Letters to the Editor for Tuesday, January 31, 2012

Overcoming traumatic brain injuries

Marsha Mercer’s Jan. 29 column, “When applause isn’t enough,” was quite appropriate and troubling. She correctly notes that Rep. Gabby Giffords is a remarkable woman, with considerable drive and energy, as well as many resources that are not available to the average person. She has made use of many professionals, most likely including speech therapists, physical therapists, occupational therapists and others, for her remarkable improvement from a horrific brain injury. The rehabilitation efforts are exhausting for the patient, as well as for family members, and are generally not covered well by commercial insurance plans. I am sure Giffords has felt more than once that it might be simpler to just give up.

The brain is a very fragile organ, and there are possibilities of significant improvement if there is appropriate therapy quickly after the traumatic insult.

Mercer notes that the Affordable Care Act includes provisions for these specialized therapies and should be endorsed by our Congress. It is very troublesome that much of the public has little understanding of the efforts necessary for rehabilitation, until it is their own family member, and then finds out the limits of the resources. It is not enough to simply wish that the person with traumatic brain injury ”pull themselves up by their own bootstraps,” because the brain is not able to respond without considerable specialized care. If there is not treatment, frequently there are numerous secondary social problems of violence, substance abuse, marital problems and legal problems. The military is addressing the problem, because there have been many traumatic brain injuries in the recent wars in Iraq and Afghanistan. Our understanding of the brain has improved dramatically, but there continue to be many needs, both for the veteran and the civilian with traumatic brain injury.

Our natural human reaction to a person who speaks differently, such as the way that Gabby Giffords must very deliberately speak each word in a halting manner, or someone who has significant problems relearning the routine social rules that we take for granted, is usually one of confusion at best. At worst, because most people do not understand, the common reactions are disgust, impatience, and anger. These reactions further accelerate the confusion on the part of the person with the brain injury. If we do not pay for treatment, then persons with traumatic brain injury will be relegated to the streets, jails, and nursing homes, while we attempt to pretend that they do not really exist. There are many ways to be very busy and look away, and hope that somehow these people with problems will simply “get better.”

As Mercer states, hugs and applause for Gabby Giffords are great, but not nearly enough for the relief that could, and should, be provided.

DR. DARYL H. YODER

Lynchburg