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When the Unthinkable Happens: Support for Siblings After a Traumatic Brain Injury Strikes a Family

Comments [13]

Dixie Fremont-Smith Coskie, BrainLine

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When the Unthinkable Happens: Support for Siblings After a Traumatic Brain Injury Strikes a Family
2009/Coskie Family Picture: Jack (born three years after Paul's crash), Steven (Dad), Dixie (Mom), left to right – Monica, Anna-Theresa, Caroline, Paul, Amanda, Brianna, Kevin.

On a day that began like so many others, I received the unthinkable news that one of my children had been hit by a car and was clinging to life. My husband and I were told that even if our thirteen-year-old son Paul survived, the quality of his life would be questionable because he had sustained a traumatic brain injury (TBI).

I have learned that TBI changes not only the people who sustain an injury, but entire families. Day and night, my husband and I kept vigil by Paul’s hospital bed while our other six children were suddenly abandoned, distraught, and left in the care of others. I was incapable of thinking of them — I couldn’t take on the added heartache of knowing how much they were suffering, not knowing if their brother whom they loved and adored would live or die.

The reality was I couldn’t help my other children — aged 16 to 6 at the time of Paul’s crash. Even when I returned from the hospital for brief visits while my son lay in a coma for weeks, my mind was preoccupied with the fear of losing him, the foreign medical terminology, the unknown…. When I could be at home, I gave an abundance of hugs and let my other children know how their brother was progressing, but their sorrow, grief, and fear persisted. I couldn’t even stop crying myself. I couldn’t help my son heal faster or help with my children’s fears or my husband’s denial. I wanted to smash my car into a brick building. I could visualize the glass shattering, my body immobile, my mind silenced.

My children became fearful of everything; getting out of bed in the morning to attend school or other activities was a struggle. I wanted them to speak to counselors at school or the hospital to help them work through their anxiety, but they resisted. I couldn’t and didn’t want to force them to openly express their feelings of terror and uncertainty. I often cried along with them, letting them know it was okay to express any feelings they had — guilt, shame, jealousy, fear, resentfulness, abandonment, anger, anxiety, denial …. I wanted them to know that thoughts or feelings of Why me? Why my family? Why my brother? were all normal.

Although some days this seemed impossible because of lack of time and energy, from the earliest days after Paul’s accident, my husband and I tried to involve his siblings, empowering them with knowledge of their brother’s injury and keeping them informed of his health condition. When we could, we talked one-on-one and provided written, audio, or video information — at age-appropriate levels — through different phases of Paul’s medical status and recovery. We also let them know that they couldn’t have done anything to prevent the injury and that they were in no way responsible for what had happened. My husband and I also tried our best to let our children know that their needs mattered, too. We assured them that they were just as important as their brother, but for right now they needed to understand that we needed to be at the hospital with Paul. We always let them know how much we missed them, that we were thinking of them, and that we’d stay connected by phone, text, and e-mail as often as we could.

Some of my children, especially the older ones, kept their emotions inside, feeling that they had to be the “strong ones” and that expressing how they truly felt would burden my husband and me even more. When we could, we encouraged the kids to vent their concerns and fears, let down their guard, and talk about any of their feelings, fears, and insecurities. It was important for my husband and me to listen — not to try to fix the problems. "I hear how painful this is for you,” or“You sound scared; I am too. Our family will be okay … together we can get through this.” We tried hard to do this but sometimes we just didn’t have the time or emotional energy. I had to remind myself that all I could do was my best.

As Paul’s health condition changed, his siblings often thought the worst. They needed to be reassured to keep hope alive, while also being realistic. We had numerous conversations about their brother’s injury, his possible death or lingering deficits, and we repeated these conversations as each child’s understanding of the circumstances evolved. We tried to tell all the kids “I love you” as often as we could and make small, loving gestures like leaving notes in their lunch boxes or stuck on the bathroom mirror. We reassured the kids that their brother was getting the best possible care and we’d give them updates no matter how incremental. When my husband and I couldn’t be around, we recruited neighbors and family members to help keep school, extra-curricular activities, and schedules as normal as possible. Our friends and family were amazing and also helped with domestic chores and care of the younger children.

My husband and I spoke with other TBI parents to help us better understand the injury and how they helped their other children through the grief and heartache. Our kids often felt isolated from their peers, feeling as if no one could understand what they were going through. How could they? We offered websites for our older children, picture books for the younger ones, and opportunities for all of the kids to talk or interact with other TBI siblings. We gave them their space when needed, and left time for just the siblings to be together so they could share with each other if they wanted. We also watched closely for any lingering issues with appetite, anger, or depression so that we could intervene and get medical help if needed. We tried as often as we could to communicate with teachers to make sure we were aware of any problems our children might be developing at school.

