The Irony of Brain Injury
While some patients with a brain injury are able to return to work, others reveal how their often-normal appearance belies the lingering cognitive effects of brain injury.
Written By John Christensen
Photography By Gary Meek, Louie Favorite and Jeremy Wilburn
David Aschmann is a cheerful and engaging 32-year-old single father of two young boys. He had a great job with a Boston software firm that sent him to places like London and Tel Aviv. But four years ago on a business trip to Paris, David was hit by a motorcycle and spent 28 days in a coma. When he regained consciousness, he had no memory of the accident and was surprised to learn he had two sons.
When he returned to the United States, David spent 13 months doing inpatient and outpatient rehabilitation in New England and three more years undergoing day program and outpatient therapy at Shepherd Pathways, Shepherd Center’s post-acute rehabilitation program for people with a brain injury. Now, he says: “Things are very different. I’m learning to live a new life.”
David, who lives in Atlanta, is one of more than 5 million people in the United States who have a brain injury, the leading cause of death and injury for people under the age of 45. Brain injuries are notable, in part, because unlike most injuries, which are visible – a broken leg requires a cast, a wound needs stitches – brain injuries are often invisible.
David looks normal, and in many ways, he is normal. But the lingering effects of his injury include struggles with processing speed, confusion and memory loss. Going back to his old job is not feasible for David, but he is volunteering at his children’s school. He has some difficulty with tasks that were easier for him before his injury, but he says he finds fulfillment in being involved at the school.
The disconnect between appearance and reality is confounding not only to those who have a brain injury, but also to people around them. Where people with visible disabilities often get the benefit of the doubt, those with brain injuries often do not.
“The assumption is that when people with brain injuries get out of the hospital, they should be OK,” says Terri Kohn, a licensed professional counselor at Shepherd Pathways. “If you look as good as before, the expectation is for you to be the person you were before. But that’s not the case, and friends and family may think you’re lazy, selfish and disinterested. The brain-injured person may not initiate tasks or participate in the family as before, and it can cause anger and frustration for other family members.”
Some people have a full recovery while others have lingering effects physically, emotionally and cognitively. The goal of rehabilitation is to optimize a patient’s independence and quality of life in the home and community.
“Brain injuries are very complex, and simply getting someone who’s been in a coma to walk again, and feed, bathe and take care of their self is a huge step forward,” says Debbie Page, a vocational rehabilitation case manager at Shepherd Pathways.
Kohn and Page are part of a rehabilitation team that includes a physician, speech, physical and occupational therapists, therapeutic recreation specialists, nurses and case managers. The team also includes the patient, family and others close to the patient.
“It is always a challenge to get everyone on the same page,” Page says. “We work hard to help patients and families move through their understanding of brain injury and adjustment to changes in their lives as they transition back to school or work.”