This blog post is taking a departure from my faith journey to something also very near and dear to my heart...working with people with traumatic brain injuries (also called TBI).
The tragic shooting in Tucson has affected the lives of so many Americans and brought to light many issues. The politicians debate gun control, public safety, and the immigration issue in Arizona,while the public remains glued to updates on Congresswoman Gabrielle Giffords's recovery.
But for me and other professionals who work with people with TBI, this story is strangely personal. See, Giffords sounds like the patients I work with every day, who have survived brain injuries due to gunshot wounds, car accidents, falls, and many other unusually tragic circumstances. I read the above articles with a thoughtful perspective, wondering what Ms. Giffords's rehabilitation course will entail, planning hypothetical treatment sessions.
However, the true issue, to me, is not gun control or arguing about what Sarah Palin or Barack Obama may or may not have said to encourage this kind of event. The issue is the lack of understanding and education to the general public about brain injury and the lack of support and resources for many of my patients and their families, who will not have the benefits of Ms. Giffords.
TBI is vastly under-reported, misunderstood, and socially isolating for people recovering from brain injury and their families. Some people with TBI have obvious physical impairment (ie, a limp), while others look totally 'normal,' yet face major difficulties in concentration, personality, language, and interacting appropriately with others. Claudia Osborn's book Over My Head is a great example of an insider's perspective to TBI, although she had amazing financial and social support that many people lack.
My hope is that as Ms. Giffords recovers, people will become more aware of the complexities and challenges of treating and living with brain injury, so that these people will not be so marginalized in society. I know many of you may not agree these people are marginalized, but I know many of them. They ARE marginalized and they are people just like you and me,and often cannot express themselves in appropriate channels (ie, voting) because of their impairments.
These next comments may upset some people for their possible political implications. Sorry, but you can stop reading. I believe that working with people with TBI is a much a divine calling as becoming a missionary or going to seminary, so excuse my passion. Besides, I can only write about what I have learned, seen, and witnessed in my short time working in America's hospital system.
Sadly, many of my patients lack the resources to get the best possible care possible, and our country's health care system is not structured to often support optimal recovery. Funding issues and family financial issues restrict many people from going home or receiving ongoing care. Yes, some people are out there to milk the system, but I've seen parents break down crying that their very impaired child is denied even the most suboptimal nursing home at age 20. I'm involved as a research liaison for my hospital in a multi-site research study of TBI, and we have strong data that Americans with TBI are sent home significantly sicker than Canadians with TBI are admitted to rehabilitation hospitals. Canadians also have a significantly higher return to employment rate after TBI than Americans.
I know that socializing medicine is not the simple answer it seems on paper. On the other hand, I do believe that as Americans (and particularly the American government) we need to be more fiscally responsible and work to avoid the ridiculous amounts of debt that seem to be the vogue. But usually doing the right thing costs you something, and I wonder if for too long we have not understood what is the right thing for many marginalized people in our society.
Like the diagnosis and treatment of people with TBI, the answer is complex, unexpected, and never clear-cut. Unfortunately, we as a nation may need tragedies like Tucson to unveil the tragedies already at play in our society. I'm praying for all of the people affected by the Tucson shooting, and that others hearts would be changed because of this tragedy.
Honestly, the true tragedy would be for this event to leave us as people, clinicians, and a country unchanged.
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