Those living with a brain injury are aware of the injury every minute of the day. As are there carers.
But I suppose we've got to bring the rest of society along with us. This is my effort to do so . . .
BRAIN INJURY WEEK . . .
For three months after the car crash I was unable to get out of bed. After that came another four months in a wheelchair; then, finally, a frame. Sometimes ‘getting better’ seemed to be happening at an infinitesimal rate yet, still, it happened. Everyone could see I was improving. In some ways (such as the increasing distance between my footfalls) it was possible to actually measure progress and give it a number.
Eventually I moved onto crutches and, ultimately, a walking stick. That was when I finally went back to see the orthopaedic surgeon who’d patched up the battered body that was brought to him after the car smash nearly a year earlier.
The accident had occurred in Bangkok where I’d been working as the ABC’s Indochina Correspondent. A drunk Thai driver had crashed into the rear of my car. I was flung forward into the steering wheel, which engaged in a brief contest with my hip. Neither won. The wheel broke, but my hip was shattered. Fortunately a tuk-tuk driver rescued me, pulling me from the car and taking me to the nearest hospital before I was flown back to Sydney.
The Royal North Shore Hospital hadn’t seen bones as badly smashed around as mine for years and I was incredibly lucky to get the orthopod who spent eight hours patching and fitting together the jigsaw puzzle that my hip had become. But it was only when I saw the surprise on his face that I really understood how bad the injury had been.
“Goodness! I thought you’d never walk again”, he said as I hobbled slowly in on my walking stick. He shook his head. “It’s amazing.” He walked around me and watched my shuffling gait. “Well, that’s that then.” He was aware he’d accomplished something like a miracle. Thanks largely to his skill the bones were knitting well and I’d continue to progress. It seemed as if the operation had been a complete success story.
And, physically, it had been. Journalists like to use shorthand to tell stories like this. ‘INJURED MAN WALKS!’ scream the banner headlines. It’s a simple tale with a happy ending. The only problem is that in the real world nothing’s ever quite so simple or as neatly stitched-up as that glib phrase suggests.
The problem was it wasn’t just my hip that had a traumatic impact. My brain had been travelling at the same speed as the rest of the body when it was arrested by the steering wheel. The seatbelt wasn’t an inertia one so the bones of my skull were also brought to a sudden halt. The brain – always pretty squishy – kept moving. It smashed into the front of the bony skull like a jelly thrown onto cement. This time the score was very one sided and the brain, that most delicate part of the body, came off second best. Very much so.
There’s no need to go into detail about how this affected me – after all, this is a family newspaper. But the point is the accident resulted in a far more significant legacy than my slight limp. We don’t, however, normally cart our brains around in wheelchairs or use crutches that can demonstrate someone’s suffered a sudden impact to the brain. It’s also far more difficult to measure or understand exactly what’s happened to the delicate flower that blooms inside our cranium. That’s why brain injury’s called the hidden disease – but it’s no less real just because it can’t be seen.
Every now and then I still make mistakes that I attribute to the injury. A couple of columns ago, for example, I mixed up two very different Athenians: Cleon and Solon. This was, I’m absolutely certain, a dysphasic mistake attributable to the injury. After all, who could possibly get the great lawgiver mixed up with the general? Unfortunately, I can’t use that as an excuse all the time. Earlier this year a Professor correctly ‘pinged’ a error of Latin. My former teachers would gleefully insist I never mastered the rudiments of the language!
Nevertheless, given the chance, most of us would prefer to end the day closer to perfection than we began it. We don’t deliberately go out to be aggressive or negative (unless, of course, you are a newspaper columnist, in which case all of these attributes, along with a general obstreperousness, are part of the job description). Unfortunately, many people with an acquired brain injury don’t possess full control of their emotions. This can leads to a spiral of problematic behaviour that can, in turn, cause other problems to erupt. It impacts on everyone. Yet because the brain injured don’t use crutches it can be difficult to understand exactly what’s happening in their mind.
That’s particularly so in the case of those people who aren’t so obviously badly damaged. Those injured playing sport, for example. Anyone who hangs around with boxers very quickly becomes aware of the lasting damage a sport that encourages blows to the body can confer. It seems odd that we don’t immediately recognise that people playing rugby or AFL might suffer similarly as a result of being concussed repeatedly. Or, indeed, any activity where the soft tissue of the brain suddenly crashes against the immovable cranium (jelly and cement again).
Imagine the brain’s like a city. The neurones develop particular paths (roads, expressways) to connect the synapses that light up the different sections that allow us to think. A brain injury is like a bomb, destroying not only buildings but also the critical road network along which signals pass. Rebuilding takes time. Sometimes there’s too much damage to rebuild. You may as well just start again.
Recovering from the most obvious physical effects of my injury still took years. Recovering from the traumatic injury to the brain has taken more than a decade. Indeed, judging from the letters page, many readers still believe there is more recovery to come . . .
The (Canberra based) National Brain Injury Foundation can be contacted on 6282 2880. Brain Injury Australia’s contacts are 1 800 272 461 (that's 1800 brain 1), or a webpage at braininjuryaustralia.org.au