Anthony Gold’s Injury & Medical Claims department specialises in dealing with claimants who have sustained a brain injury following an accident or negligent treatment. Recent media reports have led me to ponder what the intended audience understand when they read “brain injury” (I comment further on these reports below). A layperson will most likely imagine a scenario whereby the injured party is unable to function independently, suffers with consequential physical disabilities rendering them bed/wheelchair bound and possibly requiring care within an institutional environment.
The reality is that there is a spectrum of injury ranging from coma to concussion and every shade in between. This blog will focus on “mild” traumatic brain injuries and, more specifically, those that cause suffer permanent symptoms.
To confuse matters, mild doesn’t really mean mild when we are talking about symptoms which will impact on a client for the rest of their life. Mild can, and often does, equal devastating. I cannot stress this strongly enough. Mild brain injury can encompass things like (and this is not an exhaustive list) loss of memory, the inability to process information as quickly and comprehensively as before, reduction or loss of senses (such as taste or smell), loss of inhibition and (this is a biggie) a change in personality.
In my experience of acting for claimants, psychiatric injury often goes hand in hand with sustaining a mild traumatic brain injury. This is often a delayed reaction. For a period, the individual will be concentrating on their immediate physical recovery from an accident (fractures healing, follow-up appointments, physiotherapy etc). A brain injured client is often in denial that there is anything wrong with their brain function and, even if they acknowledge that there is a problem, they convince themselves that they will eventually belong to the majority who will go on to recover from any cognitive deficit.
But what about those who don’t recover? Take for example the project manager who is no longer able to process information as quickly as before. Coping mechanisms can be learnt such as detailed note taking, dictating instructions to oneself, taking photographs as visual aids and employing assistants to delegate tasks. This all has financial implications when it’s understood that projects take longer to complete, less projects can be undertaken and extra staff eat into profit costs. Reduced earning capacity will be a maintaining factor for the psychiatric reaction to the brain injury. Depression, anxiety and adjustments disorders (all well known psychiatric injuries following brain injury) can in turn have an impact on an individual’s ability to learn coping strategies. It is an ever increasing vicious cycle. As solicitors, it is our job to ensure that any future losses are thoroughly considered and investigated so the claimant is appropriately compensated. This can be a tricky task if your client is in denial about the existence and/or the severity of their injury.
The media reports I refer to in my opening paragraph concern the marriage break-up of James Cracknell and Beverley Turner announced in March 2019. There are numerous reports so I will not link to a specific one. Those familiar with James’ story will know he sustained a brain injury in 2010 leading to (amonst other things) a distinct change in personality. At the time of the accident the couple were told by treating doctors that 75% of marriages involving brain injury fail. They were determined not to be one of that majority. Over the intervening years the media has reported James’ “recovery”, his return to sports, the challenges he has set himself and, most recently, his return to study and participation in the Boat Race. For the media this may have been a “shock split” but for those familiar with brain injury the outcome is a sad and familiar one.
When working with brain injured clients and considering their cases from a medico-legal point of view it is easy to overlook the fact that when someone sustains a brain injury it happens to the whole family and beyond. The injured and those around them have a relentless daily struggle. Years down the line when the shock, sympathy and support proffered in the immediate aftermath have depleted, those living with brain injury are still doing just that, living with brain injury.
James’ story – or I should say more correctly, his family’s story – demonstrates that sustaining a brain injury does not mean it has to be life limiting. His brain injury does not define him. But it also does not mean that life will be all good after a certain recovery period has passed. There are some injuries for which time is not a complete healer.