Pretend for a moment that you are Gabrielle Giffords, about whom we are at last being told the truth. After 6 months of inpatient treatment, the best that money can buy, you can't speak fluently and must rely upon facial expressions and hand gestures to make up for words that vanish as you search for them. But continuing rehabilitation will not be available to you because your insurance won't pay for it.
Imagine yourself the victim of a serious brain injury: losing the ability to bathe yourself, feed and dress yourself, walk, and even think clearly. Imagine that the career you love will be lost, and that the people you once took care of must become your caretakers, unless you can get further treatment.
No effort or force of will can prevent your personality, relationships, and career from being seriously and possibly irrevocably changed.
Those are often the consequences of even a "mild" brain injury. Every 19 seconds someone in the US sustains a traumatic brain injury, and 90,000 Americans are left with long term disabilities each year. These alarming numbers do not include military personnel, tens of thousands of whom also suffer a TBI annually.
Unlike Gabrielle Giffords, their inpatient rehabilitation ends after 6-12 weeks, not 6 months. They will be discharged the moment they can transfer from bed to commode and use a walker, even if they are incoherent and cannot take care of themselves in the simplest ways.
Once at home, visits to a cognitive, speech or occupational therapist are limited by insurance policies to 12 to 15 hours total. Ready or not, you are then forced to rely on whatever resources you and your family can muster. No one will pay for the years of therapy that your recovery would require.
Giffords may someday be able to return to Congress, but she will need a great deal of assistance to track details of policies and news stories, read proposals, summarize meetings, and write speeches. These high-level skills will take years to fully integrate. Most brain injury patients do not have their job waiting for them, much less the medical care, support staff, and cognitive, speech and physical therapy to assist them with that job until they are up to the task themselves.
Giffords's office has urged President Obama to require that insurance companies offer all brain injury patients the same continuity, quality, and duration of inpatient and outpatient rehabilitation services that are being provided to Giffords at taxpayer expense. Congress should mandate this coverage so that ordinary people with brain injuries, both veterans and civilians, have a chance to return to their careers.
It is a national tragedy for a gunman to shoot a US congresswoman in the brain, but it is a national disgrace that most brain injured civilians and military personnel in the US never receive the therapy necessary to recover any semblance of their former lives.
Dr. Ruth Bettelheim currently practices as an Executive/Life Coach in Los Angeles. She was trained at the University of Chicago and UCLA, and has been a practicing psychotherapist and lecturer, for over forty years. Geralynn S. Knorr, MS CCC is the director of Cognitive Rehabilitative Services, which provides home and community services in language, cognition, physical and occupational therapy in the greater LA area since 1985.
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