Perspective Chapter: Bambi Trauma – Surviving TBI Twice

Abstract

This essay tells you about my two experiences with traumatic brain injury. In 1993, a woman drove into me from behind as I was walking across the street (with the walk sign!). I had two brain surgeries, and was not expected to live or work again. I did. By 2016 I was a chaired professor of law. Then a young stranger attacked me, throwing me to the ground and leaving me bleeding from my head on the street. I survived that attempted murder. I am still a law professor, teaching, writing, and thinking. This essay tells you about the attacks and my recoveries, and how I learned to take care of my brain.

1. Introduction

I woke up in a hospital in Houston, Texas. I could hear some news about the presidential election on TV or from people talking about it in the hospital. It was November 2016. Why was I in Houston, as my home was in Nevada? Medical personnel and my brother told me a stranger had attacked me in Nevada. He threw me to the ground and told people there I was dying. I was in Houston to get the best medical care I could, at a hospital that specializes in brain injury.

2. The beginning

Bambi Trauma. That’s what they called me at the Las Vegas hospital where, on October 7, 2016, I was delivered after a stranger threw me to the ground and left me bleeding from my head on the sidewalk. It was an otherwise-peaceful Friday afternoon in Henderson, Nevada. The paramedics took me to the hospital; the police took my attacker to jail. Today, in 2024, I still do not know why I did not have my wallet on me, as I usually carry it with me. It took everyone a few days to find me.

My records tell you a story that I cannot remember. I’ve paged through the detailed records that the hospital gave me. I’m a good lawyer, and teach in a law school, so I always have records of everything. I am Bambi Trauma on the forms at the beginning, as no one knew who I was. Several things stand out to me. I was the victim of “assault,” suffering from “closed head injury” and “respiratory failure” [1]. I understand the first, as I was thrown on my head. But it is interesting to see how much work they had to do to keep me breathing. I was intubated at the scene of the accident as I could not breathe there. Apparently I suffered from “dyspnea,” or shortness of breath. My files report a “tracheostomy tube” I learned online that a “tracheostomy is an opening created at the front of the neck so a tube can be inserted into the windpipe (trachea) to help you breathe” [2]. Tracheostomy is the hole and tracheotomy is the surgery. I also had to look up the word “atelectasis,” which is the “collapse of a lung or part of a lung,” as it is listed I had that [3]. I also had a feeding tube.

I noticed a few times in my files the words “intracranial hemorrhage,” which is not something you want to have on your brain. They also talk about hematomas, or bruises on the brain, which are not good either. The records say they had to do an EVD on me. What is that? An External Ventricular Drain. Physicians teach me that if your spinal fluid is not working well, your brain is not really working in the right way. Sometimes they put in an EVD to get the fluid moving. Did they really carve an inch in my head and stick a drain in? Yikes! [4]. I think that’s what they did to impose a right frontal ventriculostomy catheter.

As I was leaving Nevada to go to Houston, the physicians summarized my medical experience this way:

P:

Neuro: Pt initially GCS 10T, intubated by EMS prior to arrival and remained intubated until she was trached on 10/12/16. GCS has continued to improve to a max of GCS 14 trach collared. Neurosurgery followed pt initially and besides R frontal subgaleal drain placement, didn’t require any other neurosurgical intervention. R Frontal ventriculostomy drain was removed 10/15. Completed > 14 doses of Keppra 500mg BID.

C-spine: C-spine precautions always in place and cleared after MRI c-spine negative for any ligamentous injury.

Facial Fractures: R temporal & maxillary bone fracture (non-displaced) on CT scan. ENT recommended non-surgical and for pt to remain under R ear water precautions & f/u outpatient PRN.

CV: Was initially bradycardic- in the 40’s, which EKG demonstrated sinus brady w/o any heart blocks or abnormal rhythms. That has since resolved. Hemodynamically stable during hospital stay, not requiring any pressors.

