A LOSS OF SELF
Of concern to any survivor of a brain injury is the loss of the person they had been.
As humans we carve out our own identity in life. We do this by our choices in education, career, lifestyle, friends and family. So let's just create a mock life - it could be anyone's but we'll call him Josh.
Josh is quite a jock in high school, has always loved sports and made many friends from his hockey team. He graduates with the marks needed to study physiotherapy at university and upon further completion of that program he's ready to start his career.
He finds work in a clinic that specializes in therapy for sports injuries. Josh is in his element there and makes many more friends among his colleagues at the clinic and has even taken on a client from an NHL team in his province. He continues to play hockey with a local team and between friends, his family nearby and his beloved career, he feels like a lucky man.
His life takes another positive step when he meets Kim. Kim is also a physiotherapist at the General Hospital not far from the clinic where Josh works and they hit it off well. She spends many evenings in the various arenas where Josh's team is playing and he in turn cheers her on in the amateur theatre she is involved with.
We all know what comes next, right? The huge rock on her left hand and the wedding date is set for May. They buy a house that winter and anticipate the approaching date with a great deal of excitement...yay!
One evening in February, Kim sits in the stands as Josh's team heads into yet another game. Kim cheers on her feet at every goal they make but jumps up and down ecstatically, pumping her fists when it is Josh who sends the puck home. At intermission he rushes over to the concession stand where she waits for coffee ordered. He hugs her hard and gushes excitedly about how the game is progressing. He chugs down his coffee and heads back to the ice.
It's in that next period that things quickly go wrong. Josh is racing down the sidelines when a player from the opposing teams ploughs into him, sending him crashing into the boards. Josh collapses to the ice where he lies motionless. Kim races through the stands and makes her way through the players standing around him. The sudden hush is deafening as she holds him waiting for medics to come and transport him to Emergency at the General.
A week later, he is diagnosed with a severe brain injury. 2 cervical discs were fractured in his neck
and the blow to the head caused swelling that had to be relieved with removing a portion of the cranium for several weeks. They then replaced the boney segment when the edema had receded.
What follows starts with a postponed wedding to make way for the urgency of the best possible recovery for Josh. Rehabilitation as an in-patient takes place 5 days a week for 8 months before he is finally able to leave the hospital but he still needs to continue 3 times a week as an outpatient.
It is fortunate that their recently purchased home is newly built as the electrical wiring, plumbing and general carpentry was completed with an eye for all the new building codes. But more importantly maybe, everything including 3 bedrooms and the den were on the main floor. Kim had started to have it modified for Josh's ambulatory and living needs several months before his discharge, so when he came home again there was an outdoor ramp for the walker he would need to use for at least the coming months, a therapeutic gym complete with a treadmill, walking rails and various other equipment necessary to his rehab.
Upon his settling back into their home, Kim is enthusiastic to begin the work required to return Josh as close as possible to his former self. She is a physiotherapist after all and between the two of them much hard work would be necessary.
A personal support worker was hired to be with Josh throughout the day until Kim returned home at 4:00 from the hospital. At that time she put her feet up for a half hour to just chat with Josh about his day. He had trouble speaking and it took some time to understand his new voice.
At 4:30, they moved to the kitchen where she prepared dinner and he relearned, very slowly at first, how to work along side Kim. The first few weeks were spent just setting the table. Each Sunday she dressed the table up and lit candles. On one of those Sundays, Kim had dashed out to the kitchen for a forgotten item when Josh accidentally knocked over a lit candle. He tried to shout for her to come back while he clumsily attempted to right it but unable to throw his voice for her to hear, the table cloth started to burn. Slowly, he made his way into the kitchen to alert her. Although much of the table surface was charred, she managed to extinguish it before it spread to the rest of the room. After getting Josh off to bed, Kim sat at the island and sobbed. That night would be the first of many like it, frustration at the realization that many things would never be as they were before.
A year later, much improvement was seen. Josh walked now with just the use of a cane (slowly albeit but steady). He could fix a simple meal for himself but was encouraged to avoid using the stove yet. He still could not drive but as the passenger he was able to get around with the use of the cane. His voice had improved greatly but his speech slurred when he became fatigued. That first year he cut down his napping to once or twice a day.
