The Olympian Task of Cognitive Rehabilitation in ATBI

olympic skiierThere’s nothing glamorous about having a head injury.  Likewise, there’s nothing glamorous about having had a head injury; or for that matter, about writing about head injury.  Because of its mysteries and its stereotypes, head injury doesn’t elicit the kind of compassion or sympathy that cancer or other illnesses engender.  Nor does it enjoy the popularity or accolades of, say, being an accomplished musician or developing a new invention.  People don’t like to read about head injury, let alone talk or think about it, primarily because head injury is negative and uncertain, and in its way, intimidating.  In general, people don’t like to think about unpleasant things that seemingly don’t affect them.

At best, closed head injury is typically reduced to ignorance and unknowing, an intangible illness that most like to make sophomoric jokes about.  No one much understands what really goes on with closed head injury, and because it affects cognition, people like to reduce it to a type of insanity or reduced I.Q., of which it is neither.  This misconception isn’t always the fault of ignorance.  It’s easy to misjudge what one does not understand.  Even doctors disagree on the prognosis of the head injured; so, there is unfortunately enough confusion and debate to confound just about everyone concerned.  Yet most people are not concerned about head injury, unless and until this sort of tragedy befalls them, as it did me the year I turned 50.

When you are the unfortunate person experiencing the effects of closed head injury, you are given no choice but to endure it…and it is an unimaginable anguish that one can only hope to convey, if one is as lucky as I was even to survive it.  Indeed, we hear all the time about those who die from blunt force trauma to the head. When I was suffering the early effects of my injury, I never envisioned another day of writing, or especially a new day of blogging.  It took all my energy just to breathe and survive the physical pain.  And that went on for years.  In many ways I feel I now must write this blog, solely because I can.

However much energy recovery takes, recovery from head injury is not seen by most as being anything as magnificent as the focused endeavor of, say, playing a concerto piano piece, publishing a book, or of gliding through snow and air like an Olympic skier. Accomplishing recovery from head injury is generally not even rated up there with the less grandiose task of washing and waxing one’s automobile.  In fact, full or even mostly complete remediation from head injury is not even always believed, even when we witness it. Despite all the bias that exists against head injury, and in its own metaphoric way, healing from acquired traumatic brain injury (ATBI) is all these things and more.

Recovery from acquired traumatic brain injury does not lack focus.  The person has to work and fight hard.  In some ways, the battle is equally arduous as that of the olympic trainer.  While there is no piano or ski slope or car to wax, the head-injured person competes against the dying brain, the brain that controls every thought and every movement…the brain that is torn up and subsequently moving toward shutting down.  In this way, both the person’s will to endure and the brain’s ability to rewire are as phenomenal and as Olympian as the longest tenacity and the finest precision we can envision.  We can and must be grateful that this is the case, while not underestimating the seriousness, as we know many who are not as fortunate, through no fault of their own.

So, how does a person begin the business of cognitive rehabilitation after acquired brain injury?  First of all, as discussed in an earlier post, one has to realize that doctors and healthcare alone cannot complete the job of cognitive rehabilitation.  Nor does the organ, the brain, solely repair itself.  The patient herself must participate, and indeed initiate some of her own measures.  And when she or he is unable to do so, someone who cares needs to be willing to step in.  There are always important and valuable rehabilitative measures available to both the injured and to the caretaker(s) who may need to advocate on the patient’s behalf.  In order to reach maximum rehabilitation, one must not hesitate to avail oneself of these.

I am fortunate that somehow in my cognitive demise, I was myself aware of this need.  Even when I was in too much pain to lift my head (or body, which felt equally broken), I somehow knew that I must work my brain.  Something compelled me to listen to music, which I could hardly put on for myself.  Something told me that even though I was off work on medical leave and unable to read without crushing fatigue, I could still write a poem.  Something drew me to online community that kept me connected socially when, due to the debilitating physical affects and compromised speech and communication skills, I rarely left my home–or actually, my bed.

In the next few posts, I would like to share some of the activities I sought that ultimately turned the darkest years of my life into some of the brightest and most nourishing.sparkle

@ Debra A. Valentino, all rights reserved.

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