Traumatic Brain Injury (TBI) A Book Review 7/27/14

“Mindstorms: The Complete Guide for Families Living With Traumatic Brain Injury” – by John W. Cassidy, M.D. – Copyright 2009 De Capo Press.

If you have anyone in your life with Traumatic Brain Injury (TBI), I highly recommend this book. I only wish it had been published in the mid 70’s, for the difficult part of TBI is for those that are the caregivers and loved ones of someone who suffers with these deficits.

As Dr Cassidy states, “if someone you love has suffered a brain injury, that person you knew so well may suddenly seem like a stranger – someone who doesn’t act the same way, doesn’t think the same way, and who many even become violent.” “. . . the family’s sense of stability may be threatened again and again.” Episodes of maladaptive behaviors are the most difficult for family members to handle.

Traumatic Brain Injuries are always caused by a number of pathologic changes to the brain, depending on the type or types of injuries involved in the initial trauma. And it doesn’t need to be the result of a head injury. A local friend in his late 60’s tripped over a parking bumper in a lot and ended up with TBI. It took him a year to overcome short-term memory deficits, and 3 years after is still dealing with impaired capactiy for self-reflection about his own behavior.

TBI, according to Dr Cassidy, affects over 6 million Americans (2% of the population). And at long last the world is beginning to recognize TBI for what it is , damage to the brain that changes us forever. “If we hurt our brain it’ going to affect our behavior.”

The book is full of information about the disorder, but discusses ways for family and friends to get beyond guilt and how to help their loved one move on, even if it’s just tiny steps and simple ways to cope. One woman cannot get beyond short-term memory deficits so she has a personal journal and check lists to make sure she gets things done. Overstimulation from large crowds and noisy groups is a common deficit for TBI patients. Many families have changed their entertainment to at home, small groups, and less noise.

Many TBI events are due to “…oxygen deprivation [and] can be produced by . . . severe blood loss associated with broken bones in the legs.” That loss of oxygen can produce any number of problems from strokes to severe boughts of anger. Their sense of reality is altered and recognition of their deficits can be severe. “. . . patients who regained only very minimal insight were more apt to minimize their deficits. . . they were not grounded in reality, and they thought they were able to do more than their therapists and caregivers knew they could.”

Feeling normal is vital for those that care for a TBI patient, and Dr Cassidy’s vast experience can help. “If the human brain were so simple that we could understand it, we would be so simple that we couldn’t.”

Footnote – all quotes are from Dr Cassidy and his book.

Posted a short version on goodreads – Mindstorms: The Complete Guide for Families Living with Traumatic Brain InjuryMindstorms: The Complete Guide for Families Living with Traumatic Brain Injury by John W. Cassidy

My rating: 4 of 5 stars

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Clive Bundy – The Newest David and Goliath

I Love “David and Goliath; Undergods, Misfits and the Art of Battling Giants” by Malcolm Gladwell. I first became aware of Mr. Gladwell and his book through a “60 Minutes” segment about him. His comment about those that experience extreme life experiences becoming indifferent to many things was what captured my attention. Maybe my indifference to others minor “daily drama’s” was normal.

His explanations to support his thesis are complete and well documented, as you would expect from such a seasoned writer. But the ease of reading makes this educational and spell binding. And, it’s one of the best examples of how to write books on sociology without boring your reader. Whether it’s in the main text, foot notes, or chapter notes, Mr. Gladwell is constantly is having a “conversation” with you.

What struck me most during my reading was the similarities between the events shared in Part Three: The Limits of Power and the principles of Legitimacy and the BLM’s handling of Clive Bundy in Nevada (also known as the Cattle Battle). The statement “when the law is applied in the absence of legitimacy, it does not product obedience. It produces the opposite” was clearly in play when the Government decided to confiscate Mr. Bundy’s cattle in payment for grazing fees he has never paid. Clive Bundy’s fight and the inclusion of the militia resulted in the same possible outcomes – more military – arrest Bundy – slaughter the cattle.

As Mr. Gladwell stated, “Power has an important limitation. It has to be seen as legitimate, or else its use has the opposite of its intended effect”. That was clearly the case in Nevada. Average Americans didn’t have a vision of the BLM, Forest Service or National Park Service Rangers as thugs, cops, or law enforcement. They viewed them as helpers, guides, and resource managers. It would be interesting to survey citizens to assess any chang in opinions on these “rangers” after watching the poorly managed, armed conflict in Nevada. “Force without legitimacy leads to defiance, not submission” was clearly in place and the BLM has now backed itself into a corner it will be hard to come out of.

New attempts to resolve the situation are now using the age-old political tactic – if your argument isn’t good enough to sway voters attack your opponent personally. The recent press on Mr. Bundy’s sons’ battles with the law are an attempt to sway public opinion back to the government by discrediting his reputation in hopes that his support group will leave him. But this also supports Mr. Gladwell’s statement “the powerful are not as powerful as they seem – nor the weak as weak”.

The BLM’s attempt for compliance did not appear to have legitimacy at a time when the average western citizen is feeling repressed by government oversight and mandates. If this was an ordinary citizen having a good old fashioned range war with their neighbor western rules would apply. Get out the gun, gather up the men and take back what is rightfully yours. But it isn’t, it is the U.S. Government that put together a posse to round up the bad guy, take what they want, and torch the house before you leave to show who’s powerful – at least that’s what it looked like on the nightly news. But Mr. Bundy is old, seasoned, and clearly feels he has nothing to lose. So Mr. Bundy can be a Trickster and use his unexpected freedom that comes from having nothing to lose. The trickster gets to break the rules, and he did. Now the BLM has to find a way to become “legitimate”.

Thanks, Mr. Gladwell for helping me put this into words through your great book.

Until next time – – – –

Envy – not for me!

Thoughts pop into my mind at the oddest times. Sitting at the breakfast counter eating cereal this AM I thought about my friend that will be undergoing a double mastectomy the end of July. She went through radiation and chemo the first round. The form of breast cancer she had was so difficult they gave her the most they could so that she isn’t eligible for more this time – it’s been 4 years. She’s gone through a tremendous amount of pain and agony with this disease and I don’t envy her. But I used to.

When I first met her , years ago, it seemed she had the world by the tail. A wonderful old family home, plenty of financial resources, a tribe of their own successful children and grandchildren, and their faith. They appeared to be the ideal family and, yes, I was envious of what appeared to be absolute bliss. My life was a version of David and Goliath compared to hers. And then I got to know them over the years and I wouldn’t trade lives for all the tea in China.

We come from two distinct worlds and the comparisons are stark. She’s an educated certified teacher and I graduated with a degree in HK&E – Hard knocks and Experience. When I started comparing the other elements of our lives, it’s the contrasts that make us friends. And it’s those same contrasts that make me appreciate the life I have.

I have my own physical ailments, and probably won’t live to be 80, but I haven’t gone through what she has, and I don’t envy her that. I’ll take my arthritis, bad kidneys, and migraines any day compared to cancer. I’ve been blessed with two great daughters and two great grandchildren. I’ve been blessed with a myriad of experiences and lots of hard knocks. But they’ve made me stronger, and they’ve made me realize how blessed I am.

Until next time.