Brain-Injured Daughter Gets Assistance From Computer

Times Staff Writer

Karen Lambert was going home.

It was August, 1982, a sunny morning full of good feelings and hope. Karen was driving back from a flute lesson that did justice to a flowering talent. The car rounded a curve. . . .

She does remember her car colliding with another. She remembers being thrown through the windshield and run over by another car. From there, memory blanks. She spent 81 days in a coma.

Afterward, life was a different game.

Some people say Karen's lucky to have a father like Carl Lambert, 43, a retired naval officer and computer scientist whose skills gave his daughter a chance. From the start of five agonizing months in the hospital, Lambert pestered doctors and nurses and made spies of orderlies to learn more about Karen's critical condition.

Then he went to a computer terminal.

Lambert has played a herculean role in the better-than-hoped-for recovery of scarlet-haired, freckle-faced Karen, now an 18-year-old freshman at Southwestern College in south San Diego County. As a "brain-injured" person, she may never be "all the way back," but now, at least, there's hope.

Lambert learned his computer craft in the Navy. What he's done for Karen is compose programs--currently 28--that enhance short-term memory and concentration and recondition the mind's cognitive reflexes. His success is now being watched by hundreds of others. Medical centers across the country have shown interest in the software, which Lambert sells for $245. (He's sold more than 100, most to rehabilitation outlets, a handful to private individuals.) He also has plans for a research foundation based on his daughter's experience and the new-found knowledge that computers can be a force in the healing of an injured mind.

"It finally boiled down to one thing," Lambert said. "If you focus attention on a task, see it through to completion and do it in a reasonable time, you've conquered the three things most normal folks face every day. For the most part, these are the things head-injury cases can't handle. I had to figure out some way Karen could."

Father Gets Credit

Dr. Robert Magnuson, Karen's physiatrist (specialist in physical medicine and rehabilitation), gives Lambert credit for his daughter's amazing comeback.

"He dedicated his life," Magnuson said, "to seeing that she gets back every bit of function she possibly can. He worked with occupational and speech therapists, defined the goals they needed to work on, applied game theories to them and wrote programs. If Karen's work wasn't successful, he did it again and again until he somehow got exactly what he wanted." (Lambert estimates writing more than 200 programs until settling on the current 28.)

It took a lot of time, a lot of effort, a lot of pain. Karen's mother, Joyce Lambert, also played a role in the healing of an only child.

"Mostly, I worked," she said with a tired laugh. (Carl Lambert receives retirement pay from the Navy, but Joyce Lambert's salary for office work was, he said, "the energy" that carried them through.)

Pleased With Recovery

"It was frustrating for both of us," she said. "Oh, my, you wouldn't believe how frustrating it got. It still gets frustrating. I feel I can't do enough for her, and, I have to work. But we were pleased with her recovery. You couldn't imagine how much. It's the difference between watching her live, and watching her die."

When Magnuson first saw Karen, she had "no function in any extremity, couldn't sit up, couldn't verbalize, could do nothing for herself in the area of self-care. She had no control over her bladder. She had impaired swallowing and a feeding tube."

Now Magnuson marvels at a woman fully sufficient in personal hygiene, who works as a hospital volunteer, walks with little difficulty and pulled off the feat of graduating with her class from Hilltop High School in Chula Vista.

"Certainly, I've seen other hurt people do well," Magnuson said. "But I don't know that I've ever seen someone hurt this badly do this well."

Karen came home from Paradise Valley Hospital in National City in February of '83. Enough has happened to the Lamberts since to fill a lifetime for most people. Carl, now an object of curiosity and praise in a medical community hungry for new knowledge, admits to a high degree of innocent obsessiveness. It isn't easy being a father who seemingly everyone has been calling a genius.

Hope Is Possible

"He is," said Ruth Tucker, a clinical psychologist and specialist in learning disabilities. Tucker is based in the Diagnostic Learning Center of Southwestern College, where Karen received treatment. "There's a tremendous number of brain-injured people living in the country. And up to now there's hardly been hope (in making such persons fully functioning). It's difficult to find ways of getting hope. This can be . . . one of those ways."

Brain-injured people, Tucker said, take longer to process an ongoing flow of rapid information. Lambert's programs get the process speeded up again.

"He develops connections--hints," she said, "that help with the thoughts that oftentimes are right there, on the tip of the tongue. . . . He's stimulating the familiar, waking up the unconscious."

