picking up the pieces

ONE OF MY PATIENTS is a young man, twenty years old, who sustained a brain injury last year after shooting himself in the head. He can’t remember how it happened, which is commonly the case with injuries of this magnitude. There’s often a chunk of memory from the days or hours leading up to the injury that’s lost, as well as a period of time after the injury during which the person cannot remember any details. Sometimes the amnesia goes back for months, often erasing major events such as getting married, the loss of a family member or having children. In this case, he can't recall what led him to shoot himself, so it has remained somewhat of a mystery.
     Over time, some of the memories comes back. And this has been the case with this young man. He now recalls taking four tabs of LSD prior to the shooting.
     The injury left him paralyzed on one side, missing half of his skull and also missing an eye. When I first met him he was wearing a helmet to protect the vulnerable soft spot over half of his head where the only thing covering his brain was a layer of tissue and scalp. He was very depressed. He didn’t want to do any rehabilitation. He didn’t want to do much of anything. And, really, who could blame him for feeling such despair?
     Brain injuries are devastating in general, but even moreso when you’re twenty years old and you have a long life ahead of you. You’re on the verge of independence, and now you can’t walk, or use an arm, and you’re missing so much of your skull. Add into the mix the fact that you have no insurance, that your family has little income, that you can’t afford the surgery to have your skull replaced, and, well, we all would probably feel like he did, like it just wasn’t worth carrying on.
     But he did, and his family was there to help him through it. Fast forward one year after the injury. I arrived at the rehab center last week, and I was caught off-guard when I saw him standing near the entrance. His family had received a call out of the blue from the county hospital the week before and told him that his skull replacement surgery would be happening the following day. So they took him in and the surgeons were able to reconstruct his skull. I was caught off-guard when I saw him because he was standing near the door, and he wasn’t wearing a helmet. He was wearing a Houston Rockets cap, a snapback, like any 20-year old would wear. 
     “Looking good there, buddy,” I told him as I walked through the door. He smiled and shook my hand.
     He still has limited use of one arm, and he’ll never get that eye back, but things are looking up for him. His mood has improved, his future looks brighter, and he’s on his feet again.