Resp: Intubated prior to hospital arrival and had Trach placed 10/12. Had moderate R pleural effusion and atelectasis-resolved after switching Vent to APRV mode. No thoracentesis required. Has been using trach collar for more than 48 hours and tolerating well without any hypoxic events.

GI/Nutrition: Initially was NPO. PEG placed 10/12. Tolerating tf at goal. On Dulcolax for bowel regimen.

Hematologic: Thrombocytosis -resolved.

MSK: No injury. Initially had flaccid RUE but has regained some strength and is now 3/5 and equal with other extremities Has been OOB with PT/OT and tolerating well.

ID: Received 1 week of Ancef, after subgaleal drain placement. No evidence of infection during hospital stay [5].

I cannot tell you anything about the month from October to November. Many other helpers have filled in the details for me. I was in Las Vegas’s Sunrise Hospital, and then my family flew me to Houston, Texas, where I became a patient at the TIRR Memorial Hermann Hospital, which specializes in brain injury. The attack was October 7, 2016, and the flight to Houston was October 27. I do not remember what day I woke up in Houston. I was awake by the presidential election day, November 8, 2016. I was upset that I had not been able to vote. I was trying to figure out what I had missed as Donald Trump defeated Hillary Clinton. I am a tenured constitutional law professor, so of course the presidential election received most of my attention. I always tell people that when you vote for the president, you vote for the Supreme Court. I knew the Court was at stake in that election, and later events proved that it was.

That means I have not one single memory of the attack or of my comatose and near-death state in the hospital. Everyone wondered if I would survive.

I did. I went from TIRR to a Houston rehab clinic, then to a hotel on the University of Houston campus, and finally to a friend’s house in Houston. I used to teach at the University of Houston, which is why everyone had chosen Houston as the place to go post-Las Vegas. They took good care of me there. I went home to Nevada on December 23.

Why did I survive and work again? I provide here some reasons why I think I did.

3. The relevant past

I was and am an independent person, with strong opinions and a lot of determination. That helped my recovery post my almost-murder. Why? You will be amazed to hear that on April 6, 1993, in Phoenix, Arizona, I was hit by a car from behind as I was a pedestrian crossing the street with the walk sign (Figure 1). Smash to the back of my head. I had two brain surgeries on consecutive days in 1993. I was in a coma for a while. All the news was bad. Many people told me that brain-damaged people could not survive, work, or function, and that they had to live permanently in rehab. Some of my rehab associates told me that I should stay in Phoenix for long-term rehabilitation.

Figure 1.

That’s what it looks like to be hit by a car!.

I did not. My terrific surgeon, Dr. Arnold B. Calica, wrote a letter about me on April 20, 1993, explaining I “underwent two craniotomies within 48 hours after being struck by an automobile. Her life was in serious danger, and her condition was critical” [6]. Even reading the records today, 30 years later, my medical picture appears grim. The documents record my “left epidural hematoma intracranially” and my “right temporal intraparenchymal hemorrhage” [7]. Other reports said: “She did have loss of consciousness and was reportedly combative. She has remained somewhat inappropriate since that time” [8]. One word I saw a lot in reviewing my day-to-day medical records was … headache! I apparently had a lot of headaches, which is unsurprising after two brain surgeries. Tests showed a lot of deficits with memory and reasoning problems. I went to in-hospital rehab on April 12, when “cognitive dysfunction was present” [9]. They sent me off to the non-hospital rehab center on April 23rd.

I burst out laughing when I read the chart from April 13, 1993. “Nursing states pt awoke during middle of night last pm wanting a snack. Requests an hs-snack. One is being set up” [10] Why did I laugh? Even today, when I am hungry, I want food immediately. No delay acceptable. Without food I get completely cranky. True in 1993, true in 2024! Later, on April 16, I rejected the hospital’s worksheets, saying they were “silly” and that I was “too tired to participate” [11]. That sounds like me too. I apparently complained “I’m being held against my will” [11].

