7 Facts About Head Injuries that Hollywood Almost Got Right

This submission was rejected by Cracked.com for its similarity to another article, 6 Deadly Injuries that You Think You'd Survive (Thanks to Hollywood), which was not mine, so you get to read it here.

Will Gabrielle Giffords return to politics? Why is that player such a pussy and can't just walk it off? Why does that soldier think he deserves a Purple Heart for a bump on his head? Why does that boxer talk funny? Where's my shoe? All these questions and more will not be answered. I just want to reset your expectations about the walking wounded.

7 Facts About Head Injuries that Hollywood Almost Got Right

Most humor writers rely on a form of situational irony to get the point across to the reader. Indeed that is the forum of great philosophers called Cracked.com. In turn, fiction writers rely on an unspoken agreement with their audience that a suspension of belief is required. Viewers though do not always get the memo. They're here to watch stuff and not get all caught up in details like reading unless it's followed by something of onomatopoeic value. This approach to life may all be well and fine when picking softdrinks, clothes, and romantic partners, but decisions on long term health care are not ones that should be influenced by seeing Uma Thurman will herself to move her big toe.

Coma in Hollywood is the ultimate failure of plot device. TV and movies give us the “sleeping beauty” version of coma that features a healthy, tanned individual with muscle tone. Now by tanned I don't mean like they just came back from a Caribbean vacation. I mean they don't look like that sandwich you bought from the gas station that's been laying under fluorescent lights for the last 17 days. Never mind the lack of feeding tubes, monitors, catheters, and the occasional ventilator. The audience wants to believe that all is OK and that losing consciousness is just like sleeping. The fact is though, the longer that you're in one, medically induced or otherwise, the less likely you are to be much more than drooling meat sack when you wake up. On the plus side, you're going to lose a lot of weight. The down side being that most of it will be muscle mass. There's an excellent chance that you'll lose a few IQ points as well.

The medical industry literally has a detailed character description for the taking, and writers piss it away every time. On that it should be explained that there are two types of brain injury. There is the obvious Traumatic Brain Injury (TBI) and the not-so-obvious, Acquired Brain Injury (ABI), each having it's own list of causes. For those two types of brain injury,  medical professionals also have a means of grading them that clearly fiction writers tend to overlook. The Glasgow Coma Scale (GCS) was created to assess the status of the central nervous system on a spectrum. The Ranchos Los Amigos Scale (RAS) was developed as a way to gauge cognitive and behavioral presentations of patients as they emerge from coma. A patient scoring at the top of both scales would be considered perfectly normal; at the bottom, dead. If the dead person scores higher, run.


You see it's all right here in the charts. There was no injury, they're just stupid.

Fortunately I'm here to help you separate the bullshit. Having been there myself gives me license to bitch. The last thing on my mind when I woke up wasn't so much about “Who's next?” as it was, “Where the fuck am I?”, “Where's the bathroom?”, and “What's wrong with my legs?” in that order. It is a tremendous exercise in humility having petite Asian women that you did not hire pick you up off the floor and hold your junk so you can pee in a bottle in the middle of a dimly lit room. It's like being black-out drunk, but horrifyingly sober. So congratulations! You now have a head injury. Let's see some what you can expect.

The Dead Zone: your head hurts for a reason.
The television show, The Dead Zone itself was one starring Anthony Michael Hall based on the character played by Christopher 'freakin' Walken based on a book written by Stephen King where our hero wakes after a six year coma to find the world he knew is no longer available, which in reality can happen after just a couple days of calling in sick to work. The injury itself causes our hero's brain (Walken's, not Hall's) to remap itself around the injured areas with a side of awakening precognitive abilities.

In reality these dead zones are caused by Axonal Shear, which is the term used to describe the severing of nerve fibers in the brain. The inside of your brain case is much different from the outside, and unlike the TV series, is full of points. Your brain being really just a big ball of fat with some fibers running through it tears against these points during an injury and scar tissue begins to form around the severed neurons creating 'dead zones'. Your brain eventually remaps around these areas in order to transmit, store, and retrieve information. The term for this is neuroplasticity, which probably was King's first choice of title for the book.


Ewwww, it's all bruised.

