Tuesday, August 07, 2012

CRASH! CLOSED SKULL CONCUSSION

March 9, 1949.  A traveling man.  A dark rainy night near the Oregon coast, near Clatskanie, twenty miles east of Astoria along the Columbia River.  A drunk, a split second, a crash.  My family’s life changed forever.  I don’t know what happened to the drunk and I don’t care much.  





My father’s first impulse was to take photos.  This is his car.  You can see where his head hit the windshield.  He was lucky not to go out the window.  There were no seatbelts in those days.  When the drunk hit him, he was trapped between a bluff and a river on a narrow highway.





This is the drunk’s car after it had been towed into Clatskanie.  I don’t remember whether our car was totaled.  Maybe both of them were.




My grandfather went to collect my father and the little box of valuables he had, like his camera.  They had held my father in the hospital for a little while and put on what they called “a compression bandage,” but beyond shining lights in his eyes and checking reflexes, etc.  there were no other tests.  No MRI.  I don’t know whether they did an x-ray.  He had a three inch wound in his forehead.  The implications of that only gradually developed over the next decades.

The parts of the jelly-like brain right behind the forehead manage the following mind-functions:
1.  Body regulation
2.  Attuned communication
3.  Emotional balance
4.  Response flexibility
5.  Empathy
6.  Self-knowing awareness
7.  Fear modulation.

These are all subtle abilities, the most recent for humans to have evolved  and almost all relating to the ability to understand other people and choose one’s response.  They are the intelligences that override the fight/flight/freeze responses that are basic mammalian behavior.  They are what alcohol and other drugs cancel.  My father did not drink.  HIs mother had lost a brother to alcoholism and drilled her children NEVER to drink.  (That’s faded now.)  

I was ten years old.  I don’t remember any discussion about the injury, but then when my mother’s breast was removed in a radical mastectomy a few years later, no one said anything about that either.  We were Scots -- stoic, enduring, forbidden to complain.  My father’s father died two years later, his brothers lived far away, his sister and her family had moved out of NE Portland to a new development in the West Hills, and my father’s mother died four years after the accident.  I made a rocky transition to high school in 1953.  It was a family slo-mo train wreck.  If my father were irritated, he would spank every kid in the room -- hard.

At the supper table in those years the conversation was always about my father’s nemesis at work, Helen Something, who was constantly critical, interfering, and keeping him down.  Then my mother would work to assure him that he was all right and to suggest ways to compensate.  I ingested this with my food.  But it never occurred to us that his brain was not functioning properly.  We thought he was ornery.  He became more and more explosive, less and less successful at work, and gradually my mother realized that she would have to do something.  She made peace with her own father so she could borrow money for tuition and went back to school.  It was the best decision she ever made.  For her.  And us.

By the time I was teaching in Browning, my father was showing Parkinson’s symptoms, still unrecognized.  He refused to go the doctor because he was grossly overweight in spite of self-invented drastic diets.  Illnesses connected to guilt and shame prevent medical care.  By the time I was married to Bob Scriver, my father had lost his former job and was piecing along by teaching at community colleges.  Finally he died of a massive stroke.  Troublesome as he had been, my mother did not relish living alone.

But in a decade or so, my youngest brother -- an MFA professor of metal-smithing at a community college -- fell while unloading sacks of cement mix and smashed his forehead into the sidewalk.  His eyes wouldn’t focus, he was confused, all his friends in that fairly alternative community told him there was nothing anyone could do about a concussion, so he went home to his mother.  And that’s where he stayed until she died.  

His behavior was like that of our father, like that of thousands of victims of closed-skull wounds from Iraq and Afghanistan.  Explosive, then inert, unable to form a purpose or make decisions, and yet seemingly normal except for huge quantities of cigarettes and coffee.  He didn’t drink.  He refused to go to a doctor (he was afraid of being labeled crazy and locked up), which meant that he was never identified as disabled and therefore was never qualified for disability checks.  There was nothing to be done.  After my mother died, he did apply for welfare but fought with the intake workers, who threw him out.  After he had a heart attack while living on the street, he was accepted into a VA Hospital.  (He’d been a Marine for four years but not in combat.)  

The VA hospital was just beginning to realize what all the closed-skull concussions meant.  My brother, conspiring with our cousin, signed himself out to the care of a dead uncle, went back to the street and died there.  It’s what he wanted.  By then I was living in Valier on a very low income in a very small house a couple of hundred miles away from any VA hospital.  I had no phone number of mailing address for him.

Of course, I am hugely guilty now, mixed with relief.  This is what drives my interest in neurological research.  Why didn’t I do this research then?  Was there anything to read, anything to consult?  There was no Google.  An expert was there in Portland, but I didn’t even know there WERE experts.

Research shows that a majority of prison populations have this sort of brain damage: inability to hold focus or make decisions, emotional explosions mixed with near-catatonia, vulnerability to addiction.  Life in the rural West is full of trauma hazards.  Long drunken night drives on poorly maintained roads with carousing passengers will do it.  Discipline and feuds often aim for the head.  Concussion -- pass it on.  Got a baseball bat?  Got a length of pipe?  You only need a gun for hunting or mass murder.  We see people “knocked out” as a way to control them in every TV and movie show.

This is not a kind of damage that a person has alone.  It damages everyone, one way or another.  We still haven’t taken it in.




3 comments:

Ron Scheer said...

I puzzle over the fatalism fed to certain of us about health. My mother died of diabetes at the age of 41. My father developed lymphoma and was gone at the age of 70. No one, myself included, did more than trust the doctors. Even afterward, when a medical opinion might have made a difference. I didn't want to know. (German, not Scots.)

That was then. Today I marvel that my young neighbor, a carpenter, parries any question about his health with a stoic acceptance of the inevitable. Die now or die later, it's all the same.

Maybe there's something of this in the gut level resistance people have to Obamacare.

linda hurren said...

I read this story with a heavy heart.
The medical world is very closed minded over the powers our brains hold. The front of your brain controls almost all of our moral controls. From childhood to adulthood we learn proper ways to express our thoughts when the front of our brain is effected their filter gets removed. When you dont allow the brain to heal with rest it continues to be injured. My son was a victim of several mild to severe concussions basicly since birth (the canal would not open) he played rough as a child and also played a very physical 8years of lacrosse. Close to his 20th bday he slipped and smashed his head on the coner of a wall front left side. He ignored the signs of concussion and after vomiting went in to work a very mental and physical job. Withen 2 weeks his brain basiccly went into safe mode and it seemed i had a 6 yr old in a 20yr old body. The medical society immediatly diagnosed him with sckitzifrennia. They would not listen about head injury. After 3 weeks i had researched and found my head injury theory to make the most sense. Im extremely happy to say he is drug free and back to himself he went back to his job working midnights. It still scares me to death to think if i didnt pull him out and refuse the meds he would still be strapped down getting injections that just made everything worse. Its to bad the doctors who were wrong have never wondered what ever happened to the boy whose mother said it all started with a hit to his head. The blessing is my family dr witnessed it all and in the future will always consider a head injury when someone comes to him with completely unexpected mental heath issues.

Mary Strachan Scriver said...

Thank you, Linda.

Prairie mary