Confronting Traumatic Brain Injury: Devastation, Hope, and Healing

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9780300070262: Confronting Traumatic Brain Injury: Devastation, Hope, and Healing

Traumatic brain injury is the fourth most common cause of death in the developed world: in the United States alone, 75,000 to 100,000 people die of brain trauma each year, and another 70,000 to 90,000 are left permanently impaired. This book explains what it is, how it is caused and what can be done to treat, cope with and prevent it. William Winslade presents facts about traumatic brain injury; information about its financial and emotional costs to individuals, families and society; and key ethical and policy issues. He illustrates each aspect with case studies, including his own childhood brain injury. He explains how the brain works and how severe injuries affect it, both immediately and over the long term, pointing out how resources are often squandered on patients with poor prognoses and adequate insurance, while underinsured patients with better prognoses do not receive appropriate care. He tells about the lack of regulation in the rehabilitation industry and what federal and state legislatures are doing to correct the situation. And he offers recommendations for policy changes to lower the instances of traumatic brain injury (such as raising the minimum driving age) as well as practical steps that individuals can take to protect themselves from brain trauma.

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Review:

Author William J. Winslade suffered from a traumatic brain injury (TBI) as a 2-year-old, when he fell from his second-story porch and landed straight on his head. He's one of the lucky ones who's recovered fully, both physically and emotionally; his only souvenirs of the fall are a three-inch scar and a dent in his skull. He warns that of the 2 million Americans who suffer from TBI each year (most of them from car and motorcycle accidents), up to 100,000 of them will die prematurely. More than 90,000 of them will face up to a decade of extensive rehabilitation, at a cost of up to $4 million each. Even a TBI as seemingly minor as a concussion can have devastating long-term physical consequences, causing seizures, memory loss, learning disabilities, and more. However sorry these problems may be, he writes, "the truly debilitating deficits" are the less-obvious emotional effects, "such as social isolation, [which] take their own insidious toll."

Winslade is on mission to spur massive attention to TBI, both from the public and the government, to increase awareness to prevent these injuries, and to improve resources for when injuries do occur. And the profiles of TBI victims in this sobering book should move anyone with a soul to action. Without slipping into melodrama, he presents harrowing tales of the dramatic personality changes that can result from TBI. Winslade ends on a practical, moving note, advocating several ways that TBI can be prevented from raising the driving age to banning pro boxing. "Consider the misery and money that we would save by cutting in half the number of Americans killed or severely disabled by brain trauma every year," he writes. Until simple preventive measures are taken and until the "long national slumber" of ignorance ends, he warns, TBI will continue to be the leading cause of disability and death in children and young adults.

From Booklist:

"The primary cause of accidents is our fatalistic acceptance of them," says Winslade, who also points out that traumatic brain injury--TBI--kills 60 percent more people than AIDS does and afflicts a group of victims of an even younger average age, for it is a common result of driving accidents that seat belts, air bags, helmets for motorcyclists, and daytime running lights ought to reduce considerably. Hearing of a few striking recoveries from TBI, most people don't realize that the usual TBI rehabilitation program is lengthy and often restores only minimal functioning. Strongly interested in the law, bioethicist Winslade emphasizes that the U.S. TBI death rate ranks badly on the world list, that the U.S. generally doesn't have the necessary transportation ready for TBI emergencies, that there is nothing obliging state and federal legislatures to provide sufficient funds for trauma centers and research, and that the rampant waste, fraud, and abuse in some (especially for-profit) rehabilitation centers are overlooked. A book that may provoke considerable discussion. William Beatty

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William J. Winslade
Published by Yale University Press (1998)
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