Tag Archives: military

Why Are We “Suddenly” Hearing About Brain Injuries

Brain injuries are a hot topic in today’s media.  Whether it be football players with lasting damage due to concussions, soldiers suffering from brain injuries due to overseas conflicts or the latest youth sports concussion protocols, it seems that there are suddenly many news stories on brain injury that simply were not around just five or ten years ago.  Some individuals may be cynical and wonder whether brain injuries are simply the “diagnosis of the moment”, one of the many diagnoses that are suddenly “hot” but will disappear over time.  To those individuals, I would like to offer several rational reasons why brain injury stories have become more prominent over the last few years.

First, many people are now living with brain injuries who would have died from their injuries in previous eras.  The medical world has advanced significantly over the years and now doctors are able to save the lives of people who would have otherwise died. However, just because their lives were saved does not mean they emerged from their health emergency unscathed.  These survivors often have brain injuries which require treatment.  Please allow me to give an example of this change over time.  I once was talking over lunch with an older rabbi about Transitional Learning Center.  He relayed a story about his time at a synagogue many decades ago in Indiana.  A young man in his community had a serious motorcycle accident and as his rabbi, he visited the young man in the hospital.  After conversing for a while and finishing his visit, the rabbi exited the room.  As he left, the doctor pulled him aside and said “You know he will be dead in three days”.  The rabbi was shocked, having just had a full conversation with the young man.  But the doctor was correct.  The hospital had no means to manage his brain injury.  Due to either brain swelling, bleeding or both (the rabbi did not know the details), the young man passed three days later.  Today, a person with a similar motorcycle accident would have a surgery and other potential procedures to manage his injury and would stand a good chance of living, albeit with a brain injury.  Similarly, improvements in military field medicine are allowing many soldiers to survive blasts and other dangers that would have killed them in previous battles.  Thankfully, these soldiers still have their lives, but often struggle with long-lasting brain injuries suffered in their military service.

Second, it is important to acknowledge the active suppression of information regarding brain injuries in certain circles that is only recently coming to light.  Most famously, the NFL actively denied and hid data on the long-term brain injury effects of concussions to former football players.  Through a series of lawsuits, the NFL opened up about brain injuries and is now acknowledging the long-term injuries that many former players have suffered.  This has led to a complex $1 billion settlement for players with long-term effects of brain injuries.  Following these court cases, many other lawsuits have been filed against other professional and amateur sports, leading to further agreements and new safety protocols.  The suppression in the past contributed to an artificial perception that brain injuries were less common than they actually were.

Third, we are in an age of information so it is much easier to learn about what is happening to people across the country, and even across the world.  Just think about how often you hear or read stories about a robbery or kidnapping occurring hundreds of miles from where you live.  Until the age of the internet, most of those stories would be confined to local media.  Now, stories can go “viral” and suddenly everyone knows the details.  This phenomenon is equally true in the realm of brain injuries.  A simple keyword search of “brain injury” will bring up a plethora of local stories that prior to the age of the internet would have been hidden from most of the world.  These local stories existed in the past but only now d0 we have so much access to them.

Fourth, we are now having a more honest conversation about brain injuries.  In the past, people generally did not talk about brain injuries.  Athletes and soldiers rarely mentioned their deficits due to fear of sounding “weak”.  Individuals with brain injury deficits from car accidents, strokes or other methods were often afraid of negative views and discrimination if others knew about their deficits.  We are now coming to an age of sharing without fear.  It may be hard to believe but the Americans With Disabilities Act (ADA), the civil rights legislation that has allowed for a greater involvement of people with disabilities in the workplace without fear of discrimination, was only passed in 1990.  In comparison, the Civil Rights Act, which blocked discrimination due to issues such as race, gender, and religion, was passed in 1964.

Fifth, we are much more able to diagnose and treat brain injuries than in the past.  Technology such as MRI and CT exams to scan the brain and locate injuries are relatively new.  Moreover until fairly recently many people, even health professionals, did not even know the right questions to ask to identify a potential brain injury.  For instance, if a high school athlete is concussed in a game today, the coach and athletic trainer often have a protocol to follow to ensure proper health management.  Twenty years ago, the player would likely have been just given smelling salts, asked if he or she felt “okay” and sent back into the game.  In fact, many states now have mandatory concussion training for coaches and athletic trainers.  This was unheard of just a few years ago.  In the past, people with brain injuries were forced to suffer in the silence of unrecognized deficits.  Now, these brain injuries and their concomitant deficits are more likely to be accurately diagnosed.

Overall, there are many rational reasons why we are “suddenly” hearing about brain injuries in the media, despite these injuries having been an issue in the past.

