New York Times on: Veterans and Brain Disease

The New York Times has a great article on CTE and the returning servicemembers

Veterans and Brain Disease

He was a 27-year-old former Marine, struggling to adjust to civilian life after two tours in Iraq. Once an A student, he now found himself unable to remember conversations, dates and routine bits of daily life. He became irritable, snapped at his children and withdrew from his family. He and his wife began divorce proceedings.

This young man took to alcohol, and a drunken car crash cost him his driver’s license. The Department of Veterans Affairs diagnosed him with post-traumatic stress disorder, or P.T.S.D. When his parents hadn’t heard from him in two days, they asked the police to check on him. The officers found his body; he had hanged himself with a belt.

That story is devastatingly common, but the autopsy of this young man’s brain may have been historic. It revealed something startling that may shed light on the epidemic of suicides and other troubles experienced by veterans of wars in Iraq and Afghanistan.

His brain had been physically changed by a disease called chronic traumatic encephalopathy, or C.T.E. That’s a degenerative condition best-known for affecting boxers, football players and other athletes who endure repeated blows to the head. …

Read the rest of the article here >>

The wars we wage – of sport, concussion, and our warrior style – Part II

This series of posts comes as a response to a lot of discussion that’s been happening, lately, about concussions in football — who knew what, how they handled it, who’s responsible, and what might be done about it all… for the sake of our (and our kids’) future. I started out intending to write one post about this, but the issue is much larger, and my time is not as plentiful for one long extended post, so I’ll break it up into several. Part I is here. Please hear me out in the entire thing, before jumping to conclusions.

Football ~100 years ago Warfare ~100 years ago

Part II – What Do We Expect?

Without meaning to sound cynical or sarcastic, I have to ask it — After years and years of continuous hits to the head in organized football, hockey, soccer, etc., and knowing what we now know about the effects of continued knocks to the head over time, what do we expect to happen, when we subject ourselves — and our kids — to years and years of hits to the head?

It surprises me a little that it comes as a surprise to so many that the kinds of hits that don’t knock you out can add up. But then, I guess that’s to be expected, as the medical establishment has only recently got on the ball about a loss of consciousness not being necessary to experience concussion, even brain injury. When I say “recently” I mean in the past decade or so. And even if the medical establishment is (a bit more) on the ball about traumatic brain injury, that doesn’t mean that every doctor is up to speed on it, let alone the general populace.

What worries me more than widespread ignorance, however, is something much deeper, something much more pervasive, and ultimately far more dangerous – it’s the denial so many of us are under, the refusal to entertain the possibility, even probability, of the worst happening.

What’s driving the headlong rush into brain trauma, is, of course a complex and many-faceted set of issues. There’s no one easy explanation for it, though I’ve heard different theories about how it has to do with the changing face of masculinity and the altering of “norms” for behavior. Or it has to do with our innate need for conflict. Or it has to do with the struggle of good vs. evil. Or it has to do with cultural insecurities that drive one society to attack another. Or it has to do with oil. Or it has to do with weeding out the weak and unfit. I’ve also heard folks say that we need our war and our warlike games, because it’s a proving ground for adulthood.

On the last count, I probably agree. Not because I believe that is necessarily true, but because I’ve seen it in action, time and time again. And the folks who seem to be the most compelled to launch head-first (literally as well as figuratively) into combat of one kind or another are often young and have something to prove.

I can’t help but think, time and again, of the young man at the farm stand down the road from me who announced, immediately after the September 11th attacks, that he was going to sign up with the armed services and go teach those %(&^$*& a lesson. He was totally focused on his goal, his mission — to exact revenge — and he was going to put everything on the line for it. I heard that a lot after 9-11, and if I hadn’t spent a decade married to someone whose father was a WWII veteran who paid an unbelievable price — and exacted the same from his family — thanks to the effects of what was arguably our last “justifiable” war, I might have felt the same way.

But you see, having seen first-hand what war will do to people — even if they are fighting for the right side, even if they do survive the horrors — I chose not to take myself to the front lines in that way, though so many did make that choice.

Don’t misunderstand me — It’s not that I don’t believe that war is sometimes a necessary part of life. It’s not that I don’t respect the choices of others who take themselves to the front lines. I do, on both accounts. My point is, if you’re going to put yourself out there and lay it all on the line, you can expect to get hurt. And badly. If you make it home alive. Even if you aren’t injured, you will be changed. Irreversibly. So, choose well, whether or not you can pay that price.

