Who Is It That Awakes?

by Attorney Gordon S. Johnson, Jr.

MaryAnn, a coma survivor had this to say about herself:

"Yes I have gone through the grieving process, I buried Mary Ann sometime last year."

This is one of the most difficult issues to understand about survival after brain injury. Many caregiving spouses firmly believe that their spouse died from the brain injury and that the person who awoke was not the person they married.

I cannot accept this view or Mary Ann's view of her self-burial.

We all change continually throughout our lives; each significant event, success, tragedy, trauma has molded who we are. Likewise, our mother's preaching about politeness, manners, proper behavior has molded us.

The impact of brain injury is largely a function of what part of the brain was damaged by the trauma. (This is part of the problem with these distinctions of mild, moderate and severe. The critical issue in assessing brain injury is not the severity of the pathology, the length of the coma, but the part of the brain that was injured. Minor pathology to certain parts of the brain, is more serious than severe pathology to other parts.)

In my opinion, survivors are still the person they were before the injury, it is just that the combination of traits that gave them their personality, has been thrown out of balance. That balance was the result of a lifetime of work by parents, friends and self. That throwing out of balance often results in an amplification of negative traits, magnified by the frustration and sense of loss felt by the survivor. (If Mary Ann had not survived her injury, the sense of loss and mourning she feels for herself would not exist.)

The process of rehabilitation is not creating a whole new person, but trying to bring those traits back into balance, and finding ways to compensate for new deficits. Don't return the survivor home too early, especially to a spouse.

Retuning the balance, in face of the frustration and anger felt by the survivor, is harder than molding the healthy mind was the first time. While we cannot take another lifetime to reset that balance, if we miscalculate the pace of the retuning, the consequences to the marriage and ultimately to the survivor, can be catastrophic.

Click here for My Nightmare. One spouse's account of coma and the return home.

Understanding Subtle Brain Injury

The concussions that disable, are almost always more symptomatic at 24 hours, than at the 2-4 hour time frame when injured persons are evaluated in the emergency room. Brain injury symptoms escalate over the first 24 hours, because brain injury involves a cascade of events. It is critical that if you are still symptomatic the day after your injury, go back to the same Emergency Room, don’t wait for a doctors appointment. It is critical that the Emergency Room personnel see that the symptoms still persist or have gotten worse.

Contact the Brain Injury Law Group: 1-800-992-9447

This site is brought to you by the advocates of the Brain Injury Law Group, a community of plaintiff's trial lawyers across the United States united by a common interest in serving the rights of persons with traumatic brain injuries and a common commitment to fully understanding the anatomic, medical and psychological aspects of TBI.