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Bethany Vaccaro, The American Scholar (page 2 of 5) Page 2 of 5
The phrase head trauma meant very little to me that night. I wondered to myself if my brother had perhaps lost an ear or an eye. The possibility of cognitive changes never crossed my mind. I was only vaguely aware of traumatic brain injury as the so-called “signature” wound of the Iraq war, something that is largely due to the increasing sophistication of the explosive devices used by the insurgency. I learned later that the Defense and Veterans Brain Injury Center, which operates out of Walter Reed Army Medical Center, had treated 1,803 cases of TBI stemming from the Afghanistan and Iraq conflicts as of November 2008, while cumulatively their sites had recorded 9,100 cases of this injury. I was completely unaware of the large advocacy and support networks, such as the Wounded Warrior Project, that exist to rally for the treatment of severely injured service men and women, the influx of whom our government has proven sadly unequipped to handle. I didn’t know that it is still an uphill battle for many families to receive the kind of care that this incredibly complex injury needs in order to maximize recovery. This was the world we were about to enter that night, although we couldn’t have been more ignorant of its existence.
As soon as my brother was moved to Bethesda Naval Hospital in Maryland, my parents began the arduous task of attending to him. I never saw a hint of hesitation in them, even through the long months of care, as everything else in their lives took a distant second place. They were unflinchingly proud of Robert, as they had been when he joined the Army, decided to volunteer for deployment, and ultimately left for Iraq. My parents saw his wartime role in crisp black and white. They were not angry, like I was. Any political context for his actions and what had happened to him collapsed into the overarching fact that he is their son and was in need.
The day my mother prepared to leave for Bethesda, she told us she might stay the whole week. She was sure we could mind each other (two of my brothers were still being homeschooled), the house, and our grandmother for that amount of time. It would be hardest on my nine-year-old brother, who had never been separated from both his parents at once. But we were all eager to rally and pitch in, snapping into an automatic mode that propelled us through our daily routines. My mother was gone for the better part of four months, my father for six months. They would rotate, depending on my father’s university work schedule, and were often not home for more than three days at a time. But even when they were home, my parents were present in Rhode Island only in body. Their minds and all their energies were concentrated on a single hospital bed hundreds of miles away.
I’m not sure when I realized that the shock wave that penetrated my brother’s brain continued across continents and seas, engulfing my parents, my siblings, and me. Our lives were transformed rapidly, and it was months before I explicitly acknowledged the extent of the change. I had graduated from college three weeks before my brother’s injury and was working at a restaurant while I plotted my next move. But without my parents at home, the bulk of the housework, cooking, homeschooling, and grandmother care fell on my shoulders, giving me the unusual opportunity at the age of 22 to experience the life of a middle-aged married woman with children. My head became filled with grocery lists, grade school lessons, the appointment calendar, a barrage of daily details that had nothing to do with my own life plans or preparations. I quit my job, and life narrowed to my siblings, my family’s needs, and trying to keep everyone afloat. On a rare night out with one of my friends, I explained that my siblings had asked me to be home by 10. I wasn’t sure which was more bizarre — the fact that I had readily assented to this curfew or the fact that I thought it was a fair compromise for being “allowed” to go out. Even as I told myself that I was on the moral high ground, resentment began to fester within me as the sacrifices, the hurt feelings, and the hardships began to pile up.
As my family’s reality continued to revolve around my brother, I began to realize that every family member of someone with TBI becomes enslaved by the condition of their loved one. But while the tedium of this sometimes threatened to overwhelm me with self-pity, the tautness of the real tragedy was continually re-framed and re-focused. Despite all of the changes to my life, my attention went again and again to my brother, who languished at the upheaval’s epicenter, suffering at a level that could not be compared to ours.
The first time I saw Robert, three weeks after his injury, he was still being kept in an induced coma. I flew down to Washington, D.C., with my sister Anna for the weekend. We were giddy and giggly in a bleary haze of extreme nervousness. When we asked what to expect, our father said that nothing could prepare us to see the devastation that was our brother. Outside of his room in the intensive care unit, we donned yellow gowns, masks, and gloves. We could see the end of his bed from the door. His feet were clad in gray socks and listing outward in extreme lassitude. We could already hear all the hospital noises, the beeps and whirs, the heavy whoosh of his ventilator. I wasn’t brave enough to walk right in and confront my brother, so I peeked around the corner with one eye. Recoiling, I whispered to my sister that I wasn’t sure if I could do this.
Robert was swollen and bloated; his skin was puffy and enamel white. He looked worse than dead and somehow a bit reptilian, more cadaver than creature. The violent rise and fall of his chest with each pull of the ventilator looked painful, as if the machine were assaulting him. His eyes were fluttering a bit. When they were open, his pupils sometimes rolled around, not entirely in synch with one another. The right side of his head where the skull had been removed had a cavernous dent, the skin sinking in because there was nothing to hold it up. Mucus had built up around his nostrils, his lips looked extraordinarily thick, and his face was damp. He looked strained, far from peace, and barely human.
Reprinted from The American Scholar, Volume 78, No. 3, Summer 2009. Copyright © 2009 by the author.
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