28 Days Later and The Walking Dead: you will have to learn to walk again.
These are the same programs and I will treat them as such. Atlanta, London, they're both places I haven't been and both have had governments that the United States once beat into submission so yep, they're the same. In those places we find our unshaven hero waking up alone in a barricaded hospital room slightly confused to find a post-apocalyptic scene has unfolded around them. Determined, he makes his way back home and witness' varying degrees of horror on the way, one by one collecting the shattered pieces of his past.

Though this may sound like your typical Sunday morning, sans the taste of weed and hooker spit in your mouth from the night before, this guy wasn't even sleeping off that much. I mean at the very least he should have woken in puddle of his own urine since the catheter was not an issue, and trust me, they are. Beyond that he would have been zombie chow since muscular atrophy in the legs would have been the worst possible thing to need therapy for in a zombie apocalypse. Muscular atrophy is the same reason that astronauts on extended  trips to space exercise furiously and still experience muscle loss. Sedentary jobs have similar effects so you might want to get out of that chair.

Because even Tom Hanks could beat your ass.

Resident Evil I and II: multiple bouts of unconsciousness are a bad thing.
OK she wasn't in a 'coma' per se, but she did lose consciousness in both movies, and it's Milla Jovovich, naked. We cannot have a serious conversation about brain injuries without a naked  Milla Jovovich. End of argument.

It was more of a concussion really in the first, though both bouts of unconsciousness were chemically induced. Regardless, any loss of consciousness can be bad. The more times you lose consciousness in your life, the worse off you are, such as with Second Impact Syndrome. Generally your doctor would not recommend such instances more than once every 18 months as the cumulative effect can result in long-term neurologic and functional deficits, kind of like most any retired boxer, or in other emotional disturbances such as with Ernest Hemingway. Sure she's hot now, but soon all of her children will be named Alice and she'll be found running through the streets of Pamplona.


He died as he lived.

[50 First Dates: you will have issues remembering things.
Though in the movie Drew Barrymore is given a fictionalized form of anterograde amnesia, she still functions as a normal part of everyday society despite the fact that she is unable to form new memories. Daily her family relives her birthday until Adam Sandler steps in and decides to brutalize her with the truth of her condition, daily. Trust me when I say that you will be the first person to remember it when you have memory issues. The last thing you want is for some well meaning soul (pronounced, asshole) to continually remind you of it.

This is the type of person that isn't allowed outside unescorted. Sure the movie may seem cute and romantic, but the fact that Adam Sandler has to get his game on daily for this woman makes him more the type to opt for a windowless van than cheeky video tapes.


Remember me?

Hard to Kill: you may have some anger issues.
This is the cliched meeting our hero in lying a coma for several years, alone in a hospital bed with a building sense of pending doom. We meet the henchmen  followed by some harrowing escape. They did get the reality of the situation right in that you will need something to facilitate your mobility such as a wheel chair or in this case, a bed with wheels on it while you're in the hospital because really you're going to need it unless you would like to develop an intimate relationship with the floor.  They did miss that you get a cadre of therapists that will help you redevelop everything from learning to swallow your food and talk, to controlling the urge to snap the neck of every ass-clown you meet. Unfortunately people are going to piss you off by the shear fact that they are trying to be helpful meaning family, friends, and healthcare providers. Maybe Hollywood got that last part right and Steven Seagal  just had something to fixate on. It really makes me want to know what was written on the note that he sent Kelly LeBrock to Chinatown with. It was for his “herbs and needles,” I'm sure.


Roid-rage: it does a revenge good.

Rocky II: this will not make your relationship stronger.
Here we find the stereotypical down and out boxer working to get back into the ring against his wife's wishes when she goes into labor and falls into a coma. Rocky, being the loving husband stays by her side, refusing to see the baby until she wakes up so they can meet him together...awe. Her eyes flutter. They stare lovingly into each other and in her drug induced haze, consents to his re-entering the ring.

Divorce rates among couples where one spouse has incurred a head injury are reported to be as high as 78%, significantly higher than the general population. This has much to do with the strain such injuries place on a relationship because the person emerging from the injury is not always the same person they were before. In reality she would have probably woken up confused and very agitated, but considering that she's cool with his decision, her first act was probably to go change diapers, and for the fact that she folded faster than Superman on laundry day suggests that she was either already beaten, or it was the equivalent of her saying, 'fine'.

Don't make me tell you again.

