Successful Outcome Post-TBI Depends on Treatment -- and Significant Self-Motivation
Dr. Jordan Grafman talks about the Vietnam vets in a longevity study who were able to create stable, good lives for themselves and their families without much systemized rehab like there is today. But with more treatment, would their outcome have been better?
When we first saw them, it was clear by their own self report that they had at best modest rehabilitation. There was no systematic rehabilitation that they received at the time--after Vietnam. And so, any improvement or change that we could detect really had to do with their own willingness and efforts in their home life-- family members helping them--so it was they're thrown into the world, and let's see how they make it. And actually it's quite surprising how successful many of the vets were. We would throw up their CT scans. We didn't do MRIs because it was a penetrating brain injury, and they had retained metal in their brain often, and so we could do CT scans; but the CT scans were very clear in showing these lesions--this damage to the brain-- and you would see somebody that you thought had some very significant damage, but here they are the CEO of a company that's successful. So, we know about individual differences in recovery, and that surely accounts for some of this good--we want to know why somebody was able to become that CEO. But even in the case where somebody might not be viewed as being that successful, nevertheless almost all of them felt they had some duty to themselves and their family to develop a life or a career that was stable and successful to the best of their ability. There was 1 guy who used to work at a fish market. He didn't drive. He walked miles to get there. It was along the Mississippi river, and he was very happy in doing it, and he had what he considered a good life in doing that, and that seemed to be worked out by all these veterans themselves without a lot of help from the health care system. They sort of did it on their own. Now, whether they could have had a better outcome had there been more intervention, we don't know.
Posted on BrainLine February 12, 2013.
Jordan Grafman, PhD, is director of Brain Injury Research, Rehabilitation Institute of Chicago. His investigation of brain function and behavior contributes to advances in medicine, rehabilitation, and psychology, and informs ethics, law, philosophy, and health policy.
Produced by Victoria Tilney McDonough, Justin Rhodes, and Erica Queen, BrainLine.