The same holds true, I believe, with collision/contact sports. Football, soccer, hockey, even baseball and basketball to some extent. And extreme sports, too. People run into stuff, and they run into each other — and get hurt — in the course of play. It comes with the territory. So, we can expect there to be sprains, strains, broken bones, and concussed brains. We can expect it. We can count on it. And we need to quit fooling ourselves about being able to prevent it.

When you give yourself to something wholly and completely and without reservation, be it a game or armed conflict, you can expect some nasty sh*t to go down. And it will leave you changed.

Football Today Warfare Today

It’s not the changes that bother me, actually. As much press as there is about CTE and the dangers that come with repeated brain injury, those aren’t the the aspects of concussion that trouble me. I’m not keen on the business of dementia and early onset Alzheimers, not to mention insomnia and chronic pain, memory loss and personality changes, and all the other alterations that can come in the aftermath of years and years of subconcussive hits, but what truly gets to me, is our seeming inability to mentally prepare for these things as well as develop meaningful responses to them, when they do happen.

Seriously, what do we expect? That we can just use our heads as weapons, play after play, game after game, season after season, without any effects? People don’t call us “dumb jocks” for nothing. And when we do start reaping what we’ve sown, what makes us think we can just merrily continue on as though nothing is happening? It brings to mind my grandfather, who insisted on driving ten years longer than it was safe to, because he couldn’t give up on the idea of being wholly independent — even at 80+ years of age, with legs that were giving out.

It’s like we’re all living under this spell that says, “Just keep going as though nothing is wrong, and everything will be alright.” Except it’s not. And even then we ignore it and pretend that all is well. And it continues to get worse. And worse. Until we’re so collectively screwed, that the best we can hope for is not ending up in a metaphorical cardboard box under a metaphorical bridge, fighting off rats for our dumpster dinners.

I suppose it makes more sense, to talk about myself, than our collective unconsciousness. Because I’m talking about myself as much as anyone. Heck, when I was a kid, lo those 35-40 years ago, nobody knew about this concussion stuff, and when I played ball, it actually felt good when I hit my head. After the initial woozy, wobbly, sick-on-my-stomach feeling, I was overtaken by a buzz that propelled me onwards and gave me an other-worldly high. Knowing more about concussion, I suspect it was that metabolic cascade of glucose flooding into my brain to compensate for the neurons that got switched off or went to sleep.

The Neurometabolic Cascade of Concussion explains it:

Immediately after biomechanical injury to the brain, abrupt, indiscriminant release of neurotransmitters and unchecked ionic fluxes occur. The binding of excitatory transmitters, such as glutamate, to the N-methyl-D-aspartate (NMDA) receptor leads to further neuronal depolarization with efflux of potassium and influx of calcium. These ionic shifts lead to acute and subacute changes in cellular physiology.
Acutely, in an effort to restore the neuronal membrane potential, the sodium-potassium (Na+-K+) pump works overtime. The Na+-K+ pump requires increasing amounts of adenosine triphosphate (ATP), triggering a dramatic jump in glucose metabolism. This “hypermetabolism” occurs in the setting of diminished cerebral blood flow, and the disparity between glucose supply and demand triggers a cellular energy crisis. The resulting energy crisis is a likely mechanism for postconcussive vulnerability, making the brain less able to respond adequately to a second injury and potentially leading to longer-lasting deficits.

That’s what happens during/after a concussion, and by the time this takes place, there’s not much room for behavior adjustment on the part of the concussed individual.

The time for adjustment is actually before the event has a chance to take place, and/or after, led by an outside observer who can objectively direct the next actions to take. The person who’s been concussed / sustained a mild traumatic brain injury is in no shape to be calling the shots. When you let them decide what to do, you get situations like Second Impact Syndrome, or pro football players returning to play in the same game, then having seizures on their way home.

It’s when the people in charge don’t make the right calls, or they shirk their duty to protect… or they care more about winning than about the well-being of those who serve them (like in the case of my father-in-law who was shot up three times and sent back to the front twice, before they finally let him come home)… that we get into trouble. When our whole society, our whole culture is so steeped in the need to win, the desire to be Better Than, that we willingly send our strongest and healthiest into harms way to be torn down to nothing — maybe not right away, but give it a few decades — then our society can expect to find itself footing the bill in some way, on down the line.