At first rehab review, “[i]t was determined on her psychometric evaluation, she was having a wide variety of neurocognitive memory and attentional deficits with visual spatial and frontal areas impaired. Her overall intellectual function was thought to have probably dropped and that was specifically in the performance area, visual spatial areas and verbal cognitive areas” [12].

I spent April 23–30, 1993 at one rehab hospital. After that, I visited the Adult Day Center at Barrow Neurological Institute from May 3 to May 14 [13]. At Barrow they noted “deficits in the area of visual perception and executive functioning. There were also some indications of memory deficits” [13]. My medical history shows problems with the Wisconsin Card Sorting Test. After that, I was not so good on the Booklet Category Test and the Oral Symbol Digit Test, the Trail Making Test, and the Tactile Performance Test. I suffered “moderate impairment” [13]. “They noted there are still a number of areas which are significantly below her premorbid abilities. These include delayed visual recall, overall speed of information processing, tactile perception, psychomotor tracking and simple motor speed” [13].

I observe in the reports that my communication was above average, and I had high reading comprehension. On those issues, I had a “superior level of functioning” [13]. My picture naming, however, was slow. It remained slow in later months when I faced more tests about how well I could copy a picture. And definitely my neuromuscular tests and balance were not as good as my words skills.

That is what the papers say. I remember hating rehab, and in particular many of the neuro games we played. On one test, the staff said I was too slow, and did not use the fastest way to solve the problem. I responded that I had to consider every option slowly, as I was a law clerk who always had to see all the options. I had a different problem with the Wisconsin Card Sorting Test. They ask the patient to identify the criterion determining their movements. But the criterion always changes. I thought they should have said criteria instead of criterion. I saw that as an inconsistency and therefore did not like the test. And kept failing it. People to this day say I am much too literal and the Wisconsin test probably proves that.

Once I went to out-patient rehab I was living back in my apartment. I needed a Lifeline machine that will beep and notify people if you fall or hurt yourself. I had generous neighbors who always kept an eye on me to make sure everything was okay. I was not allowed to drive, and had to spend time going to rehab, which, let me repeat, I did not enjoy at all. The one medical issue I faced was that I developed vertigo, and went to the hospital once to check on that.

I went back to work in Judge Schroeder’s office on May 17, where everyone welcomed my return and supported my recovery.

On June 3, 1993 Dr. Calica wrote a memo about my frustration with intense neuropsychiatric therapy and noted I would like to stop. He thought I could leave it, and noted I was working half days at my legal job without frustration. It is true doctors always expect frustration from a brain injury patient. You get frustrated if your brain is not working the way it used to. In a later memo, July 13, 1993, Calica told the state of California that I was capable of driving.

The rehabbers noted my hyperverbality and gave me an MMPI-2 test. They wanted to keep an eye on me because of some weaknesses in all my testing.

Today, I still have stacks of files connected to this accident. The files remind me I had lawyers who handled everything, collected all my bills, made sure everything was legally sound, checked with my insurance and the driver who hit me. The bills are enormous, and both times my insurance covered most of them. That experience is why I always want everyone to have health insurance. I had federal employee health insurance the first time and state employee insurance the second. It does pay most of your bills, which is much better than paying thousands of dollars yourself.

I left Phoenix, and attended the Harvard fellowship I had won before the accident. I had a doctor there who had worked with a brain-injured patient and knew the patient had recovered. Her confidence in that patient added to my own growing sense that I could be okay. Neuropsychologist Dr. Dorene Rentz guided me through the ups and downs of brain recovery and stress.

For the record, the medical tests that my Nevada doctors did on me in 2016 observe that I had had two craniotomies (Figures 2 and 3) [14]. The effects of surgery stay on your brain! The experience of Phoenix stayed with me in Nevada. I had survived brain injury before and knew that I could do it again.

Figure 2.

My brain (1), October 2016.

Figure 3.

My brain (2), October 2016.

4. My characteristics

How did I survive this? First, I was almost always cranky. There’s no way around that. In my mind, there is nothing good about being in a hospital. Nothing at all. All of it is terrible. I expressed my crankiness quite frequently.

