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The Effects of Head Injuries Come
in 'Rippling Proportions'
A Spouse's Perspective



Boulder Freewheeler, Fall, 1988

Summary: This article is still the most personal and most poignant account we have seen on living with the aftermath of traumatic brain injury.


\ As a mode of transportation, the bicycle is a remarkably simple and satisfying machine. In fact, bicycling is so addictively pleasant an undertaking that it is synonymous with fun, exercise and good times.

But head injuries on a bicycle are not fun. It is very serious stuff, and the challenge to an individual to find his way again is enormous. The challenge handed to that individual's family and friends is equally large.

My husband, "Jim," was thirty-eight years old when his bicycle was hit by a pickup truck on the outskirts of Boulder. He landed directly on his head, fractured his skull, survived two emergency brain surgeries, spent nineteen anxious days in intensive care, six weeks in a coma, and four long months in Boulder Memorial Hospital's rehabilitative unit. Almost two years post-injury, Jim lives at home and continues treatment as an outpatient. He goes to "work" three days a week. He is unable to drive a car and he struggles to read and to write. His speech, his gait, his memory, his judgement, his confidence, his competence have all been affected. Jim was not wearing a bicycle helmet.

Those are the facts. Jim, obviously, has his own story to tell and, given the magnitude of his injury, there can be no question that he has come a long way. It is to his great credit (and to the credit of some very special therapists) that he has managed much of it with some humor and some decency. This article, however, is a spouse's story and a request to consider the merits of wearing a bicycle helmet. It is an emotional plea to anyone who loves riding a bicycle. When you don't wear a helmet, you are at so much greater risk for a head injury, and a head injury is a loss of rippling proportions.

These days the word "head injury" appears all too frequently in the news. Due to advances in medical technology, more and more people survive. But the journey from "survival" to "recovery" is an arduous and an elusive one.

Unfortunately, other than stabilizing the brain post-trauma, very little can be done to "fix" the damaged areas. Damage occurs not only at the point of impact, but also with the extensive nerve shearing that takes place elsewhere in the brain. Intensive therapy, balanced by a lot of rest, encourages the brain to stay stimulated in hopes that new nerve pathways can be rebuilt or rerouted. Just as each head trauma is different, so is each outcome different. While some people end up in nursing homes, others make substantial progress. All head injuries require struggle. The heroics of everyone involved from victim to family to friends to therapists to nurses to doctors boggle the mind and the pocketbook and the emotions.

The brain is an extraordinary organ. It is so complex that it still defies understanding, yet it is vital to determining "who" we were, "who" we are, and "who" we shall be.

Tripped up by a serious head injury, a "new Jim" is evolving. While the outside is endearingly familiar, the inside is suddenly changed. His whole being is forced to focus on retrieval: bits of memories, pieces of intellect, scraps of emotion. Things that were a given, now demand huge effort and thought. Jim was easily so much: a good architect, a sensitive father, an exceptional friend, a lovely thinker. Now he struggles in all those pursuits. As his spouse, I miss terribly the sophistication of his person. I miss the partner in our marriage, the promise of our dreams, the male balance for our three children.

The dilemma for me personally is that I both have a husband and don't have one. There exists a vacancy and a burden. The position requires equal energy to the scenario of being single: parenting three small children, keeping life "normal," coping with decisions; and equal energy to the scenario of being the spouse of a head injured adult. The latter means: dealing with doctors who measure up medically, but are seriously lacking in compassion; encouraging Jim's parents to exchange denial for involvement; doing extensive battle with insurance companies who understand little of head injury other than it is monstrously expensive; and finally and most importantly, finding a nurturing niche for Jim to foster dignity and growth.

It is an exhausting prescription of tasks. Sometimes I wonder if love has limits. Despite all the history we have together, is there a point when all the giving leaves a relationship too uneven to continue well?

Within the negatives of a tragedy though, there seems to be a human need to salvage some positives. One obvious plus is that you learn a great deal about yourself. You learn, rather surprisingly, that you do not drown. That somehow, you are resilient enough to keep looking for the beauty of a bird in flight and to keep holding your children's smiles around you like a warm cloak.

You learn to marvel at the depth and breadth of peoples' ability to care. You learn not to remember too often what once was, because it hurts too much, and not to look forward too far, because it is too scary. You float for now, somewhere in the present tense between the promise and the impossibility of daydreams.

You learn to hunker down within yourself to try to find a responsible way through head injury. Like a plant with leaves and blossoms done in by a freak frost, you are forced to grow more roots. You learn to reach to the warmth of friends and you wait to bloom again. Someday.