It was in the 3rd year that folks noticed that many of the initial symptoms had faded. But what Kim saw was much more subtle - like the repetition in conversation, the forgetfulness and the obvious disconnect in his thought process. He might tell her that he was going to go and get a glass of water but upon reaching the half way point to the kitchen he would stop and wonder what he had been about to do. Of course, this happens to just about anyone, but for Josh it happened several times in a day.
He was no longer able to keep his balance on skates so hockey was out of the question. He was still unable to return to work due to the cognitive change in his thought processes. With Kim's help and regular sessions with an Occupational Therapist, he was able to write legibly and perform other simple tasks in the office. What he could not do was multitask. He couldn't write out a treatment plan for physiotherapy as he had done hourly for so many years. He could not figure out how to answer a ringing phone while filling out a simple form. Kim was unable to say to him, 'Okay Josh, just fill out that form, stuff it into an envelope, address it and put a stamp on it. The stamps are in the second drawer on the far right." By the time she tells him where to find the stamps, he has forgotten the 3 previous instructions.
Josh had tested that 3rd year for driving ability but was not granted a license. Just shifting, steering, braking and managing the mechanics of driving were somewhat like riding a bicycle in his case. Never forgotten. The impairment was seen in his reaction time and his slowed thought processing. Remembering to look for the light at intersections or just understanding that red meant he had to stop were problematic for him to obey without cruising through that red light. Thankfully, it was not on a busy street, but a computerized screen that he was running red lights!
The two of them had never married and Kim eventually did meet someone else. She continued to drop in at the house they used to share just to visit but now a Personal Support Worker lived in to assist Josh in all things day to day.
So much had changed... 10 years later, Josh works 2 hours a day in the office of his former clinic helping the receptionist. He naps, he gets up again to take part in light gardening, housework and some sedentary activities. His work as a physiotherapist is over. Playing hockey, too. Driving a vehicle will never happen. And Kim was gone.
The hopes and dreams of parent hood, traveling with his wife and owning a cottage - all have disappeared.
Brain injury... loss of self.
Josh is quite a jock in high school, has always loved sports and made many friends from his hockey team. He graduates with the marks needed to study physiotherapy at university and upon further completion of that program he's ready to start his career.
He finds work in a clinic that specializes in therapy for sports injuries. Josh is in his element there and makes many more friends among his colleagues at the clinic and has even taken on a client from an NHL team in his province. He continues to play hockey with a local team and between friends, his family nearby and his beloved career, he feels like a lucky man.
His life takes another positive step when he meets Kim. Kim is also a physiotherapist at the General Hospital not far from the clinic where Josh works and they hit it off well. She spends many evenings in the various arenas where Josh's team is playing and he in turn cheers her on in the amateur theatre she is involved with.
We all know what comes next, right? The huge rock on her left hand and the wedding date is set for May. They buy a house that winter and anticipate the approaching date with a great deal of excitement...yay!
One evening in February, Kim sits in the stands as Josh's team heads into yet another game. Kim cheers on her feet at every goal they make but jumps up and down ecstatically, pumping her fists when it is Josh who sends the puck home. At intermission he rushes over to the concession stand where she waits for coffee ordered. He hugs her hard and gushes excitedly about how the game is progressing. He chugs down his coffee and heads back to the ice.
It's in that next period that things quickly go wrong. Josh is racing down the sidelines when a player from the opposing teams ploughs into him, sending him crashing into the boards. Josh collapses to the ice where he lies motionless. Kim races through the stands and makes her way through the players standing around him. The sudden hush is deafening as she holds him waiting for medics to come and transport him to Emergency at the General.
A week later, he is diagnosed with a severe brain injury. 2 cervical discs were fractured in his neck
and the blow to the head caused swelling that had to be relieved with removing a portion of the cranium for several weeks. They then replaced the boney segment when the edema had receded.