My friends have all told me that no matter what anyone did, I was always trying to get free of the hospital, of the room, and of any restraints they placed on me. Everyone was horrified by my actions, and I think some believed it was proof of my brain damage. My attempts meant I did not have the discipline to stay put. The hospital staff closed my bedroom door, blocked the elevator, kept their eyes on me, etc., etc., etc. It bothered the rest of you that all I wanted was to be free. In my mind, it is a sign of health. No healthy person wants to be in a hospital, and so I joined the healthy in trying to escape. I was always cranky when I could not.

My brother tells me he has a friend who works with brain patients. She warned him that once I came to, I would be horrible to deal with. He tells me that I was. I kept telling him negative things and how I did not like anything, including him. He dealt with it because she told him that being cranky is part of recovery. I am proof of that.

This cranky person is also independent. I like that word, “independent,” more than the word “autonomy,” a word we traditionally use in bioethics. I teach Bioethics, which is the ethics of medicine and medical research. In Fall Semester 2016 I was using the first edition of my casebook, Practicing Bioethics Law, to teach a seminar at the law school. So I knew a lot—academically—about patient autonomy, a term that usually means that the patient gets to hear full information from the doctor and to give her informed consent to any procedures she undergoes.

I was independent in Nevada and Texas because I had that 1993 experience in my brain and in my body. I had definitely beaten the odds in Round One. Let me emphasize, it was not easy. Nevertheless, from 1993 to 2016 I attended my fellowship at Harvard University, received a tenure-track position at a law school, worked in the Office of Professional Responsibility at the U.S. Department of Justice, got law-school tenure, received a chaired position at one law school, and then a chair at another school, wrote many articles and textbooks, and filed some amicus briefs in different courts of appeals. By October 2016 I was leading the good life, and not even thinking about whether I was brain damaged way back in 1993.

My attacker tried to take all that away from me in 2016, as the car driver had in 1993. Why was I independent as well as cranky? Because no one was going to tell me that my brain did not work. No one. Period. Family, friend, doctor, researcher, genius. I did not listen. I told myself they had been wrong before and now were wrong again.

Admittedly, it is easier the second time than the first. By then you know better than anyone what to expect, and have learned life lessons that never desert you. Brain Injury 2? I had survived Round One so I knew what I had to do.

Do you prefer the word stubborn or resilient? Allied to my independence was a stubborn commitment to my well-being, through thick and thin, good and bad. A good friend who works in medicine tells me stubborn sounds negative, and resilient is more positive. I agree. It is. But I think stubborn describes me better. Whatever happened, I stubbornly proceeded as if I were healthy and my brain was still functioning. From Injury 1, I knew that recovery would take time, so I gave it to myself. I knew recovery was not a sign of permanent damage. It was just part of the long slow process that recovery involves.

For every medical person reading this, I want you to acknowledge that recovery takes time. I knew that, so I waited for it. My insurers were not as patient. At the beginning of my injury, they were ready to give up on me after 2 weeks, suggesting I be sent to a permanent rehab home because the 2 weeks made it clear I was not going to heal. My insurance law colleague had to fight with them to extend their coverage. My advice? Do not watch the clock. Rehab takes time. Families, do not give up on your loved ones too early. Many of us are still in there, recovering, and just waiting for the opportunity to tell you how terrible the whole experience is and how glad we are to see you.

Traumatic Brain Injury also involves sorrow. I will not pretend that going through brain injury once or twice was fun or relaxing. I was filled with sorrow. I could not believe that I would have to prove my intellectual talents again, as I had been required to do in 1993. Then 59 years old, with my chaired professorship, would I really have to convince people I could still think? By pure coincidence I was on sabbatical in spring 2017, so I used the time to rest. I gave three talks, two that were scheduled pre-attack. At a bioethics conference, I talked about my experience of attack and injury. No one seemed to believe I was too injured to work.

