would say something to me, or I would be distracted by something. It’s really embarrassing to admit, but I used to just freak out, if they talked to me while I was preparing supper. ย I simply could not handle more than one task at a time. I would drop things and get panicked and yell and really pitch a fit — waaaaaay out of proportion for what was going on:

my spouse said something to me while I was dicing an onion.

Heaven forbid.

Well, anyway, I’m really happy to report that that foolishness has stopped. My neuropsych has helped immensely, training me to think in terms of being able to control that kind of behavior, rather than give into it, just ’cause I’ve been injured. Plus, I’ve realized that when my spouse talks to me, I don’t have to respond immediately in that moment. They can wait a few minutes till I get done chopping. And I don’t have to cut my fingers anymore. I used to do that a lot, when people talked to me, which freaked me out (needless to say). So, I developed this complex about people talking to me when I was cutting things with a knife.

But that’s cleared. And I can chop up my food without losing it.

Woot – woot

It’s the little things, you know?

Well, anyway, I just wanted to do a quick check-in about that. Cooking, with its timing and patience and impulse control elements, is extremely good exercise for me. It helps me on so many levels. And when I’m done, I actually have something to show for my work. If I screw something up, there’s always tomorrow night. I haven’t burned the house down (though I’ve ruined a few pans by turning up the heat “for a little while” and then forgetting all about them… and then discovering something was amiss, thanks to the smoke alarm). And even when I’ve burned the food, I’ve managed to salvage it. Most of the time.

Probably the best thing about this, though, is that it makes me a productive contributor at home, in ways I can actually manage after long days at work. I don’t have much energy for much anything else, by the time all is said and done, but I do have energy to cook. And lo and behold, I often find that after cooking supper, I’ve got some energy back, which is good for my home life.

What a drag it must be, to live with someone who can’t manage to stay up past 8:30 every night… Staying up a little later gives me a few hours to check in and remind my spouse who I am, what I’m about, and keep our marriage going.

And what a drag it must have been, for those many years, when I was a terror in the kitchen, freaking out and flying into a rage over small and simple things… having temper flares and melt-downs over little things like dropping a spoon… getting all agitated, just when my spouse would talk to me… and being so unbelievably irritable, there was almost no dealing with me.

Cooking lets me focus in on what’s in front of me, do something useful and needed, and it lets me practice each night the skills I need to live beyond the kitchen — patience, executive functioning, sequencing, coordination, time management, working memory stuff, and more. It doesn’t just feed me for an evening — it can feed me for a lifetime.

Concussion amoung school-age kids getting more press

Source: marines.mil

A few days ago, Google News had reports about updated numbers on E.R. visits among kids due to concussions. Unfortunately (or perhaps fortunately) I was really busy at work, so I didn’t get a chance to read much. And then I got busy at home, so again I missed the window. Looking at Google News, I’m not seeing this anymore, so I looked up “concussion” results for the past week.

Sports-Related Concussions on the Rise in Kids on WebMD heads the list, followed by other articles in major mainstream news sources, like the Wall Street Journal and Business Week. This is good news. When major news outlets which are highly trusted sources for information for people in power are talking about an issue, it’s bound to get more attention than when average folks (like me) are tap-tap-tapping on our drums.

The Business Week article says:

The number of concussions suffered by school-age children appears to be rising even as participation in certain organized team sports declines, according to a new study published Monday in the journal Pediatrics.

The study, by researchers at Hasbro Children’s Hospital and Brown University, both in Providence, R.I., is the first national look at concussions in school-age kids, who may be more vulnerable to long-term complications from such head injuries than adults.

The study looked at more than 500,000 emergency room visits for concussions in children ages 8-to-19 from 2001 to 2005 with a focus on concussions caused by sports injuries.

Of the approximately 502,000 emergency room visits for concussions, more than 252,000 were sports-related, which included individual sports like bicycling and snow-skiing as well as team sports.

Children ages 8-to-13 had a higher rate of sports-related concussions at 58% than children ages 14-to-19.

The study’s lead author, Lisa Bakhos, who is now a pediatric emergency room doctor at Jersey Shore University Medical Center in Neptune, N.J., said that while many studies have been conducted on the impact of concussions among high-school, college and professional athletes, little is known about sports-related concussions in school-age children.

Woo hoo! That is to say, hooray that they’re paying attention to this issue. The fact that they’re stating openly that “little is known about sports-related concussions in school-age children” tells me that doors may (eventually) be opening to funding for this sort of thing. It’s one thing, to raise awareness in the scientific community, but when the business leaders of the world are alerted to issues that need to be addressed, I suspect there’s a little more chance that the money to do the necessary research will be forthcoming.

Business leaders like Bill Gates and Warren Buffett have been pitching in mucho schekels for research and humanitarian causes, so there’s precedent there. Not to get anybody’s hopes up, but it’s still a great sign that the business world is talking about this issue.