We concuss our student athletes regularly. We have coaches and managers who are more interested in winning than protecting the brains of their star players. Some of our brightest and best are being sacrificed for the glory of Friday night lights, as well as the battlefields overseas. In another 20-30 years, if we have a healthcare crisis on our hands around these “gladiators” who have all sorts of complications… and we have a workforce crisis around a whole lot of folks who are not performing up their full potential thanks to combat TBI and sport-concussion-induced cognitive decline… and we’ve never lifted a finger to actually address these issues when they were still fresh and (perhaps) manageable, then we have only ourselves to thank.

What do we expect?

A new kind of war

I’m about to start an early meeting, so I can’t write much, but looking at a lot of the great info and discussion over at The Concussion Blog, lately, something has occurred to me — we don’t fight the same kinds of wars anymore.

I’ll have more to say later, after my meeting. But for now, I’ll leave it at that.

War and peace

Working away...

Been thinking about war, lately. With Memorial Day just past and all the world events (like the legislation that looks like it’s going to pass, giving the President the right to wage wars anywhere in the world without Congressional approval), I’ve been thinking about what place that concepts associated with war have in my daily life.

Apparently, they have had a pretty prominent place in my life. Everything from the corporate environments I work in, which have conference rooms designated as “war rooms” and meetings called “triage” and where onetime National Guard members and former servicemen and -women interact with each other in a hierarchical way, using terminology that has a distinctly military feel to it… to the imagery I use in my everyday life… war is always there.

My neuropsych has taken issue with my referring to interactions as “push-backs” and my daily life as “barrage”, as being decidedly conflict-oriented. But the whole push-back thing is common vernacular in my job, and frankly, with the amount of work that gets thrown my way is pretty much of a barrage. And that’s my experience of it. Having people show up at my desk in an aggressive stance, pushing and threatening… it does tend to be a bit of a barrage. And there’s a lot of it.

My neuropsych is trying to train me to think about these conflicts and interactions in ways that are not battle-oriented. They’re trying to get me to think about my LIFE in ways that are not battle-oriented.  I’m not sure how well it’s working out. Sure, I get that it can be more constructive to conceptualize solutions that are mutually beneficial. And that’s generally how I try to orient myself.

But sometimes, things get to be a battle. And there’s no way around it.

Interestingly, I’m finding a lot of comfort in reading military memoirs. Stories of Patton and Montgomery. Accounts of fighter pilots doing the impossible, and military campaigns that went well… or didn’t.

I’m not sure what the attraction is. I’ve never been a very militaristic person, and I do believe that conflict is often an unnecessary distraction from what really needs to get accomplished. I guess it just helps to read about people who have had to overcome serious odds in life-and-death situations, when I feel like I’m surrounded by spoiled, coddled co-workers and family members who can’t manage to do the most basic of things, like do a full day’s work and get out of bed at a reasonable hour.

It just feels like so many people around me are weak and unwilling to work. I tell myself that that’s on them — I get a great deal of satisfaction out of earning what I have and putting in a full day’s (and more) work. It works for me, and I feel a little sorry for people who can’t be bothered with experiencing a little discomfort for long-term gain.

But I rely on people to get my job done and live my life. So being surrounded by people who can’t handle any sort of stress or strain, and who buckle at the first sign of trouble… well, that is troubling.

It’s not like I’m a hard-ass. It’s just been my experience that life will throw a lot of crap at you, and you just have to soldier through and keep going. It’s worked for me over 25 years of being steadily employed, and I have yet to see any other strategy that actually works in the long-term. Sure, focusing on the positive and envisioning the world you want to create is all very well and good. But there’s an awful lot of boring old work involved, too.

And trying to avoid the discomfort of work with mental gymnastics and rationalizations that paint a boring, drab, uncomfortable experience in a positive light, ultimately will fail to produce the kinds of results that actual work will. Because any sort of prolonged success will necessarily demand a level of tolerance for discomfort and boredom and drudgery that sees you through all those hours of effort.

Peace is fine. Peace is nice. But being able to handle yourself in wartime conditions can also come in handy.

The importance of a one-track mind

Staying steady – it’s about the only thing that saves me. Staying focused on what is important to me, what matters to me, what drives me in life. Truly, without knowing these things — what I’m willing to live for, what I might even be willing to die for — it may sound old-fashioned, but it’s the stuff of my life.

