Terry Smith was nineteen years old when the three-ton military truck that was carrying him and his fellow Marines-in-training flipped over and rolled three and a half times in Quantico, Virginia. A man died in the accident, and others were critically wounded. Terry Smith himself sustained a traumatic brain injury. During brain surgery he died not once, but twice. When he awoke from his coma, he says, “I did not remember what happened or anything or anyone before the accident.”
This Memorial Day, as Americans across the country remember those who have died while serving in the United States Armed Forces, advocates and public health officials are highlighting an illness which with many returning vets struggle: traumatic brain injury (TBI), which, according to the Centers for Disease Control and Prevention (CDC), may be described as “a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.” Says Borimir Darakchiev, MD, FAANS, FACS, an affiliated neurological surgeon with Good Samaritan Hospital Medical Center in West Islip, NY, “The symptoms can vary from mild headaches to weakness of upper and lower extremities, speech problems, blindness and loss of consciousness.”
Approximately 1.7 million people sustain TBI injuries every year, according to the CDC. According to the Defense and Veterans Brain Injury Center, those who serve in the military have a high risk of TBI, with the most common causes being bullets, fragments, blasts, falls, motor vehicle traffic crashes, and assaults. Despite the large numbers of returning vets affected by TBI, “TBI may present as mild, moderate, or severe, and often symptoms of mild TBI are not recognized for what they are,” says Harry A. Croft, MD, former army psychiatrist and author of the book I Always Sit With My Back to the Wall, has evaluated over 7,000 veterans. Since symptoms of mild TBI are often emotional (feeling depressed or anxious, mood swings, irritability), or behavioral (dizziness, memory problems, insomnia, fatigue), it’s important that family and friends familiarize themselves with the intricacies of traumatic brain injury.
Paul after his accident
Dixie Coskie has first-hand experience of how important awareness is. When her son Paul was in the eighth grade, he was riding his bike without a helmet and was struck by a car. He suffered severe trauma to his head and “was given last rites and not expected to live.” After waking up from a month-long coma, Paul was in inpatient rehab for sixth months, relearning how to walk, talk, and to perform basic everyday tasks. Since then, Coskie has been active in spreading awareness about the illness: “If you tell someone your child has cancer, people understand and accept the diagnosis. If you tell someone your child has a TBI, there is a stigma attached. Most people do not understand the magnitude of the injury or the challenges of caregiving.” Coskie has now authored two books on the subject of parenting a child with a TBI, and says, “TBI does not just change victims, it changes entire families.”
Coskie and other advocates, along with public health officials and physicians, seek to debunk many of the myths surrounding TBI. Our sources have listed the following as common misconceptions many people have about TBI:
1. Myth: The Symptoms of TBI are Easy to Recognize
Fact: “Many people believe that since TBI has physical symptoms, such as dizziness, nausea, vomiting, headaches, weakness, and paralysis, that TBI is an easily recognizable illness,” says Dr. Croft. “Often these symptoms, if present at all, are overlooked or are not as obvious as behavioral or emotional ones that are seen as only resulting from post traumatic stress disorder (PTSD).”
2. Myth: TBI is the Same as PTSD
Fact: While the symptoms of TBI and PTSD overlap, and while patients can have both, “TBI implies direct injury to the brain,” says Dr. Darakchiev, “whereas PTSD refers to the impact of trauma, which not limited to brain injury, on the patient’s psychological and emotional state. PTSD can occur without TBi, such as when an individual witnesses traumatic experiences, war related casualties, other people suffering, or the death of a family member.” Ezriel Kornel, MD, Director of The Institute for Neurosciences at Northern Westchester Hospital, in Mount Kisco, NY, agrees: “There is a common misconception that the symptoms of TBI are due to emotional changes related to the horrors of combat. Though the stress of combat can indeed lead to PTSD, the primary cause may, in fact, be a TBI.”
3. Myth: To Get TBI, You Need a Penetrating Head Injury
Fact: Says Dr. Croft, “Most TBI in veterans results from a blast injury as opposed to bullet wounds, vehicular accidents, etc.”
4. Myth: TBI Will Lead to Devastating and Incapacitating Permanent Impairment and Paralysis
Fact: “Although in extreme cases, this may be true,” says Dr. Darakchiev, “the majority of patients do regain their ability to move extremities, ambulate, and speak, and can live independent, or partially independent lives.” Dr Kornel agrees, saying that, with treatment, which may involve medication, surgery, or physical therapy, “People who suffer TBI can and should be able to be guided into a happy and productive life.”
Paul today
Today, both Terry Smith and Paul Coskie are making the most out of life. Prior to his accident, Smith had had hopes to serve as a Marine Corps Officer until the rank of Major, after which he planned to run for the U.S. Senate. “At the age of nineteen I learned that life does not always unfold the way we plan,” he says. After his TBI, Smith said he was “unable to go outside into the living world; my life was driven into seclusion.” Today, after years of treatment, he enjoys writing “in the seclusion of my home,” and has now authored three books, one of which deals with his experiences with TBI entitled Surviving Head Trauma.
Paul, son of Dixie Coskie, is now in his mid-twenties and is now attending Lesley University’s special program for young adults. “Caregivers need to keep hope alive, says Dixie, “It has been ten years since Paul’s accident, and we still see small gains.”
Reflecting on her experience as a parent with a child with TBI, Dixie says, “I have come to find that parents acquire a universal language or emotion when they are suddenly thrown into a catastrophic situation, such as being told that their child has been injured. They experience emotions of fear, grief, helplessness, and hopelessness. What every parent in this situation craves and needs is hope. Hope that their child will survive. Hope that their child will not suffer. Hope that their child will get better and have a meaningful and happy life.”