Music After Severe Brain Injury: Helena Part One
Helena Realizes She Still Had the Music After Severe Brain Injury, in Her
We have discussed in other stories the question of who survives. The story of Helena comes out strong on the side of the debate that the fundamental core person survives. For Helena, a professional musician and singer, it was when she sat down to play the piano that she realized that “she was still me.” Her music after severe brain injury helped her through.
Helena explains making this discovery, music after severe brain injury, a week after surgery for a severe brain injury:
I sang a couple of Christmas carols, and it was a very frail, faulty voice, but I knew I could, and that was the time where I knew I was still me. It didn’t matter if nothing else worked, I still had music in me.
Tragically, other than her music after severe brain injury it has been a long and hard journey to get the rest of Helena back.
Helena was injured when the car she was driving was in a one car accident, only 17 miles from home her home near Green Bay, a week before Christmas, 2007. She was 62 at the time. The big problem with determining the cause of most brain injury accidents is that the injured person’s memory of events is missing, incomplete or illogical. She explains what she has been able to piece together about the accident:
I was out of work, trying to find a new way of earning a living. In a last-ditch effort to find some meaningful work to do, I was on my way to Eau Claire to start a new job. I had eaten a good breakfast, I had a pillow in case I was tired, because that sometimes happens, and I set out…
What is the next thing you remember?
Shortly, all I can describe it as, I came to. I looked at the road and I said, you’re going to have an accident and there’s nothing you can do to prevent it. Roads were dry, the sun was out. I went into the ditch in the median, and I understand the car turned around, and there it was.
I lost consciousness periodically, but I could hear the, I couldn’t see, I heard the police come, and their first question was, were you wearing a seatbelt? I said yes, I was wearing my lap belt. The ambulance came and took me to Saint Vincent’s. When I woke up I was in ICU with two doctors standing over me, telling me about the surgery they had done.
She does claim to remember the day of the accident, even within a few moments of the accident.
I remember that I was driving and driving carefully and driving under the limit, but we determined later, especially from the weeks before, that I, in all likelihood I had had a CAT seizure and lost consciousness and that, because it felt different than, you know, if you’re going fall asleep or whatever. It’s like, so that’s why I say I came to. I remember very briefly, I was in the ambulance and they said, what hospital do you want to go to and I said Saint Vincent’s.
I fractured a vertebra in my, in my neck, which was blessedly, minor. I fractured my clavicle, but the main thing was my head went into the windshield on the right side, and that’s where my brain injury was. I had a subdural hematoma with a midline shift, and so the doctors performed a craniotomy and removed the blood.
She explains what she was told about her injury by the doctor.
The neurologist later explained that the dura is something to sort of hold the brain matter in. The dura mater, which he says is like the hard mother, and it’s a, it’s like a great big elastic rubber shield around the brain, and so it was a closed-head injury, and so under that dura mater, mater part, I began to bleed. There was enough blood that it started to shift the right part of my brain towards the left part of my brain. They needed to stop the bleed, and I, I never found out, but I imagine there was pressure because of the midline shift. So they made an incision, they told me it was a, the parietal, right parietal and occipital lobe, so my scar looks like a backward question mark.
Like the subject of our last story, Gina, she also had a lucid interval after her accident:
(I was) at least semiconscious, because I could answer, I could understand the questions and it took me a long time to answer but I could answer them. I heard the police ask me if I was wearing my seatbelt. I do remember that, and I answered that affirmatively. I was not wearing my neck belt. I had two different belts, because the car was so old.
She was driving an older model car with a two-part seatbelt mechanism and no air bags.
I’m a professional singer. I’ve been a professional singer all my life, and one of the reasons I didn’t wear the belt over my chest, I’m so short, it really comes across my neck, and if I had had that car accident, my trachea would’ve been crushed. So I, in that car I always just wore my lap belt.
Helena was in hospitalized 10 days for her brain injury, but states that she was never in a coma. That once the anesthesia wore off, she was conscious.
I never went into a coma. I was in ICU for four, four days, and once I had woken up from the surgery, I remained conscious, and I have a degree in counseling so I could tell, every time the nurses came in and gave me a mini mental status exam, to find out if I knew who I was and I knew where I was, and so I, I scored completely out of the stage of coma.
So you remember, the day of your accident?
No. Sometime very late that night, the next memory that I have is opening my eyes and seeing two people in white, which were my doctors, and one or two other family members that I could not identify.
She claims to have continuous memory beginning the next day and remembers her time in ICU, which is quite unusual. What Helena’s story demonstrates is that brain surgery and brain damage are not necessarily synonymous. Brain surgery is done to limit secondary brain injury and in an extraordinary case, could limit the brain damage to such an extent, that an individual would be fully aware as soon as they awoke from the surgery. The length of amnesia is a far more accurate predictor of poor outcome than brain surgery and that Helena has memories of the events both before and after the wreck, are both positive indicators.
She continues with her memory of her time in St. Vincent’s.
I was on neuro ward for one day, and then I went into rehab. There is a part of my brain that absolutely did not work; it was black. And there’s another part of my brain that was struggling to identify things that would keep letting me know that I was alive and that my brain could function in some way. So I kept journals and I have a little part of my journal that’s called jokes from ICU. And that was one of them, I was thinking, you are barely conscious and yet you’re aware that they’re doing this psychological inventory.
She was in the ICU for four days, the neuro unit for one and then the rehab unit for five days. She started keeping a journal less than a week after her injury. It is a unique stay for a severe brain injury, but not necessarily remarkable for a woman like Helena.