What follows starts with a postponed wedding to make way for the urgency of the best possible recovery for Josh. Rehabilitation as an in-patient takes place 5 days a week for 8 months before he is finally able to leave the hospital but he still needs to continue 3 times a week as an outpatient.
It is fortunate that their recently purchased home is newly built as the electrical wiring, plumbing and general carpentry was completed with an eye for all the new building codes. But more importantly maybe, everything including 3 bedrooms and the den were on the main floor. Kim had started to have it modified for Josh's ambulatory and living needs several months before his discharge, so when he came home again there was an outdoor ramp for the walker he would need to use for at least the coming months, a therapeutic gym complete with a treadmill, walking rails and various other equipment necessary to his rehab.
Upon his settling back into their home, Kim is enthusiastic to begin the work required to return Josh as close as possible to his former self. She is a physiotherapist after all and between the two of them much hard work would be necessary.
A personal support worker was hired to be with Josh throughout the day until Kim returned home at 4:00 from the hospital. At that time she put her feet up for a half hour to just chat with Josh about his day. He had trouble speaking and it took some time to understand his new voice.
At 4:30, they moved to the kitchen where she prepared dinner and he relearned, very slowly at first, how to work along side Kim. The first few weeks were spent just setting the table. Each Sunday she dressed the table up and lit candles. On one of those Sundays, Kim had dashed out to the kitchen for a forgotten item when Josh accidentally knocked over a lit candle. He tried to shout for her to come back while he clumsily attempted to right it but unable to throw his voice for her to hear, the table cloth started to burn. Slowly, he made his way into the kitchen to alert her. Although much of the table surface was charred, she managed to extinguish it before it spread to the rest of the room. After getting Josh off to bed, Kim sat at the island and sobbed. That night would be the first of many like it, frustration at the realization that many things would never be as they were before.
A year later, much improvement was seen. Josh walked now with just the use of a cane (slowly albeit but steady). He could fix a simple meal for himself but was encouraged to avoid using the stove yet. He still could not drive but as the passenger he was able to get around with the use of the cane. His voice had improved greatly but his speech slurred when he became fatigued. That first year he cut down his napping to once or twice a day.
It was in the 3rd year that folks noticed that many of the initial symptoms had faded. But what Kim saw was much more subtle - like the repetition in conversation, the forgetfulness and the obvious disconnect in his thought process. He might tell her that he was going to go and get a glass of water but upon reaching the half way point to the kitchen he would stop and wonder what he had been about to do. Of course, this happens to just about anyone, but for Josh it happened several times in a day.
He was no longer able to keep his balance on skates so hockey was out of the question. He was still unable to return to work due to the cognitive change in his thought processes. With Kim's help and regular sessions with an Occupational Therapist, he was able to write legibly and perform other simple tasks in the office. What he could not do was multitask. He couldn't write out a treatment plan for physiotherapy as he had done hourly for so many years. He could not figure out how to answer a ringing phone while filling out a simple form. Kim was unable to say to him, 'Okay Josh, just fill out that form, stuff it into an envelope, address it and put a stamp on it. The stamps are in the second drawer on the far right." By the time she tells him where to find the stamps, he has forgotten the 3 previous instructions.
Josh had tested that 3rd year for driving ability but was not granted a license. Just shifting, steering, braking and managing the mechanics of driving were somewhat like riding a bicycle in his case. Never forgotten. The impairment was seen in his reaction time and his slowed thought processing. Remembering to look for the light at intersections or just understanding that red meant he had to stop were problematic for him to obey without cruising through that red light. Thankfully, it was not on a busy street, but a computerized screen that he was running red lights!
The two of them had never married and Kim eventually did meet someone else. She continued to drop in at the house they used to share just to visit but now a Personal Support Worker lived in to assist Josh in all things day to day.
So much had changed... 10 years later, Josh works 2 hours a day in the office of his former clinic helping the receptionist. He naps, he gets up again to take part in light gardening, housework and some sedentary activities. His work as a physiotherapist is over. Playing hockey, too. Driving a vehicle will never happen. And Kim was gone.
The hopes and dreams of parent hood, traveling with his wife and owning a cottage - all have disappeared.
Brain injury... loss of self.
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