Kill Bill Vol. I: your last employer may not be happy to see you.
Again with the cliched meeting our hero in lying a coma for several years, alone in a hospital bed with a villain thoughtful enough to have called ahead for an orchestra to play an ominous tune as they enter the hall. We're so used to seeing it as a plot device that we naturally expect to see some dramatic turn of events the moment our hero wakes up. A quick closeup of the eye suddenly opening and , BAM! Someone needs to restock cans of Whoop-Ass on isle five. A few scenes later and they're back on their game without having spent a single montage on physical, or even vocational rehabilitation.

The truth of the matter is that returning to your previous line of work will be difficult, at best. If your job requires learning new information or you are a student, you might want to consider a new field. I'd recommend something that doesn't involve much math or learning a new language, because you're going to have enough difficulty speaking your native language as it is.


Now try it just like I said it, “booobsza”.

Making Sense of Tuscon

Unfortunately many do not realize that in their opinions regarding the events surrounding Jared Lee Loughner they are addressing very real 1^st, 2^nd, 4^th, 5^th, and 6th Amendment issues. Regardless of the media overload, they also deserve to be looked at as individuals are using this for their own opportunity. Understandably it is a new story, but the media has been rife with misinformation and agendas.

The outpouring of support I have witnessed in these few passing days since the attempt by Jared Lee Laughner has been nothing short of amazing to me. Equally, We the People have been together shocked and horrified into recognizing there exists a very real situation. We scan the media daily moving from bite to byte seeking answers for what we could do to better prevent such future atrocities. Journalists question their sources and report. Through them we find expert commentary from police officers, school administrators, and doctors. We also find personal opinions, though steeped in fact, still opinions penned by politicians and fellow citizens.

Congress on Your Corner

A single action from a single man has caused us to react as anyone responding to their own personal injury would: we seek to take inventory, count our losses and learn from our mistakes, and then we make more mistakes. Many it seems fail to realize that mental illness is a complex label as it is unlikely that any one single factor contributed to these events. More likely it was a culmination of events and conditions that brought the 22 year old Mr. Laughner to snap. Unfortunately the information on Loughner has been limited, leading to wide speculation.

And just as multiple events come together to create one event, we each have run down different roads looking to apply an opinion. Since 1:20 PM (MST) on Saturday, January 8, 2011 we have been told how both political parties are seeking to capitalize on tragedy of another. We find commentary discussing harsh political rhetoric. We follow a trail of bread crumbs leading to the red flags that define the strange behaviors of Jared Lee Laughner. We remember Virginia Tech. We remember Columbine. And we asked ourselves the same question then, “Why?” and in answer a chorus of talking heads respond with words that serve a specific agenda.

The Loughners

Many had their first glimpse at Jared Lee Loughner through his profile on Youtube where aside from the five videos he'd posted, he had also provided a short-list of favored books. Most notable from this list came Mein Kampf, Animal Farm, and The Communist Manifesto, which led many to speculate on Loughner's motivations. Few discussed “Fahrenheit 451.” None discussed “To Kill a Mockingbird,” with its themes of rape and racial inequality. And no one speculated on those written by Aesop, Jonathan Swift, J.M.Barrie, or Lewis Carol. Initial speculation on these sources though led many to believe Loughner the product of the Tea Party movement and anti-imigration groups, and later to identify Loughner as a Neo-Nazi. Message boards of course light up with their own logic suggesting that he should be charged with a hate crime as Giffords is Arizona's first Jewish Congresswoman. Unfortunately it was not mentioned that Loughner's mother was also Jewish and as it follows the maternal line, Jared was also a Jew.

On the day of the shooting, Politico.com reported that Loughner had attempted to enlist in the military and was denied, but due to privacy concerns the specific reason could not be shared. Pima Community College, where Loughner attended school made available a press release on the date of the attack that provided a broad overview of his time at the college and that there were five incidents and a Youtube Video that led to his suspension. Details regarding those incidents was not made available until Wednesday when the Pima College Police Department made available redacted versions of those reports. The college did not release the video until Friday.

In an exclusive interview with Mother Jones published Monday, two days after the shooting, Bryce Tierney, a friend of Loughner that is speculated to be the last person with whom Loughner may have had contact with mentions the message that he received, "Hey man, it's Jared. Me and you had good times. Peace out. Later." Having once been close friends in high school, Tierney had made himself increasingly distant over the passed few years as Loughner's questionable behavior escalated, including an apparent obsession with Rep. Giffords. News of the attack on Giffords hit the media eight hours later.

