Tuesday, November 5, 2013


As you're aware, I've had a head injury (or, as it now appears to be described - somewhat more accurately - a brain injury). 

One of the reasons these updates have been so chaotic lately is that I've been spending so much time on the National Brain Injury Foundation. 

This column is one, very simplified attempt to explain why the NBIF is closing its shingle. It will reopen as a part of Hartley LifeCare. 


As astute readers of this column (Are there any other sort? - Ed) will have noticed, every now and then there’s the occasional pronouncement they might consider, well, “out of the box”. As one might suspect, the reader is always right and there’s a reason for things being a bit unusual. It’s because, while working as the ABC’s Indochina Correspondent, your columnist suffered a rapid, traumatic brain injury. Another car smashed, suddenly and with extreme prejudice, into the rear of my car as I drove across a bridge in Bangkok.

Fortunately, I was wearing a seatbelt. Unfortunately, it was not the inertia type. As a result my head was flung swiftly forward until it came to an abrupt halt. The soft, gooey material that makes up the brain, however, continued moving rapidly forward in an unrestrained manner. It eventually cascaded, milliseconds later, into the front of the skull – which had, by that stage, stopped moving. The result had the same effect as a swift frontal lobotomy.

I’ve never ‘recovered’. I’m a very different person to the one I was before the accident. With the help of my wife and others, however, I’ve learned to work around the injury. Or not. Sometimes, for example, despite the weekly proof of brilliant insight and acumen revealed on this page, a number of letter-writers attempt to assert that your marvellous columnist is still displaying the effects of brain injury despite the lucidity of my writing. Imagine that! Confounding, isn’t it?

Once it occurred, the accident completely derailed my plans for worldly glory and the success for which I was undoubtedly destined. It did, however, help me realise that other things are far more important. Like love, for example. And children. And friends, and the myriad of other things that make life worthwhile and can never be quantified in dollar value. That’s why, eventually, I decided to get involved in some way with assisting other people who’d sustained similar injuries. Which is a long way into how I first became involved with the National Brain Injury Foundation.

Despite its grand name, the NBIF is neither “National” (it’s ACT based) nor a “Foundation” (you know the sort of thing; housed in a building with huge sandstone pillars out the front and inside a library, where an ageing retainer stands clutching a bottle of sherry). The trouble is, although it was only established some forty or so years ago, the world has changed. Back then the ideas of Dr Ted Freeman challenged medical orthodoxy for treating head injuries. His ideas are elaborated in a brilliant book by Professor Peter McCullagh available (free) on the ANU’s web-site (Ted Freeman and the Battle for the Injured Brain: A Case History of Professional Prejudice).

In the 1970’s, the medical profession thought it understood the way the brain worked. Freeman knew we didn’t. Together with Professor Roger Rees, Dr Bob Compton, the indefatigable and marvellous Dorothy Sales and many, many others, he worked on patients that had previously been (effectively) written off. Read the book and you’ll discover a great deal. It’s inspirational – not just for what it says about the mind but as a story of someone fighting for an idea.

It’s important, nonetheless, to realise that when the brain is injured it’s not like a broken leg – it can’t just be put in plaster and left to get better. Sometimes the damage is too massive. Even if it’s not, that doesn’t mean the brain will necessarily recover. Don’t believe what you see in the movies. And almost always the person after the injury won’t be anything like the individual they were beforehand. You never ‘recover’ from a head injury. You become someone else instead. That’s why hope alone is not a strategy and it’s cruel and false to suggest recovery is always possible. The point is, rather, that these ideas have managed to have an effect on medical practice, making it more informed.

Volunteers inspired by Freeman’s ideas were responsible for establishing the Foundation, but much has changed in 40 years. Importantly, although our concept of how the brain works remains sketchy, we now have a much better understanding. This informs medical practice. Time’s moved on, but the Foundation hadn’t.

The volunteer model doesn’t seem to work in today’s society. People are often too busy working to offer help. They expect to pay for services. They want proper care and don’t have time or the inclination to work for someone else, they’d rather pay someone else to do it. The trouble is there’s still a need to support people with a brain injury . . . but there’s also an urgent need to transform the model under which the Foundation was operating. 

Change is always threatening: these alterations have proved no exception. Some people disagreed with the basic premise I’ve outlined here; others thought there were other, different and better ways of dealing with emerging problems. That’s part of the challenge of being in a member-based organisation: although everyone shares the same objectives, there are many different ways of accomplishing them.

But when the crunch came, at a special meeting last month, there was unanimity. Everyone decided the time had come to wind up the organisation. Eventually the members agreed to offer the Foundation’s assets to another, similar member-based organisation with a slightly broader focus, Hartley LifeCare. Happily, the lessons of the NBIF won’t be forgotten. Hartley is establishing a special brain injury program and will be ambitiously working for similar objectives. This is the key.

It doesn’t matter what structures are used; the vital thing is to focus on objectives. That’s why I’m happy. Instead of fading away, the aims of the NBIF will still continue being accomplished.

Nicholas Stuart was the President of the National Brain Injury Foundation.

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