September 1, 2000

Life journey interrupted

Imagine a man going for a walk on a remote stretch of New England beach one bright, late winter afternoon. His senses are wonderfully alive, as if in praise of the coastal beauty. His thoughts are briefly interrupted while turning to view the distance already traveled, footprints capturing his imagination. Upon returning his attention to the distant horizon, the walker comes to the slow realization that he is in the midst of an impenetrable fog unlike any other that he has ever known. Out of the clear blue sky has come this phenomenon so powerful as to make the prospect of returning safely home both a dream and a nightmare. The crashing surf, screaming seagulls and solitary surroundings are frightening, as are his growing fatigue and seemingly diminished powers of reasoning and comprehension. Without a vision for a positive outcome, he soon will become helpless to himself – the future hopeless indeed. Two years later, the man is finally able to write a few words about part of this experience. I am that man and these are my words.

Some patients who have suffered a brain injury describe their post-injury life experience as a homeward journey in an otherworldly fog. The cognitive rehabilitation program "Steps to Success" offered at the MGH was created by Sucheta Kamath, MA, CCC/SLP, of the Speech-Language Pathology Department, and is designed to help those who are lost in this so-called fog. The intensive, six-week program is available to certain patients who are being treated for mild-to-moderate traumatic brain injury, resulting from either an external impact or an acquired condition such as a brain tumor.

Most important, "Steps" is an ongoing process concerning the patient's own recognition and acknowledgment of brain injury. Only with such self-awareness is the patient truly able to participate actively in treatment. This process is intellectually difficult and emotionally painful. With great compassion, Kamath helps her patients learn how to improve the memory, attention and information processing skills that were compromised by brain injury. The regimen of rigorous mental exercise administered throughout treatment resembles an advanced course in the hybrid study of logic and linguistics. For example, a patient may re-learn how to memorize a lengthy series of random numbers, self-analyze his or her strategic thinking and then communicate a clear, detailed account of the entire reasoning experience.

Over time, the patient realizes that although the symptoms of brain injury may never completely dissipate, there is a way in which to live productively. As constant as the ebb and flow of the sea itself, the inevitable "fog" of mild-to-moderate traumatic brain injury comes and goes. Help is available, however, by taking "Steps," and those with such an injury need not remain lost forever.