For Many With Head Injuries, Life Is Forever Changed

It was her only daughter’s wedding, and the Irvine woman, who had been so excited, so consumed with every detail, could not have cared less.

Shortly before the festivities, a split-second slam into a car making an illegal left turn stole every trace of anticipation and joy.

“All of a sudden, it seemed like something I had no interest in,” she said. “All of a sudden, it was, ‘I don’t care, use paper plates and plastic forks.’ ”

In fact, she didn’t feel like she cared about anything or anyone anymore.

Three years later, she is still wondering how a traffic accident, causing a brief but violent jerk to her brain, could have taken so much from her. Once passionate about her work and family, this middle-aged woman was left feeling only frustration and loss.

Head injuries can be like that. Sometimes they mangle your memory, sometimes your reason, and sometimes, the very feelings that define you. A severe jolt to the brain, especially to the prefrontal lobes of the cortex, can alter the personality patterns of a lifetime.

Victims can be pushed to emotional extremes--to states of uncontrolled rage and sadness, or to a sense of virtual disconnection from any feeling at all.

Such patients are walking examples of the brain’s complex--and delicate--role in human emotion. Before the advent of brain scanning, head injury victims provided researchers with some of the most valuable information about how humans feel.

Now, patients like the Irvine woman hope to benefit from what has been learned. But recovery after severe injury is rarely complete.

“We can help improve some problems a patient may be having, but returning to life as it was is usually very difficult,” said Douglas E. Harrington, a neuropsychologist and consultant with the Coastline Community College Traumatic Head Injury Program in Costa Mesa. With significant injuries, he says, “it usually doesn’t happen.”

From what the Irvine woman has been able to piece together, her car was struck nearly head-on. Her buckled-in body was heaved between the two front seats and her brain was smashed against the insides of her skull. If she lost consciousness, it wasn’t for long.

At first, she was treated only for broken ribs, internal injuries and bruises. The head injuries, later described as “global” by her physician, initially went unnoticed at the hospital. They left no outward sign.

But inside, she was profoundly transformed. It wasn’t just that she couldn’t do basic math anymore or that she neglected to pay bills.

When her elderly mother was hospitalized in intensive care, she had to be repeatedly reminded that the older woman was ill. She could no longer sense what clients at her bustling small business wanted, or why. She forgot the troubles of her longtime friends soon after they confided in her.

Coastline’s program, believed to be the first of its kind in the nation, has helped to sharpen her memory and organize her life. She is better at keeping reminder notes and at planning around her weaknesses.

Over 18 to 20 months, Coastline provides classes to help patients cope with daily living and problem-solving, touching on everything from how to spot the main idea in a news article to how to cope with family conflicts.

“They’re not necessarily re-creating lost skills as much as learning new ways to compensate for what’s no longer there,” Harrington said.

Still, the Irvine woman has trouble protecting herself from day-to-day hazards. Recently, a man distracted her in her front yard with a bogus hard-luck story while his accomplice burglarized her home. Her index of suspicion is broken, she says. She knows she must be cautious, but says she feels no worry or fear.

What she misses most is the feeling of love. She can’t bring herself to tell her daughter or her parents about that loss. She has to remember to pretend.

“I know that they love me very much and to not be able to give that back in the same way . . . I know I think about the way it used to be, and to say that I don’t remember . . . “

She breaks off, and tears form in her eyes.

“I feel loss for not being able to have that feeling,” she said. “I know that feeling was very important to me.”

‘I’m Not the Same Person’

Bill Sellers was the smiling parcel delivery man, reliable, not easily ruffled. For 12 years, his bosses gave him the tough jobs, knowing he could handle whatever came up.

But he couldn’t handle the guy who jumped him one day in an isolated corner of a company lot. His assailant, a disgruntled client who had been needling Sellers for two years, beat the deliveryman nearly senseless, pummeling him about the neck and face.

It was his second serious head injury. Years before, when he was 19, he had been in a car wreck in Costa Mesa. His right eye socket was slammed so hard it broke. He was hospitalized for 11 days but doggedly recovered.

His luck didn’t hold after the 1991 attack.

“I’m not the same person,” Sellers said. “My emotions are up and down radically. . . . Not a day goes by that I don’t have tears.”

A brain scan two years after the beating detected abnormalities in his prefrontal lobe and temporal regions, records show. Both are involved in the regulation of emotion.

But his wife and two adolescent daughters didn’t need the scan to know something was seriously amiss. Sellers, 45, gets tired and confused, and hasn’t been able to return to work. But perhaps most disturbing to his family, his affable, upbeat personality has vanished.

He is introverted and cries often at slight provocations. He sometimes launches unpredictably into rages. He is oddly impulsive.

“He used to be very pragmatic,” his wife, Beth, said. “Like when we needed a washer or dryer, he would do all the research, then decide which was the right one and then buy that one. Now he can’t do that. He’ll impulsively buy something and we’ll look at it and say, ‘We don’t need this.’ ”

Like the Irvine woman, Sellers says he has benefited enormously from the Coastline program. He is taking career tests and hopes to work again someday.

In the meantime, he wants only to hang on to his family and his home, all he has left from his old life. He constantly tries to remind himself that he is luckier than most: Many fellow students at Coastline have lost spouses and children who could not live with how much they had changed.

“I always say you take your vows for better or worse,” Beth Sellers said. “This is the worst part. It’ll get better.”

Her husband looks at it another way. “I’m just struggling to survive every day,” he said.