The Many Faces of Traumatic Brain Injury (TBI)

Traumatic Brain Injury (TBI) carries a huge complexity of factors, each of which complicates the healing process.  There is of course the impact, the moment of trauma, causing significant damage to the brain and oftentimes other body structures.  This is the primary concern as the patient is rushed to the emergency room for life-saving procedures.  For everyone involved in a tragedy of this sort, it soon becomes apparent that TBI generates aftershocks that extend way beyond the central nervous system of the individual involved; the aftershocks go on for years to come.

As a naturopathic physician and acupuncturist, I have treated patients with TBI in a primary care setting.  As a student I wrote my thesis on the naturopathic treatment of TBI.  I thought I understood the complexities of this condition.  In fact, I was preparing the outline of a book highlighting my understanding of TBI and the treatment of chronic syndromes that continue for years following injury.  A year ago, however, I was exposed to an entirely new understanding of TBI when one of my patients hit a tree at a projected speed of 120 mph.  She was a passenger in a car and received the full brunt of the impact.  What I would learn is that the impact extended much further, as family and friends, healthcare providers, and many others gathered to support each other and the patient in the healing process.

People mobilized from around the country and gathered in the waiting room of the ICU.  Two could visit at a time, and the rest patiently awaited and prayed for good news.   It was there, in the waiting room, that I saw many angles of the experience transpire.  My first day I met the driver of the car, and the remorse was evident in the downward gaze and the pale expression of worry.  Soon I would meet the driver’s family, the patient’s family, and the school friends, all of whom supported each other and maintained hope for the best possible outcome.

An undeniable presence in a trauma of this magnitude is the attorneys, the media, the insurance companies, the doctors and nurses, the priests, and the bankers; all present on the scene to “help” navigate these treacherous waters.  Some provide support while others make the challenge much more difficult.   Mixing all these ingredients together with the volatility of emotions of sheer joy and utter sadness and grief, the experience mirrors that of a human pressure cooker.

There were many details to organize, like who was taking care of the dogs at home while the family lived in the hospital?  How often would one leave the hospital to shower? There was the horrendous hospital cafeteria food that all were subject to, and the sleep deprivation from consecutive nights in upright chairs.  At one point, a family member awoke with a homeless man sleeping next to her.  Emotions were on overload, as people blindly traversed each moment awaiting updates from medical staff.  Shock and tragedy have a way of catapulting you into the present moment, where nothing else matters.  There’s no more room in the inn.  All emotional sensors are activated.  There were already family rifts present from a previous divorce and a history of abuse with a family member.  Now all were in one room together, forced to get along because this moment was not about them.  Past and future seemed far away.

The media was sneaking into the ICU to get interviews with the family.  Lawyers for the insurance companies were calling to deny charges.  Soon the banks would start sending liens on the family’s home.

I will not get into the details of this experience for the sake of protecting patient confidentiality.  I bring this story to light only as an example of the complexity of TBI.  This story repeats itself over and over again, every time someone experiences a severe head trauma.  The CDC reports that each year, an estimated 1.7 million people sustain a TBI.  Of these, 1.3 million report to the ER.  275,000 will require hospitalization, and 52,000 will die.

The experience of TBI extends way beyond the patient.  As a clinician I focus on helping patients navigate trauma and heal the nervous system.  This involves nutrients, herbs, nutrition, acupuncture, and the movement arts.  Complete healing must also include the families and friends involved, as they too are attempting to release the memory of trauma and accept the ongoing challenge of supporting a loved one dealing with the chronic effects of post-TBI syndrome.  Healing this requires a community.

Written by Andy Swanson, ND, LAc practicing at Nature Cures Clinic in Portland, OR