2012年1月15日 星期日

Sentinel reporter Kimberly White shares a story of loss, rehabilitation and coping

About 10 years ago, I was rummaging around in a cabinet at my parents' house when I found a small pile of papers stuffed in a back drawer. I pulled them out, scanned them and realized they were depositions that led to a manslaughter charge in 1985.

On July 8 of that year, my mom, 13-year-old brother, Ken, and I were on our way home from the library when a man, blinded by the setting sun, ran a stop sign and broadsided our car. The impact killed my brother, severely injured my mom and left me in a coma. I was 10 years old at the time and have no memory of the accident or anything leading up to it. Later, I was told that Ken and I raced to the car to claim "shotgun."

Losing that race is probably what saved my life. But sometimes, on my darker days, my survivor's guilt is tinged with envy. Maybe he was the lucky one. He may have died, but at least he never had to suffer.

I spent the first six weeks in a coma at Henry Mayo Newhall Memorial Hospital in Valencia. Waking up was such a gradual process that I can't recall my first memory. I just have these vague images, their edges fuzzy and undefined: seeing my leg suspended in the air, a metal rod running in one side and out the other, thrashing against the arm restraints, the steady beeping of a monitor, grasping my parents' hands, not knowing who they were.

I couldn't talk or make meaningful sounds. I screamed a lot, but even the screams weren't meaningful - they didn't represent pain or anger, they were just something that happens as a severely damaged brain begins to heal.

At some point,Product information for Sell electronicplasticmoulds from China! a family friend brought me a dry-erase board, and the first thing I can remember communicating, scrawled in a kindergartner's penmanship, was a single word: "Why?"

Doctors initially didn't think I'd live, and later told my parents that I was unlikely to recover enough to cope with even my most basic needs. A long-term care facility, they believed, would be best. Refusing to believe their prognosis, my parents brought in a neurologist from UCLA for a second opinion, but he agreed: The probable extent of my recovery might allow me "to sit outside on a nice day and enjoy the feel of the sun," but not much else, he told my dad. At that point, I had the mental capacity of maybe a toddler, but with less coordination and emotional control.

I made some progress over the next few weeks, regaining the ability to speak a little and feed myself (messily). But by the time I was ready to be discharged, the insurance company just didn't see the point in sending me to a rehabilitation facility: They thought I'd recovered as much as I ever would.

My parents, still refusing to accept that grim prognosis, fought the insurer's decision and were finally able to have me transferred to Children's Hospital, Los Angeles. The month I spent there was like an expedited childhood - re-learning how to walk, talk and socialize, brush my teeth and tie my shoes - as my brain continued to heal.

Looking back, I think it must have been hardest on my parents, watching me struggle like that, all while trying to cope with the loss of their son. But in my diminished state, living in that odd new environment, away from the real world, it was just a big adventure - the stuff I've always lived for.

I don't know why I recovered as well as I did, but I mostly credit my parents, who absolutely refused to believe what the doctors were telling them and researched ways to aid my recovery. They stayed by my bedside day and night, talking to me, playing audio recordings of my favorite movies and filling the room with pictures, trinkets and other familiar things. My teachers and friends helped, too, by organizing several get-togethers over the summer, everyone gathering around a tape recorder and talking about how much they missed me and were looking forward to my return to school.

Even after reading the depositions and the shaky future doctors had anticipated, I remember thinking, "Huh. Guess I proved them wrong." I typed up the relevant pages in case I ever wanted to look at them again, put them in a file on my computer and forgot about them. I did not know until the middle of last spring - 26 years after that deposition was written - that I've been disabled most of my life.

Regaining a foothold in society was incredibly difficult, and I suffered a lot in the process. But compared with most TBI survivors,CBMI is leading the world in preventing cheapipodnanoes , I've been successful, graduating with my sixth-grade class, then high school, then college - then entering a career field marked by chaos, wrought with distractions and that lacks structure.

I'll obviously never know how who I would have been if the accident hadn't happened, and there's no point in dwelling on that. But having been told over and over again what a remarkable recovery I made, I just assumed my brain healed itself and never gave much thought to how the brain injury affected my personality or life as an adult.

Last spring, I felt completely overwhelmed at work and, out of frustration, contacted the Brain Injury Association. I described some of the problems I was having and asked whether they might have something to do with the TBI.

I was completely shocked at the response.

