By Joseph S. Ratner, M.D.
Chief of Psychiatry, New England Rehabilitation Hospital
TRAUMATIC BRAIN INJURY is always a life-altering event, both for the person who suffers it, and for the family and loved ones who must endure the painful course of recovery and the often distressing sequelae of an injured brain. The very phrase is frightening.
As a psychiatrist with thirty years’ experience working on a brain injury unit of a major rehabilitation hospital, I have had the privilege of working with patients and their families as they struggle to cope with, and try to comprehend the meaning of seeing themselves or their loved one in such a profoundly altered state.
I am often struck by how little experience people have with head injury. It is as if those who suffer it live in a hidden part of our culture, often keeping to themselves, or worse, shunned by the general public. This, in spite of the fact that traumatic brain injury is common.
The Center for Disease Control statistics tell us that there are 1.7 million reported instances of traumatic brain injury each year (and probably untold millions more unreported). And it is sad to experience the virtual epidemic of brain injury cases that have returned with our troops from Iraq and Afghanistan. And there is additional distress in learning of the large number of children and athletes with potentially permanent brain damage from head injuries and concussions while playing football and other sports.
There is a robust technical literature on brain injury, with several journals dedicated to various aspects of the diagnosis and treatment of this condition. There is one voice, however, that is largely missing, and that is the voice of the person and the family who are actually experiencing it.
Now, Elise Rosenhaupt has given us that voice. In a memoir that is both profound and thorough, she somehow found the courage and the discipline to look this event straight in its horrible eye, and to take notes. The result is Climbing Back, the record of her son’s brain injury and its unfolding as it affected his life and the life of his family.
Elise captures vividly the sense of shock and anxiety and confusion that arrives with that phone call every parent unconsciously fears receiving. “Your son has been struck by a car. He’s in the hospital. We don’t know how bad it is.”
Thus begins a journey no one would ever choose, but one which this young man, and his family, managed to finally engage on their own terms, with grace and dignity, and ultimately with a sense of victory. How they do it will be compelling reading for any professional in the field, and especially for those enduring the injury itself.
And along the way, we learn truly invaluable clues and lessons about how to navigate through the complexities and ambiguities of a family’s recovery.
We learn, for instance, the importance of having to rely on many experts, who suddenly have control of your child’s body. We learn the more profound lesson of coming to rely on the family’s own perception and judgment. A healthy disrespect for authority-for-its-own-sake becomes a path for the family, and for their son to slowly regain a sense of independence. Autonomy becomes a healing force on its own.
We learn the importance of not allowing the family to become isolated and enclosed. “It is as if we all arrive deaf and blind, in a trance, completely alone. Then the clouds begin to lift, we see one another, and eventually we speak.”
And we hear the even more important lesson of not becoming internally isolated. The fear, the tears, the anger must all be validated, must all be given their time to speak and be felt and shared.
As Martin moves through recovery, he begins the healthy process of separating from his mother, who describes her watchful nurturing of his early recovery as “a speeded up replay of motherhood.”
As her process of healing continues, she makes a journey back to the sites of the trauma, the ICU, the acute care hospital, the rehabilitation facility.
She tells us with great wisdom, “To be in all those places with those same people, and to have Martin well, in some way undid the spell of my sorrow.”
She concludes, “Knowing that nothing can keep us safe, how do we live? . . . I watch Martin in the way he has of being absolutely present in his joy at being with those he loves, and I feel as though, knowing that nothing can keep any of us safe, he knows how to live.”
And now, having read this remarkable document, perhaps we will know better how to live as well.