While reading our Brain Injury Special Report, I found myself wondering about an 8-year-old boy I'd met a decade ago. He'd told me about the time he was quarterbacking his team toward a championship when he suddenly tripped, went down, and stayed down. Eventually he was escorted to the sidelines, feeling woozy and seeing stars. “How many fingers do you see?” his coach asked. “Are you all right?” While the boy tried shaking it off, his replacement fumbled away a tie. The coach turned to the injured quarterback and said, “Son, can you get back in there? The team's depending on you.”
The boy must be in college now, and I often wonder how he's doing. With a head injury, you always wonder if there will be a long-lasting impact on the person's life.
Unfortunately, that boy's story is all too common. Every 21 seconds, someone in the U.S. sustains a traumatic brain injury (TBI). That's 1.5 million Americans each year, and those are just the ones who get diagnosed.
We focused our Brain Injury Special Report on wounded soldiers because war is in the news every day. But TBI is TBI, whether it's sustained on the battlefield or the ballfield. On the home front, the biggest cause of TBI, by far, is traffic accidents. Ironically, for civilians and soldiers alike, advances in medicine and protective gear are saving more lives but leaving more people living with severe brain injuries.
“There are a lot of walking wounded who may look fine on the outside, but on the inside, they're not the same person they were prior to the injury,” says Jonathan Lifshitz, Ph.D., an assistant professor at the University of Kentucky's Spinal Cord and Brain Injury Research Center.
Nearly all the experts we talked with refer to TBI as a “silent epidemic” for several reasons. For starters, the numbers are staggering: 5.3 million Americans are currently disabled by TBI, with 80,000 sustaining long-term disability each year. And these statistics from the Centers for Disease Control and Prevention surely underestimate the problem. That's because many head injures go undiagnosed, the result of being invisible to begin with and not being taken seriously on top of that.
Just consider the attitude many people have about the importance of head injury relative to the importance of getting back into the game. “It's just a ding, coach” or “Take one for the team” are phrases we've all heard, and maybe even said ourselves a time or two.
As you will read in this issue, brain injury has devastating consequences for adults and can be beyond devastating for children. Among children 14 and under, TBI leads to nearly 2,700 deaths, 37,000 hospitalizations, and 435,000 emergency room visits each year.
Even so-called “mild” injuries can have long-lasting effects. Or as Dr. Lifshitz tells us, “There's nothing mild about any TBI.”
Another reason why TBI is a silent epidemic is its lack of a high-profile spokesperson to raise public awareness as well as funds. Most diseases have a celebrity who takes up the cause—calling attention to the condition, lobbying for more and better therapies, and raising money for treatments and research. But many people who have suffered brain injury don't want to speak out in public, preferring to blend in.
That makes the people profiled in our Special Report all the more remarkable. Not only do they display grit and determination every day in battling back from their brain injuries, but even more amazing is the courage they exhibit in simply speaking out.
Education is one of the best tools we have to prevent and treat this problem. It's time to raise our consciousness and our collective voice about an epidemic that's been silent for far too long.
Robin L. Brey, M.D.