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Traumatic Brain Injury
An Anniversary View of Fictional Brain Injury
Personal Perspective: What does brain injury recovery entail?
Posted January 19, 2024 Reviewed by Gary Drevitch
As I approached the incomprehensible 24th anniversary of my brain injury on January 15, I finished reading Left Neglected by Lisa Genova, a fictional account of an intelligent, driven, Type-A woman thrust into the unwanted life of brain injury.
I borrowed Left Neglected reluctantly a decade ago. The lender brushed aside my trouble reading and my doubt about when I'd read it, and pushed it into my hands. So much reminded them of me and my travails.
I had read and watched inspiring accounts of people with brain injury gaining back their lives within a year or three, accounts that ignored that they hadn’t regained the kind of independence healthy people take for granted. For some reason, I thought Left Neglected was this kind of non-fiction, too.
I moved this novel from bookshelf to table and back again every time I had rare energy to dust my bookshelves. It stared back passively, reminding me of what I couldn’t do anymore because one driver needed to tailgate down a highway hill and another felt speeding was the only option. Although I regained my reading comprehension in 2018, I buried Left Neglected under a pile of books so that it’d stop taunting me.
But two weeks after I suddenly decided to take a complete social media, computer, and writing break — a break from the horrible world — I fished it out, ready to read it. I think I was ready because I’d read, reorganized, thought, dusted, polished wood furniture, set a new Goodreads reading challenge, and watched an awful lot of Netflix and TV. All that physical activity counteracted my usual cognitive efforts and let me enter 2024 differently than I'd exited 2023. Regular breaks was a post-injury lesson I’d forgotten, which recent losses had reminded me of rather harshly.
As I read, much resonated with me: Sarah's age; the suddenness of the car crash that upended her world; rehab’s insistence on acceptance and her rejection of it; believing return to work would happen within weeks; rehab’s blunt rejection of that fantasy; practice, practice, practice of skills but never a return to 100 percent. Yet I steamed over how Sarah was given standard rehab with no neurostimulation or neuromodulation. I reminded myself that the publication date was 2011 and that Genova probably wrote it in 2010, three years before the clinicians at the ADD Centre evaluated the research on tDCS and trialed it on me.
Neurostimulation Accelerates Brain Injury Recovery and Enhances Rehab
Transcranial direct current stimulation (tDCS) is a battery-operated, targeted, microvolt stimulation of the brain. A diagnostic qEEG determines where to place the sponge that conducts the microvolt current into the brain, either stimulating or inhibiting electrical activity in that area. During the 10 to 20 minutes of neurostimulation, the person with brain injury engages in the activity that they want to restore so that the brain “knows” which pathways the tDCS’s electrical activity should rewire. This is what we did at the ADD Centre: I chatted while the tDCS stimulated an approximately 6-cm area of the left side of my brain. Because I chatted, I regained my natural speaking ability and conversational skills to the astonishment of one young brain-injured man’s mother.
I’ve written previously on audiovisual entrainment, brain biofeedback, qEEG evaluation, and photobiomodulation or low-intensity light therapy. If Sarah had received any, her clinical team would’ve been able to evaluate and treat her brain areas that had excessive and low brainwave activity. True, the only ones proven at the time for brain injury were qEEG, brain biofeedback, and audiovisual entrainment, yet she could have benefited from them. Why aren’t these part of standard brain injury rehab today?
Intelligence Alone Doesn't Mean You'll Question Out-of-Date Knowledge
Sarah may’ve been a Harvard graduate with a high-powered job in the business world, but she used none of that to search for a cure for her left neglect. She accepted without question that time and the offered rehab were the ways to heal her brain.
I did not.
A doctor once told me I’m doing better than 90 percent of those with brain injury. Even so, after 24 years, I’ve still not fully recovered.
What Is Brain Injury Recovery? Solely Neuron Restoration?
Recovery is more than restoring the brain, for if one only needed neurostimulation to recover, I’d be fully recovered. Sure, I write a blog for Psychology Today, but my health care team ensures I get it done. Sure, I read novels most days now. But when I drew off my bookshelf Battle for God, I stuffed it back within minutes, intimidated by its large pages of text. I’d begun reading it after my brain injury in 2000, but the foreign terms I used to know so well had suddenly become incomprehensible. It had proven to me brain injury had trashed my reading ability.
Although treatment and daily practice keeps improving my reading comprehension, I suffer from merciless reading loss flashbacks: not from the loss but the unwillingness of family members to accept my reading loss and professionals to hunt relentlessly for restoring treatment.
Social Support Affects Recovery
Unlike me, Sarah's family and friends accepted her deficiencies as real. They plunged into therapy with her and saw her as a capable woman with expertise still worth following. They didn’t pat her on the head with “that’s a good idea” while dismissing it. Nor did they deny her existence, elevate their limited knowledge over her experience, and diminish her knowledge and intelligence as valueless on a practical level.
Pre-brain injury medical history may also affect recovery. For example, measles can inflame the brain, lead-polluted air can damage it, and COVID-19 is known to injure it. Pre-existing sub-clinical trauma and viral injury may have partially slowed down or prevented my full recovery. Further research is needed to understand the roles these play. Nevertheless, without neurostimulation, I’d be unable to hold a sophisticated conversation, never mind read.
Recovery cannot achieve 100 percent without love accepting the full catastrophe, participating in treatments, seeking better ways to restore, accommodating and remaining in the injured person’s daily life, and treating them and their ideas as valuable as they’d been before brain injury.
Copyright ©2024 Shireen Anne Jeejeebhoy
