TBI SoS – Your life is a whole rehearsal…

… for the moment you are in now.

Thus spake dictionary.com, when I wandered over to look up a word. True, true, true.

And if all my life leading up to this moment is a rehearsal for this moment, then this moment is also a rehearsal for what’s coming later.  You can improve your brain matter at any age. You can prepare for any eventuality. I’m convinced of it. Of course, your preparation may not be adequate, or you may be preparing yourself to fail, by setting your sights on things far beyond your scope of ability — like taking up downhill race skiing at the age of 92, when osteoporosis and arthritis have set in. Discretion is the better part of valor, so why set yourself up?

I’m feeling a little like I left the TBI SoS series a bit abruptly. Things got busy. I flew across the country. I had other things I wanted to talk about. Distractability can be a real bitch, sometimes.  Anyway, the magical three steps I’ve identified for restoring my own sense of self are:

1. Understanding the nature of Self as an expression of an individual’s unique personal abilities.

2. The overt, conscious valuation of those abilities both by the individual and those around them.

3. The repeated practice of progressive abilities, all of which lead to further growth and improvements and expand the sense of Self beyond the limits it once had (even beyond the limits it sensed prior to the injury).

Which is to say, this thing we call our Self is specific and unique to us. It’s the part that’s unlike any others, but which makes it possible for us to connect with others. Those differences are not deficits. Not if we value them. And the overt, conscious, deliberate valuation of our differences, our abilities, is what helps us to get back to a place where we feel like ourselves again.

Indeed, if you consider that differences are what make us individuals, then the changes that take place in us after TBI aren’t necessarily deficits. Of course, if we look at them as losses (which to some extent they are) and get stuck in that loss, and we continue to try to get back what may be gone or changed for good, then we lose the chance to seek out new ways to be unique and individual.

One of the BIG problems I have with TBI rehab — based on reports from survivors as well as videos I’ve watched on YouTube — is the focus on accepting your deficits and resigning yourself to a life that is less than 100%. Less than 100% of what, exactly? How we were before? What we were before? That may be an accurate assessment, if you use your old life as a measure of your future prospects, but the minute we start doing that — basing our current value and self-assessments on an old, outworn mesaure — we hobble ourselves and our future.

Who among us ever remains the same throughout the duration of their life? Not a one. Who among us never changes, due to circumstances? Only someone who is stunted by fear or some sort of imbalance. Normal people change. We change all the time. After job changes. After life changes. After marriage, divorce, death, birth, and all those other life passages that we as humans participate in. Our bodies change over time. Our personalities change, as well. But all along, we remain who we are. And so long as we feel comfortable and fluid in our self-expression, we can be reasonably sure of who we are in the world.

It’s the dramatic life changes that turn us upside-down. Natural disasters that destroy our homes. War and pestilence that decimates our families. Sudden divorce. Unexpected deaths. TBI. All of these — and more — do their part to warp our sense of Self and make us strangers in our own skin.

See, here’s the thing (for me, at least). The tragedy of loss of Self is not so much about losing specific abilities or capabilities. It’s not about losing your balance or your hearing or your cool. The real loss comes from losing the sense of fluidity, the sense of mastery, your sense of beign a viable individual. It’s the loss of ease and grace that hammers us, not the loss of specific abilities. I would even suggest that even in the face of a substantial loss, if we have backup abilities that can come online to help us immediately — say, we become intensely sensitive to light and sound, but we soon learn to use sunglasses and noise-canceling earphones to protect our senses… or we suddenly have a piss-poor memory, but we’ve got a PDA that we constantly use and we’re already used to writing things down — that can soften the blow and keep us from disintegrating into a pile of quivering self-doubt.

It’s not the loss of specific ability that gets us. It’s the loss of confidence, and the loss of our sense that We are Alright, because we can handle whatever comes along, that does the damage.

And given that, if it’s the loss of the feel of grace and ease and mastery which undercuts our sense of who and what we are and defines our individuality, then hell yes, we can restore a sense of Self over time. Our renewed sense of Self comes from repeated actions, practiced actions, the over and over and over again that goes along with things we seek to do well.

These don’t even need to be big things. I can tell you in no uncertain terms, I have gained some of  my greatest wins and restored a considerable amount of confidence from seemingly stupid little steps that I mastered. Things like daily exercise. Things like being able to get through making my breakfast without melting down and messing up the kitchen. Things like being able to relax.

In my practice and mastery of those things, I found a solid footing I had lost in the aftermaths of my TBIs. Not just the most recent one in 2004, but all the others I’ve had, each of which took something from me that was a core value about myself. The cumulative effects have not been easy to to deal with. Far from it. But through the simplest of actions — making lists about what I needed to do each morning and following them until I had my routine down pat — I found my footing. Solid footing. And that set the stage for a level of comfort I had all but given up on.

And these small steps, these small ways I was able to restore my sense of mastery, also restored my sense of Self. Because in the midst of all the confusion and frustration and trial and error of my daily life, I was able to make good, solid starts to my days which set the stage with confidence and surety. Before I had my morning routine down pat, I started out every day steeped in the most caustic acid bath of self-doubt and insecurity. Before I figured out how to get my breakfast made without blowing up, I couldn’t get out the door and get on with my day in a sane frame of mind. But once I had the basics mastered, it set me up in a very good way for future success and future confidence. And even when everything at work was looking confusing and frustrating and not very promising, being able to go back to the basics and practice them with mastery, retracing my morning routine at night, and ending each day on a stable note, did wonders for my ability to cope and just get on with it.

No matter how small our actions, no matter how insignificant our new masteries may be, the fact that they are masteries, is what gives them potency. It’s what gives them power. They can be the “littlest things” — being able to brush our teeth, take a shower, and wash our hair every morning, being able to make breakfast in such a way that the coffee isn’t cold by the time the egg and toast are ready to eat. Or they can be more complex things — being able to control our emotions when confronted by the unexpected, to read a book or participate in a conversation, or to go on an extended business trip and participate fully in the experience without melting down. The main thing is how we participate and experience them. The main thing is not what we do, but how we feel.

That feeling of mastery, even if it’s related to a new activity or an old activity we’ve changed, is what restores us. And if we focus on that, rather than the specifics of what we’re doing and our judgments about them, we have a chance to increase the value of those things, and come to accept ourselves and our newfound ways more than ever.

Take, for example, someone who’s been hurt in an accident, and is unable to walk without braces and canes. I once knew someone like that — they’d fallen 100 floors in an elevator, and lived to tell the story. They could have given up and given in, but they turned their attention to other activities — ones that weren’t dependent on their legs to get by. They went from being an elevator inspector to being a stock market investor, and in the process they ended up much better off, financially, than they’d ever been before. Even with the stock market crash of 1987, they only lost a fraction of their holdings, because they were smart and didn’t get greedy. They couldn’t walk without canes, but they could drive a modified sportscar and they could certainly participate on other levels. I doubt they would have said falling 100 storeys in an elevator was the best thing that ever happened to them, but they made it work. They made their life work.

