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Brain injuries are a hot topic in today’s media. Whether it be football players with lasting damage due to concussions, soldiers suffering from brain injuries due to overseas conflicts or the latest youth sports concussion protocols, it seems that there are suddenly many news stories on brain injury that simply were not around just five or ten years ago. Some individuals may be cynical and wonder whether brain injuries are simply the “diagnosis of the moment”, one of the many diagnoses that are suddenly “hot” but will disappear over time. To those individuals, I would like to offer several rational reasons why brain injury stories have become more prominent over the last few years.
First, many people are now living with brain injuries who would have died from their injuries in previous eras. The medical world has advanced significantly over the years and now doctors are able to save the lives of people who would have otherwise died. However, just because their lives were saved does not mean they emerged from their health emergency unscathed. These survivors often have brain injuries which require treatment. Please allow me to give an example of this change over time. I once was talking over lunch with an older rabbi about Moody Neurorehabilitation Institute. He relayed a story about his time at a synagogue many decades ago in Indiana. A young man in his community had a serious motorcycle accident and as his rabbi, he visited the young man in the hospital. After conversing for a while and finishing his visit, the rabbi exited the room. As he left, the doctor pulled him aside and said “You know he will be dead in three days”. The rabbi was shocked, having just had a full conversation with the young man. But the doctor was correct. The hospital had no means to manage his brain injury. Due to either brain swelling, bleeding or both (the rabbi did not know the details), the young man passed three days later. Today, a person with a similar motorcycle accident would have a surgery and other potential procedures to manage his injury and would stand a good chance of living, albeit with a brain injury. Similarly, improvements in military field medicine are allowing many soldiers to survive blasts and other dangers that would have killed them in previous battles. Thankfully, these soldiers still have their lives, but often struggle with long-lasting brain injuries suffered in their military service.
Second, it is important to acknowledge the active suppression of information regarding brain injuries in certain circles that is only recently coming to light. Most famously, the NFL actively denied and hid data on the long-term brain injury effects of concussions to former football players. Through a series of lawsuits, the NFL opened up about brain injuries and is now acknowledging the long-term injuries that many former players have suffered. This has led to a complex $1 billion settlement for players with long-term effects of brain injuries. Following these court cases, many other lawsuits have been filed against other professional and amateur sports, leading to further agreements and new safety protocols. The suppression in the past contributed to an artificial perception that brain injuries were less common than they actually were.
Third, we are in an age of information so it is much easier to learn about what is happening to people across the country, and even across the world. Just think about how often you hear or read stories about a robbery or kidnapping occurring hundreds of miles from where you live. Until the age of the internet, most of those stories would be confined to local media. Now, stories can go “viral” and suddenly everyone knows the details. This phenomenon is equally true in the realm of brain injuries. A simple keyword search of “brain injury” will bring up a plethora of local stories that prior to the age of the internet would have been hidden from most of the world. These local stories existed in the past but only now d0 we have so much access to them.
Fourth, we are now having a more honest conversation about brain injuries. In the past, people generally did not talk about brain injuries. Athletes and soldiers rarely mentioned their deficits due to fear of sounding “weak”. Individuals with brain injury deficits from car accidents, strokes or other methods were often afraid of negative views and discrimination if others knew about their deficits. We are now coming to an age of sharing without fear. It may be hard to believe but the Americans With Disabilities Act (ADA), the civil rights legislation that has allowed for a greater involvement of people with disabilities in the workplace without fear of discrimination, was only passed in 1990. In comparison, the Civil Rights Act, which blocked discrimination due to issues such as race, gender, and religion, was passed in 1964.
Fifth, we are much more able to diagnose and treat brain injuries than in the past. Technology such as MRI and CT exams to scan the brain and locate injuries are relatively new. Moreover until fairly recently many people, even health professionals, did not even know the right questions to ask to identify a potential brain injury. For instance, if a high school athlete is concussed in a game today, the coach and athletic trainer often have a protocol to follow to ensure proper health management. Twenty years ago, the player would likely have been just given smelling salts, asked if he or she felt “okay” and sent back into the game. In fact, many states now have mandatory concussion training for coaches and athletic trainers. This was unheard of just a few years ago. In the past, people with brain injuries were forced to suffer in the silence of unrecognized deficits. Now, these brain injuries and their concomitant deficits are more likely to be accurately diagnosed.
Overall, there are many rational reasons why we are “suddenly” hearing about brain injuries in the media, despite these injuries having been an issue in the past.
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