It’s interesting that this is coming to light in the mainstream press, just about the time when I’m plucking up the courage to look back into my own concussive childhood to reconstruct what it was like. Dealing with the world after having sustained multiple concussions by the time I was eight wasn’t easy. The effects lasted into my teen years, and beyond. But it’s hard to separate out what difficulties were due to my early childhood injuries, and which were due to my later injuries. Having sustained mild traumatic brain injuries on a regular basis (every few years), starting around age 4, kind of muddles the picture. And it probably makes me a lousy candidate for scientific enquiry. What’s the control? How can you gauge/compare/contrast my experience with anything or anyone? I’m not unique, but I’m also not run-of-the-mill, which would probably make most neuroscientists absolutely nuts.

Bottom line is, my whole growing up experience was pretty rotten, in many ways, due in no small part to the influence of my TBIs. It’s one of those things that I generally prefer not to talk about. My spouse sometimes comments/complains that my childhood is a big blank to them. I just don’t discuss it much… either because my recollection is too jumbled and turned around to relate sequentially, or it was distinctly unpleasant, or I just don’t remember things.

When my parents talk to me about people and events from their/my past, they usually preface it with, “Do you remember…?” And when I (usually) say I don’t, they give me a little background information and context, so I can understand what they’re talking about.

But at the same time, when I look back on my childhood and think about how it was for me, internally, there was a lot of joy and happiness I experienced. I have to say, the vast majority of my enjoyment happened in total solitude. Away from the intrusions of people who were constantly finding fault with me, constantly trying to get me to behave the way they wanted me to, constantly embarrassed by my behavior or confounded by my “willfulness,” or calling me names/teasing/taunting me. It’s remarkable, what a dichotomy there was between my external world, which wasn’t much fun, and my internal world, which was a continuous source of intrigue, learning, and entertainment for me.

Dealing with the outside world was largely a losing proposition for me. I didn’t have many friends, and the ones I did have, I often drove away with my intensity and my moodiness. When my parents sent me outdoors to play with the other kids, I was either overly domineering or withdrawn and marginal. It was all or nothing with me, and what few memories I have of my childhood social expriences are shrouded in a fog of confusion and confabulation.

Not that I want to sit around and feel sorry for myself… When I think back, I’m actually fascinated by the degree to which I was able to protect and shield myself from the outside world, simply by withdrawing into my own little world. I had a whole bevy of imaginary friends, I did role-playing ‘fantasy’ enactments, based on books I’d read, which I experienced like real life. In a very real sense, I constructed my own parallel universe where I could be “normal” and safe at the same time. None of my imaginary friends (even my enemies) ever made fun of me or treated me like the freak the rest of the real world did.

Books… yes, books… They were a great way to get away from it all. When I was reading, no one would bother me. And the rhythmic back-and-forth motion of my eyes was very soothing. Thinking back now, I realize that I didn’t understand everything I was reading. I often just let my eyes go back and forth across the page, picking up things here and there. My progress was very spotty. Sometimes I’d get what I was reading, and I’d follow it for a few pages. Then my attention would wander and I’d find — several pages later — that I’d lost track of where I was. But I wouldn’t go back and catch up. I’d just keep going, all the while making up my own story about what was happening in the book. I would literally “rewrite” parts of the story to fit what I thought was going on. And by the time the book was done, I had very little idea what it was actually about. I thought I knew, but when I talked to people about the story, their interpretation and recollection was usually pretty different from mine.

It never bothered me much when I was a kid, immersed in fiction. But as I grew up and I continued to construct my own parallel interpretations, it became a real problem. Being looked at like I had two heads is something I just got used to.

That habit of not fully understanding but making things up that “fit” my interpretation has dogged me all my life, and only in the past few years have I started addressing it. Only since I started working with my neuropsych have I actually been able to pause in the middle of a conversation and ask for clarification. That old habit of just pushing on without all the facts and information and concocting my own “brew” of world interpretation has been both a blessing and the bane of my existence. True, it satisfies a part of me and it lets me look like I’m keeping up — even ahead of the game — but in the end, I’m way farther behind than anyone really knows. It’s sometimes hard for me to believe I’ve gotten as far as I have in life, but instinct really does play a role and it’s served me well over the years. And presenting with an air of confidence and surety goes a long way, too.

All the same, it’s pretty friggin’ awesome to be able to get to the end of a conversation and know what it was about. Thank you, Dr.ย  C, for that.

Anyway, enough about me. People are starting to sit up and take notice of concussions in kids. And in professional athletes. And high school jocks. This is a good thing. Eventually, someone is going to figure out what many of us have had to find out on our own, and they’re going to start teaching it in schools. And I’m not just talking about an hour-long talk in an assembly, but a real, honest-to-goodness part of curriculum — perhaps as part of preparation for participation in sports. Prior to the season start, when schools are doing baseline cognitive testing on their student athletes, that would be a good time to educate players about concussion — the dangers, the warning signs, and the proper way to respond, both as an injured player and a concerned teammate.

If they can figure out how to do that, that will be a very good thing.

Oh, look at the time. Must get back to work.