So, no matter how different we may end up, after TBI, there is always more about ourselves that we can discover. We can certainly stay stuck in our past, interpreting our every mistake as an indication that something is wrong with us, and we’re too damaged to get on with it. But the simple fact is, our brains are plastic. Our lives are plastic. We can shape and change them however we like – within reason, of course. Not a single one of us knows just how much we are capable of. And until we stop clinging to the past and decide to move on to the future, we cannot find out.

We’re all — TBI or otherwise — like shards of a broken vessel, that needs to be put back together again. Tikkun Olam is one way of saying it, I think. Repairing a broken world. Repairing our broken Selves. Restoring our whole Selves — and others — in the face of shattering circumstances, so that the light we all hold within ourselves can shine forth. When we see the light, instead of the broken pieces, and we find new ways to experience and express that light, how much more can we be, than just survivors of some terrible accident or fate?

Ultimately, all of this TBI SoS series is just a very long way of saying:

  • Our Selves are the collection of unique qualities we express with ease and grace.
  • Our sense of Self depends not only on our uniqueness, but on a sense of mastery and fluidity that comes with practice of those qualities.
  • When that sense of mastery is disrupted, our sense of Self is, too. We get lost. We lose ourselves in the newness of our reshaped brains.
  • Nevertheless, we can restore our Sense of Self by achieving mastery. These can be in small ways, or in large. But they should matter. They should have value for us and for others.
  • By practicing our mastery, day in and day out, we can build a foundation for our sense of Self that restores our own confidence on small but important scales, which then set the stage for later, more complex masteries.
  • Ultimately, we can find our way back to our Selves by expanding our definition of who we are and what we’re capable of doing. And we may just find that the new Self we inhabit has abilities and talents we never would have discovered, had we not been forced to.

All of us change over time, without exception. Welcoming the changes in our Selves and letting our Selves be made new again isn’t something to be feared. It’s something to be encouraged and valued. Fearing changes helps no one. Fearing differences just makes matters worse — for ourselves and others.

And in the end, it’s not so much what life sends our way, that determines our future and our comfort level with who we are, but what we do with those well-camouflaged gifts.

This is the eighth part in a multi-part exploration of sense of self and how it’s affected by traumatic brain injury. Read the other sections here.

Note: I am currently writing a full-length work on Restoring a Sense Of Self after TBI, and I am posting the sections here as I write them (click here to go there now).

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Head injury recovery – it’s sort of like rebuilding Haiti

Looking at my stats to see who’s reading this blog, and seeing how they found out about it, I often come across search engine terms that include the words “slow” and “concussion” in the same search phrase. No coincidence there. Slow can refer to your brain slowing down after concussion, as well as the length of time it takes to recover. “Slow” and “concussion” seem to go pretty well together.

As the news highlights both the perceived delays in the rebuilding of Haiti after their earthquake about a year ago, and the amazing recovery of Rep. Gabrielle Giffords, I have been thinking a fair amount about how the two situations might have things in common. I think, in particular, about how Rep. Giffords’ progress has been so amazing… beyond the hopes and dreams of just about anyone involved in her recovery. And I have to wonder – not out of spite, but out of compassion – if her progress will continue at this amazing pace. I also wonder if the people around her who have been so supportive and hopeful will stay that way, if her recovery should happen to slow… even appear to reverse… in the coming months and years.

I would never wish ill upon her or anyone else, but I have to wonder if the rate of her progress will last — and what might happen if it appears to slow. Surely, it would be amazing if it does, and I certainly hope it does. At the same time, however, I wonder if the folks around her — or who are rooting for her from afar — are prepared for the possibility that she might have a very long road to recovery ahead of her. Her husband has said that she will make a full recovery, and it will be wonderful if she does. But if things take longer than people expect, or she experiences setbacks (as so many of us do), what then?

And I think of Haiti — that already dreadfully impoverished nation that was to terribly hit by the earthquake last year. In the immediate aftermath, there was a huge outpouring of help and pledges for help from many, many people. Millions upon millions of dollars were promised, and work commenced. But now, a year later, many are wondering if there’s actually been any progress. And they’re wondering where the money went.

It’s a fair question. And it’s not uncommon. In times when disaster strikes, and there’s an immediate need for help, so many eagerly pitch in… then find themselves stymied by bureaucracy or unanticipated complications that could not have been forseen. They had such momentum at the start, and they were bound and determined to Make Progress, no matter what. The will was there, the spirit was there, the determination and dedication were there.

But then things get hung up, for whatever reason. And it’s human nature to start to question the progress you’ve been making, as well as the direction you’re taking. The things that seemed so clear at the outset, get gray and muddied and stop being so straightforward. It’s one thing, when disaster is fresh in everyone’s mind, and the stress hormones are working overtime to block out gray areas and a gazillion little details that the physical system deems “unimportant”. But when the initial shock wears off, and the whole system starts to right itself, all of a sudden, there are all these little details you’ve got to contend with… all these little pieces that need to be picked up… and nothing is simple and straightforward anymore.

With Haiti, we had an initial outpouring of grief and compassion and cooperation. An initial single-minded determination that We Will Rebuild! Then the donation controversies started, and the problems of gangs of former convicts roaming the streets, and women and girls being gang-raped by maurauding men, and money disappearing or never actually reaching Haiti proper, started to come to the fore. What an excruciatingly unholy mess. Wasn’t this supposed to be fixed by now? What happened to all that money and expertise? WTF?!

With TBI, there’s often an initial outpouring of love and concern from those who care about you (if they realize what’s going on). There’s the survivor’s innermost determination that I Will Rebuild! Nothing is going to hold you back. You can do this thing. YOU CAN DO THIS THING. Then the insurance money runs out. Or you hit a wall with your neuropsych. Or you can’t seem to keep up the enthusiasm for neuro rehab. And the physical problems — the headaches, the pain, the sensory issues, the fatigue — as well as the cognitive fog and the crazy mood swings just keep coming. Everyone else says you should be fine. Everyone else says you should be on the mend. But you don’t feel like it. No way, no how. You’ve lost yourself somewhere along the way, and you’ll be damned if you can find your way back.

I’m not saying that the circumstances of TBI survivors are necessarily the equivalent of the extreme and widespread needs of Haiti, but on a certain level there are similarities. The expectations that more progress would be made by now, the determination that has a way of waning over time, the human need to see things fixed much more quickly than they can be… on small scales and large, this seems to be our lot, when things go terribly, terribly wrong.

But just as rebuilding Haiti means doing more than just putting up houses and distributing food, so does TBI recovery involve more than healing up the bullet wound or getting out of rehab. Restoring Haiti involves rebuilding the government structures, restoring utilities, building roads that were destroyed, getting schools up and running again, and ultimately making the place safe for people to live their lives, go about their business and make a living. And recovering from TBI means much the same kinds of activities, though on a much smaller, more individual scale. In same cases, executive functioning needs to be sharpened and strengthened. In some cases, physical capabilities need to be fine-tuned, or coping/compensatory techniques need to be learned. In some cases, the brain’s infrastructure of electrical connections has been so disrupted, it’s like you’re careening down a dark road without any lights or any clear view of where you’re going (let alone managing how fast you’re moving). And then there’s the learning. The constant learning. And the behavior mangement and modifications required to make you safe to deal with by your friends, family, and co-workers.