In today’s world, we are surrounded by constant enticements to stray off course. Media tempt us with a constant stream of engaging images which ultimately bring us nothing other than a moment’s entertainment. Advertisers and marketers interrupt us constantly to tell us about things they would like us to buy. Everywhere we look, everywhere we go, people are vying for our attention, and for those who have trouble staying on track, it can be murder.

It can literally wreck your life.

So, it’s up to us. It’s up to you. It’s up to me. To stay focused. Steady. Intent. It’s important not to take ourselves too seriously, but at the same time, don’t fall into the trap of discounting yourself and your values for the sake of some brief relief — fitting in, “taking the pressure off”, or whatever other reason you have for straying from your path.

What IS your path? What matters most to you? What do you want to devote your life to? Your family? Your country? Your job? Your home town? What? What matters enough to you, that you will get up early each day, and stay up late each night, in order to do it? What matters so much to you that you willingly forego personal comforts and convenience to do/have/achieve it?

These are important questions. Especially when it comes to TBI recovery. I am thinking particularly of the servicemen and women who have sustained TBI’s in the course of their service, who now come home to a life they may not recognize, in a country that owes them the world, but cannot/will not help them.

To these folks I say, “Find what matters to you. Find others who share those same values. Find your tribe, your home, your extended family. And put everything you have into serving your common cause.”

To all of us, I say, we should do the same. Find what matters most to us, what drives us, what feeds us, what keeps us going, no matter what. These things can — and do — save lives. Because they hold our focus and they keep us on track, when all the rest of the world is being pulled in a million different directions by a million different messages, very few of them are actually true.

Stay the course. Find your spark. And keep on keepin’ on.

Knowing your warrior nature

Four Samurai - Source: wikimedia commons

Something came together for me over the weekend — it’s something that has been in my mind for a number of years, now, but suddenly it has a whole new meaning. It seems to explain pretty well some of the things that have puzzled me over the course of my life.

It’s the idea that the injuries I’ve sustained are a warrior’s injuries. And to address those injuries, I need to do so as a warrior, using a warrior’s tools. My main tool of choice is Zen. Za-zen. Sitting with the intention of overcoming the limitations of my unruly mind.

As a bit of background, I have been fascinated by warrior codes and cultures for as long as I can remember. As a kid, I was practically obsessed by King Arthur and the knights of the Round Table. Something about the stories of the knights really captured my imagination, and I spent many an hour as a child studying heraldry, swords, draft horses, and castles.

To this day, I’m still fascinated by stories of chivalry and the exploits of knights errant. Something in me really relates to them.

In the course of my travels, I have had the good fortune of having encountered a handful of people who have been Zen practitioners. The ones I related to most strongly were solitary practitioners. They sat za-zen in the morning outside — in all seasons of the year, no matter what the weather –before they did anything else, they traveled around and had adventures, they wrangled with family and community problems, and through it all they had a sparkle in their eye (even a wicked gleam) and their most common response to anything unexpected was, “Isn’t that fascinating!”

I sat and listened to their stories of what they encountered along the way in their lives, and I was amazed by the courage they showed in the face of tremendous adversity. But to them, it wasn’t a question of courage, it was a question of simply being with the situation and responding the the way that seemed most appropriate.

I guess it rubbed off on me, because I felt myself drawn to zen — particularly za-zen, the act of sitting motionless for some time, focusing on the breath and just letting the attention disperse. Not following any of the thoughts that come up, but noticing them and then letting them go. I practiced this for some time, myself, years back. I didn’t attend any formal sitting sessions at zendos or meditation centers. I was a solitary and I liked it that way. Plus, I was very nervous about being around other people who knew how to do something I was new at. I was so accustomed to new people taking issue with the way I did things and/or finding fault with me and/or making a public example of me doing things “wrong” that I just couldn’t bring myself to spend any time with people who did this sort of thing.

I thought about it many times. But I could never bring myself to move forward.

Then I fell in 2004, and my practice fell apart. It just disintegrated. I couldn’t be bothered with sitting in silence. I couldn’t be bothered with intentional breathing and paying attention to what was rattling ’round in my brain, for the sake of letting it go. I couldn’t be bothered with any of that silence stuff. I was too agitated, too restless, and I was too injured to realize that something was amiss.

