In 2006, our world was moving forward
as most people's do. Bob was traveling overseas for his job,
Lee had work deadlines, kids to get to school, the stuff of
everyday life.
And then, as happens to so many others who experience
a traumatic event, life changed in an instant. For
some, it is an unexpected fall or sports injury, a car or bicycle
accident; for others, an act of violence. For our family,
it was a bomb in the middle of an Iraqi war zone.
Bob had newly been named the co-anchor of ABC's
World News after the untimely death of Peter Jennings. He
was in Iraq to report on the progress of the coalition forces.
The 155-mm shell exploded about 20 feet from the armored
personnel carrier when Bob was filming above the
hatch. Hundreds of rocks packed around the shell blasted
into his face, neck, and back, and the power of the explosion
shattered his skull. The prognosis was grim, and as is
often the case with a traumatic brain injury (TBI), the extent
of the concussive effects of the injury, the shearing of
neurons within the brain, and how that would affect Bob
was impossible to know initially.
Our family began to travel on the rollercoaster that too
many others know so well, experiencing the many octaves
of pain, suffering, grief, frustration, expectation, disappointment
and, on good days, small blessings. We learned
to hold hope for ourselves on the days when the medical
community wouldn't or couldn't offer it. We adjusted to
life in "the new normal."
Most people with TBI would tell you that the injury or
the accident is the easy part. After five weeks in a medically
induced coma, Bob did wake up, and he began the
most difficult portion of his journey—the journey to return
to himself through recovery. This involved an excellent
medical and rehabilitation staff, including cognitive work
with a neuropsychologist. Through a combination of determination,
sheer will, repetition, rest, focus, the love and
support of family and friends, and the sheer power of the
human spirit, Bob drove his recovery.
Each year, 1.5 million Americans receive a brain injury,
and 5.4 million live with this injury every day of their
lives. These are often the people whom one doctor referred
to as "the folks that live in the back of the house." They are
often mistaken for the mentally impaired, socially unacceptable,
inebriated, or simply inappropriate and "off."
TBI can result in a range of emotional, behavioral, and/or
cognitive impairments, among them a quickness to anger,
loss of executive function, depression, emotional highs
and lows, inappropriate behaviors, or colorful language
when the filter is gone from the impact. These differences
often lead to vast changes in relationships; one statistic
places the divorce rate after TBI at more than 80%.
In the past few years, with the wars in Iraq and Afghanistan,
the number of TBIs has risen dramatically, making it
the signature injury of this war. In previous wars, soldiers
did not survive the more severe kinds of head wounds.
Those who did were diagnosed with "shell shock" with
little or no treatment prescribed. Medical technology and
intervention, as well as better body armor, have increased
survival rates. In the sixth year of the war, a new study
confirmed that at least 325,000 of U.S. returning troops
have some form of a brain injury with or without concomitant
posttraumatic stress disorder, combat stress, and/or
personality disorder.
Severe TBI is often obvious. The person may live for
months, before the cranioplasty, with part of their skull
missing, or the resulting scars may be visible. But many
brain injuries are hidden. Once the person heals on the
outside, the damage remains on the inside, which is why
the brain injured are often referred to as the "walking
wounded."
Sadly, we are welcoming home a new generation of
wounded with our returning veterans. This has placed TBI
somewhat more prominently in the public's eye. But there
is so much more work to do in the areas of public awareness
and education, scientific research, long-term rehabilitation,
and insurance reimbursement.
The good news is that the war is rewriting what we
know about TBI in many ways. It used to be believed that
after almost two years a person was mostly finished healing.
Now, with a better understanding of the power of cognitive
rehabilitation and the brain's keen abilities to rewire
itself, we are seeing progress in ways that could only have
been hoped for decades ago.
It is critical that TBI be recognized as a major health
problem, and resources must be devoted to educate psychiatrists,
rehab specialists, and other mental health professionals
about all the various aspects of this serious and
life-changing epidemic.
We were honored to write the foreword for the Textbook
of Traumatic Brain Injury because information is the
key to understanding TBI and bringing about the critical
support that millions of families need. It is our hope that
this text will aid in understanding the very complex and
individual nature of TBI and help to educate and inform
professionals who are often not trained in this critical area.
The authors are well known in the field, and the variety of
topics provides a comprehensive resource housed in one
volume.
This second edition of the Textbook of Traumatic Brain
Injury, published by American Psychiatric Publishing,
Inc., is a comprehensive, up-to-date book co-edited by
three neuropsychiatrists with extensive academic and
clinical expertise in the assessment and treatment of people
with brain injury. It comprises 39 chapters that are divided
into five sections that cover, comprehensively, the
assessment, pathophysiology, signs, symptoms, and treatment
of those who with TBI. This is a lively, practical, and
interesting book that will be of vital help to professionals of almost every medical specialty, as well as the full range
of mental health professionals who care for those among us
who have suffered from this disabling condition. We who
know, first hand, the painful and disabling effects of TBI
derive hope from the science and treatments described in
this book and are grateful to Professors Jonathan M. Silver,
M.D., Thomas W. McAllister, M.D., and Stuart C. Yudofsky,
M.D., for editing and organizing this remarkable text.
Bob and Lee Woodruff