Imagine going back to UNLV in Fall 2017 to teach my first law class after everyone knew about the whole trauma from reading it in the newspapers and talking about it at school. And, of course, there were all those students who had lost me halfway through the Fall 2016 semester. I kept wondering if students would quickly recognize I was brain damaged and start talking about it among themselves. That was a lot of stress. Recovery from brain injury is bound to give you stress.

Yet I kept going. But I felt incredible sorrow that I had to go through this a second time. I had strength from having learned about it the first time, but sorrow that I had to prove myself again.

I believe that my strength came from the first experience. I had learned once that the brain can recover. It was a lesson I knew and remembered, and I did not have to learn it again. I knew it with all my heart, soul, and mind, and that memory kept me going even when times were hard, even when everyone else was giving up on me.

Were times hard? Yes. In 2017, I wrote about the attack, and noted that I felt fear and caution [15]. I did and I do. I think any hospital experience of illness brings about those reactions. It is hard to live when your body has been beaten to a pulp, or to survive when you have almost died. Your body needs recovery time to get your strength back. Recovery does not come all in 1 day. It takes time for the various parts of the body to heal. Any patient knows this and may show it in fearful and cautious use of their body parts. We do not want to reinjure body parts that have already survived an attack and much illness.

I had an additional fear and caution, both times. A driver ran me over, and a stranger tried to kill me. Neither illness started in my own body. The injuries were imposed by others. Post-1993, I used to joke that you could tell me I was winning the Nobel Prize in a crosswalk and I would not hear you because my eyes were always on the traffic. Today I do not let anyone walk behind me. I live in a beautiful Nevada park. I’m sure it looks weird that I always look behind me and sometimes stop so people can pass me. Why? Because someone tried to murder me from behind. I do not remember the attempted murder, but my body is always protecting itself. Why? I think fear and caution are a normal part of the patient’s life, and being an attacked patient makes them worse. I accept my fear and caution as a normal part of an attack victim’s life, and never dismiss them as a weakness.

I also know that you have to respond to brain injury with confidence. To get through the hell of brain injury, you need to have confidence. Why? Because in my view the best thing you can do is keep your brain working, not accepting that its prime is past. You’ve got to believe your brain is working and keep using it to show it can work. Otherwise, it will just rest until it gets worn out from not working at all. It matters if you keep telling patients they can and should use their brains. That is much better than telling them to rest all the time, as my hospital doctors used to do. You cannot work all the time, but you can use your brain and keep it active.

I really know this lesson about confidence. In 1993, no one was confident about me. A lot of doctors told me the brain could not heal at all. Once it was hurt, they said, it was gone. They gave me tons of tests in rehab to prove that. They urged me to rehab my way through life and accept all the limitations that a car driver had imposed on me. All those negative talks influenced me in the post-1993 years. I always felt that I had to prove myself to other people. I did feel like I had to show I was not the brain-injured legal clerk who had lost her career on the streets of Phoenix. Being told you are brain damaged and cannot do anything because everyone will notice your injury does not aid your health. It is a terrible way to go through life. The negative message undermined my confidence for years. But I stubbornly kept that confidence because it was the only thing that kept me going.

For the record, I think all those brain tests proved I am not an athlete! I later learned from my athletic coach that no one can survive negative people with negative world views. Athletes take failure as a lesson, not as a reason to stop working. Many brain-injured people stop thinking because their helpers keep telling them they are brain injured and cannot get better. That discouragement takes recovery away from people. I know that because I faced it and confronted it. For the first injury, the rehabbers’ negative remarks stayed with me long-term. I had to face the negative down. Fortunately, my neurosurgeon and my Massachusetts doctors were much more positive, so I kept strong in my own confidence by hearing their confidence in me and in their other patients.

