MTBI from Concussion – Crashing the Bill’s Mind
MTBI from Concussion – The Story Continues
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As we began our treatment of MTBI and concussion, we started a story of Bill’s accident and analogize his MTBI from concussion to a computer crash . We continue it here:
The Bill’s of this world are rarely diagnosed with MTBI from Concussion, even if they get to the ER. Without the diagnosis of MTBI from concussion, the later diagnosis of permanent, disabling brain damage, is far more difficult to make. My primary motive in writing in my treatment of MTBI from Concussion is to achieve three things:
- First, to improve the diagnostic accuracy of a concussion (which means brain injury) in the first few hours after an accident or injury.
- Second, is to catalyze a movement to require next day professional evaluation of every one suspected of having had a MTBI from Concussion, not just athletes.
- Third is to tell stories of permanent disability caused by brain injury in a way that the patient, the loved one and the doctor will grasp the nature and the full extent of this life robber.
Bill’s brain injury was not diagnosed in the Emergency room for two reasons:
- No meaningful effort was undertaken to see if his brain was functioning normally, and
- The conditions which separated his concussion from less serious concussions, had yet to evolve. Bill’s concussion would have been clearly apparent at 24, 48 and 72 hours if someone in the medical establishment had asked him the right questions.
Ironically, within a couple hours of the wreck, Bill was thinking straight enough to realize that he wasn’t going to feel well enough the next day to make it to his hearing. When he called Suzy on her cell to tell her of the need to change his court appearance, she was only part way through the recreation of the “crashed” brief.
While Suzy masked her relief at the reprieve, it was hard for her not to see it as bit of good fortune. Justifying that Bill had enough to worry about, she decided not to tell him about her own crisis and promised to place an emergency call to the judge first thing in the morning for a postponement. She assumed that she would be able to finish the rewrite before Bill would make it back.
While Bill seemed shook by the wreck, it never occurred to her that the mind that she relied upon so completely to mentor her, direct her activities, would not be restored of function like her computer was by the restart. Restoring Bill was not just a matter of recreating the input of the hours around the crash. The computer within Bill’s skull was permanently damaged.
Over the next several months the change in Bill’s ability to function as a talented, trained individual – in a profession requiring the instant application of judgment, memory and drive – was objectively established. The objective evidence was not a CT or MRI. The objective evidence was his failure at the most accurate test: life. It wasn’t Suzy’s computer that was crashing, it was Bill’s mind.
Bill’s failure was not entirely preordained at the moment of the crash. Had his health care professionals, his family – had Bill been armed with the knowledge that he had suffered a significant concussion, the synergistic collapse that occurred might have been less severe, less vocationally catastrophic.