Tuesday, January 22, 2008

Accepting a new me

I have a couple of clients I've been working with since I started covering the maternity leave for a co-worker at an outpatient site who are ready, at long last, to be discharged from therapy.

One is kicking and screaming, one is running out the door while his wife keeps a "nervous" hold on the desire to continue. Both have made great progress, both are ready to return to the activities they were doing before, if physically able to, and both have been a pleasure.

Both are forever changed by their injuries and aren't quite ready to face this new life as a person with an altered brain.

Holding on to therapy seems to be holding on to the hope that they will not have to be this person, that they will regain all their skills and be no worse for wear. Despite articles like this one, it simply is not true. Changes in the brain, regardless of the mechanism, result in changes in the person the brain controls. It just makes sense, but in many other medical ailments things heal. You have a cold, you get over it. You scrape your arm, you scab up and it goes away. Even if someone breaks a leg, they seem more likely to accept the fact that they might have a slight limp or know when it's going to rain before anyone else than to accept the notion of a "new me" post injury.

I can certainly understand it -- I would want 100% recovery for myself or someone I loved. The tricky thing about it is brain injury tends to ramp up your pre-injury weaknesses -- whatever bad habits/vices/character flaws you bring to the brain injury table that you've worked to minimize all your days get fancied up and put in the store window for passersby to admire. Not fair, and I wonder sometimes if people aren't clinging on to therapy to try to make this "new me" not just someone living with their injury and returned to a baseline level with some modifications, but a radically better person who doesn't have all that junk -- that the injury serves as a neurologic Salvation Army and takes all the stuff away that you didn't want in the first place. Seems like you should get something good out of the deal after all of the indignity suffered.

So as a matter of public record, here's a list of things I am currently NOT good at, and won't be, not matter how much I may want to be. Should I ever need therapy for a brain injury, tell my therapist this. I will try to stay in therapy until I've mastered these things that are un-masterable, because I wish they were different:

1. If I don't write something down, it doesn't exist.
2. I transpose digits in phone numbers when I write them down.
3. I get grumpy very easily and frequently snap at people when I don't mean to.
4. I get all of the football Joes turned around (Montana -- was he the one in Chattanooga Choo- Choo or was the Namath?).
5. I don't have much in the way of muscle memory so my golf swing is wickedly inconsistent.
6. I worry about things that I can't control.
7. I am helplessly awful at Guitar Hero.
The symbol above is the new life element in Adinkra - a highly-valued hanpainted cloth of West Africa. It is actually two symbols -- the morning star representing a new start, placed in a wheel representing independent movement.

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