… All of which takes a whole lot longer than you ever expect it to. And in some cases, you’re never done. The old connections in your brain that used to be so reliable… some of them may be gone for good, but even though you know it intellectually, your system, your person, your identity habitually goes back to trying to do things that the old connections made possible. And fails.

Which leaves everyone around you wondering why it’s taking you so damned long to get your act together. Are you just not trying? Are you being lazy? Are you just not applying yourself? Or are you faking it for the sake of sympathy?

Problems. Problems, indeed. All around.

That’s not to say that you can’t ever get to a level of functioning you’re happy with. Not at all. But chances are good, it will take a lot longer than you or anyone else ever expected. And there will be times when you and others will be standing there, tap-tap-tapping your toes, impatiently waiting for something to change for the better. Just like plenty of people are wondering why it’s taking so long to get Haiti back on its feet.

TBI SoS – Restoring a Sense of Self After Traumatic Brain Injury – How Can We Get Our Selves Back?

This is the seventh part in a multi-part exploration of sense of self and how it’s affected by traumatic brain injury. Read the other sections here.

Note: I am currently writing a full-length work on Restoring a Sense Of Self after TBI, and I am posting the sections here as I write them (click here to go there now).

Good question. Some might say restoring the sense of Self is a mysterious process that nobody fully understands, but I think it’s worth exploring. I have seen a really marked improvement in my own sense of self over the past five years, and about six months ago, I found myself actually thinking aloud that “I feel like I’m getting myself back.”

This was never an expressed goal of my neuropsychological rehab, and indeed the times I’ve raised the question of Self with my neuropsych, they didn’t seem very interested in exploring it. Still, when I announced that I was starting to feel like my own self again, they seemed pleased with this apparently coincidental by-product of our rehab work together.

But I don’t think that the restoration of the Self needs to be a coincidence, a happy accident that just happens by chance for no apparent reason. I believe that the Self can be — and is — restored (or rehabbed) through specific actions and specific approaches which are no less practical in their improvements in the “gray areas” of the life of the Self, than say physical exercises are for the strengthening of atrophied muscles.

I believe that restoring the Self results from the following understandings and actions:

1. Understanding the nature of Self as an expression of an individual’s unique personal abilities.

2. The overt, conscious valuation of those abilities both by the individual and those around them.

3. The repeated practice of progressive abilities, all of which lead to further growth and improvements and expand the sense of Self beyond the limits it once had (even beyond the limits it sensed prior to the injury).
Here’s how I understand all of this more in-depth:

1. Understanding the nature of Self as an expression of an individual’s unique personal abilities.

Each of us has certain abilities and activities that we do uniquely well, which make us distinct and whole persons in the world. It’s important to emphasize that while old abilities may have been altered or damaged by injury, the world is an awfully big place, and the human spirit is a profoundly powerful force, and it’s entirely possible to find other areas to gain mastery, which may not have been noticed or valued before. It needs to be understood that one’s sense of Self can indeed be restored through action and intention.

Now, along with regard for the depth and breadth of possibilities that life and the world offer, it’s also vital to understand just how devastating it can be for someone to lose their former abilities. It’s of paramount importance to understand the extent to which a person can be derailed by something as simple as not being able to butter a piece of toast without it ending up on the kitchen floor. Our Selves are elaborate and intricate, and our sense of loss and disorientation may be “wildly disproportionate” to the perceived importance of the lost skill. It’s vital to not underestimate or dismiss the impact that lost abilities can have on a person’s sense of Who They Are in the world and the role they can play in life at large.

2. The overt, conscious valuation of all forms of ability both by the individual and those around them, and treating the restoration process as an ongoing, often challenging, way of life, rather than a set group of steps that will end in time.

Once you understand what you’ve lost and why it matters that it’s gone, you can start taking steps to turn it all around. But it can be slow going, at first. It’s important to recognize the little abilities that come with repeated practice, and every little bit of progress matters. It’s easy to tell someone that their improved performance at holding a butter knife is a great thing, but to someone who used to be able to do it with no problem, it sure as hell doesn’t feel that way. Progress needs to be put in some kind of believeable context, so that recoverers don’t feel like they’re being condescended to. Self-assessment is notoriously difficult for TBI survivors, but it’s an ability that needs to be cultivated, so they can truly appreciate their progress — and continue with the work that’s required. Masteries can be large or small, but they should be measurable and they should have realistic, believeable importance attached to them for the person in recovery.

Now, some abilities may actually already exist, only the survivor didn’t recognize them before. Skills and abilities that were taken for granted prior to the injury, may suddenly come front and center, as the recovery process proceeds. And these latent talents and gifts should be recognized and valued at every turn as evidence that there’s more to the Self than what was lost. These gifts may be used to restore fluidity in injured areas (such as a talent for thoughtful regard being recruited to create a mindful environment while getting ready for work in the morning, so that the toast stays on the plate as it’s being buttered). They may also be strengthened in their own right, essentially “fleshing out” the recoverer’s sense of who they are, in a new and expanded light.

This recognition of the recoverer having more talents than what they lost to the injury could turn out to be an important foundation for the continuous work of recovery. Not everyone “bounces back” from TBI in short order, and there are many accounts of the process taking a lot longer than anyone expected, with small progresses being found at unexpected intervals, sometimes many years post-injury. Recognizing and focusing on already extant talents and abilities and valuing them for the Self-hood that they grant to the recoverer, can be vital to their ongoing work ethic and determination to persevere. It can help everyone see that not everything has been lost, and in fact some unforeseen circumstances (like the sudden discovery of a hidden talent) can work in your favor. With TBI, uncertainty is often a constant companion — finding a way to make peace with some forms of uncertainty can be truly good for the soul.

3. The repeated practice of progressive abilities, all of which lead to further growth and improvements and expand the sense of Self beyond the limits it once had (even beyond the limits it sensed prior to the injury).

Once we recognize the nature of the Self, appreciate the impact of lost skills and talents, and learn to value both the hidden talents we discover as well as our steps of progress along the way, we can go about the lifelong business of taking repeated steps to achieve competency in certain areas of our lives. These areas can be as small and seemingly insignificant as figuring out how to butter a piece of toast without having it end up on the kitchen floor. Or they can be as broad as being able to interview for a better job and improve your lot in life. Whatever the scope, by constant practice and mindful application of our lessons, we can embark on achieving fluidity in activities that once stymied us. We can start to regain that sense of wholeness, that sense of mastery, that TBI ripped from our grasp without warning.

We can get our Selves back.

For example, one of the biggest steps back to feeling like myself, came when I managed to get through my morning preparations without melting down in a pile of steaming emotional wreckage. I had struggled for years with just the basics of getting out of bed, doing my morning personal care, getting downstairs, and feeding both the pet and myself. I could never figure out why I always ended up an emotional mess before I even got out the door in the morning. A host of sensory issues, balance issues, and the way I responded to my clumsiness and absent-mindedness, all contributed to my difficulties, and at times it seemed as though things would never change. I would always be doomed to never having a good morning.

