Head Cases

Head Cases

Michael Paul Mason
Book on brain injury, blast injury and PTSD features chapters on adults, children and veterans discussing changes in memory, self-image, violence, suicide, family stress and war in Iraq.
Item: HECA
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Full Description

Michael Paul Mason takes readers on the road to meet survivors of brain injuries as they struggle to map and make sense of the new worlds they inhabit. You will meet an athletic snowboarder whose life became permanently surreal after an errant jump; an "ultraviolent" child who has lost the ability to control anger and violent impulses; a young man who cannot cry; and an Iraq war veteran whose odd maladies suggest that brain injury will be the war's most conspicuous legacy.

Mason writes with a clear and engaging style while he exposes the contradictions, bittersweet ironies, and injustices of brain injury rehabilitation. He shows that treatment is too often limited or not available because of inadequate funding and insufficient resources. The consequences for the survivors and their families expose the emotional trauma that accompanies the physical damage to the brain.

Underlying each of their stories is an exploration into the brain and its mysteries. When injured, the brain must figure out how to heal itself, reorganizing its physiology in order to do the job. Mason gives us a series of vivid glimpses into brain science to help readers appreciate the complexity and the vulnerability of this organ. Head Cases is both illuminating and deeply affecting for professionals, advocates, families and survivors.

Details
Item HECA
ISBN# 978-0-374-53195-9
Pages 310 pages, 5 1/2 x 8, softcover
Year 2009

Authors

Michael Paul Mason

Michael Paul Mason was born and raised in Tulsa, Oklahoma. After earning an undergraduate degree in English Literature, Mason wrote and edited for a number of Oklahoma-based publications. In 2000, he created the unconventional literary journal Me Head, which included the works of writers and poets such as Sarah Brown, Matthew Crouch, Christopher Dooley, Jared Gilbert and Shin Yu Pai. Mason continues to write on a variety of topics and is currently a contributing writer to DISCOVER magazine.

From 2002 through 2007, Mason worked as a brain injury case manager for the Neurologic Rehabilitation Institute at Brookhaven Hospital. As a case manager, Mason traveled to nearly every state in America in an effort to help survivors of severe traumatic brain injury find appropriate treatment. Moved by the heroic struggle of survivors and their families, Mason began collecting stories, which became the groundwork for his first book of non-fiction, Head Cases: Stories of Brain Injury and Its Aftermath.

In February 2007, by invitation from the Department of Defense, Mason traveled to Balad, Iraq where he witnessed the "brain injury capital of the world" in motion. The Air Force Theater Hospital at Balad Airbase proved to be the catalyst for several magazine articles, among them Dead Men Walkingand Iraq's Medical Meltdown. Mason also includes a moving account of Iraq War veterans and wounded Iraqis in Head Cases.

In the course of working as a brain injury case manager, Mason become a certified brain injury specialist and continues to advocate for reforms in brain injury care. Recently, he was one of the moderators of the first annual Brain Injury Consensus Conference, which brought together over 100 brain injury professionals in an effort to address treatment issues for Iraq War veterans as well as American civilians with TBI. Mason currently serves as vice-president of the Brain Injury Association of Oklahoma and regularly delivers engaging talks nationwide.

Review of Head Cases

Reviewed by Kris Shields, Program Administrator &TBI Coordinator for the Department of Health, Brain and Spinal Cord Injury Program

Head Cases is the most fascinating book on brain injury that I’ve yet read. Fascinating because, although we say it all the time, no two head injuries are ever the same. This book illustrates that in a way so plaintive, illuminating, and painful that each chapter becomes almost increasing difficult to read. Most books about brain injury deal with one survivor and the survivor’s families and friends, all who are trying to cope each in their own way. This book however, is a series of vignettes, chapters on a chapter in each individual’s life that irreversibly changes that life.

Take, for instance, the first chapter, “The Hermit of Hollywood Boulevard,” about a young man named Cheyenne Emerick, who was a most serious, experienced, and renegade (I guess that goes without saying) snowboarder who had traveled west to Snowbird mountain from his native Sugarloaf in Maine, to test himself. Snowbird was known as “the most daring, dramatic mountain the West had to offer.” It was on his first trip down the mountain that “the ground rushed up from nowhere. The force of the impact drove his knee into his forehead, blasting away all his senses in a burst of white pain.” Thus began the start of Cheyenne’s seizures that continue to control what he can and cannot do with his life. He cannot hold a job, he cannot drive, he is poor, living a “minimalist” life, not by choice, but by chance. According to Cheyenne and his mother, “Medicaid has denied them, and Cheyenne’s injury is too invisible for disability income.” So it goes.

Or take Doug Bearden, who served 20 years in the Air Force, many of them as an air traffic controller, a coveted and stressful job. In 2003 Doug took an early retirement because of the stress and began another chapter of his life. He never thought about the series of cold sores on his lips and mouth he had had. Never really had any health worries to speak of. But the bomb was ticking and it was called HSV-1, herpes simplex virus type I, which decided to manifest itself in Doug Bearden’s brain and wreak the same kind of havoc that a traumatic brain injury can. Doug Bearden who holds two masters’ degrees, one in education and one in theology, was working that summer as a regional training manager for a local pizza chain while he and his brother pondered establishing their own church with their own congregation. He never made it to work that morning or any morning after. He was found 24 hours and a over a hundred miles later, a three hour car drive from his home, asleep underneath a bush on the grounds of a plastics manufacturing company. Even today, over a decade later, Doug has no memory of that day, “it was already lost, along with other large chunks of Doug’s past.” Because of the damage of the virus to his brain, Doug lost his short-term memory, much of his long-term memory, the governance over his emotions and behaviors, and “In a matter of months, Doug Bearden went from a model of self-reliance to requiring round the clock care. He simply could not be left alone.” In one sense though, Doug is one of the lucky ones. Because a simple notation in his military medical record noted the instance of cold sores, he’s being treated by the VA system, but not before a pleading, public relations campaign on the part of his family with important legislators, including the governor in the state in which they live, did he get the services he needs. Mason writes, “In ways we may never fully appreciate, Doug Bearden lost his life. Within a period of three years, he endured over twenty different medical placements. His family was forced into bankruptcy, and every person he loves bears some type of scar, emotional or otherwise, from the experience.”

