Running head: TRAUMATIC BRAIN INJURY 1

Point of view assignment: Traumatic brain injury

Gretchen Kempf
The University of Scranton










TRAUMATIC BRAIN INJURY 2
My knowledge of traumatic brain injury (TBI) mostly stems from reading textbooks used
in my occupational therapy classes. My hands-on experiences are limited to brief observations,
during volunteer work or clinical field experiences, of patients who had suffered strokes. Hitting
a bit closer to home, while I was away at college during my senior year, my own mother had to
go to the emergency room when she suddenly lost her memory a few days after returning home
from caring for her own mother during the final weeks of my grandmothers life. My mother was
diagnosed with post-traumatic stress disorder. Although she recovered her knowledge of her
childrens names and birthdates and the like within a few days, she was left with a permanent
hole in her memory of a period of about twenty-four hours. While this may not rise to the level
of severity of a TBI, it nevertheless left me quite shaken and amazed to hear that my very
independent, strong, educated mothers brain could react in this sudden and frightening manner.
Although I had no idea what it is actually like to live with a TBI prior to reading this
article, I must confess that TBIs have fascinated me, from an academic standpoint, since I first
crossed paths with a patient living with TBI in a volunteer stint at a physical therapy outpatient
office. I have always been intrigued by how differently each person living with TBI is affected.
Some patients are left with severe physical disabilities while others have tremendous mental
disabilities even though they may appear to have normal motor functions.
I had a very emotional reaction to this article. It gave me a tangible sense of the chaos,
helplessness and frustration that could be experienced during the space of a couple of hours
during an ordinary day for someone living with a TBI. It struck me that it is sort of cruel and
unfair that a TBI could leave someone looking fine on the outside so that no one knows how
mightily they are struggling to keep their composure. Such patients most likely do not arouse
feelings of empathy on sight and probably do not receive many unsolicited offers of support.
TRAUMATIC BRAIN INJURY 3
This article may have been quite short, but it was very powerful since it was written from the
point of view of a person living with a TBI. I read it with a rising sense of stress, frustration and
dread because I would remember what tasks or chores needed to be done, but she could not! I
just wanted to step into the scene that the article portrayed so that I could give a helping hand.
I felt overwhelmed myself when the author described her feelings while getting her
daughter dressed and ready for school. The authors use of the word miracle once the daughter
was finally ready actually was heartbreaking because this is an everyday task that is an integral
part of parenting. It made me worry for both the mother and the little girl. There was no
mention of a husband or a father in this article and I fear that the mother is a single parent (my
fear was underscored when I read the authors note that TBIs are often the cause of the breakup
of a marriage or other relationship). I know single parenthood can be overwhelming to someone
without a TBI so I wonder if the daughter will be able to stay in the mothers care or whether she
will have to be placed in the care of others for her own safety and emotional development. On
any given day, the strongest, healthiest parent can find a preschooler to be quite difficult to
manage. How much more difficult such days must be for Kimberly! Before reading this article, I
had not really thought about the effects of a TBI on people other than the patient. This article
drove home the point that a single TBI can claim many victims. Its almost too painful for me to
imagine the long-term effects that Kimberlys TBI might have on her daughters development.
Will it end up causing psychosocial issues and/or affect her ability to learn? I also fear that
having to deal with her daughter may inhibit Kimberlys recovery from the TBI. I found myself
desperately wishing for a mention in the article of a grandmother, neighbor, friend, social worker
or the like who could enter the scene to save the day for Kimberly.
TRAUMATIC BRAIN INJURY 4
This article really made me compare and contrast my everyday life with Kimberlys life. I get
so flustered and overwhelmed when I have a lot of papers, exams and projects for school and I
sometimes feel sorry for myself if school makes me miss out on an opportunity to do things with
friends or watch a favorite television show. This article actually made me feel embarrassed to
feel that way. My frustrations are temporary mole hills compared to the impenetrable mountains
Kimberly is faced with everyday. I am so grateful that I have the ability to participate in school
and to work toward achieving my dream of becoming an occupational therapist. I recognize that
I take these abilities for granted when I compare my life to Kimberlys. This article made me
take a moment to step back from my life and to realize just how lucky and blessed I am. I easily
juggle multiple tasks and remember important dates and appointments andusually!
remember quite easily what task I came to accomplish when I walk into a certain room. From the
