A small profile in courage

Let us offer a bow to Gabrielle Giffords, who has had the courage to resign from Congress to concentrate on her rehabilitation in the face of a year of media marshmallow fluff. Let us also give her a pass for holding onto a resolve to return to Congress. It will keep her going.

The odds are that she won't. I don't see the long-term effects of traumatic brain injury (TBI) as closely as my daughter, who as a clinician deals with it daily. I just push the paperwork. My kid said once that the hardest part of her job was sitting down with families and explaining that their loved one would very likely never be the same person again. You have to deal with TBI to see past the hype, to understand the odds. A high-calibre bullet in the left hemisphere is a grave injury; today it takes exceptional surgical skills to save the victim of such a wound. Giffords' rehab has done wonders as well, to give her the skills she already has. One must keep trying, of course, but if this is all there is for her, it's far ahead of what many TBI patients can achieve. For me, the party of her successor is secondary just now.

This week we're presented with the full spectrum of TBI expectations. Canadian freestyle skier Sarah Burke has died of her brain injuries. Giffords has achieved an impressive range of skills, including the wisdom to resign from Congress. American competitive snowboarder Kevin Pearce is back on his snowboard.
That's what you can expect. It depends on a host of variables, not the puffery of broadcast journalists.

Coming down to common sense

I'm repeating myself a little. A few days after Gabrielle Giffords' shooting, the interwebz rumour mill decided to practice medicine without a licence. The annoucement was that Gabrielle Giffords had got out out of bed and was sitting in a chair.

Regular readers know I have a daughter in the neuro rehab line of work, who happened to be home during the start of all this, and that I have a few healthcare creds of my own. My kid confirmed my skepticism at once.

Now, some days after, we have credible people willing to define the reality of what Ms. Giffords faces. She may be able to conduct activities of daily living (read, sit, stand, eat, eliminate). She may be able to speak. She should be able to interact at some level with her family.

Will Giffords be able to sit in Congress? When you consider the intellect of some people currently in Congress, that seems more likely.

My daughter deals regularly with the disappointment of families who must adjust to the idea that these limited goals are successes, and the biggest successes their loved one may ever have. To suggest that victims of traumatic brain injury will be just as they ever were is the cruelest form of hypocrisy. They'll be the best they can be, nothing more or less.

I'll leave it there, and avoid HIPAA violations.

More shooting...of the foot

One trouble with the American left is its penchant for enabling the cowardice, excuses and ignorance of ranters, usually (not always) of right-wing persuasion, We are in the midst of a fit of hand-wringing over Sarah Palin's testy comment that American media had committed a "blood libel" by linking her violent rhetoric to the Gifford shooting. That includes me.

Come on now. Given this woman's lexical history, why on earth is anyone wondering whether she meant to use a reference to Jewish history, a reference that is a tad obscure even if you are Jewish? Those who wonder are giving her a degree of credibility she couldn't muster herself. She's doing what Limbaugh did in 1995; what every loudmouth before and since has done. It's called whining. Every bully who ever lived has whined just like this when they've been caught out. Let her whine. Take the lesson of his horrid act and learn from it, and let the bullies zig and zag and try to avoid their part of the responsibility.

There is a lesson and it is not entirely Palin. This is apparent from the inability of many on the left to figure out the lesson in any but partisan terms. The lesson is that when people who ought to know better start using vituperation as the core of their daily discourse, people who don't know better are listening. The vituperation goes in one ear as daily rants, and it comes out the other as fact. It does not matter if it is Sarah Palin or anyone else. What matters is that for every listener who knows that hyperbole is a literary effect, there are ten who do not. At least one of those ten is going to be nursing a psychotic rage that the hyperbole will direct. If they hear enough of the vitriol, they will act on it. They don't need a gun, just a truck loaded with fuel oil and fertiliser.

That's why it is unwise to wring one's hands and blather about Palin's free speech rights. We've had that discussion:

“The most stringent protection of free speech would not protect a man in falsely shouting fire in a theatre and causing panic.... The question in every case is whether the words used are used in such circumstances and are of such nature as to create a clear and present danger that they will bring about the substantive evils that Congress has a right to prevent.” (Oliver Wendell Holmes, Schenk v. United States, 1919).

We come daily closer to the threshold Holmes had in mind, and it's time the whining about it stopped. The last time we permitted vituperation to get this far out of hand, it ended in a was that cost 600,000 lives. In proportion to population, such a war today would cost 30 million lives and leave the entire country in ruins. So stop it.

Shooting one's mouth off

I've commented before on my daughter's occupation. She's been home this week, and we had a chance to talk about Gabrielle Giffords' wound. Not its social or political dimensions, but its clinical dimensions. She sees trauma of this level daily.

We hear--we hope--that Ms Giffords will live. That is just one part of the challenge.
In the opinion of one traumatic brain injury specialist, she will be very fortunate if she can ever again function at a Congressional level. After high-caliber injuries at short range, the brain suffers massive trauma. As a rule, complete recovery happens only in Hollywood movies.

As I scribble, the leading figures of right-wing vitriol are doing what they did after the Oklahoma City bombing: running and hiding. Now, of course, we have in addition a vendor of right-wing vitriol who pretends also to be a legitimate candidate for high office.

In 2005, I thought it would be meet and just if Terry Schaivo had been able to appear before Congress: simply because, just possibly, there might have been enough people in Congress and the media capable of feeling ashamed at the act.

Today, I should like to look forward to a day when the vitriol vendors could visit Ms Giffords en masse. If she is very fortunate, she may be able to form a coherent sentence when they do. It isn't likely, but rehab must cling to hope or fail entirely. I am not in rehab, so I hope only for those who run away from their responsibility to have their noses rubbed in it.

Sleep well, Sarah Palin.