But through persistence and repeated attempts, I managed to turn this around. Through the systematic use of lists to keep myself on track, changing some parts of my diet to cut down on allergic reactions (especially to dairy), as well as rethinking my reactions to my clumsiness and disorientation, I was able to create a morning routine for myself that was both mindful and increasingly fluid. The better I got at getting through the morning without melting down and beating myself up and feeling like crap, the more ability I gained, the more smoothly I was able to do the things I needed to do. And as my ability increased, my sense of Self began to return.

And with that foundation, that series of lessons about how I can plan for and take action on things that matter to me, I was able to branch out further into other areas, use the same techniques for improvement, and work my way back from a place of cowering in a corner, lashing out at anyone who approached me with the intention of helping, and disqualifying myself from participating in the world around me.

Once upon a time, I couldn’t even get my breakfast and get dressed for work without hurting everyone who came within reach of me. But with time and practice, that completely turned around, and now it’s all but a non-issue for me.

And I feel more like mySelf again.

Where had my Self gotten to, in all this? My Self got lost in the most basic of places — in the way I got into my day, in the ways in which I interacted with myself and the people around me. It got lost when I got swamped in minutiae and lost track of my emotional state. But in changing the way I got into my day — turning it into a mindful and thoughtful routine each moring — I found my Self again. I found it in my improved ability to plan and carry out my morning routine. I found it in my improved ability to interact with my spouse each morning without shutting them out, or barking and yelling at them. I found it in the increasingly fluid ability to just get up in the morning, eat, shower, dress, and get on the road to work.

Out of mastering that seemingly simple process, I was able to build on the rest of my day, applying the same mindset and thoughtfulness to my other activities. It’s led me to a deeper understanding of myself, a deeper connection with others, and a broader and more profound use of my skills and abilities in the world.

I don’t feel like my old Self, but I do feel more like my own Self again.

This ends the seventh part in a multi-part exploration of sense of self and how it’s affected by traumatic brain injury. Read the other sections here. More to come…

How Can I Recognize a Possible Concussion?

One of the nice things about being a blogger is that I can add my information to the general wealth of data about subjects of interest to me – in this case, mild traumatic brain injury. This blog is about more than telling my side of the story — it’s about fleshing out info that other trusted sources provide, in ways that are personal and individual… and hopefully contributing to the general understanding about traumatic brain injury, and sports-related concussion in particular.

The CDC has a wealth of information on concussion in youth sports over at their Heads-Up site.

What’s missing is a bit of in-depth explanation about the different points they make.

Since this month is Brain Injury Awareness Month, I hope to contribute to the awareness piece with further info and examples from my own concussion experiences.

From the CDC site about recognizing concussions:

To help recognize a concussion, you should watch for the following two things among your athletes:

  • A forceful bump, blow, or jolt to the head or body that results in rapid movement of the head.

AND

  • Any change in the athlete’s behavior, thinking, or physical functioning.

Athletes who experience any of the signs and symptoms listed below after a bump, blow, or jolt to the head or body should be kept out of play the day of the injury and until a health care professional, experienced in evaluating for concussion, says they are symptom-free and it’s OK to return to play.

Signs Observed by Coaching Staff

  • Appears dazed or stunned
  • Is confused about assignment or position
  • Forgets an instruction
  • Is unsure of game, score, or opponent
  • Moves clumsily
  • Answers questions slowly
  • Loses consciousness (even briefly)
  • Shows mood, behavior, or personality changes
  • Can’t recall events prior to hit or fall
  • Can’t recall events after hit or fall

Symptoms Reported by Athlete

  • Headache or “pressure” in head
  • Nausea or vomiting
  • Balance problems or dizziness
  • Double or blurry vision
  • Sensitivity to light
  • Sensitivity to noise
  • Feeling sluggish, hazy, foggy, or groggy
  • Concentration or memory problems
  • Confusion
  • Does not “feel right” or is “feeling down”

Remember, you can’t see a concussion and some athletes may not experience and/or report symptoms until hours or days after the injury. Most people with a concussion will recover quickly and fully. But for some people, signs and symptoms of concussion can last for days, weeks, or longer.

Now, for some explanation to fill in the blanks…

To help recognize a concussion, you should watch for the following two things among your athletes:

  • A forceful bump, blow, or jolt to the head or body that results in rapid movement of the head.

The head, atop the neck, holds our precious brain — which has the consistency of pudding, and is surrounded by fluid which protects it from the bony inside of our skulls. Unfortunately, the bony insides of our skulls can have rough/sharp edges which can rake across the surface of the brain and cause damage that way, should the head/bodybe knocked so hard that the brain pushes past the protective fluid and scrapes against the inside of the skull.

You can see a video of different types of brain injury at YouTube. It’s very informative, and I recommend it.

When the body or head is hit hard enough, the brain can hit against the front inside part of the skull, be injured there — and then fly back against the rear of the skull (called coup-contracoup — which means head-back0fhead — injury), causing damage to the rear part of the brain as well. Under ideal conditions, the protective fluid provides an ample buffer to shelter the brain, and the inside of the skull is not really sharp and uneven. Unfortunately, there are no guarantees that that’s the case.

Forceful bumps or blows or jolts to the head can be things like:

  • being hit on the head by a ball, such as in soccer or baseball
  • colliding with another player and bumping heads
  • being elbowed or kicked in the head
  • colliding with the catcher and slamming your head against his/hers when you’re trying to steal homebase
  • falling and hitting your head on the basketball court floor

Another way the brain can be injured by a hard hit to the body, is a whiplash effect — where the connections that are located at the base of the skull and neck are twisted and torn by the head snapping forward and backwards really hard. You don’t need to be knocked out, and you don’t even need to have your head hit, to sustain a concussion in sports.

Forceful bumps or blows or jolts to the body can be things like:

  • being tackled hard in football
  • being fouled hard and knocked to the floor in basketball
  • falling during a soccer game
  • colliding with another player when going after the same ball
  • landing hard after any kind of fall, even if your head doesn’t hit the ground
  • running into the wall when you’re eplaying squash/raquetball

It’s important to remember that these very common collision/impact occurrences (which are part and parcel of just about any sport) will NOT necessarily lead to concussion. If everyone who was tackled hard, or fell, or was fouled hard and ended up on the floor/ground sustained a concussion, there would be a whole lot of impaired people walking around.

Being hit or tackled or falling during a game or practice is NOT a guarantee of a concussion. This is where the next criteria comes in… the “and” part.

AND

This AND is important. The first set of criteria — the bump, blow, or jolt to the head or body are no guarantee that a brain injury has occurred, but they can serve as a trigger to watch out for the following. The next point is what acts as an alert that a concussive event has occurred.

  • Any change in the athlete’s behavior, thinking, or physical functioning.

Signs Observed by Coaching Staff

  • Appears dazed or stunned
  • Is confused about assignment or position
  • Forgets an instruction
  • Is unsure of game, score, or opponent
  • Moves clumsily
  • Answers questions slowly
  • Loses consciousness (even briefly)
  • Shows mood, behavior, or personality changes
  • Can’t recall events prior to hit or fall
  • Can’t recall events after hit or fall

Symptoms Reported by Athlete

  • Headache or “pressure” in head
  • Nausea or vomiting
  • Balance problems or dizziness
  • Double or blurry vision
  • Sensitivity to light
  • Sensitivity to noise
  • Feeling sluggish, hazy, foggy, or groggy
  • Concentration or memory problems
  • Confusion
  • Does not “feel right” or is “feeling down”

Here are some examples from my own experience:

When I sustained a concussion from a hard tackle during a football game in high school, there was an immediate change in my thinking and physical functioning.