It has to do with the reticular formation of the brain, which affects the ability to focus. "To get anything done takes hours ," Lambert said. "You and I can feed ourselves with a full meal in 10 minutes. For a head-injured person, just draining a glass of high-protein liquid takes 30, 45 minutes."

Much of that problem, for Karen, was overcome in the hospital. But what happens when the patient goes home? "A lot of times, that's it," he said. "They go home. And it all shuts down."

Reversing the Trend

Lambert wanted to reverse the trend, to continue the momentum started before going home. To do that, he had to learn about brain damage and what would get the mind working again. So the first target was short-term memory.

One program Lambert devised on his Apple 2-E was "Number Search." The screen is divided into four sections, with numbers displayed at random. The objective is to name the section where each number is located.

A coordination game was "Vision Drill." Two bars move toward a dot at the center of the screen. The objective is to stop the bars as they cross the dot, using any key.

Karen's scores got better and better, until Carl Lambert devised a "poker" game that has lately kept her at a keyboard for hours. Her prowess at poker, Lambert said, shows an intelligence rapidly coming back, "and, a reason for pride."

Her intelligence has, however, been an issue elsewhere. Tucker noted that Karen was a gifted student before the accident, and believes such intelligence may have played a big role in a major recovery. Tucker wonders, then, if Lambert's programs can have the same effect on patients of lesser intelligence; and if Karen's progress was aided more by the love of parents who are not only bright, but dedicated--tirelessly--to recovery.

Perseverance a Key

"She has a great deal of perseverance, and they're really a combination," Tucker said. "I don't know that she'd be as successful without him, or someone like him. All along he provided the tool."

"His programs are already widely used," said physiatrist Magnuson, "and people are said to be very impressed. The problem is, they were written almost exclusively for Karen's needs. He's just now working on programs for people with problems other than hers. You have to remember that no two brain-injury cases are alike. And they're predictable only for unpredictability. We never say never. Some people make unbelievable recoveries.

"Unlike Karen, some patients have difficulty with words. Karen's language skills were, it appears, fairly protected. Some patients look at a letter and haven't the foggiest notion what it is. Carl's now writing programs that tend to focus less heavily on language skills."

Carl Lambert hopes to use proceeds from the sale of software for another endeavor--funding of the Karen Lambert Research and Development Foundation, which is in the early planning stages.

Center to Help Others

"We could provide the physical stimulation necessary," he said, "to improve conditioning. We could establish a high-tech training center using computers and video systems. We could establish a storefront to provide on-the-job training that these people need. Desperately. We'll have a direct-mail catalogue outlet."

Lambert leaned forward, on the edge of his chair. "And the people running the store? The head-trauma cases," he said. "They'll do the accounting, ordering, receiving. They'll run the cash office and handle sales. It'll be their baby."

Lambert is stout, with a baby face, extraordinarily pale eyes and wavy salt-and-pepper hair. A native of the rural South who finished only the 11th grade (he achieved the equivalent of a bachelor's degree in the Navy), he speaks with a buttery accent and a gentleman's charm. He can be tough, however, as doctors found out.

"It's awfully hard for me to tell you how traumatic 81 days in a coma is," he said. "It involves 12 hours a day of hanging around a hospital, kind of hanging on every word. You begin to manipulate housekeepers, nurses. . . . They don't want you in intensive care, and I'm not the kind to stay out."

Humor Has Returned

When Karen came home, she was weak, confined to a wheelchair, immobile without help. Today, though she still cannot play the flute, she can run, kick soccer balls and has artfully reconstructed a clever humor.

"Stick in there that Karen is underpaid," she said with a devilish smile. "Got it? 'Give-Karen-a-paying-job.' "

She walks with a slight sway and talks with a slow lisp, as though the words are sometimes difficult to form or pronounce. Two fingers on the left hand are paralyzed, perhaps permanently. But she works as a volunteer two days a week at Paradise Valley.

Carl credits physical therapy--specifically, a program headed by Peggy Lasko at San Diego State University--with putting most of Karen's basic coordination back together again.

"Lay in bed 81 days, in a prenatal position, and the muscles atrophy," he said. "Therapists have a battle, to get muscles toned, to get rid of atrophy. They work like slaves to get rid of that stuff. When I say Karen was maybe 15% recovered in coming home, I mean cognitively . Physical therapists get the arms to move--to grab a glass, a spoon, a toothbrush. . . . They do that in the hospital, and they do it well. It takes another three to five years--in Peggy's program--to get back the grace, the beauty, the rhythm. It's hard, but worth it."

Lambert paused, and said with a sigh, "It's all worth it. It's independence. And independence is the greatest gift."

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