Concussion to Conan O’Brien – Amnesia not Confusion

Concussion to Conan O’Brien – Amnesia without Confusion

By Gordon S. Johnson, Jr.

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The concussion to Conan O’Brien is another verifiable case study that confusion and amnesia are not the same thing.  The concussion to Conan O’Brien happened on his show on September 25, 2009.  Conan was running into the studio with actress Teri Hatcher, after they both had competed in a triathlon.  Conan in an attempt to sneak past Hatcher at the mock finish line in the studio, fell backwards.  He landed first on his butt and then hit the back of his head on the hard surface studio floor.  At one time it was easy to find on Youtube.  Unfortunately, NBC took down the original version of this event, which included him discussing the events after the concussion at his next show. See http://www.huffingtonpost.com/2009/09/29/conan-obrien-falls-hits-h_n_302471.html

In Concussion to Conan O’Brien he was Amnestic but not Confused

To really understand the lesson we can learn from the concussion to Conan O’Brien, one must listen to the contrast between what Conan did shortly after his brain injury and what he remembers about it.  Conan said this about his concussion:

“In that moment, I saw stars but I just tried to keep going. Then referring to what he did in the seconds after the concussion, “I don’t remember this part, but I guess I threw to a replay, I tried to stand up but I couldn’t stand up, so I tried to throw to a replay, which I did.”

What he did, within 10 seconds of the injury was say: “Lets see if we have a slow motion replay of what happened right there. I believe I won.” Then as the replay clearly shows Hatcher crossing the line first, “I did not win.”

Conan is not confused on that video.  In the first couple of seconds his voice seems a bit slurred.  Yet, the viewer really can’t tell if he is playing the role of the comedian who has just fallen, or whether this is a symptom of brain injury.  However, even this objective evidence of injury has cleared within 10 seconds.  There is absolutely no question that Conan was never unconscious.  There equally should be no question that for Conan, confusion and amnesia were not the same symptom.

Compare the way Conan retook control of his show to the concussed quarterback, calling the plays, directing his teammates, avoiding rushing linemen and completing a pass. Yet despite all that activity, Conan remembers nothing of what he did after the event.  “I kind of couldn’t speak. I thanked Teri Hatcher, and I don’t remember any of this.”

He did what he would have been expected to do, what his conditioning trained him to do, like a quarterback.

“I went into my dressing room, changed my suit, they blow dried my hair real fast. I sat at the desk, the audience is sitting here just like they are now, the band’s playing, and they hand me a blue card.   I’m sitting here looking at the Seth MacFarlane card, and I look up at my producer Jeff Ross and Dan Ferguson, and I say: ‘I don’t know what I’m supposed to do. I don’t know what this is.’

It was like a menu for an Egyptian restaurant. I mean it might as well have been. “

The further it gets from the time of the event, the poorer he is functioning.  When what is likely a half an hour later he is actually required to process new information, his change in functioning is far more apparent than it was in the minute after the fall.    This is not like a boxing match. In boxing, we are conditioned to believe that if the knocked down fighter survives the round, he may come back and win the fight. Brain injuries are thought to get better not worse. In reality, in the first 24-72 hours, they often get worse. Conan’s did.

Confusion and Amnesia are Dysfunction of Different Memory Modes

There exist many different technical and neuropsychological categories of memory as it goes from instant to long term memory.  Yet, despite all of the research, we know very little about the process. That the hippocampus is involved in memory is clear.  Yet what the intermediate stages are between immediate memory and long term memory is too complex for our testing instruments.  It is also too variable to be applied to generalities.

Each person  has a unique capacity for immediate memory, a capacity which may be dramatically different than their long term memory ability. I have an excellent long term memory, yet I am not particularly good at remembering names.  I was once exceptional at remembering numbers. I am not as good at it anymore since my Iphone remembers all of my phone numbers for me. My immediate memory ability, standing alone, would not have gotten me beyond high school.

Neither an individuals immediate memory capacity nor his or her long term memory capacity is impacted significantly by concussion. That immediate memory still functions, even after a blow that will leave the person amnestic is established the video of the concussion to Conan O’Brien. Conan could recall what happened at the finish of the race, when he watched it on replay.  That recollection was within a minute of it occurring.  His inability to remember the events came at a later time.  It is the capacity of the brain to maintain immediate memory, despite a brain injury, that makes it so important to distinguish between confusion and amnesia.

Next – Diagnosis of Amnesia Requires a Full Inquiry into Different Periods

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Gordon Johnson

Attorney Gordon Johnson is one of the nations leading brain injury advocates. He is Past-Chair of the TBILG, a national group of more than 150 brain injury advocates. He has spoken at numerous brain injury seminars and is the author of some of the most read brain injury web pages on the internet.

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