Over the past 5 years or so, however, I’ve been drawn back to zen. I can’t be bothered with a lot of the doctrine that gets tossed about – all those words and pontifications about something that is essentially about just being. Maybe I’m just a contrarian, but many of the people who purport to practice zen annoy the crap out of me. But in place of the people, there are the writings of practitioners and students from years gone by, and I’ve been digging into them a bit — one of the pieces I’ve found that I’m enjoying is The Religion of the Samurai, which is a free download at Project Gutenberg.

I have been reading a few places where scholars have wondered aloud why Zen (which may or may not be part of Buddhism, depending whom you talk to), would have been adopted by the Samurai, a warring class, as their “religion”. Buddhism, from what people say, is a practice that honors all life and warns away from killing other living creatures. How could Zen end up the practice of a warrior class specifically dedicated to being highly effective “killing machines”?

The answer, I think, lies in the effect of Zen on the autonomic nervous system. It’s been my experience that Zen is extremely effective at teaching you how to modulate your fight-flight responses, as well as training you to ignore the pointless chatter of an overactive mind. In my own experience, it seems to specifically condition your mind and your body to do as you choose, not simply race from one stimulus to the next, in a never-ending and ultimately futile attempt to assuage every fear, satisfy every appetite, and overcome every perceived foe. Za-zen practice (in my own experience) trains you to “hold your sh*t”, if you’ll excuse the expression, and keep your act together, even in the face of truly daunting odds.

That, I believe, is why Zen (especially za-zen) became such an important part of Samurai culture. It trained and toned their minds and their systems to be masters of their own unruly passions, and put them in the driver’s seat of their own lives.

That’s a mighty powerful thing. And the clearer I get — each month seems to bring a little more clarity (though I do have set-backs) — the more drawn I am to the practice of Zen… za-zen… sitting with my breath and taming my unruly mind.

Because in a classical sense, I have a warrior’s injuries. I’ve been attacked. I’ve been hurt in accidents when people ran into my car. I’ve fallen from heights while attempting some exploit. And my last injury in 2004 came from me being over-tired, pushing myself to “so my job” and not paying attention to my posture and position when I was in the midst of an important task. I was literally  injured in the line of duty.

What’s more, the types of injuries I’ve sustained are the kinds of injuries warriors sustained, back before there were guns and cannons and laser beams. Back in the day, warriors fought hand-to-hand. Think Braveheart. Think Lakota raiding parties. Think Maginificent Seven. Once upon a time, when you went into battle, you had a sword and/or a spear and/or a shield. And you did what you could with what you had. Sure, there were often archers, but on the ground, you went up against a live person. And you got hit on the head a lot.

Think about it — when you’re going for the kill in a spot that’s the least protected, what’s often the easiest target? The head. The body has arms and legs and usually some sort of clothing or armor to protect it. But the head can be difficult to protect — you almost have to have it unprotected, so you can see and hear and smell and taste your way through the heat of battle. A lot of people take swings at your head, and maybe you duck and miss some, but you can also get clunked on the head by a glancing blow or a direct hit, and you have to keep going. You still have to keep standing, keep fighting, keep swinging.

When I think about it, that’s one of the things that TBI-induced stubbornness is good for — staying in the fight. The very thing that works against athletes when they’re concussed — that determination to get back in and keep going — is precisely the kind of quality a fighter needs in times of war. You can’t just sideline yourself, when you’re injured. Not if you’re in the thick of battle and you have no escape route at all. What are you supposed to do? Lie down and play dead?  Meanwhile, your comrades in arms are battling on around you, possibly dying themselves, because you’re lying there taking a breather.

From where I’m sitting, TBI is a warrior’s injury. It’s not just a recent “signature wound” from the recent Iraq/Afghan wars. It’s been that way since the beginning of time.  We probably lost sight of that with the advent of firearms and cannons and long-distance warfare, with soldiers sitting at consoles pressing buttons instead of grabbing a jagged knife and wading into the fray. But think back and imagine, if you will, how wars used to be fought. Take a trip to the library, if you’re unclear on the images. You’ll see what I mean.

Now, I’m sure there are folks who will say, “Having a car accident isn’t the same thing.” Or, “Getting clunked on the head by a piece of falling tile isn’t the same as getting knocked out in an IED blast in Kandahar Province.”

True enough. But keep in mind, the after-effects can be quite similar — and maddeningly so, because that car accident or the thing with the falling tile hardly seems significant enough to produce the kinds of complications that come afterwards — lost jobs, lost relationships, lost money, lost homes, lost self.