  • First of all, I was not thinking as quickly as I was before the hit. Even I could tell I was slower — I wasn’t following the calls by the quarterback very well, and I was clearly a little dimmer than I had been before the hit. I had trouble understanding what was said in the huddles before the following plays, and I had trouble following the instructions I was given. For example (I can’t remember the exact details, but this is how it was), when I was told to go long and then cut left at a certain point, I went long, but I didn’t cut left.
  • Secondly, I was not as coordinated as I had been before the hit. I ran clumsily — like I was drunk — and I couldn’t catch the ball when it was thrown right to me. I also stumbled a lot, and I fell a few more times. For all I know, I did more damage to myself, but I was so totally focused on continuing the game and not letting my teammates down, I refused to take myself out of the game. They had to stop the whole game, completely, to get me to quit playing. I was that stubborn.

When I sustained another concussion from a fall during a soccer game a year or two later  in high school, there was yet another immediate change in my physical functioning and behavior.

  • First of all, I was a lot less coordinated than I had been before I fell. I couldn’t control the ball as well as I had before, and it felt like I was moving in slow motion. I stumbled and fumbled, and there was obviously something different about how I was playing.
  • Second, I was not the same player I’d been before my fall. Before, I had been aggressive and confident on the field. Afterwards, I was hesitant, confused, and I hesitated before shooting on the goal (or just plain failed to shoot). I had a number of opportunities to score, but I didn’t, because I was uncertain and confused. I was also less able to be a team player. I didn’t pass the ball to my open teammates as frequently as I should have. I also became more withdrawn and was not communicating with the coaching staff on the sidelines. It was like I was in my own little concussed world, suspended in a foggy soup that slowed down all the input and output.

Athletes who experience any of the signs and symptoms listed below after a bump, blow, or jolt to the head or body should be kept out of play the day of the injury and until a health care professional, experienced in evaluating for concussion, says they are symptom-free and it’s OK to return to play.

Absolutely, positively. This must be done. Unfortunately, I myself never received any medical evaluation or treatment for my injuries. But on the bright side, I was removed from play in both instances. Nobody watched me afterwards to make sure I was symptom-free and it was OK for me to return to play. Then again, by the time I got to those games, I’d had a number of TBIs already, so I already showed symptoms of impairment. Still, the changes I did experience, on those two separate instances, were clear indicators that I’d undergone a concussive event. I only wish someone had known what to look for, and helped me out.

Another important piece of the CDC info is:

Remember, you can’t see a concussion and some athletes may not experience and/or report symptoms until hours or days after the injury. Most people with a concussion will recover quickly and fully. But for some people, signs and symptoms of concussion can last for days, weeks, or longer.

This cannot be overstated. Concussion, hidden as it is inside the skull, can also be hidden by time. It can take hours or days for symptoms to show up, which is why it is so important that not only coaches, but also teachers and parents and teammates are all familiar with the danger signs and informed about how to respond appropriately.

One of the things that can show up later, are behavioral issues. Indeed, behavioral issues are the bugaboo of mild traumatic brain injury, because on the surface everything looks fine, and the brain may have recovered from its initial trauma, but there are microscopic changes under the surface that can have long-lasting effects. If you know someone who plays sports, whose behavior has suddenly started to change for the worst – suddenly they have a lot of anger, rage, irritability, distractability, sensory issues, fatigue, insomnia —  it could be they had a concussion during a game or some other event — and nobody realized it, including them.

Concussion doesn’t just affect the student athletes — it affects everyone who interacts with them, everyone who loves and cares about them. It’s in all our best interests to learn about it, learn what to watch for. And to report it to someone who can help.

As the CDC says, most people recover quickly and fully, and it doesn’t need to wreck their lives. But if you don’t pay attention to the first warning signs, it is all too easy to re-injure yourself (having a concussion increases your chances of experiencing another one from 2-6 times). So, paying attention, right from the get-go can help prevent other problems from happening.

In retrospect, I wonder what might have happened, if I’d stuck with track and field and cross country exclusively, and not played any team sports that involved tackling or the danger of falling/collisions. I wonder if I would have been so susceptible to drugs and alcohol, if my behavior would have been so problematic. Thinking back, I had a ton of problems when I was a kid that actually resolved as a result of organized sports. Unfortunately, the thing that helped me most, also introduced more problems to my mix.

Well, I can’t worry about it. What’s done is done, in my case. I’m just happy I’m as functional and well-off as I am, today.

I also hope that coaches and trainers and teachers and teammates are learning enough, today, to help avoid the kinds of situations I got myself into… and help address the after-effects of the kinds of injuries that I — and hundreds of thousands of others young athletes — experienced. The CDC material is really helpful, and they have lots of free information and additional materials available.

Check ’em out. It’s worth the trip.

All or nothing – for real

I have been looking at my notes from the past days, seeing what I’ve gotten accomplished, and what I haven’t.

There is a whole hell of a lot I have not gotten accomplished, that I have been promising myself I would. Some of the things I have not done are serious. They are job-related. Survival-related. Pay-related.

I cannot NOT do them. But that’s what I’ve been doing.

Not.

I’ve also been thinking about how long it took me to realize that my fall in 2004 had affected me the way it had. Some call it “denial.” Some call it a “cognitive blind spot.” I call it “not sinking in because I have so many other things to think about.” Things like stray distractions that come across my path that for some strange reason I cannot resist following. Like a mynah bird. Magpie me.

The really freaky thing is, I ‘got’ that my concussions as a kid had affected me tremendously, when I was young. The discipline problems. The meltdowns. The outbursts. The getting kicked out of class because I was too much of a handful and nobody knew what else to do with me. I also ‘got’ that the concussions of my childhood had affected my development and made it difficult for me to really function as a regular adult throughout most of my life. Certainly, I did a great impression on the surface, keeping a job (well, a series of jobs) and getting married and settling down and doing important things.

But nobody on the outside ever saw what went on inside. And very few people ever knew what living with me was really like.

The fact that my spouse has stood by me all these years is nothing short of a miracle.

Anyway, the reason I bring up my cluelessness about the impact of my fall in 2004, is that it’s the same kind of obliviousness that I now sense, around my work and the things I have let slide. It’s like I’ve been in this haze, this wandering-about fog, where my brain is busy thinking about everything except what it’s supposed to think about. And that happily distracted piece of me is quite content to not give much thought to my work.

But I must change this. Because focused attention is what helps restore my everyday function, one task at a time. I hate that I have to approach just about everything I do like some rehabilitation exercise, but I do. I just do. I have to make extra effort to get things started, and I have to make extra effort to stay on track, and I have to make extra effort to finish what I start.

I don’t like it. I hate it, in fact. But that’s how it is. That’s how it is with me.

So, I’ll make the extra effort.

And yes, I’ve decided to drop my shrink, once and for all, because they keep encouraging me to not work so hard, not be so hard on myself, not expect too much of myself.