outside, Kimberly and I look the same. How sad that no one knows how Kimberlys internal
struggles complicate and compromise her abilities to handle her responsibilities! I suspect
Kimberly must be a much stronger person than me; I think I would crumple under the weight of
her burdens.
I also experienced feelings of anger that no one had recognized that Kimberly needed help. I
started to develop a list in my mind of possible agencies that might be able to get her some help.
I wanted to pick up the telephone and call on her behalf. I found myself wondering what
happened to the social worker who was briefly mentioned in the article.
What I found most interesting about this article was that Kimberlys condition appeared to
fluctuate so much. She noted that the week before she was able to get her daughter to school on
time every day but this week was completely different. I recognize that this fluctuation must be
so difficult to handle. I cannot imagine what it is like to constantly struggle to gain control and
TRAUMATIC BRAIN INJURY 5
then, just when you think you finally are managing things, everything falls apart again. The
constant search for stability and structure would be so chaotic and stressful. I thought
Kimberlys description of her brain as being in manual operation status with a less-than-capable
engineer at the controls was very illustrative and telling. It succinctly captured the lack of
control Kimberly felt in her own life.
I also found it very interesting that Kimberly used a service dog. I wish that she elaborated
on the use of the service dog because I wanted to know what the dog was capable of helping her
with. I wanted to be able to compare TJs experiences with his service dog with Kimberlys. I
am having trouble imagining how the dog could help with any of the struggles that Kimberly
described in the article.
This article helped my understanding of what it would be like to live with a TBI by
allowing me to see the utter chaos that everyday activities can precipitate. This article also made
me look at disabilities with a new perspective. Kimberly may have a TBI, but also she must fill
the same roles as those who do not have a TBI--such as being a mother and a responsible, tax-
paying citizen. Each and every aspect of her life was complicated by her disability. Society,
unfortunately, is not very supportive and sympathetic to the struggles of those who live with a
disabilityespecially those who look normal. These patients are left to figure out on their
own how to perform the roles in life that they have been assigned such as wife, mother, daughter,
employee, neighbor, homeowner, citizen, etc. This must add tremendous stress to their lives. It
serves as a cautionary reminder to never judge a book by its cover.
From the viewpoint as an aspiring therapist, this article showed me why taking a holistic
approach with patients is so important. Like I mentioned before, Kimberly was forced to fulfill
TRAUMATIC BRAIN INJURY 6
the roles of being a wife and mother as well as the role of someone living with a TBI. As her
therapist, it would be important for me to find occupations in her life that go hand in hand with
these roles in order to instill meaning into treatment. By focusing on occupations that directly
related to Kimberlys everyday roles, would hopefully help to improve and settle some of the
chaos she experiences throughout this article.
This article will serve to influence my development as an occupational therapist since it
has shifted my focus from the physical to the psychosocial aspects of TBI. Since cognitive
disabilities may not be readily observable, they easily can be overlooked. Whether they can be
seen, however, is in no way indicative of the influence they can exert on the life of the patient.
In many ways, a physical disability may pose less challenges to the activities of daily living than
a mental disability such as disorganized thought process. As a therapist, I know I cannot rely
solely on my eyes to give me the complete picture of the patient. The article also helped me to
recognize that timing of an assessment can be critical. What if I, as a therapist, had assessed
Kimberly only during her good week? In such a case, I would not have gained any inkling of
her disability. I also realize that if I had assessed Kimberly during her bad week that she most
likely would have been nearly incapable of articulating her state of mind since personal
interaction and the sound of voices was so painful for her during such an episode. I see that there
is a need for repeated and on-going assessment during a course of treatment and that the therapist
must have flexible responses in their treatment approaches.
This article helped to bring into focus the extremely complex challenges presented by TBI
and the critical need for concerned therapists to have knowledge of a wide variety of treatment
approaches and techniques. Knowing that Kimberlys experience with TBI is unique to her and
that no two patients with TBI will exhibit the same symptoms and effects serves to highlight the
TRAUMATIC BRAIN INJURY 7
complexities of diagnosis and choice of treatment. These situations clearly require the continuing
commitment of the occupational therapist to be a life-long learner. Perhaps most importantly,
the article also underscores the vital need for patience on the part of the therapist.