I ' d think about the type of kid I was before. I'd start crying. I thought someone was playing a joke on me. --Charles, 20
What's so scary is, it's like you're lost. It's like you're in space. All of a sudden your surroundings just drop out from underneath you. --Jeffrey, 29
My biggest problem is, people look at me and say: "You're fine." --Diane, 27
A lot of the people in this story have had their names in the newspaper before. They appeared in brief news items with headlines such as, "Crash Halts Rush-Hour Traffic on Interstate 405." They were the survivors, the ones "reported in critical condition with head injuries."
Last year, more than 700,000 Americans, mostly males between 16 and 25, received head injuries severe enough to require hospitalization, according to the National Head Injury Foundation in Framingham, Mass.
Because of major advances in emergency medical care, people now live through blows to the skull that were almost always fatal just a decade ago, experts on such injuries say. Ambulances and helicopters arrive at accidents more quickly and carry increasingly sophisticated life-support gear. Improved imaging devices, such as computerized axial tomomoters (CAT) and nuclear magnetic resonance scanners, help doctors diagnose brain damage more effectively; new neurosurgery tools and techniques help surgeons minimize continuing damage to the brain, and innovative rehabilitation programs give patients increased hope for physical recovery.
Left With Problems
Despite all this technical wizardry, Head Injury Foundation statistics show that 50,000 to 90,000 of the people who suffered head injuries last year were left with intellectual, physical and behavioral problems that may prevent them from ever living independently again. Specialists in the field call the problem "the silent epidemic," and say there is a tragic shortage in this country of programs to which the injured can turn for help in putting back together their shattered memories and thought processes and dealing with their crushed emotions.
One place that professionals and patients are looking to as a model of what can be done is the Traumatic Head Injury program at Coastline Community College in Costa Mesa. It is the first low-cost program of its kind in the country, according to Pat Arlington, dean of handicapped services for Coastline. For a tuition of $50 a semester, Coastline provides the sort of structured "cognitive retraining" that was previously available only at New York University (at $1,500 a month) and a few innovative hospitals (at prices ranging from $3,000 to $15,000 a month), staffers at Coastline say.
In the Los Angeles area, long-term rehabilitation for the head injured is also offered by the New Pathways program at Daniel Freeman Memorial Hospital in Inglewood, Casa Colina in Pomona and Northridge Hospital.
Four mornings a week, 70 people with head injuries arrive at Coastline's Mesa Verde Learning Center in Costa Mesa. From their clothes to their hair styles and their casual flirting in the hallways, it would be next to impossible to tell these students from those at any community college in Southern California. And therein lies a key problem, a paradox of sorts that takes patience and a bit of philosophizing to understand, Coastline staff members say.
Hard Pressed to Understand
Because these people look, and in many ways act, much as they did before their accidents, friends and family and employers are hard pressed to understand the complex ways in which they have been affected. They fail to realize, instructors point out, that in a certain sense, the person who was injured didn't survive after all.
"When you think about it, what is man but the sum total of his experiences, which he can only remember?" instructor Bobbye Killian asked during a morning class at Coastline. "If you lose your memory, you lose yourself, and a lot of these people have severe memory problems. It's got to be the most hideous form of torture."
Ida Smithson, 30, would not dispute that remark. Two years ago next February, Smithson, who is now a THI student, was seated in the grandstands at Centinella Park in Santa Ana, watching a slow-pitch softball game. A batter struck out, and in a flash of rage, threw his bat. It cleared two fences and struck Smithson on the head.
"I'm a different person," Smithson said. "Part of my life is gone."
Repeatedly prefacing her remarks with what may be the four words people with head injuries use most--"It's hard to explain"--Smithson tried to describe how her life has changed. "I walk around and it's like there's something in my head," she said. "It's cloudy. I'm not clear-headed."