Learn about brain injury treatment services at the Transitional Learning Center: http://tlcrehab.org/

 

 

July 4th Fireworks

Every July 4th, Americans across the country light up the sky with fireworks.  This patriotic spectacle is commonly enjoyed at large outdoor celebrations, though often fireworks are also set off at private homes.  This circumstance brings to the fore an issue that we as a society may not generally afford sufficient attention.  Namely,  how do our family and neighbors react to fireworks?

After a brain injury, many survivors are highly sensitive to loud noises.  Fireworks can be quite disturbing to a survivor, even if he or she enjoyed them in the past.  Fireworks may lead to agitation, frustration and acting out.  Prior to attending a fireworks celebration (whether public or private), loved ones should check with survivors and their therapists as to whether those survivors would do well at a fireworks display.  If the survivor chooses to attend a display event, loved ones should have an exit plan prepared just in case the event goes poorly for the survivor.  Neighbors should check with survivors and their families prior to setting off fireworks.  Fireworks are not truly a “private” matter, since everyone in the nearby vicinity will be hearing them whether they wish to or not.  It is not fair for the survivor to be put in serious distress just because a neighbor likes to set off fireworks.

This issue may prove even more pertinent when a survivor is a combat veteran.  Many combat veterans who suffered injuries in battle also have Post-Traumatic Stress Disorder (PTSD).  PTSD symptoms can include flashbacks in which the veteran feels like he or she is back contending with the relentless stressors of life in combat, painful memories of the trauma of friends dying and serious sleep disturbances. Fireworks can trigger all of these symptoms and more.  Additionally, many in the South have a custom of shooting guns in the air on July 4th.  If fireworks are a bad idea around combat veterans with PTSD, then shooting guns is a horrible idea.  (As a sidebar this practice is simply remarkably dangerous.  This writer knows a woman who was hit by a bullet that was shot by an unknown individual in the air to celebrate a holiday. The bullet fell into an open restaurant area and lodged in her lung.)  The combined effects of a brain injury and PTSD can make these situations especially tricky for veterans.  Loved ones should check with survivors and their therapists as to whether these veteran survivors may have a PTSD-type reaction around fireworks or guns.  Again, neighbors should check with combat veterans to ensure that the neighbors’ celebrations do not harm the psychological well-being of these individuals.  Some combat veterans have taken to putting signs on their lawns identifying themselves as combat veterans and asking others to be courteous with fireworks.  These signs should be taken seriously and neighbors should not shoot fireworks or guns near these veterans.  Again, no one should be forced to suffer in service of a neighbor’s idea of “fun.”

Wishing everyone a Happy July 4th!

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Book Recommendation For Working With Soldiers/Veterans

In recent years, public awareness has been growing of the increasing presence of brain injuries in combat soldiers and veterans. Many doctors and therapists are now working with these soldiers and veterans but often do not fully grasp how this population may differ from other patient populations.

 
The military is in no way simply a nine to five job. For many soldiers and veterans it encompasses much of their life and identity. Under combat deployment, there are no days off from work. The soldier is on duty 24-7 without a true break or rest. Due to the demands and risks of the military, soldiers are part of a culture that is very different from that of the civilian world. For instance, it’s relatively common for an employee at a store to question a supervisor’s directives and perhaps even lodge a complaint with management. This process may last for several days and either see action taken or not. In combat, a soldier is not in a position to question a direct order. Life and death decisions have to be made moment by moment. The immediacy of danger also leads soldiers to develop intense and special bonds with one another. The loss of a fellow solider in combat may be felt as strongly as the loss of a family member. Since being a soldier so often encompasses so much of the individual’s life and identity, being dismissed from the military due to an injury is not like being fired from a job. The effects of emotions such as grief and anger felt resulting from losses suffered in the course of a veteran’s service are often experienced on an entirely separate level of magnitude.

 

Below is a list of a few books that may help doctors and therapists to better understand this population:

Hidden Battles on Unseen Fronts: Stories of American Soldiers with Traumatic Brain Injury and PTSD by Patricia Driscoll and Celia Straus

On Combat: The Psychology and Physiology of Deadly Conflict in War and Peace and On Killing: The Psychological Risks of Learning To Kill in War and Society by Lt. Colonel Dave Grossman

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Free Continuing Education Credit

WETA (the public television/radio station of Washington D.C.) and the Defense and Veterans Brain Injury Center have partnered to create a great website on brain injury,www.Brainline.org.

Brainline.org is now offering a free continuing education (CE) course called Identifying and Treating Concussion/mTBI in Service Members and Veterans.  The course offers free CE credits for members of the American Medical Association and American Academy of Physician Assistants.

Below is the link to the course:

http://www.brainlinemilitary.org/concussion_course/introduction.php

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org