My brain injury

My Impression of Rehabilitation – Six Years on
Introduction by Derick Wade.

I have learned much from my few significant (but not ‘serious’) illnesses involving hospital care, I hope to the benefit of my patients and those I teach. Healthcare professionals cannot experience all illnesses. We need to learn from our patients, by listening and by being curious and inquisitive, while respecting a patients privacy and wishes. Another way is to read about experiences. This page is written by David Wozny, summarising his experience. Details are given on his website. (here)

One really important sentence immediately struck me: “My mother had seen me find purpose in life through the various volunteering roles (see link) I became involved in, her exact words were: “You needed to be needed”.  My recovery approach could also be stated in a very short sentence: I desperately wanted to feel useful again.” People need purpose, a reason to get up each morning. For a more clinical explanation, see here. Read this and learn. Also, read another perspective from David here.

Written by David Wozny.

I suffered a brain injury when I was aged 45 in July 2015, due to a cycling accident collision with a car.  A shortened chronology of events. detailed here, is:

  • Comatose – four weeks
  • Hospital rehabilitation – ten weeks
  • Home adjustment – forty weeks
  • Vocational rehabilitation – fifty weeks
  • Normality – returning to work in July 2017
The impact made by my thankfully helmeted head on the vehicle windscreen

The bullet points above read to me now like a straightforward sequence of tasks to be executed in a methodical manner, leading to a seemingly inevitable outcome of returning to normality for me (employment).  The actual lived experience throughout my first ninety weeks of post-coma recovery was that I’d no expectation whatsoever of achieving the outcomes which actually transpired.  I never imagined I would ever drive a car, return to work, go on a holiday, or undertake any number of commonplace life experiences.  I reflect that despite having many ingredients for a depression soup, I’m proud that I didn’t allow myself to feel frustrated, never mind miserable.  I was mindful that my loved ones were experiencing their own inner torment, since my personal misfortune was directly impacting their lives at that time.  I knew that my TBI made their futures as uncertain as my own, since it was inevitable that my outcome, be it positive or negative, would impact them in a corresponding manner.  My resolution was such that despite having no expectation of a meaningful recovery, I outright refused to contemplate my becoming a burden to my loved ones.

The first use of my mobile phone post-coma

During my hospitalisation period I was often a little dismissive of visitors to the rehabilitation ward who’d endured trauma themselves, before making positive recoveries and were now available to share their experiences.  Despite chatting and engaging these folk, I simply couldn’t imagine they’d experienced trauma similar to what I was going through at that time and had then attained ‘normality’ in their lives.  When I contemplate my current attempts to engage TBI folk in the midst of their own trauma fog in hospital situations, I know I have a credibility challenge since I don’t look or sound like someone who’s experienced a severe brain injury!  I sometimes sense a disbelief in folk that I could have experienced life impacting events akin to what they are undergoing.  Once or twice I’ve sensed resentment of my positive outcome – rather than be dismissive, I find their perspective understandable.

A note posted by Ruth on my hospital room wall

In the immediate year following my injury, my personal outlook was that I’d never be in a position to work again in any capacity.  Consequently, I was initially dismissive of the benefits I could gain from engaging with any occupational therapists (OTs) which came my way.  When I first encountered an OT I couldn’t absorb how their role could help me, as I’d misunderstood their role to purely be supporting me in efforts to return to employment.  It would have helped me if my OTs had carefully explained what their role was in the context of supporting me, and what we could hope to achieve.  I now see that my OTs weren’t actually focusing on employment as an objective, rather they were crafting a way forward where I had planned structure and a purpose to achieve on a daily basis.  Beyond my initial scepticism, I subsequently engaged properly with OTs.  I feel that I moved on from simply “getting through each day” into my new realms of normality – albeit far removed from my previous normality of a challenging and stimulating job.

I lost 42 lbs during my 3 month hospitalisation period, the collar of my T-shirt is hanging limply.

In periods of thoughtful contemplation of my rehabilitation journey, I often ponder what aspects helped me the most.  I’m proudest of the pragmatic approach with which I applied myself to everything I tried.  I never felt that anything was pointless or beneath me, I was purely satisfied to have a purposeful activity to occupy me.  Taking on a befriending role with the Royal Voluntary Service, working in the storeroom for a charity shop or undertaking volunteer dog walking tasks were both fulfilling, and an opportunity for me to engage with people.  With the benefit of hindsight, I see how these undertakings helped distract me from any potential of wallowing in my own vastly diminished life purpose.  I consider it was the experience of meeting new people which stimulated me most, rather than the actual work I was doing.  I’d come back home each day with something new to discuss with my life partner.  Just as importantly, I’d have upcoming activities to plan or arrange, therefore giving me some structure to my otherwise featureless days.

Vocational rehabilitation as an IT buddy at my local library – I loved it

My impression of rehabilitation six years on, is that the most important characteristic I exhibited was acceptance, which was driven by my already mentioned determination not to become a burden to my loved ones.  Complementing this acceptance was my determination to not consider how my present state related to where I was in my previous life, which I knew would be a dark path of frustration and of no benefit.  On the contrary, I was determined to find satisfaction in the daily baby-steps of improvement, such as being able to cycle (on pavements) to my mother’s house or learn a new life skill, such as cooking an omelette.  On a practical level, I can see how my undertaking voluntary roles (vocational rehabilitation) was the single most important aspect of my rehabilitation.  The self-worth I gained through volunteering was enormous, although I didn’t realise it at the time – I was simply doing things to keep myself occupied.

My present time – contented.

To wrap this up, I’d like to express how I feel about my present life outcome – contented.  I’d never previously reflected on my mindset or my attitude to life events, this has changed enormously.  An example is that when taking my fifteen year-old daughter on a walk and during conversation she may inquisitively ask me of my feelings about death.  I typically reply along the lines of “I’m so contented in the now that I don’t fear or have any reservations about death, such that if / when it happens to me, she must reflect that her dad had found contentment in life.”

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