Trauma Also Takes Its Toll on Families of the Victims

Tom Smithson clutched his wife’s fur coat, watching expressionlessly as she and a young man danced to a rousing Cyndi Lauper tune.

In the two years since a runaway softball bat flew over two fences and cracked Ida Smithson on the head, her husband has quietly struggled to understand the various subtle and not-so-subtle ways in which his wife has changed, he said. Now, as he scanned the auditorium at Coastline Community College’s Costa Mesa campus, where several dozen students in the school’s Traumatic Head Injury program danced and laughed and sipped soft drinks, Smithson talked about how his wife’s memory loss, her emotional swings, her sometimes scrambled thinking and her inability to drive or to properly care for the couple’s 4-year-old daughter have changed his life.

‘I Get Depressed’

“It gets a little hard at times. I get depressed and wish it would just go away, but I’ve accepted that it happened and I deal with it. . . . The only thing I’m pondering is, this could be for the rest of our lives. That gives me butterflies.”

“They say that 90% of marriages have problems or break up following a head-injury accident,” said Dyan Funk, 27, a student in the Coastline program who was injured in an auto accident near her Huntington Beach home last year. “After my accident, I overreacted to everything. I beat on my husband and my family.”

But her husband stuck by her. “He pulled me through it emotionally,” she said. “It’s definitely harder on the family than it is on the person with the injury.”

That seemingly stoic sentiment is expressed frequently by people with traumatic head injuries, and, according to Harvey Jacobs, an assistant research professor in the department of psychiatry at UCLA’s School of Medicine, it may well be true.

Jacobs recently compiled the results of a yearlong study on the long-term effects of traumatic head injury on the survivor and family, and last month he and his colleagues at UCLA sent out 1,000 questionnaires as part of a second study.

“The problems are staggering,” Jacobs said. “We’re already getting back mail from our new survey, and it’s absolutely heart-rending.”

‘People Are Desperate’

Although the new questionnaire bears a UCLA return address, one family was so intent on making their dilemma known that they found where Jacobs lives and hand-delivered the survey to his door, Jacobs said. “We’re getting two- and three-page letters from families, and we’ve had at least 50 phone calls. People are desperate for any kind of help.” Jacobs isn’t surprised by the response. His original study of 325 Los Angeles-area families with a son, daughter, parent or spouse who suffered a traumatic head injury showed plenty of cause for despair, he said.

The study found, for instance, that:

--While 72% of those injured had been working to support themselves before their accidents, only 15% reported working as a primary source of income afterward, and most of those were making considerably less than they had been.

--Among the 20% of the head injured with children, only a third had been able to resume parental care.

--According to family members, only a third of the victims surveyed could manage their own basic finances.

--Of the 71% of victims who were living with parents or spouse, at least half required full-time supervision, and in half of those cases, a family member reported giving up a full-time job or dropping out of school to care for the person with the head injury.

The financial strain alone of caring for a person with traumatic head injuries is enough to tear families apart, Jacobs said.

Few Have Insurance

“Even 10 years ago, there was nowhere near the survival rate (for people with traumatic head injuries) that there is now,” he said, adding that that explains, in part, why few insurance policies offer coverage for what may amount to a lifetime of rehabilitation.

The few long-term rehabilitation programs that do exist can cost as much as $15,000 a month, Jacobs said. And even without such long-term attention, the accumulated costs can be high. In fact, 28% of the families in Jacobs’ survey reported that most or all of the family resources had been used to pay bills resulting from the accident.

“You have to admire what these families are doing, and understand the bind they’re in,” Jacobs said. “They have a loved one, and they’re taking care of them. But they’re under tremendous stress. Other studies have shown that families caring for people with head injuries have two to three times the number of physical and psychosomatic illnesses--probably because of the added strain.”

Crystal Guirey knows as well as anyone about the strain the families of people with head injuries face. On Sept. 20, 1980, her son Dan, now 28, crashed a motorcycle on the Harbor Freeway. Crystal and her husband, Donald, flew from their home in Royal Oak, Mich., to be with Dan during the six weeks he remained comatose at USC-Los Angeles County Medical Center, and they continue to support him emotionally and financially as he moves from one rehabilitation program to another, trying to regain his independence.

Second Child Injured

Three years after Dan’s accident, at a time when the Guirey family was just beginning to mend, the driver of a car in which the couple’s daughter, Diane, was riding swerved across the center line on a narrow Louisiana highway and hit a truck head-on. It was Diane’s 22nd birthday. Again Crystal and Donald Guirey arrived at the beside of a comatose child.