Another friend, Zane Gutierrez on Tuesday also mentioned Loughner's erratic behavior in a New York Times interview, “He was a nihilist and loves causing chaos, and that is probably why he did the shooting, along with the fact he was sick in the head.” Gutierrez and Loughner had occasion to meet for target practice and commented positively on his marksmanship.

The parents of Jared Lee Loughner released a statement on Tuesday expressing their grief over the actions of their son and their own difficulty in understanding this heinous event. Though some neighbors characterize the Loughner family as reclusive loners, another neighbor, Wayne Smith told Tuscon station KVOA that “They're hurting.” Friends of the Loughner family, Theresa Cobb and Bud Hebert, said of them, "They're great people. They're fun. We have fun with them." The Loughner family has asked for privacy during this time. Loughner's parents did not attend his arraignment.

By Wednesday in another exclusive interview, close friend, Zach Osler appeared on Good Morning America to discuss his relationship with and impressions of Loughner. Like Tierney, Osler himself was becoming increasingly alienated by Loughner's behavior. Osler also made implicit that Loughner, "...did not watch TV. He disliked the news. He didn’t listen to political radio. He didn’t take sides. He wasn’t on the left. He wasn’t on the right." Both Tierney and Osler mentioned Loughner's growing fascination with marijuana and spice.

Osler also provided ABC News with brief insights into the personal life of of Loughner giving details on his home being, "... kind of shrouded, it's covered up ... like cold, cold dark unpleasant. ... I always felt unwelcome, always, like I shouldn't be there," He also mentioned the breakup with a high school sweetheart, Kelsey Hawkes as being around the beginning of Loughner's peculiar behavior. Hawkes issued this statement, "'I did date Jared Loughner six years ago in high school but he's not the same Jared Loughner that the world now knows as a mass murderer – not the same person at all.'

The Doctors

Between February and September 2010 Jared Lee Loughner had five contacts with the Pima Community College Police Department for various classroom and library disturbances which ended in his voluntary withdrawal from classes on October 4, 2010. Loughner's parents did attend that meeting. Former classmate, Lynda Sorenson had written of Loughner in June, “I’m not certain yet if he was on drugs (as one person surmised) or disturbed. He scares me a bit.” His Mathematics Professor, Ben McGahee also expressed concern after being approached by several student about Loughner's behavior and on finding Jared had written, “Mayhem Fest” on one of his quizzes. What Ben McGahee did not know was that The Mayhem Festival was a Phoenix area event scheduled for July 16.

A letter to the family from Pima Community College dated October 7 indicated that Loughner, “must resolve his Code of Conduct violations and obtain a mental health clearance indicating, in the opinion of a mental health professional, his presence at the College does not present a danger to himself or others.” Whether he obtained that evaluation is currently unknown. Since the attack additional questions and criticisms have surfaced regarding Loughner's competence, unfortunately investigators have yet to present findings from their suspect as he is not cooperating with investigators.

Mark Goulston M.D. laid a basic foundation of mental illness for the public to better understand the potential of the suspects undiagnosed condition. Some have speculated that Loughner may have believed he was dreaming during the attack. Others are convinced his are the actions of a paranoid schizophrenic. What is certain is that informed decisions are what will determine the type of sentence he will receive.

Many though have been asking the question of how this man, through all the red flags, the police, his school, friends, neighbors, or family, did not become a part of the mental health system. According to this Newsweek article, Arizona provides the easiest methods of involuntarily committing an individual. According to Arizona's law, a person has to be a danger to themselves or others, unable to meet one's own physical needs, or persistently or acutely disabled meaning unable to manage one's own care. Ultimately evidence of this can be presented by expert; laypersons such as the police, his school, friends, neighbors, or family; or the subject's own writing such as what he had posted on Youtube. Everyone had observed or had been informed of his behavior, just no one did anything about it.