5. Others

That’s why every patient needs at least one advocate. I was lucky because I had many, through first and second injuries. My mother was still alive during the first, and my siblings during the second. They flew in to see me and to help however they could. Many people, including my colleagues and students, visited me repeatedly, keeping me company through my agony. Or, at the beginning, they told me, they just stood there hoping I would wake up and talk to them. Colleagues whose career is studying insurance and health law made sure my insurance would give me full coverage and help instead of hurt. Many friends stayed up on my down days. They did tons of work that I have completely forgotten. Pulling for me and, of course, taking over my classes when I could not teach anything.

I’ll say it a million times. TBI is a terrible experience. It tests every element of you and your life. After the second attack, I thought a lot about quitting. Retiring. When someone almost takes your life away, you wonder if you should keep working. You wonder if it is not better to quit, especially as many people think you cannot work. So why try? Let me repeat what I said above. Your brain will not work if you do not use it. It’s like any other part of body exercise that I learned from my coach. If you do not use it, you lose it. So TBI survivors everywhere, do not let anyone tell you to stop trying. Do not overwork your brain. But use it to keep it strong. You can retire from many things, but do not quit. Be patient with a slow recovery, but do something for your recovery every day.

I’m grateful for all the help I received from so many, family, friends, colleagues, students, nurses, doctors, and rehab experts. UNLV had to fill in for me with other professors when I could not show up, mid-semester, to do my job. And there was never any thought that they were going to fire or replace me because of my illness. That is lucky, because some TBI patients lose their jobs very quickly.

Yet you also may have to recover alone. Especially women. There are many studies now that show that women receive different medical treatment than men [16]. Medicine is often geared to men’s bodies more than women’s, and women’s complaints of pain are also taken less seriously than men’s [17]. I have seen studies that women patients lose caretakers more quickly than men do, and that many women lose their spouses because the husbands cannot tolerate the wives’ injuries. Without a caretaker, you are alone. Women often are, as I have been. Recently I told my athletic coach what I concentrate on and what’s important in my thinking of day-to-day life as someone who has recovered from brain injury. And he said, “no man would want to put up with that.” It’s a stark statement, but there is some truth to it. If you are focused on rehabbing your brain so that it works as it always did, you may spend a lot of time alone, just making sure your brain can work. That may not appeal to you, but it also may be a part of recovery for many women who suffer TBI.

6. Lessons learned

I wrote in such detail about my TBIs because I think it is very important for people to understand the lived experience of the patient’s brain injury. Dr. William Winslade was my colleague at the University of Houston Law Center, and then invited me back to the University of Texas Medical Branch (UTMB) at Galveston post-my attempted murder. Winslade has had a significant effect on bioethics and medicine. The title of his book, Confronting Traumatic Brain Injury: Devastation, Hope, and Healing, captures much of what brain injury patients go through [18]. I hope this chapter shows you how devastation, hope and healing affected me. Twice.

Like me, Winslade faced a brain injury that was supposed to kill him or ruin his life. It did not. He has lived a full and happy life. He knows, as I know, that one successful patient can help another to heal. If I can heal twice, you can heal too. Medicine needs to be full of the stories of patients who heal, not only of those who do not.

Doctors need to remember this. Sometimes doctors expect everyone to follow the same scientific experience. As they told me in Phoenix, brain damage ends your life. Period. Do not ask us about that, they said. Just know your life has changed.

In contrast, some doctors have emphasized that, while technology gives great insight into human health, medicine should never lose sight of the “physical exam and humanistic aspects of medicine. Overall, a machine cannot offer a shoulder to cry on, a warm hand to hold or words of comfort during a life-altering diagnosis” [19]. The “iPatient” [19] is never the whole patient. These doctors hope that artificial intelligence “can allow us to spend more time interacting with our patients” [19]. This is what patients look for. Doctors who understand their experience and give them hope.

I still hate to look at the brain slides I attached to this chapter. But my story should tell you I am much more than the iPatient pictures the doctors interpreted. They had to deal with me and not just with my technology.

Neuroscientist Adrian Owen explained this in his book, Into the Gray Zone. He learned that medicine involves both caring for people and scientific discovery [20].

