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.

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.