Tom Smithson clutched his wife's fur coat, watching expressionlessly as she and a young man danced to a rousing Cyndi Lauper tune.
In the two years since a runaway softball bat flew over two fences and cracked Ida Smithson on the head, her husband has quietly struggled to understand the various subtle and not-so-subtle ways in which his wife has changed, he said. Now, as he scanned the auditorium at Coastline Community College's Costa Mesa campus, where several dozen students in the school's Traumatic Head Injury program danced and laughed and sipped soft drinks, Smithson talked about how his wife's memory loss, her emotional swings, her sometimes scrambled thinking and her inability to drive or to properly care for the couple's 4-year-old daughter have changed his life.
'I Get Depressed'
"It gets a little hard at times. I get depressed and wish it would just go away, but I've accepted that it happened and I deal with it. . . . The only thing I'm pondering is, this could be for the rest of our lives. That gives me butterflies."
"They say that 90% of marriages have problems or break up following a head-injury accident," said Dyan Funk, 27, a student in the Coastline program who was injured in an auto accident near her Huntington Beach home last year. "After my accident, I overreacted to everything. I beat on my husband and my family."
But her husband stuck by her. "He pulled me through it emotionally," she said. "It's definitely harder on the family than it is on the person with the injury."
That seemingly stoic sentiment is expressed frequently by people with traumatic head injuries, and, according to Harvey Jacobs, an assistant research professor in the department of psychiatry at UCLA's School of Medicine, it may well be true.
Jacobs recently compiled the results of a yearlong study on the long-term effects of traumatic head injury on the survivor and family, and last month he and his colleagues at UCLA sent out 1,000 questionnaires as part of a second study.
"The problems are staggering," Jacobs said. "We're already getting back mail from our new survey, and it's absolutely heart-rending."
'People Are Desperate'
Although the new questionnaire bears a UCLA return address, one family was so intent on making their dilemma known that they found where Jacobs lives and hand-delivered the survey to his door, Jacobs said. "We're getting two- and three-page letters from families, and we've had at least 50 phone calls. People are desperate for any kind of help." Jacobs isn't surprised by the response. His original study of 325 Los Angeles-area families with a son, daughter, parent or spouse who suffered a traumatic head injury showed plenty of cause for despair, he said.
The study found, for instance, that:
--While 72% of those injured had been working to support themselves before their accidents, only 15% reported working as a primary source of income afterward, and most of those were making considerably less than they had been.
--Among the 20% of the head injured with children, only a third had been able to resume parental care.
--According to family members, only a third of the victims surveyed could manage their own basic finances.
--Of the 71% of victims who were living with parents or spouse, at least half required full-time supervision, and in half of those cases, a family member reported giving up a full-time job or dropping out of school to care for the person with the head injury.
The financial strain alone of caring for a person with traumatic head injuries is enough to tear families apart, Jacobs said.
Few Have Insurance
"Even 10 years ago, there was nowhere near the survival rate (for people with traumatic head injuries) that there is now," he said, adding that that explains, in part, why few insurance policies offer coverage for what may amount to a lifetime of rehabilitation.
The few long-term rehabilitation programs that do exist can cost as much as $15,000 a month, Jacobs said. And even without such long-term attention, the accumulated costs can be high. In fact, 28% of the families in Jacobs' survey reported that most or all of the family resources had been used to pay bills resulting from the accident.
"You have to admire what these families are doing, and understand the bind they're in," Jacobs said. "They have a loved one, and they're taking care of them. But they're under tremendous stress. Other studies have shown that families caring for people with head injuries have two to three times the number of physical and psychosomatic illnesses--probably because of the added strain."