Joseph Fins is a doctor who has taught us so much about the brain. Dr. Winslade introduced me to Dr. Fins when Fins gave one of his brilliant lectures at UTMB. Unbelievably, before Fins met me, some of my colleagues had asked him at a different conference if I would be able to recover. As a surgeon, Fins understood that patients are in different circumstances. He explained that some patients achieve a minimally conscious state that gives them the ability to communicate and relate with other people [21].

Fins emphasized that brain injury had taught him, and should teach us, that patients have a right to care. In law and bioethics, we frequently discuss the right to die. There are lead Supreme Court cases on death that are in the early chapters of my bioethics book. Remember Karen Ann Quinlan and Nancy Cruzan, two cases about just what rights individuals have about their deaths and how to manage them? [22].

Dr. Fins says brain injury should teach people to care for our patients, who are all in different circumstances, not just about their deaths. He invited me to talk about Neurorehabilitation and Society: Going through Hell, at the 2022 International Neuroethics Meeting. His important book has another inspirational title: Rights Come to Mind: Brain Injury, Ethics, and the Struggle for Consciousness [23]. Rights. That’s what bioethics is supposed to support. Patients’ rights to live and be healthy. My insurance company, you learned above, was ready to give up on me too early. Patients need care and attention, and it usually takes time and patience for them to heal.

As I’ve tried to explain in my story, brain injury patients are often ignored, told they cannot live well and that they cannot recover. Fins’s awareness of the treatment of brain-injured patients made him a member of the community of advocates for the disabled. In one article, he joins a group of scholars explaining that the Americans With Disabilities Act has not done enough to integrate the disabled into society. These authors propose instead an Americans With Abilities Act. They identify different ways the law can help people live lives of ability. They explain how their statute will work “prospectively through the provision of technologies that help individuals achieve their forward-looking potential” [24].

Abilities, even in the saddest circumstances. Their message is positive. As the message must be if patients are to recover. It was the positive, pro-future people who always helped me.

As a last note, I rarely talk about any books or articles on insurance. I know people who do not believe in health insurance, or do not want to pay anything for it. I have a very strong message on this, and it does not rely on anything I’ve read. I tell people you never know when one—or two—days may require you to pay a lot of health bills for injury to your brain. Be sure to get insurance so that if TBI happens to you, you will not have to pay thousands and thousands of dollars in bills.

7. Conclusion

I hope you never have to join me on the recovery road. For those of you who do, stay positive. You can do it. With the help of your medical personnel, who should know they should always send you a positive message that you can do well. That you can use your brain and build your future.

But remember it is your brain, not mine. Mine is good at communication and writing, which are academic skills. Today it just amuses me that my athletic and other talents are not as good. I can accept that. I am happy I am still working. The rest of you may have different talents. Do what your brain allows you to do.

The brain is remarkable. So be sure to use yours.

Conflict of interest

The author declares no conflict of interest.

Acknowledgments, notes and thanks

Many people saw me through these traumas. My late mother, Doris Schanning Griffin, my sister Deborah Griffin, and my brother Joe Griffin. Dr. Arnold Calica was a fabulous surgeon who helped me get back to my clerkship with the wonderful Judge Mary Murphy Schroeder in Phoenix. Dr. Dorene Rentz helped cure me from the first accident. Kevin Worth supported all my efforts to heal. Ruben Garcia and Tori Carreon helped find me in the Las Vegas hospital after I did not show up for a Friday night dinner. Stacey Tovino is a great health and insurance lawyer. Joan Krause is also a health care lawyer who paid my bills and kept her eyes on things while I was unconscious. Darlene Walker visited me in the Houston hospitals and took me into her home post-discharge. Nadine Matta Balombin offered steady care. Vegas’s Nancy Rapoport, Whitney Short, and Erica Medley kept me focused on recovery, and made sure my legal papers were in order. Dr. William Winslade and Dr. Joseph Fins gave me great insight into the brain and encouraged me to write about it. And there are many, many more, to whom I send my thanks.