Concussion!

Head injuries are in the news. Most of the news is from the sports angle and the impacts it has on kids playing football or even professional ball players. Some people have died from head injuries. Well, I talked a little about the physical effects of being in a car wreck, and how I weaved it into my story. One thing I didn’t discuss much was the impact the car wreck has on the human brain.

First, let’s talk about the story. When Will’s patrol car, Trigger, gets slammed off the road, he spends several seconds looking at the ceiling of the cab. He isn’t thinking. There’s a smell (gasoline) he can’t place, and his feet are wet. He isn’t online enough to figure out that the gas tank may have ruptured and that the car is in water.

While Will is wearing a ballistic helmet (same type we wore in the military), and it no doubt saves him from cracking his skull wide open, what it doesn’t do is provide good brain protection. Here’s why.

The brain is a computer. Those of us in the trade have a term for it. We call it “wetware.” Where your typical computer is built of metal and plastic and is hard to the touch, the human brain isn’t. It’s soft, and floats in the skull. The skull (think of it as a case) protects the brain. Between the brain and the skull is fluid that helps to keep the brain from sloshing around and impacting the skull. Understand that there isn’t much space between the skull and the brain. Anything that impacts the skull can have the force of the impact transmitted almost directly to the brain.

The human brain is amazing. I remember the first human brain I ever saw was in a biology lab in college. It was in a bottle of preservatives and just floating freely in it. It was amazing to think that collection of tissues represented a person. Everything you know, everything you ever saw, heard, or experienced is locked away in that roughly three pounds of cells.

No matter how you look at it, if it’s the end result of billions of years of evolution or the end product of an amazing God, the brain is an incredible piece of engineering. But like anything complicated and so ingenious, let something happen to it and you’re in trouble.

This is what’s happened to Will. The force of impact has shifted his brain so it slammed into the skull. The effect is a bit like taking a punch to it. Blood vessels break and there could be localized bleeding. The bleeding causes an increase of pressure on the brain. Since the brain itself has now been damaged, it swells a little to help protect itself and begin the healing process.

What we have here is what we call in layman’s terms is a concussion. Will is experiencing one full force. These are some of the symptoms of a concussion, and describes what Will felt. I’m also adding my experience to it.

CONFUSION – It takes him several seconds and RJ yelling at him to realize that Trigger is in water, the water is streaming in, and that he could drown. Additionally, he finally realizes he smells gasoline, and that’s not a good thing. Confusion and an inability to focus are hallmark symptoms of a brain injury.

When I had mine (I wasn’t blown up or in a car wreck. Nothing so dramatic. Mine was the end result of being stupid out of season – and one day I may post the whole story), I recall asking a nurse at the hospital if what was going on was even happening. I wanted to know if this was real. It seemed more like I was in the middle of a bad and very disorganized dream. I remember her assuring me it was.

I also recall making a statement that made no sense to anyone at the time, but explained perfectly how I felt. I said, “Now I know what a computer in the middle of bad reboot feels like.” I just couldn’t focus or get it together. It was as if my brain had been removed and someone was nice enough to replace it with a pillow.

MOTOR SKILLS – Will experiences having trouble making his body work. He fumbles for the seat belt latch, and he can’t seem to make his hands work well enough to work the release. Impaired motor functions could also be indicative of a concussion.

In my case, my hands wouldn’t work. I couldn’t make them hold anything and the most simple functions seemed beyond me. I couldn’t make my body work the way it was supposed to, no matter how hard I tried.

CONFUSION CONTINUES/HEADACHE – Even when he gets out of the car, Will finds himself unable to think clearly. He stands up while being shot at. RJ has to pull him down. He complains of a terrible headache.

My head felt terrible. I couldn’t feel it, but at the same time it hurt, if that makes sense. It was like I had an intense amount of pressure in my head. I felt like if I moved wrong, it would pop.

FOCUS – Will is in the middle of a tactical situation, needs all his wits about him, and doesn’t have them.

Common sense things seemed beyond me. I remember being x-rayed, and I noticed a knob on the machine. I was intensely fascinated by it, and reached out and started playing with it (or trying to). The tech had to ask me not to, and to stay still. Like Will, I was doing stupid stuff.

Will finds himself falling back on training and preplanning (when he remembers it). When they see several armed people approaching and moving in a V formation, he wonders if they might be his people. Using a prearranged signal, he gets rifle fire instead.

It seems there’s nothing wrong with his targeting skills because he’s able to drop one of them.

But when help arrives, he recognizes the person but can’t believe he’s actually seeing him, or can’t understand what’s happening a hundred percent.

RJ is having to really watch Will. When they see the others approaching, it’s RJ who has to ask Will if he has a flashlight, and reminds him of what the code is. Three dots and a dash, the opening to Beethoven’s Fifth. Interestingly, when RJ mentions the Fifth, Will knows what he’s talking about.

When fired on, Will knows what to do. This is because he’s trained for it and it becomes automatic.

SPEECH – Will tries to speak with a wounded assailant, only to find out a language he speaks fluently (Russian) isn’t coming out right. Additionally, he’s slurring his words. Some people who have experienced a concussion actually have reported the inability to speak for a while afterwards. Interestingly, they might not be able to speak, but they can sing and swear. Those functions are handled b y a different part of the brain.

In my case, I found myself speaking German to the doctor. Talk about having your brain scrambled.

SYMPTOMS INCREASE – Will’s inability to focus is getting worse. Light and sound causes his headache to increase.

NAUSEA – Finally, he experiences nausea, starts throwing up, and collapses.

I don’t recall getting sick, but it is a common symptom. Nor did I collapse. I couldn’t have stood up if I wanted to.

All these are classic signs of a bad concussion. A person can get one from falls, car wrecks, or walking into something. So, it’s not just a sports related injury.

The after effects of a concussion can also be troublesome. There can be changes in a person’s personality. Or skills a person once had are gone. I used to be able to look at a page and be able to quote it back to you. Now I’m lucky if I recall a few sentences. I used to be able to do complex math in my head. Not anymore. Thank God for calculators.

I also write everything down. If I learn something new, I write it up. This gives me a good record of how to do something, and reinforces it in my brain.

Mine was a rather extreme case (I wasn’t expected to live and if I did, I’d be childlike the rest of my life). I do feel I’ve lost some of my abilities after the incident, but I also feel like I’ve gained from it. I’m more driven today, and I have more empathy for people. From my viewpoint what was lost was really a gain.

All this to say, never take any kind of head injury lightly. You don’t have to be in sports or combat to experience one. You can get one just walking down the street, tripping and falling.

If, following an accident, you experience any of the symptoms above, get medical attention.