The Politics

It almost seems that Pima County Sheriff Clarence Dupnik coined the term “vitriol” when he openly criticized politicians and media during a press conference on the day of the shooting. His criticism seemingly touched a nerve as heated arguments have regularly been a staple of United States politics leading up to the polarization of social issues along party lines: Democrat, Republican; good and evil, wrong or right. Almost immediately this gave relation to Sarah Palin's Political Action Committee poster, “Let's take back the 20, together!” showing cross-hairs aligned on Rep. Giffords district.

That evening SarahPAC member, Rebecca Mansour went on the radio show, Tammy Bruce Saturday discussing these cross-hairs as being anything but. Tammy Bruce suggested they could in fact be ”surveyor's symbols.” Rush Limbaugh also found himself the subject of similar scrutiny spending an evening on the radio undermining this perceived threat from the left. Limbaugh furthered his effort by suggesting a connection between Loughner and the Democratic party. Glenn Beck suggests that this may lead to a reenactment of the Fairness Doctrine which would effectively end shows such as his, Limbaugh's, or any other pundit program, potentially even Steven Colbert and John Stewart. The doctrine itself lasted from 1949 until 1987 when it was repealed by the Reagan Administration under the argument that it restricted our First Amendment Rights. The threat of course being that it required the news media to remain honest, equitable, and balanced. Rush Limbaugh has been on the air since August 1, 1988 and was among the first to attack the statements of Sheriff Dupnik. Pundits of all stripes have come forward to dismiss media vitriol as being behind the actions of Loughner.

Sheriff Dupnik as it seems was the first to be sacrificed at the alter he created being. First attacked by politicians for his using the initial news conference to express an opinion, then later by pundits for those same remarks, his passed criticism of Arizona's immigration law, even his affiliation to the Democratic Party implying that such has made him incompetent and that his behavior is along party lines. By Thursday neighboring Maricopa County Sheriff Joe Arpaio's voice was similar, though the headlines were misleading.

Four days after the attack, on her own Facebook page, Sarah Palin posted her own video in response to the criticism of her own political rhetoric with an aside expressing sadness over the attack. Most notable of her video was the use of the term, “blood libel,” which outlets such as The Los Angeles Times have equated to medieval anti-semitism. The contemporary use of this term suggests a person is being publicly sacrificed at the tragedy of another. So much has it become attention has been devoted to Palin's social media persona that it has become an effort to keep her Facebook clear of messages that reflect negatively upon her or can be further construed as reflecting poorly upon her. As part of this discussion, Palin and even Wikileaks remind us that such heated statements have regularly been a part of contemporary American politics extending back to a time when politicians carried firearms and settled arguments at the barrel of a gun. Certainly then they did use such rhetoric, but at the same time they also used murder, otherwise called “dueling,” as a political tool.

Reactions to violence, and reactions to those reaction only serves to compound these events. In the hours following the attack. Rep. Peter King proposed legislation that would prohibit the carrying of a firearm within 1,000 feet of a member of Congress. House Leaders, Speaker, Rep. John Boehner and Majority Leader, Eric Cantor have both said that they will oppose this legislation, But King has indicated that he will proceed without their support. Legislation has also been introduced to prevent members of the Westboro Baptist Church from protesting as planned at victims funerals including that of 9 year old Christina Green, whom it was mentioned was born on September 11, 2001, the same day as the World Trade Center bombing.

In a seemingly unrelated topic author Karen Armstrong appeared on Radio West with Doug Fabrizio to speak of returning compassion to humanity. Among other things she discussed “the four F's” held by neuro-scientist as being the most basic functions of the primitive brain: fighting, feeding, fleeing, and “reproduction.” She also argues that altruism is a hard wired part of our brains. With that we are able to care for one another and ourselves. According to Armstrong, what separates ours from the primitive is that we have higher faculties that allows us to synthesize information and reason accordingly. Unfortunately the balance between the two brains is not always there just as the balance of altruism and any of the four F's is not always present. The hormones that influence our primitive functions produce an intoxicating effect that creates an addictive behavior. Oxytocin being that high that mother's feel for their newborns is inverse to that high felt on challenging or fearing another.

Many religious, and thus political institutions play on this primitive brain with apocalyptic rhetoric and polarized issues giving their followers a combination high of both challenging and fearing another be it person or institution. These same instincts also lead us to doubt explanations that are not in line with our own system of beliefs. In this conversation, Armstrong suggests that in our responding to fear and aggression, we poison a piece of our humanity.