Our kids knew that counseling and a support system would be there when and if they were ready. Every family dynamic is different, but I felt at some point that both family and sibling therapy would be vital for all of us when the children were ready, especially for the siblings who were struggling the most.

I wished I could have shielded the burden, the emotional suffering, and the ripple effects that TBI inflicted on my children, but I couldn’t.

Amanda, our then 16-year-old daughter, took on the role of mothering our five other children who had essentially been abandoned the day we left for the intensive care unit. Her school work suffered and she clung more fiercely to her boyfriend. Trying to stay in control of something, she began to dictate chores.

Our daughter Brianna, 15 at the time of her brother’s crash, became quiet. Panic attacks and nightmares followed.

Written exclusively for BrainLine by Dixie Fremont-Smith Coskie. © Dixie Fremont-Smith Coskie, 2010. www.dixiecoskie.com.

Comments [13]

Hi Dixie,
My colleague directed me to your blog. It was very moving to read. You and your husband certainly did everything possible to help your children understand and cope with their brother's brain injury. An experience of brain injury can often be so difficult for a sibling as they take on more responsibilities and have to grow up very quickly. I have no doubt that your writing here has helped so many other parents in a similar position through your tips and ideas! Thank you for a great read.   Maria Coyle, information editor, www.braininjuryhub.co.uk

Jan 13th, 2015 6:43am

Our family has been changed forever and now 6 years later, my husband and I are separated and will be divorced although the injury didn't cause the destruction of our marriage, it made it much more clear that it was the best choice.  Our older son is seldom involved with Michael as he's started his only family now and misses his brother, but hasn't dedicated any time to re-establishing the relationship and our younger son is filled with anger and resentment for what happened and has worked through some, but continues to manage through the issues of abandonment and grapples with his faith at times.  If I had to do over again, I'd do it differently.

Jul 23rd, 2014 11:23am

Our 2nd son has been living with a TBI since 2008 and we still are struggling with helping our other 3 children to cope...and now we as a couple struggle with what we thought was helpful almost 5 years ago was actually making things harder for us now... it is so hard to know what to do for everybody when we have to parent and 'special' caregiver to one and then still live life with the rest of the family... friends and the world!

Apr 22nd, 2013 12:02pm

thank you for sharing this story. my family went through (and is still going through) a very similar situation. i\\\'m sorry that we have to travel this road of tbi, but i am grateful you shared your story. (www.caringbridge.com/visit/landonthestuddhochstetler)

Mar 8th, 2012 4:29pm

My son was in a car accident in 2003. He is doing good except for his speech. He gets angry over the accident. I am happy your family is doing well.

Dec 31st, 2010 12:36am

reading your story brought back memories of my own when my daughter at age 5 suffered a TBI due to an auto accident in march 2001. My other two children were 3, and almost 2 at the time. Many people don't realize what the siblings go through during the time that your other child is fighting for their life. Thanks for sharing your story, I wish I would have kept a journal or something during that time. Dominique Warner

Nov 15th, 2010 7:58pm

my brother suffered TBI two years ago , i still cry myself to sleep everynight, i am fearful and want to give up on everything, i love him dearly and as i see that he will never be the same again..... and it does not help that we live in india here there are no facilities for rehabilitation....

Oct 14th, 2010 3:55am

Thanks for sharing I have a son whom 6mths ago suffered a TBI and I am still trying to accept this...Thanks for sharing!

Oct 10th, 2010 1:30pm

Awesome Story, my son suffered a TBI in January of this year. So I can relate to this story since he was one of four children.

Oct 5th, 2010 2:49pm

Check out Dixie's book Unthinkable at Amazon.com. It's Amazing!

Sep 30th, 2010 3:04pm

Such magnificent writing! What an inspiring family!

Sep 17th, 2010 10:23am

What an awesome story! I can so relate to everything that was said and I honor and appreciate your willingness to share your story. My niece was 15 when she suffered a TBI...at the time, she had two little sisters ages 4 and 2. It is truly amazing how similar (despite the age difference) that your story is. I think the one thing that everyone who has been through this can relate to and/or know is -- never, ever, ever give up!! Everything happens for a reason!! THANK YOU so much for sharing your story! Your courage does truly help others! God Bless you and your family!

Sep 16th, 2010 11:43pm

Wow, awesome article! Very intense!

Sep 16th, 2010 8:29am

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