That’s no way to recover. I need to recover, and not give up. I need to treat each and every day like a chance to recover some part of me I’ve lost — or am in danger of losing, if I don’t pay extra attention. I just can’t end up like the football players and other professional athletes who end up demented and/or dead long before their time, because they had no idea what they were doing to their brains, and they never found out what they could do to fix them — or probably ever realized that they needed to fix anything.

Enough of the blind spots. Enough of the denial. Enough of letting things slide and acting like that’s okay. I have to keep sharp. I don’t want to fade away. I don’t want to end up demented and dazed, because I was too dazed and/or lazy to put in the extra effort to keep my brain healthy and engaged.

I need to be healthy. I need to be engaged. Like the nuns in the Nun Study in “Aging With Grace” I need to keep disciplined and focused and not give in to my lazy streak… the streak in me and my broken brain that loves to wander around and follow whatever little distraction comes along. My brilliant mind knows better than to do that all the live-long day.

I must do better. Each and every day is an occupational therapy opportunity. I need to get back what I’ve lost – and make sure I don’t lose what I’ve worked so hard to get.

Is playing safe? Is it safe to return to play?

Recently, someone posted about the Maher mouth guard being effective protection against TBI in sports. I don’t know enough about it to speak with any authority, but on the other side, there’s the impact of low-level hits to consider. I believe I’ve posted about this before, but it bears repeating:

When we think about football, we worry about the dangers posed by the heat and the fury of competition. Yet the HITS data suggest that practice—the routine part of the sport—can be as dangerous as the games themselves. We also tend to focus on the dramatic helmet-to-helmet hits that signal an aggressive and reckless style of play. Those kinds of hits can be policed. But what sidelined the U.N.C. player, the first time around, was an accidental and seemingly innocuous elbow, and none of the blows he suffered that day would have been flagged by a referee as illegal. Most important, though, is what Guskiewicz found when he reviewed all the data for the lineman on that first day in training camp. He didn’t just suffer those four big blows. He was hit in the head thirty-one times that day. What seems to have caused his concussion, in other words, was his cumulative exposure. And why was the second concussion—in the game at Utah—so much more serious than the first? It’s not because that hit to the side of the head was especially dramatic; it was that it came after the 76-g blow in warmup, which, in turn, followed the concussion in August, which was itself the consequence of the thirty prior hits that day, and the hits the day before that, and the day before that, and on and on, perhaps back to his high-school playing days.

This is a crucial point. Much of the attention in the football world, in the past few years, has been on concussions—on diagnosing, managing, and preventing them—and on figuring out how many concussions a player can have before he should call it quits. But a football player’s real issue isn’t simply with repetitive concussive trauma. It is, as the concussion specialist Robert Cantu argues, with repetitive subconcussive trauma. It’s not just the handful of big hits that matter. It’s lots of little hits, too.

That’s why, Cantu says, so many of the ex-players who have been given a diagnosis of C.T.E. were linemen: line play lends itself to lots of little hits. The HITS data suggest that, in an average football season, a lineman could get struck in the head a thousand times, which means that a ten-year N.F.L. veteran, when you bring in his college and high-school playing days, could well have been hit in the head eighteen thousand times: that’s thousands of jarring blows that shake the brain from front to back and side to side, stretching and weakening and tearing the connections among nerve cells, and making the brain increasingly vulnerable to long-term damage. People with C.T.E., Cantu says, “aren’t necessarily people with a high, recognized concussion history. But they are individuals who collided heads on every play—repetitively doing this, year after year, under levels that were tolerable for them to continue to play.”

Speaking from experience, I don’t see how it’s possible to discourage kids who live, breathe, eat, sleep contact sports to give them up — even if it means they add years to their lives and they avoid the dementia and cognitive problems that can appear over the long term.

I, myself, have apparently had enough concussions in my life to make my brain increasingly vulnerable to damage. The fall I had in 2004 almost cost me everything, and it was totally a fluke — or divine intervention — that spared me and my family from complete ruin.

Parents and coaches and spectators alike should give the impact of repeated subconcussive impacts a good deal of thought, and weigh the immediate benefits versus the potential long-term costs to the next generation.

Just my two cents… on top of Malcom Gladwell’s amazing piece.

Losing Tiger

Here’s my blatantly opportunistic exploitation of a public figure for the sake of blog hits. But seriously folks, the whole situation does give me pause for a lot of thought.

Depending which radio station you listen to or which news source you read, Tiger Woods’ domestic dispute either involved him getting clocked with a 9-iron by a furious wife… and/or being scratched up when she lit into him… and/or driving around semi-conscious… and/or him sustaining injuries from ramming a fire hydrant with his Escalade… and/or his numb and non-communicative wife bashing out his car windows to save him… and/or him lying on the pavement snoring, when the medics arrived.

I don’t think anyone but the folks directly involved will ever know exactly what happened, but I’m not sure that matters. Enough damage has been done, to permanently erase the once saintly persona we once knew as Tiger Woods. And if his wife really did hit him in the face with a 9-iron, and he was in and out of consciousness, I have to wonder if the head trauma won’t screw with his fine motor control… and possibly bring his golfing career to a sickeningly tragic end.

I’m being harsh, you say? I think not. For years, this guy has made millions, at least in part by projecting a squeaky-clean image, having kids intone “I am Tiger Woods” mantras on moving commercials, and by hawking his wholesome image throughout the media. He has made tons of dough and enjoyed vast amounts of prestige, thanks to his image.

And what does he do, but not only tramp it up with impunity, apparently on Ambien, no less… but also be dense enough to leave tons of incriminating evidence, not to mention get intimately involved with the kinds of women who brag about bedding him. What was he thinking?!

I know the man was in pain, not least of all from losing his father. I know he’s been under vast amounts of pressure, due to his position and reputation. I know he’s been working as hard as any aging athlete to keep his edge in a field full of fresh young players just aching to take his place in the lead. I know the man was human, and I know he behaved like so many other men do in his position. I know that, being human, his mojo quota had to be in some kind of decline, which must have made him absolutely crazy at times… it’s not easy to peak relatively early in life (men do so earlier than women — some of the world’s greatest mathematicians achieved their masterpieces when they were but young pups) and then see yourself decline — however invisibly to the rest of the world. I know the temptations of all those women must have been too much to take at times. Clearly, at least some of them were.

But here’s the thing — if you know all eyes are on you… if you know your fortune depends on your ability to maintain a clean-cut image… if you have a wife and two kids at home and endorsement contracts to honor, you don’t fuck around. And you certainly don’t sext your hottie du jour hundreds upon hundreds of times and leave voicemails on her phone with your name. Geezuz, Tiger — what were you thinking, man?!

In a way, I can understand how it would come to this. I think the guy was set up by a system that makes artificially optimistic, insanely unrealistic, and eventually overwhelming demands on gifted but relatively frail human beings. Frankly, I think the powers that wrote up his contracts probably never genuinely expected him to uphold every last piece in the morality clause(s).  They probably figured they would ride the Tiger Train for as long as it would pull them along, and that eventually something would go amiss, and they’d get at least some of their money back from him, having made millions from his endorsements in the meantime. But they probably never genuinely expected him to violate his own artificial image in such a public and plainly stupid way.