Crystal Guirey now lives in Tustin, where she helps care for Diane, who is enrolled in the Traumatic Head Injury program at Coastline Community College. Donald, an automobile designer, continues to work in Michigan but visits California frequently. And, Crystal Guirey pointed out, although her other three children remain healthy, they’ve hardly come out of the last five years unscathed.

“It’s disrupted their lives completely to have this happen,” Guirey explained over the noise of the dance party at Coastline. “As siblings, they don’t really understand head injuries, so it’s hard for them to adjust to having a new brother and sister personality-wise. Our youngest daughter has a lot more understanding now, but she’s been robbed of her childhood.”

The accidents have also had a profound effect on her husband, Guirey continued. “I see a lot of depression in him. We were just getting to the point where we were ready to retire.” But now Donald Guirey has to keep working to provide care for his two injured children.

Dr. Sherman Holvey and Phyllis Holvey of Long Beach weren’t at the recent Coastline College dance, but they understand the emotions expressed by family members there.

Boating Accident

Six years ago their daughter, Sandi, who’s now 32, was an emergency room nurse with plans to attend medical school. She was on a water-skiing trip in the Sacramento River Delta when the boat in which she was a passenger roared under an overhanging branch. A helicopter flew the young women to a trauma center in Modesto and she was later transported by mobile care unit to Southern California where she spent 2 1/2 months at Cedars-Sinai Medical Center and another four months at Long Beach Memorial Hospital. Since then, much of the Holveys’ life has revolved around caring and planning for their daughter.

‘It’s So Unexpected’

“It’s like deja vu,” Sherman Holvey, a physician specializing in diabetes, said of the problems that confront the parents of people with traumatic head injuries. “First of all, it’s so unexpected. No one is ever prepared. Unlike chronic illnesses, head injuries for the most part affect young people at the time of their lives when they’re just beginning to move into independence and into their own world.

“So the injury puts them back into the family just when they were leaving it, and at a level of functioning that, for them, is very much like being reborn. (For parents) it’s like reliving the experiences they had when their child was first growing up. . . .”

Although the Holveys both said they missed their freedom, it is the awareness of their daughter’s suffering that causes them the deepest pain.

“One of the most poignant things about people with head injuries is the loss of self they experience,” Phyllis Holvey said. “These people realize they’ve changed. They know they can never become the person they were. That’s the tragedy. My daughter knows she was a fantastic person. And she knows she’ll never achieve what she once could have achieved--that she’ll never live out her dreams.”

Former Skills Pursued

Not that Sandi Holvey has given up. Last year she graduated from the Coastline THI program, and she’s currently observing at her father’s Century City medical practice, trying to reactivate or relearn some of the medical skills that disappeared after her accident.

In the meantime, Sherman and Phyllis Holvey said they have replaced some of their own dreams with new goals, the most ambitious of which is expressed in their creation of a Los Angeles-based organization called the Betty Clooney Foundation for the Brain Injured. Founded in 1983, the foundation is named for the sister of singer Rosemary Clooney and KNBC news anchor Nick Clooney, who died of brain injuries nine years ago.

As they became increasingly involved in caring for their daughter, the Holveys began to appreciate the often debilitating problems that families--especially poor and middle-class families--face in caring for a person with head injuries. At the same time, they realized that the survivors themselves weren’t happy returning to the family nest so soon after leaving it, Phyllis Holvey said.

“A major problem, especially for young people with head injuries, is the loss of their social life and their ability to be independent,” Phyllis Holvey explained. Although Sandi’s friends came around often during the crisis period after the accident, “she hardly sees anyone on a regular basis anymore,” Holvey said. “The loneliness can be terrible.”

Apartments Planned

So the Holveys and a number of other families are working together to raise money to create “a supervised, apartment-style complex” where people with traumatic head injuries can live with as much or as little independence as their situation warrants. As proposed, a professional staff will offer recreational, psychological and social services. And the students will help support themselves and receive vocational training at a center-run business.

First of Its Kind

The foundation hopes to build its center--which would be the first of its kind in the country--as close to Coastline College’s Mesa Verde Learning Center as possible, so that students will be able to take advantage of the cognitive retraining program there.

Earlier this fall, the National Institute for Handicapped Research presented a joint award of $49,940 to the Clooney Foundation and Coastline to develop the vocational training and employment component of the proposed living center. But the foundation is still trying to raise $1 million to complete the center itself, the Holveys said.

Until then, the Holvey family, like hundreds of thousands of other families, holds itself together with hope, Sherman Holvey said. “Our reward is the real progress that’s being made through our caring, support and patience, and our daughter’s strength.”