That being said, I believe that to effectively treat TBI and restore the aspects of our lives which have been disrupted/trashed, we need to treat the injury as a wound of our warrior lives. Maybe we were Type A personalities who were always on to go, who never took no for an answer, and managed to overcome any obstacle in our path… before the accident/attack. Maybe we were innocent bystanders who were in the wrong place at the wrong time when the car full of thugs pulled up and attacked us. Maybe we were just a little too tired and a little too distracted while we did something that demanded more than we had to offer. Whatever the disparate source(s) of our injury, the aftermath of each person (though every brain is different) shares so much in common with others, in terms of the quality of disruption and difficulty, it would be silly to overlook ways that other peoples and other cultures (especially in the past) developed to not only rehabilitate their injured, but also get them back in the game and let them rise in the world to positions of considerable wealth and power.

Like the  Samurai.

Now, I’m not saying that wealth and power should be our exclusive goals. But the same approach that made excellence of the political sort possible in Japan, those many years ago, can be used to make excellence of any kind we choose possible in this time, in our present lives.  Once upon a time, warriors got head-injured regularly. And some of them found a way to recover successfully and continue on in illustrious careers. They were the lords and barons and kings of the Western world. They were the Samurai of Japan. They were the warlords of countless lands in between. And many, if not all of them, had probably sustained multiple traumatic brain injuries over the course of their lives.

If that holds true (though I may certainly be mistaken in some respects, human as I am), and if we can find the path they followed to restore themselves to functionality, and there are vestiges of their codes and their disciplines still in place today, why can’t we use those same principles to effect the same sort of positive change in our lives?

Why indeed?

Recovery from TBI is possible. People have been doing it for eons. Since the beginning of time. For me, they key is to know my warrior nature, and to respect it as such — and treat my wounds as I would treat any injury from battle: with discipline and focus and the determination to get back out there into the fray again… next time with more insight, more experience, and yes, more success.

Know thyself.

The warrior’s walk

Over the past year or so, I have been giving a lot of thought to head injury survival through the ages. Getting hit on the head, knocked out, attacked, and generally brain-damaged is about as regular a part of the course of human history as, say, losing your teeth or having a part of your body chopped off.

Think about it — dental care as we know it today is a relatively recent development. Used to be, a blacksmith was the one with the tools to pull a tooth — or you did it yourself with a heavy object slammed against a bad molar, or a string (tied around the offending tooth) and a slammed door. And it’s easy to forget in this convenient age, that once upon a time, people used actual tools to get their work done — lots of them sharp — and lived under conditions that were harsh and unyielding. Chopping off part of a finger — or a whole finger, for that matter — losing part of your foot to frostbite, and/or having a piece of your ear bitten off in a bar fight, happened with a lot more frequency than we 21st century folks recall.

Think about it — once upon a time, wars weren’t fought in faraway lands by trained, dedicated armies that only wanted to vanquish each other. Time was, raiders and looters and rapists and pillagers roamed the seas and the countryside, doing as they pleased to whomever was there. What’s more, in the middle ages, just about the only way am ambitious young man who wasn’t the firstborn in his family could get ahead (other than by taking up a trade or currying favor with some overlord) was to sign on as a mercenary with a local feudal lord and maraud his way to fame and fortune.

In our cozy, warm homes, with only the television and the internet to connect us with a reality outside our own, it’s easy to forget just how rough life has usually been on the human race. And it’s easy to forget that traumatic brain injury is not something that is unique to football players, boxers, and survivors of car accidents and falls. We look at statistics about brain injury — how many of them come from sports and falls and accidents and assaults — and we shake our heads, wondering what we can do to make the world safer — both before and after the accidents.

But think about it for a moment… how safe can we reasonably expect life to be? Granted, nobody wants to have their brain rearranged by unexpected trauma. Nobody actively seeks out a cognitive-behavioral condition that can be not only disturbing but downright disabling. Nobody plans to be at a perpetual disadvantage in life. But it happens.

And it’s been happening for a long time.

So, what do we do?

Certainly, we can try to prevent as many head injuries as possible, with helmets and education and training and good sense. But there’s just no way to live your life freely, if you’re on constant alert about what might happen, and what that might mean for your long-term prospects.

As an old, old relative of mine says, “Life is dangerous!” To try to limit the dangers, also means trying to limit the full range of human experience. To live fully, you need — on some level, anyway — to accept the possibility of harm, damage, danger, injury. To live fully, you need to walk — head up, shoulders back — into the face of some pretty scary stuff, and be prepared to deal with the consequences.