When all is said and done, what I feel most about all this, is a profound sense of loss. The magical golden child of golf has fallen — sure as the golden calf was struck from its pedestal by Moses coming down from Mt. Sinai. And now he’s being ground up and served to all the masses in tiny little bits, strewn through our food and drink. The invention that we had and believed in — that innocent, honest, hard-working, Horatio Alger of a golfer — has failed to hold up under the stress tests of real life, and now we all have to eat crow and cringe whenever we think of those “I am Tiger Woods” commercials.

Those of us who demand perfection from others are as much to blame for this debacle as the parties involved. We are all complicit in this crime against human optimism. We put him up on a pedestal, and then when he stumbles, we go on a feeding frenzy, attacking our object for not validating our fondest fantasies. We need to get real. And stop needing the Tigers of the world to be our role models and paragons. We each need to aspire to and achieve heights in our own ways, not put all of our vainglory into a persona we prop up through consumer devotion and starry-eyed water-cooler talk.

Of course, in the midst of it all, some might cry “racism” and say he was set up and handled too harshly in the media — but weren’t we all set up and then disabused by our own dashed illusions? Weren’t we all just a little too trusting of the image, a little too inundated by all the media blitz, a little too incredulous that someone who flew so high could fall so far? It’s lonely at the top, and it gets hot up there, as Icarus found out.  He plunged from the great heights, too, and did not survive the fall. But he got a whole sea named after him.

As for Tiger… well, there probably won’t be any large bodies of water named after him, but you might get a good deal on a set of his golf clubs on Craigslist right about now…

Please join me in a moment of silence for our dearly departed hero.

I’ll miss him.

One concussion, two concussions, three concussions, four…

I had a meeting with my neuropsych last week, when we talked about my concussive history. I had read the article by Malcom Gladwell in the New Yorker called Offensive Play, and I had some questions about how my past might have made me more susceptible to tbi, later in life.

I was wondering aloud if my rough-and-tumble childhood (when falling and hitting my head and getting up and getting back in the game ASAP were regular parts of play), might have brought me lots of subconcussive events, like so many impacts on the football field. I checked in with my neuropsych, and they had me recap from the top, all the head injuries I could recall. My recollection and understanding of them was considerably better than it was, just six months ago. What came out of it was the determination that I’d had enough genuine concussions to do a fair amount of damage to myself. Forget about subconcussive events; the concussive events sufficed to cause plenty of problems, on their own.

It kind of threw me off for a day or two, and I got pretty stressed out and ended up pushing myself too hard, and then melted down in the evening. Not good. It’s hard, to hear that you’re brain damaged. It’s not much fun, realizing — yet again — that you haven’t had “just” one concussion, but a slew of them. And considering that I’m in this new job where I have to perform at my best, it really got under my skin. It’s taken me a few days to catch up on my sleep and settle myself down, after the fact. But I’m getting there. My past hasn’t changed, nor has my history. I’m just reminded of it all over again…

All told, I’ve sustained about eight concussions (or concussive events) that I can remember. Possible signs of concussion (per the Mayo Clinic website) are:

  • Confusion
  • Amnesia
  • Headache
  • Dizziness
  • Ringing in the ears
  • Nausea or vomiting
  • Slurred speech
  • Fatigue

Some symptoms of concussions are not apparent until hours or days later. They include:

  • Memory or concentration problems
  • Sensitivity to light and noise
  • Sleep disturbances
  • Irritability
  • Depression

I experienced most of these (except for nausea and vomiting, and not so much slurred speech, that I can remember) during my childhood and teen years. Not surprising, considering that I had a number of falls and accidents and sports injuries over the course of my childhood.

It’s pretty wild, really, how those experiences of my childhood contributed to my difficulties in adulthood — especially around TBI. I’ve been in accidents with other people who had the same experience I did, but didn’t have nearly the after-effects that I suffered. For them, the incident was a minor annoyance. For me, it was a life-changing concussion. A head injury. TBI. Brain damage. Geeze…

Thinking back on the course of my life, beyond my experiences with the accidents that didn’t phaze others but totally knocked me for a loop, I can see how the after-effects like fatigue and sensitivity to light and noise, really contributed to my difficulties in life. It’s hard to be social and develop socially, when you can’t stand being around noisy peers (and who is as noisy as a gaggle of teens?). It’s hard to learn to forge friendships with girls — who always seemed so LOUD to me(!) — or hang with the guys — who were always making loud noises, like blowing things up and breaking stuff — when you can’t tolerate loudness.

And when you don’t have the stamina to stay out all night… It’s a wonder I did as well as I did, as a kid. Of course, I was always up for trying to keep up – I was always game. And I wanted so very, very badly to participate, to not get left behind, to be part of something… That kept me going. I was just lucky to have people around me who were kind-hearted and intelligent and tolerant of my faults and limitations.

Anyway, I did survive, and I did make it through the concussions of my childhood. I have even made it through the concussions of my adulthood.  And I’m still standing. I didn’t get any medical treatment for any of these events, and the most help I ever got was being pulled from the games where I was obviously worse off after my fall or the hard tackle, than I’d been before.

But one thing still bugs me, and it’s been on my mind. During my high school sports “career, ” I was a varsity letter-winning athlete who started winning awards my freshman year. I was a kick-ass runner, and I won lots of trophies. I also threw javelin in track, and by senior year, I was good enough to place first and win a blue ribbon in the Junior Olympics. Which is great! I still have the blue ribbon to prove it, complete with my distance and the date. But I have no recollection of actually being awarded the ribbon, and I barely remember the throw. I’m not even sure I can remember the event or the throw. It’s just not there. It’s gone. And it’s not coming back. Because it was probably never firmly etched in my memory to ever be retreivable.

I’ve never thought of myself as an amnesiac, but when it comes to my illustrious high school sports career, when I was a team captain and I led my teams to win after win, I have all these ribbons and medals and trophies, but almost no memory of having earned them.

Which really bums me out. What a loss that is. When I hear Bruce Springsteen’s song “Glory Days” I feel a tinge of jealousy that the guy he’s singing about can actually recall his glory days. I can’t. And that’s a loss I deeply feel, mourn… and resent. Seriously. It sucks.

This could seriously mess with my head. And sometimes it does. But on the “up” side, it might also possibly explain why I’ve been such a solid performer over the years, in so many areas, yet I can’t seem to get it into my head that I am a solid performer. My memory of having done the things I did, in the way I did them, is piecemeal at best, and utterly lacking at worst. So, even if I did do  well, how would I know it, months and years on down the line? How would I manage to form a concept of myself as successful and good and productive and inventive and trustworthy, if I have little or no recollection of having been that way in the past?

It’s a conundrum.

But I think I have an answer — keeping a journal. Keeping a record of my days, as they happen, and really getting into reliving my experiences, while they are still fresh in my mind. If I can sit down with myself at the end of a day or a week, and recap not only the events of the past hours and days, but also re-experience the successes and challenges I encountered, then I might be able to forge memories that will stay with me over time. If nothing else, at least I’ll be making a record for myself that I can look back to later. And I need to use colors to call out the good and the not-so-good, so I can easily refer back to the date and see where I had successes and failures along the way.

