Footprints of Invisible Brain Injury

Last week, we talked about the term “invisible injury” as used by the Brain Injury Association, to describe brain injury and its application to discrimination against seizure dogs. That topic transitions to today’s blog about how we identify an “invisible injury”, such as brain injury.

So how do we see the invisible? Well if we are in Hollywood and we are talking about the invisible man, we wrap him in bandages, or look for the footprints. Footprints: remember the legendary story of the million posters of “Footprints in the Sand”? http://www.footprints-inthe-sand.com/ Well how are we to know from the footprints that the ghost of brain injury is lurking beneath the surface?

Identifying brain damage is a complex problem of looking thru skin, skull and normal tissue, to see what may be microscopic pathology, without peaking. This is the ultimate Xmas present-type guessing game to identify what is in the package, with no shaking allowed. Yesterday we discussed the discrimination of society in favor of the service dog for the blind versus the service dog for the brain injured, because of the visible evidence of that disability. But all we are seeing in a blind person is the footprint of pathology as well. We cannot see the blindness; what we see is the footprint of behavior changes because of the blindness.

With apologies to the blind: we might see the sunglasses, we might see the cane, we might see that the eyes don’t look directly at us or other things. We see the seeing-eye dog. While we can’t see the pathology, we see the evidence of the pathology in a pattern we almost instantly recognize as patterns of blindness. The pattern of the footprint tells us that someone is blind.

Why is that pattern so much harder to see in the brain injured? It isn’t always. Many brain injuries come with physical disabilities – problems with tone, with motor skills, with walking. While not as visually recognizable, many brain injuries come with speech deficits that are recognizable as soon as you hear the brain injured person try to communicate. Yet, profound brain injury can occur in a pattern that doesn’t fit either the physical or speech disability pattern. Frontal lobe deficits may become obvious over time, but it is thru the pattern of behavior that we can see these deficits, not just a quick sense of what our eyes and ears are telling us.

Next: Identification of Patterns in the Sand