The Effects of Head Injuries Come
Boulder Freewheeler, Fall, 1988
in 'Rippling Proportions'
A Spouse's Perspective
Summary: This article is still the most personal and most poignant account we have seen on living with the aftermath of traumatic brain injury.
As a mode of transportation, the bicycle is a remarkably
simple and satisfying machine. In fact, bicycling is so addictively pleasant an undertaking that it is synonymous with fun, exercise and good times.
But head injuries on a bicycle are not fun. It is very serious stuff, and the challenge to an individual to find his way again is enormous. The challenge handed to that individual's family and friends is equally large.
My husband, "Jim," was thirty-eight years old when his
bicycle was hit by a pickup truck on the outskirts of Boulder.
He landed directly on his head, fractured his skull, survived
two emergency brain surgeries, spent nineteen anxious days in
intensive care, six weeks in a coma, and four long months in Boulder
Memorial Hospital's rehabilitative unit. Almost two years post-injury,
Jim lives at home and continues treatment as an outpatient. He
goes to "work" three days a week. He is unable to drive
a car and he struggles to read and to write. His speech, his gait,
his memory, his judgement, his confidence, his competence have
all been affected. Jim was not wearing a bicycle helmet.
Those are the facts. Jim, obviously, has his own story to tell
and, given the magnitude of his injury, there can be no question
that he has come a long way. It is to his great credit (and to
the credit of some very special therapists) that he has managed
much of it with some humor and some decency. This article, however,
is a spouse's story and a request to consider the merits of wearing
a bicycle helmet. It is an emotional plea to anyone who loves
riding a bicycle. When you don't wear a helmet, you are at so
much greater risk for a head injury, and a head injury is a loss
of rippling proportions.
These days the word "head injury" appears all too frequently
in the news. Due to advances in medical technology, more
and more people survive. But the journey from "survival"
to "recovery" is an arduous and an elusive one.
Unfortunately, other than stabilizing the brain post-trauma, very
little can be done to "fix" the damaged areas. Damage
occurs not only at the point of impact, but also with the extensive
nerve shearing that takes place elsewhere in the brain. Intensive
therapy, balanced by a lot of rest, encourages the brain to stay
stimulated in hopes that new nerve pathways can be rebuilt or
rerouted. Just as each head trauma is different, so is each outcome
different. While some people end up in nursing homes, others make
substantial progress. All head injuries require struggle. The
heroics of everyone involved from victim to family to friends
to therapists to nurses to doctors boggle the mind and the pocketbook
and the emotions.
The brain is an extraordinary organ. It is so complex that
it still defies understanding, yet it is vital to determining
"who" we were, "who" we are, and "who"
we shall be.
Tripped up by a serious head injury, a "new Jim" is
evolving. While the outside is endearingly familiar, the inside
is suddenly changed. His whole being is forced to focus on retrieval:
bits of memories, pieces of intellect, scraps of emotion.
Things that were a given, now demand huge effort and thought.
Jim was easily so much: a good architect, a sensitive father,
an exceptional friend, a lovely thinker. Now he struggles
in all those pursuits. As his spouse, I miss terribly the sophistication
of his person. I miss the partner in our marriage, the promise
of our dreams, the male balance for our three children.
The dilemma for me personally is that I both have a husband and
don't have one. There exists a vacancy and a burden. The position
requires equal energy to the scenario of being single: parenting
three small children, keeping life "normal," coping
with decisions; and equal energy to the scenario of being the
spouse of a head injured adult. The latter means: dealing with
doctors who measure up medically, but are seriously lacking in
compassion; encouraging Jim's parents to exchange denial for
involvement; doing extensive battle with insurance companies who
understand little of head injury other than it is monstrously
expensive; and finally and most importantly, finding a nurturing
niche for Jim to foster dignity and growth.
It is an exhausting prescription of tasks. Sometimes I wonder
if love has limits. Despite all the history we have together,
is there a point when all the giving leaves a relationship too
uneven to continue well?
Within the negatives of a tragedy though, there seems to be a
human need to salvage some positives. One obvious plus is that
you learn a great deal about yourself. You learn, rather surprisingly,
that you do not drown. That somehow, you are resilient enough
to keep looking for the beauty of a bird in flight and
to keep holding your children's smiles around you like a warm
You learn to marvel at the depth and breadth of peoples' ability
to care. You learn not to remember too often what once was, because
it hurts too much, and not to look forward too far, because it
is too scary. You float for now, somewhere in the present tense
between the promise and the impossibility of daydreams.
You learn to hunker down within yourself to try to find a responsible
way through head injury. Like a plant with leaves and blossoms
done in by a freak frost, you are forced to grow more roots. You
learn to reach to the warmth of friends and you wait to bloom