Survivors of brain injury and their families who may read this Brain Waves magazine know these stories and the consequences all too well. There are thirteen chapters to this book and all of them tell a unique and important story. They illustrate that even some of us who don’t willingly or knowingly put ourselves in harm’s way can experience the bewildering array of consequences of brain injury. They illustrate that the system of care in this country is woefully inadequate to serve this array of consequences and families spend months, years, lives trying their very best to deal with the situation they find themselves in. In the end though, two essential questions remain, one spiritual, one practical: “Who am I, really?,” and “Who are we, other than our brains, really?” And by this we mean memories and our ability to connect through shared experiences. As Mason writes in his introduction, “A brain injury can shatter your notions of the future, splinter your past, and send your sense of time whirling in any number of directions. And that’s just the beginning.”

Survivors, family members, friends, professionals in the field of brain injury, struggle to answer those questions probably daily. This book examines the problems, shares some insights, gives a bit of hope, and shapes a bit of a plan to refine the way each of us attempts to answer those two questions.

Contents

Introduction
The Hermit of Hollywood Boulevard
A Prisoner of the Present
An Insult to the Brain
Rob Rabe Cannot Cry
Portrait of Injury
The Resurrection of Doug Bearden
Ultraviolent Bryan
Fugue of the Pony Soldier
In All Earnestness
The Hospital in the Desert
Wood of the Suicides
Conclusion
Appendix:  My Breakfast with Marilyn
Notes and Resources
Resources for the Care and Management of Brain Injuries
Acknowledgements
Index

Excerpts

Excerpts

Introduction

The first thing I tell her is that I cannot help. Her son Jake is thirty-four, my age. His gray, bruise-flecked limbs are splayed out on a bed before me; his mouth is dry and agape. I know I cannot help him. I cannot file a lawsuit against the insurance company, I cannot conjure a way out of this dead-end nursing home, and I cannot sucker punch the aloof neurologist or throttle the ignorant psychiatrist. I hold no sway over the waiting list in my own hospital. I explain to her that I can do nothing at all, and she sighs. She is desperate to see Jake in a program where there is a sense of progress and direction. She knows that the rehabs and specialty hospitals are as inaccessible as the moon. She has called them herself, and she knows that nobody can help. She knows I cannot help, but she asks me anyway. She asks, in all earnestness, to do the impossible and find her son a bed, and in my weakness, I agree. It’s my job to agree.

Jake turns his head toward me and I suspect he can hear me. If he can respond, no matter how minimally, then he meets the most important criteria. He closes and opens his mouth arbitrarily, but not a sound comes out. I ask him to lift his head and I wait. Nothing. His mother is quiet and nearly in tears. I ask her to turn off the fluorescent lights and shut the door, and when she does Jake exhales faintly. It sounds like relief, like the hint of a response. I ask Jake once more to lift his head. A good fifteen seconds later, his head slowly raises an inch off the pillow, and then drops back down. That’s criteria enough for me. His mother grins at me proudly, as though her son just won a marathon. In a sense, he has.

The next two hours find me thumbing through a thick notebook of Jake’s medical records, trying to decipher the scribbled progress notes and lab reports, then interviewing nurses and aides and doctors. I spend the last half hour of my evaluation explaining to Jake’s mother that this will take months at a minimum, but most likely a year or two—if anything happens at all. She will be my best resource through all of this, I tell her, as I hand her a list of administrators to call and a few forms to fill out. She tells me she will do this and anything else I ask, but she doesn’t need to say a word. If she’s been through this much already, paperwork and phone calls aren’t going to stop her.

Before I leave, she asks for my business card, not because she doesn’t already have my number, but because she wants to know my title, she wants to know what kind of person drops everything to go to look at a bedridden man four hundred miles away. I hand her my card and tell her I am a brain injury case manager, and there is the hint of a smirk because we both know that brain injuries cannot be managed any more than a thunderstorm can be managed. They can be endured, accepted, and integrated, but not managed. She clasps her hands around mine, and I say goodbye, and I get back in my car. I am forever back in my car. I turn the ignition and hope for home, so I can lie down next to my wife and rest my hand on the warm crest below her navel.

The hope is false; a singular voice mail from my director asks me if I can drive two hours north to Sioux Falls to assess a woman with brain damage due to a viral infection. Either I drive the two hours today, or I drive back home to Tulsa and drive ten hours up to South Dakota on Monday. I head north and can already hear the disappointment in Christy’s voice. When I call her from a filling station outside of Omaha, she doesn’t answer and I leave her a message. My marriage unfolds in messages.

On my way up to Sioux Falls, I think about Jake still lying there in the nursing home, and how he has been lying there throughout the past year while I was buying a house and mowing the lawn and attending parties and traveling. He has been lying there long enough for his wife to have given up hope and file for divorce, and he hasn’t seen his son in months. Jake is trapped in an awful sense of nowhere, and yet he is still present, still responding, still human. I may not be able to help, but I can act. I can act for Jake, which, right now, is more than he can do for himself.

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