Most important, is my recording of successes. I’m so quick to second-guess myself and assume that I don’t know what the hell I’m doing. And when I think back to the times when I overcame significant difficulties, I often lose track of the memory before I get to the end of the sequence I followed to succeed.

But I cannot let that situation persist. I need a strategy and a practice to reclaim my life from the after-effects of way too many concussions. I’m sure there are others in life who have had it far worse than me, but some of my  most valuable and possibly most treasured experiences are lost to me for all time, because I have no recollection of them.

No wonder my parents often start a conversation with me with the sentence, “Do you remember ________?”

Rage, rage and more rage…

I’ve had a bunch of people finding their way to this blog, looking for info on rage. Road rage. PTSD. Anger. All that.

It’s getting late, and I need to finish my taxes, but let’s consider for a moment how the ‘rage thing’ works with TBI.

The brain gets its wires crossed.

It doesn’t quite understand why it’s getting confused.

It revvs up and goes into overdrive, trying to get things sorted, but it keeps getting stopped.

Meanwhile, the rest of the world is like, “Come on! Hurry up! What’s taking you so long?!”

And the adrenaline gets going.

And it goes and goes and goes, and the parts of the brain that can usually talk it down are impaired, so it never gets chilled out. And the ptsd kicks in. And the whole works gets churned up.

Rage, rage, and more rage…

And that’s not even talking about possible seizures.

More senseless gun violence

A good friend of mine lost their nephew last week. I don’t know all the details, but I do know he was shot. Apparently at a bar. I’m not sure they know who did it, but even if they did, it won’t bring him back. It all seems so random. I didn’t know the man, and I don’t know if he was in some kind of trouble, himself, but even if he was, being shot over something — anything — hardly seems like it can be justified. By anyone. For any reason. I know there are folks out there who  believe in payback and are hardened to the effects that the most extreme forms of payback have on the “debtors”…  but I’m not one of them.

For every person who “gets what they deserved” — if they “deserved” it at all, which is usually doubtful — there are family members, friends, loved-ones, who are crushed by that aspect of the world we live in. It’s not just about “paying back” the person who did wrong — it’s about devastating the lives and hearts and futures of everyone who was connected with the person who was taken out.

Gun violence seems to be on the rise, given news reports. And it’s happening worldwide. There have been several recent incidents in Germany of people taking out numerous others — a young man killed 15 people on a shooting rampage in southern Germany this past March, a man killed his wife and child around that same time, and just recently, a court shooting in Bavaria left two people dead.

In the States, we’ve seen shootings, too.  In Alabama this past March, a man went on a shooting spree that left ten people dead, many of them children. And just recently, 13 people were shot dead in New York, and a nurse and seven elderly people at a nursing home in North Carolina were gunned down. It’s everywhere. And it happens all year round. Last year during the holidays, shoppers in an L.A. toy store had to duck for cover as a fistfight between two women turned into a pitched gun battle between their men.

Everywhere I look, these days, there seems to be gun violence. Explosive destruction on a small scale that ripples out with baffling waves of shock.

The philosopher in me wants to find some deeper meaning to this. The engineer in me wants to find the root causes and figure out a solution. The mystic in me wants to lift my eyes unto the hills and focus on Eternity. The citizen in me wants to run and hide. The social reformer in me wants both stronger firearms controls, limits on what kinds of weapons are commonly available, mandatory licensing for anyone who buys ammunition, and mandatory training in gun use for all individuals, starting at age seven (or when they’re old enough to fire a gun without getting knocked over, whichever comes first). The friend in me wants to just sit with my friend in total silence for hours on end, just being quiet, just being there for them and whatever they need.

The TBI suvivor in me is glad I don’t have a gun. I have specifically chosen not to own a firearm, not to use firearms, not to go down to the firing range to blow off steam, not to go out hunting with my dad and brother and uncles. Now, I was raised in a family of hunters, and I was taught to shoot from when I was about seven or eight years old. My dad took me out to the stubble-covered cornfields with his brothers, ’round about the time when hunting season was about to start, and we all practiced our aim on tin cans. I learned to shoot shotguns, 30-aught-sixes, and 22’s.

I went out hunting with my dad a few times, too. Deer hunting, when we went out to a cabin in the woods, got up before dawn, and I sat up in a tree stand, while he circled around to drive the deer my way. We went rabbit hunting, too. But I had a hard time seeing the rabbit, and he had to kill it for me.

Now, ever since I was a little kid, I looked forward to being one of the family hunters. One of the providers for my tribe. One of the ones who went out and did what needed to be done, to make sure my kin were fed. But I had trouble seeing, I had trouble hearing, I had trouble with my coordination. And as hard as I tried, as much as I wanted it, the whole hunting thing never “took” with me.

It wasn’t for lack of trying. I learned to track, I learned to clean a gun. I learned to shoot. I learned proper handling of rifles and shotguns. I learned how to carry a gun while I was walking around other people. And I did it all enthusiatically, from a very young age. Even  before I was able to carry and fire a real gun, I was pretending to do that, dressing up in my dad’s orange hunting vest, making sure the hunting license was clearly visible on the back.

But I think my better angels have protected me from handling guns — even in legitimate sport. I have issues with motor coordination. I have trouble with my sight and hearing at times. I also have trouble with figuring out exactly what is going on, sometimes. And I have — when I’m fatigued and/or stressed — a tendency to “go off” on raging temper flares which I manage with varying degrees of success.

Quite frankly, I make a terrible candidate for gun ownership. And even if every citizen in the United States were allowed to “pack heat”, as I’ve heard it recommended (so that we can all protect ourselves in the moment from a crazy shooter on a rampage), I doubt very much that  I would do it. I would rather duck and run for cover, than take my chances with a gun. I would be far less safe with one, than without one — as would everyone around me. I know my limits. Handling firearms is strictly out of bounds for me.

As is being around other people who carry firearms on a regular basis. When I was younger, I ran with a kind of rough crowd. And some of them carried weapons of numerous types. I’m not sure if there were guns in the midst of us, but I wouldn’t be surprised. There were drug dealers and career criminals in my immediate social circle. At the time I was running around with those hell-raisers (and worse), I was often intoxicated, and when I wasn’t intoxicated, I was definitely impaired from the aftermath of some chemical ingestion. Plus, I had a lot of unresolved TBI injuries to deal with. It wasn’t good.

Frankly, I count my blessings, these days, as I look around me and I see everything going so terribly wrong in so many ways. In my youth, I easily could have ended up like my friend’s nephew — dead after an inexplicable shooting. I could very well have had my life cut short, with my family wondering what went wrong… how they might have helped… and devastated by that inexplicable loss. Any of us could end up in that situation, really. These days, with the violence being so extreme and seemingly so random, it’s hard to know exactly how long any of us is going to make it.

But for now, for today, in this moment, I am alive. I am living, breathing, going to work on the train, and counting my incredible blessings. The world is going to sh*t in so many ways, and yet I’m still here. I’m still standing. I’m still going on with my life, to the best of my  God-given ability.

In the face of all that’s wrong, all that’s unfair, all that’s tragic and terrible and just friggin’ awful, perhaps the most exciting thing I can be is normal, boring, regular, and blessed with a delightfully uneventful life.

God bless, everyone. Stay safe.