When I checked my email last night, I was pretty shocked to see that a public figure I really admired had died unexpectedly from a head injury. Out of respect for the deceased, I’m not going to use their name. Yes, it would probably drive a lot of traffic to my blog, but I don’t feel like taking advantage of their situation for the sake of my stats. You probably know who they are, anyway.
Having been in numerous situations, myself, where I had hurt my head but I had no idea how badly, I have to say that it really is very difficult to tell how bad an injury is — especially when the injury affects the reasoning part of the injured party.
Everyone around you might be saying, “Are you okay? Are you alright?” and they’re genuinely concerned, but you just want to get away from all the commotion, lie down, and settle down. You don’t want to be bothered by all the hullabaloo, which — to your injured brain — can be very confusing, very aggravating, very anxiety-producing. It can just be too much to process. And if emergency medical teams are involved, the drama can be so disorienting, so confusing, so annoying, that it’s a relief to just get them to go away.
With me, when I fell in 2004, about the last thing I wanted, was for people to fuss over me. And I declined both help and attention for a number of reasons:
- I didn’t want to be bothered by all the drama of an emergency room, when I was just a little wobbly. I figured I just needed to collect myself and shake it off, and I’d be fine.
- I didn’t want to make a big deal out of things, when all I had done was fall down the stairs and bump my head. I had fallen plenty of times throughout my life, and I had never rushed off to the hospital before (tho’ it turns out I probably should have).
- I wasn’t sure that I could get the proper help in the town where I was visiting. This was because I wasn’t sure about the quality of medical care available in that relatively rural location and because I wasn’t sure, myself, how to describe my symptoms.
- I didn’t want to interrupt my schedule — I was packing to go home after a very demanding holiday celebration — over something as dumb as a fall. I really just wanted to go home.
- Nobody knew how badly I’d hurt myself. I was too out of it to tell just how I was, and the folks who were with me didn’t know enough about concussion or head injury to judge my condition.
Things might have been different for me, if we had all had more information about head injury, if we had known the signs, if we had had access to high quality medical care, and if there hadn’t been all sorts of other competing activities going on. As it was, in the case of my fall in 2004, everything added up to me not getting help for my problems, and proceeding to lose an awful lot of important elements of my life.
I’ve had other similar experiences, as well — particularly with car accidents. The three different car accidents I was in, that had noticeable after-effects, were never enough to slow me down or stop me for long.
The first one I had in 1987 had the immediate result of confusion, inability to understand what people were saying to me, and loss of ability to work for a number of weeks. I just couldn’t keep it together. Eventually, I was able to get back into the swing of things with work, and I was able to get back to normal functioning. But that was only after a couple of months of screw-ups on job interviews, missing cues, drinking a lot, and generally being a wreck at home.
The second accident I had in 1989 left me spacy and confused and having a hard time finding my way to the train station I was going to, after the accident. I also had a very sore neck — more sore than usual — and I didn’t feel quite right. But I still pushed through and went about my business.
The third one in 1996 also came at holiday time, in heavy Thanksgiving traffic, and immediately after it, I had a really hard time focusing, and I couldn’t for the life of me read the forms I had to fill out to send to the car rental agency. I just checked some boxes and signed the form and sent it in, hoping that I’d gotten it right, but not knowing for sure. I also started to lag at work, and I dropped a lot of projects I had started, without really understanding why… or properly assessing how important the fact was, that I was dropping them.
Every time I’ve fallen or been hit or had an accident, I’ve never actually received proper care afterwards. When I was a kid, people didn’t know about concussions. They didn’t know what to look for, and they didn’t properly estimate my need for help. Also, when I was a kid, I didn’t want to draw attention to myself and look like a “sissy” just ’cause I had gotten hit on the head. And as an adult — perhaps because of the series of re-injuries — I’ve never aggressively followed up on my symptoms and gotten medical help after my accidents.
Thinking about it within the context of our North American culture, I have to say that our world is not particularly well-suited to treating head-injured people. Our movies are chock-full of images of head trauma that has no consequence whatsoever — people are always getting punched, slammed, hit over the head, tackled, and generally taking a lot of punishment above the shoulders — all without apparent side-effects. Our sports are violent and often include plenty of blows to the head as a matter of course. Football and soccer and ice hockey are tailor made for getting hit on the head, whether through tackles, moving the ball up the field with a header, or assaulting an opponent to gain possession of a puck. Falls and bumps have entertainment value, whether it’s in a commercial for a carbonated beverage or it’s slapstick comedy or it’s in kids’ cartoons. When I think about how many images of violent assault and “fun” head trauma I saw just on Saturday morning cartoons — Elmer Fudd really took a beating over the years, and I’m surprised he survived — it’s no wonder that when I fell, myself, all those times… or got hit on the head… or experienced some tackle or hit or accident that “rang my bell”, I instinctively shook it off and declined help.
Now, I wish I could say, after all these experiences (and knowing what I know now about traumatic brain injury) that if it ever happens to me again, I’m going to do the right thing and seek medical help. But I’m not sure I will. I’m not sure I’ll be able to. When you’ve been hit on the head, your thinking can get so foggy, your judgment can be so muddy, and you can be so irritable and, well, non-compliant… that your better angels don’t have a chance to step in. Those angels may be your instincts or people around you who care about your welfare, but in either case, when you’re head-traumatized, you can be ornery and contrary and refuse any kind of help and get very agitated if those “angels” press you to assist.
It’s a conundrum. One with consequences, as too many people find out regularly. Whether they’re the head-injured person or their family or friends or co-workers, they are impacted to some extent.
Perhaps the only hope we have is education. Information… Well-informed judgment. And the willingness to endure the wrath of head-traumatized individuals (who have no idea how much help they really need) and not quit insisting they get help… until they do.
Of course, even if they do get help, the quality of it is dependent on the medical team assisting. And if you’re stuck with a doctor who’s clueless about head trauma and thinks, “Oh, everything will be just fine, so long as you didn’t get knocked out for more than 2 minutes,” and gives you some aspirin and sends you home to rest, all the perseverance in the world only goes so far.
Dealing effectively with head trauma needs to be a team effort. A prioritized team effort undertaken by people who know what the hell is really going on. It’s a goal worth working towards.