The Gun

Jared Lee Loughner used a Glock 19 in his attack on Giffords, an updated version of the Glock 17 that achieved notoriety when it was used by Cho Sueng-Hui in his attack on Virginia Tech, and later by George Sodini when he launched an attack on members of a Pittsburgh, PA area health club. The 17 was first developed by Glock for use by the military and law enforcement in 1988. Contrary to the claims of the same weapon being used by many outlets, the Glock 19 had not become available for retail until July 2010. The Glock 17 and the 19 have become favorites of law enforcement and private citizens alike for its lightweight polymer construction, though it is a concern for forensic experts in that Glock uses a polygonal rifling technique that makes it difficult to match the gun with a bullet fired from it.

Loughner legally purchased his Glock 19 for $499 from Sportsman's Warehouse in Tuscon, Arizona. He did successfully pass the mandatory background check for his purchase that concluded that Loughner had not been convicted in any court of a crime punishable by imprisonment for a term exceeding one year; was not a fugitive from justice; was not an unlawful user of or addicted to any controlled substance; had not been adjudicated as a mental defective or committed to a mental institution; was not an alien illegally or unlawfully in the United States; had not been discharged from the Armed Forces under dishonorable conditions; was currently a citizen of the United States, and had not renounced U.S. citizenship; was not subject to a court order that restrained him from harassing, stalking, or threatening an intimate partner or child of such intimate partner, or; had not been convicted in any court of a misdemeanor crime of domestic violence.

Counter to that background check, there were hints of trouble, though his run-ins with the law did not result in an arrest or conviction, concern over his behavior had been acted upon by most everyone that had touched his life including concerns over drug use, stalking behavior, and the idea that he could have been a threat to himself or another individual. Loughner had attempted to buy ammunition at a Wal-Mart store on the morning of the attack, but was turned away due to his behavior. He was able to travel to another Wal-Mart where he was allowed to complete his purchase. It was during this time that Loughner was pulled over by an Arizona Game and Fish Department officer for running a red light.

On The Huffington Post, Peter S. Goodman poignantly mentions that an event of this type has happened before and will happen again unless we do something now to keep guns from the hands of those who may be considered unbalanced. The fact is not that Jared Lee Laughner was able to purchase a firearm, the fact is that regardless of his method, a person so inclined will find a way. Yes, every country has mentally unstable people, conspiracy theorists and kooks. Yes, not every country has the uniquely American easy access to semiautomatic weapons. But counter to his point is that the media in other developed nations does show that when there is a will, there is a way. Institutions, property, and lives will be destroyed if a person is so intent.

Is this American tragedy any more important than the Winnenden school shooting or the Erfurt massacre in Germany. Is this American tragedy any more important than the innumerable dead from a rash of knife attacks in Japan? Is this American tragedy any more important than the incidence of suicide at Foxconn in China? Yes, it is more important!

It's more important because it is here and this is us, and as anyone responding to personal injury we seek to take inventory, count our losses and learn from our mistakes, and then we make more mistakes. Politicians dismiss their vitriolic rhetoric as only being offensive to the ignorant. Citizens pass responsibility to schools and law enforcement. Schools suggest it's not their job to report abnormal behavior and look to citizens to report and law enforcement to respond. Pima Sheriff Clarence Dupnik though returned that as it is everyone's responsibility!

Although this picture is one of a social failure, it is not the job of the schools to moralize our children just as it is not the rule of law to ensure that we are moralized. They are the checks to societies balance. That is their social contract. If you do poorly in school, you will not pass just as if you break the law, there will be consequences to your actions. But, if your neighbor does poorly in school, or your neighbor breaks the law, do you know? Are you concerned for your neighbor for any other reason than your own security? There were red flags seen by everyone, yet the only action was to further isolate the individual.

I find it remarkable that there could be so many people that feel isolated in a country with 311,885,968 residents. I find it remarkable that people are able to feel isolated. How many people do you talk to in a day? How many of them do you make eye contact with when speaking with them? How much of that conversation includes active listening? Do you engage the peculiar and unfamiliar? Or do you save your conversation for those you know, leaving the rest for frozen transactions?

Jared Lee Laughner and those like him; they're not just a problem for someone else, they are a community problem that must be dealt with in a constructive manner or this will happen again. I'm not sorry to announce this, but it will require an effort on your part.