Brain Injury and Coma: Thoughts Going Forward

Brain Injury and Coma: Ian Part Eleven

In the world of journalism as in the world of law, the interviewer is only supposed to ask the questions, not answer them. But this is the internet and it can be anything we want it to be. The end of my interview with his parents was to follow the traditional model about their thoughts on brain injury and coma and what they would like others in their situation to know:

Gordon Johnson: Is there anything else you want to add to the other moms and dads who might see this whose child has just had a serious brain injury and coma and what they can do to handle it better and expect it better, expect what, what to expect?

Dad: Work with, work with them as best you can. Don’t discourage them. Put ideas in. Try to help them. Questions that he came up with and comes up with yet today you just kind of throw – he’s asks a question that’s fine. Throw another question to, to let him answer the question himself. And sometimes that seems to work. So the only thing I could do.

Gordon Johnson: Anything you want to add regarding have to deal with a child with brain injury and coma?

Mom: Well like I said when I go over there three times a week when he tells me “I try”. And I told him, I said Ian it’s not just try. Do. You have to do. Try and do it don’t just use the try thing. And I said if you need something that I can help you with or dad can, maybe one of your friends can, but you need someone to back you up on some things and you don’t always want to accept that. And you don’t like criticism. And sometimes the only way you can learn is you got to be criticized for some things in a nice way so that you can correct it and grow. But after he had in therapy he didn’t no more.

Gordon Johnson: When was the last time he had therapy for his brain injury and coma?

Mom: Oh I think he was in therapy for maybe six months to maybe a year almost. And once he didn’t have to go to the hospital and, and work with his hands to make them stronger or his brain to remember things and things like this, or just small tasks, he stopped doing them. It isn’t because you can’t do them you just decided maybe you won’t, you won’t really be able to continue unless somebody was there telling you, you have to.

Gordon Johnson: Do you think he would benefit from getting another six months of therapy for his brain injury and coma?

Mom: I don’t know if, I don’t know if therapy, if therapy is the right thing but in some, some manner a little outside help from other than family. I think sometimes you respond better.

But then instead of following the format of an interview, a deposition, conversation broke out.

Dad: What do you think of the idea of anger management therapy? Is there such a thing and is it possible to do?

Gordon Johnson: The obvious problem is that managing the anger of brain-injured person is different – than managing typical problems. Although there’s always an overlap between normal bad behavior and abnormal neuro-behavior.

Mom: It is. Yeah.

Gordon Johnson: That may be because there is some neurological cause than some other than we consider to be normal bad behavior. But it is a very different process too. (Learning for a brain injury and coma survivor) takes longer and takes more reinforcement.

And some of the ways in which we motivate people to change their behavior just aren’t going to work with someone with a severe brain injury and coma because of the motivation changes. Motivation does change and it is harder.

So if you went to the classic anger management class where they send someone who beat up his wife it’s not going to do anything. A trained brain injury and coma counselor, working with the family, with the wife, with the kids may be able to make a difference but you just can’t send them to an anger management class. That’s probably going to make him angrier.

Dad: So you’re suggesting with the brain injury to, it should be a family, a family affair to have meetings rather than just him?

Gordon Johnson: He is an adult. He has freedom of choice. And, and he wasn’t one of those people who probably when he was 25 liked to be told what to do.

Mom: Exactly.

Gordon Johnson: And that person is still there but unfortunately the person who used to decide what to do is having a hard time making those decisions because of his brain injury and coma. So you can’t force him to do anything. But if the family isn’t there for him and there isn’t some other alternative like the church or something for him to make up for it, it’s going to be real hard.

I’m lawyer, I’m not a doctor but I see these things day after day in the people we represent. The more that you can understand the more you can still be mom and dad and, and to degree he may take it better from you than he does his wife.

Mom: Exactly.

Ian Concludes in Part Twelve – On Doctors and Friends After Severe TBI