My internet news today had an intersecting of two recurring themes in the brain injury world, with that of an unexpected death of a former NFL player. The first theme is the difficulties retired NFL players have with disability. The second theme the degree of depression found in post Iraq war veterans. What does the death of Curtis Whitley have to do with the other two themes? Perhaps nothing, but even if this case doesn’t, other similar cases could. For the full story on the death of Curtis Whitely, click here.
Anyone who works in the field of brain injury, has often turned the old cliché about mental illness “Its all in the head” on itself, because of course, anything to do with the brain, is in the head. But, the extent of the interplay between emotional problems and brain injury is never, and I repeat never, fully appreciated. As I sit here and write this, I can’t fully appreciate this interplay, because it involves the area of human emotions and function, that we are only scratching the surface in our capacity to understand and have no clue as to how to measure.
Brain injury deficits and emotional deficits are synergistic, meaning the whole of the problems when you combine these two, is greater than the sum of the parts. From a recent deposition I took of a defense neuropsychologist:
Q If I were going to use the term “synergistic” to apply to the cumulative effect of all of these multifactorial aspects of an outcome, is that a reasonable word to use to describe it.
A Can you define how you’re using synergistic?
Q Well, if synergistic means the total exceeds the sum of the parts, do you believe that post concussional deficits can be synergistic?
Q I’ll add to that. Do you believe that the cumulative disability from post-concussional deficits can be synergistic?
A I believe — I hope I’m answering this consistent with what you’re asking — but I believe that these factors can feed off of each other and result in a very complex, poor outcome.
With respect to Whitley, the 39 year old was found face down in a bathroom in Fort Stockton, Texas. The local sheriff said there was no indication of foul play, but the case is under investigation. That investigation will likely look at Whitley’s history of drug and/or alcohol abuse. What won’t be examined is how many concussions he had, how his dependencies on substances might have interplayed with those concussions and how his emotional vulnerabilities from the combination of the two contributed to the end of his NFL career and his premature death.
But perhaps, Iraq war veterans will have a better fate. A recent article in the Science Daily, promises more for them, and we will discuss such issues in our next blog. Click here for that story.