Severe Traumatic Brain Injury: Lethan Part Nine
The first time I heard Lethan perform “Who Am I, Again?”, I was struck by the example that he could do it, as a severe traumatic brain injury survivor, more than the words of his story. I heard him do the show three months later, and to my ear, the only words that changed were the insertion of the place of the performance, Sheboygan, Wisconsin. As remarkable as the ability to recite such a performance is, more remarkable is the fact that this story is Lethan’s work, the product of his creativity and vision.
I have struggled throughout my legal career with juror’s expectation that if you can walk and talk normal, you can’t have a severe traumatic brain injury. I have found that physicians often suffer from the same inability to see. But as I listen and watch Lethan, even my experienced eye sees no evidence of disability.
Thus, Lethan and “Who Am I, Again?” most importantly stand for hope. Lethan suffered a severe traumatic brain injury, a five-day coma, an injury more severe than most of the disabled people I represent. Yet there he is, standing before us, writing, creating and telling a story – as well as any trial lawyer I know.
Why has Lethan’s recovery from severe traumatic brain injury been so remarkable? A number of factors aligned to contribute to this. Lethan is a model as to how the system is supposed to work.
First, he was life flighted to a major trauma center that with the staff and experience to handle his acute issues. Second, he had a close family, bolstered by the community support and prayer. Third, when appropriate, he was transferred to an appropriate severe traumatic brain injury rehabilitation program.
Why did Lethan get care for severe traumatic brain injury that was denied to so many? I am sure there were a number of factors. He had good insurance, at a time before the insurance industry had so effectively institutionalized the denial of care for severe traumatic brain injury. Also, he was still a minor and had advocates for parents. His mom is a clinical psychologist, his father a college professor. They had the ability to handle the crisis of his severe traumatic brain injury he tells us about:
They were on the phone with insurance companies and they were running back and forth between the hospital and my sister at home and work and they were trying to understand what the hell the doctors are saying and I’m told stories about my parents being in a room filled with doctors throwing this conglomeration of technical terms and pushing papers and some they were supposed to sign, and some they were supposed to read. And the cardiologist wants to know this, or the orthodontist needs the history. ‘But your son might need to have brain surgery.’
And my mother, she finally stepped forward and she said ‘STOP! Get into line. One at a time. Please.’ Okay, what do you need?
I have heard it over and over throughout my career and particularly in doing http://tbivoices.com that what care you get for severe traumatic brain injury has a lot to do with how much you demand of the medical system.
Lethan’s adds this in our interview:
The best thing I can say is just fight – not so much fight the system but find a way to let the system work for you. And again I was very fortunate because I had parents. My parents really had to struggle – on a constant search to find ways to make –to recognize limitations in the system but then still work around those limitations and find ways to make the system work. I recognize that’s a lot easier said than done.
Another important aspect of Lethan’s recovery was that he was still in school. While he calls the second half of his senior year a joke, it was in fact a continuation of therapy. The tutor he cites to dismiss his accomplishment of graduating with his class, was a likely a critical extension of the cognitive and occupational therapy he received in rehab. Then he went to a community college where he continued to get structure, community integration and intellectual challenge. Less than three years after his injury, he was ready to try college away from home. Yet going away to college is not the same as going off into the “real world.” Structure is still there, accommodations available if advocated for.
One might think that college is not the place for someone with severe cognitive deficits, but I believe the opposite is the case. Two of my first severe TBI clients graduated from college, after their injuries. And unlike what Lethan said about his high school, they were never coddled. With proper accommodation and planning, higher education can become “graduate cognitive therapy.”
The key is that the survivor is assisted in the planning, class-work, homework and certain aspects of exam taking. Even someone with attentional challenges may not have a difficult time keeping up in the classroom, where typically it is quiet, except for the professor speaking. If lecture notes are provided by others, if tutoring is available and if time constraints are removed from test taking, success may be the norm, not the surprise.
Lethan reaches this great achievement of being able to do “Who Am I, Again?” eleven years after his severe traumatic brain injury. My question to him about this:
One of the issues that as I listened to the story and what has a very upbeat ending is I realize that we’re now sitting almost 11 years coming up on the 11th year anniversary and 11 years later after your severe traumatic brain injury you’re, you’re sitting on a stool or you’re standing on a stage remembering all your lines and showing a true genius both in terms of storytelling but also in grasp of something that is not well understood and is very rarely well-articulated. How did you get from the person who maybe didn’t really earn that diploma to the person who can sit on this stage and excel?
A lot of work and a lot of personal perseverance. But also I was incredibly blessed and very fortunate by having a very strong community support group. I think the main thing is kind of recognizing, not trying to be the person you were before.