To live fully, to walk fully upright in the world, you have to be a warrior.

maori warrior

Maori Warrior

You have to be ready, willing, and able to look the world in the eye with a resolve that says, “I will not bend before you, I will not break beneath you, I will not yield the ground I have won. I will not falter and I will not fail, until I have reached my final destination.  The only way I am going to fall short is if I fall permanently, period.”

To do this, to think this, to live this as a recovering survivor of brain injury (or many other kinds of injuries, including PTSD), you must be a warrior.

Now, I’m not saying everyone should pick up a sword or a spear or a gun and march out into life swinging and shooting. I’m not saying that you have to be on the defensive or the offensive at all times. Far from it. According to, a warrior is someone who is

1. a person engaged or experienced in war(fare)

2. a person who shows or has shown great vigor, courage, or aggressiveness

Vigor, courage, aggressiveness… yes. Those are key. And they are also predicated upon the experience of war.

To be a warrior, you have to realize and accept that you are engaged in war. Not only war in the classical sense, but:

War 4. active hostility or contention; conflict; contest

For those who struggle daily with TBI (or PTSD) in a world that doesn’t give a damn about our struggles, this is not a huge cognitive stretch. We are constantly faced with active hostility or contention, conflict, and contests — whether those come from within, or without. In my case, I would have to say the source is frequently more internal than it is external, but that doesn’t make it any less challenging. If anything, it makes it moreso.

Sometimes walking through the world without acting out, without attacking, without leaping in to “defend” yourself from a mis-judged situation takes more warriorship, than striking out. Being able to stand your ground… to hold your fire… to be fully present in a moment which threatens you on every level, without flinching or fleeing… that takes true strength, courage, and vigor. And mastering the self, learning to calm and/or disregard the constant chatter that goes on in our rewired brains… well, that takes a good deal of aggressiveness.

Not against the rest of the world (tho’ sometimes that’s required), but against the inner impulses which impel us to flinch and flee and fly off the handle. It takes monumental skill to stand when you want to bolt. It takes determination to listen, when you’re just dying to shout. And it takes all you can give, to walk, when everything in you is telling you to run.

Now, don’t get me wrong.  I’m not recommending that everyone just be 100% okay with the after effects of traumatic brain injury or other tragic traumas. I’m not saying we need to just sit back and take all the crap the world has to throw at us. Far from it. What I’m saying is that we as recovering survivors need to develop the inner resources to be our own people, to stand our own ground, hold true to our values, and not be diverted by externals when they keep us from our ultimate goals.

We need to be warriors in the truest sense. To walk our own paths, wherever they may lead us. To know ourselves for what we truly are, not what the rest of the world says we are. To do what must be done to protect ourselves and our lives and all we hold dear. And whatever route we take, it must be our own, and we must be loyal to the True inner voice that compels us, while learning to discern and dismiss the internal chatter and endless distractions which strive to pull us off our path.

Only we can achieve that. But when we do, we know it is our own. We have earned it, we have won it, we have paid dearly for it. And nothing and no one can take that from us.

March on.

Add Your Name to the Open Letter to the President

I just found this over at the Sgt. Sam Nichols TBI recovery blog:

Over the past year and a half, my daughter Erin has spent 8 to 14 hours a day in various military hospitals at the bedside of her husband Sam, a US Marine severely injured in Iraq by a roadside bomb.  It has become Erin’s dream to go back to school to become a speech therapist so that she can help Sam and other wounded veterans of the Iraq and Afghanistan wars learn to speak again.  She hopes to one day work in a veterans hospital.  One of the provisions of the new GI Bill is the option to allow servicemembers to transfer their GI Bill education funding to a spouse or dependent.  But—the military has been dragging its feet on getting the regulations in place, so servicemembers are still waiting for that benefit.  The Obama Administration can and must get the bureaucracy moving and make this benefit a reality.

In the coming months, President Obama has a unique opportunity to make a series of critical decisions impacting Iraq and Afghanistan veterans. Sign the open letter urging him to enact these four critical policies in his first 100 days:

    · Ensure that veterans don’t have to fight for funding for hospitals and clinics.

    · Prioritize veterans in the economic stimulus package. (Note: It may be a little late for this, but it’s still a good idea.)

    · Implement GI Bill transferability.

    · Aggressively address troops’ mental health injuries.

Add your name to the open letter here.

I just did

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