"One thing we now understand that wasn't understood before (is) that an injury to a child's brain can create problems down the road, unlike an adult's brain," the director of consumer services wrote back. The frontal lobe, which controls executive functions such as planning, self-monitoring and abstract thoughts, is not very active at 10 years old, and is not even fully developed until the early- to mid 20s. So while an injury to that part of the brain may not initially appear to be a problem, "it may become more of an issue as the child ages and requires that frontal lobe for more and more of his day-to-day activities, both in school and in social situations."

I already knew that my brain had created new neural pathways, like blazing back roads when the main highway is blocked. I just didn't realize they were created to navigate around areas that had been permanently damaged. I'd always thought children had an advantage in recovering because their brain plasticity is greater - the so-called Kennard Principle - but it's since been disproven.

The fact that children are more resilient probably does make it easier during the initial phases of recovery. But studies now show the outcome for children with frontal lobe injuries is worse than for an equally injured adult, because a vital area has been permanently damaged before it ever had a chance to develop - meaning progress ends in a state of partial disability. An adult may be able to reopen that blocked highway at some point and find their way back, but for children, they're forever relegated to the arterial roads.

Then I started wondering how the deficits I've lived with for most of my life affect my work as a reporter - especially the distractibility, tendency to become easily overwhelmed and lack of compassion, another common symptom.

For a reporter, every day is a juggling act. We call people, send out and respond to emails, verify information, work on our stories while answering back-to-back phone calls on two or three unrelated stories, update our editors, check in with photographers, set up interviews for the next day's story, cram in some background research - all with a 4:30 p.m. deadline.

The only person I thought could relate was Bob Woodruff, the ABC correspondent injured in a roadside bombing in Iraq in January 2006.

I sent him an email, and when we spoke several days later, we discussed the similarities between our experiences: Our brains both swelled and we were both in extended comas. In both our cases, the doctors believed we'd never recover enough to live productive lives. We both had to re-learn the basics. And we're both journalists, though I chose this field not even knowing about my deficits, whereas he eventually returned to his position at ABC, though in a less-demanding capacity.

We also discovered we shared many of the same initial symptoms: moodiness, impulsiveness, depression, distractibility, poor planning and organization skills, and becoming easily overwhelmed when we have too much information coming at us at once. The daily life of a journalist would be hard enough for "normal" people, we agreed. But we've both developed coping strategies that make life easier, and these deficits are much less of a problem than in the initial months and years after our injuries.

One of the symptoms from his injury is aphasia, the inability to recall names and words - an especially frustrating disorder for someone who's used to going on-air at a moment's notice. Woodruff didn't do live reports for the first couple years after the injury, and, six years post-injury, still does mostly pre-recorded segments. Before, he said, "I had a good memory, an almost photographic memory. Now it's a very destroyed memory in terms of words."

Before the accident, I told him, I was extremely competitive, mostly when it came to grades. I never did regain that competitive edge, partly because I no longer had a sibling to compare myself with. As far as school, I had too many other issues to deal with, but I also probably recognized at some level that there are more important things in life than being No. 1.

Woodruff agreed, adding, "In order to try to excel like that, I think you need to have the confidence that you'll win. You have to deeply believe you can."

Maybe we both lost that competitive streak, but in its place came a greater appreciation for how life can end in an instant, and the realization that whatever time we do have is better spent enjoying it,The mold consists of two primary components, the injectionmoulds and the ejector mold . rather than clawing our way back to the top.

One of the obvious differences between our injuries is the stage in our lives when they happened. I had my TBI when I was 10 years old. He was 44. That's significant, because he remembers his life beforehand and knows what he lost. Anyone who's had a significant brain injury wishes they could go back to who they were,The choice of beddings material is an important aspect of horse-barn management. he said, but "you reach the point where you realize there are a lot of paths you can take ... The fact that I've still got a great family and friends, that makes it much more acceptable."

In contrast, I remember very little of my life before the accident. I know I'd almost skipped two grades (my parents only let me skip one), I was always at or near the top of my class, and I was popular with my classmates. Of course, memories fade over time, and that may account for some of the fog. But I think many of those memories are probably buried back there somewhere, intentionally blocked out, because remembering too much of who I was would have made it too hard to move forward.

In retrospect,Overview description of rapid tooling processes. it's probably better that I didn't know about my deficits, because if I'd known earlier, I would have limited myself. Instead, I've really just kind of gone through life not thinking much about boundaries, instead setting my sights on whatever I wanted to do and figuring I'd find a way around anything that stood in the way.

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