Is It Appropriate?

Rep. Gabrielle Giffords. Source: giffords.house.gov

On January 8, 2011, U.S. Representative Gabrielle Giffords (D-AZ) was shot in the head by alleged gunman Jared Laughner.

For our quick-cut Saturday pieces, one of the other moderators asked me (quite reasonably) to write a few words about her recovery, since I am a brain scientist by trade.

I was initially very reluctant to do so, because I am afraid of crossing a line into prurient interest. I would submit that when she sustained a massive brain injury from a gunman’s bullet, she vacated the realm of a public figure whose life should be laid bare because of a “right to know.”

Now I believe she has become a private person who, like the 360,000 brave soldiers who sustained brain injuries in the wars in Iraq or Afghanistan or the estimated five million Americans who have suffered head injuries from falls, automobile accidents, or sports, deserve their privacy as they begin the long and difficult journey into the light.

So, I’m kicking off a meta-discussion. We may get around to the details (at least, what is known) about her recovery, but before we do that: should we be discussing this at all?


About Monotreme

Monotreme is an unabashedly liberal dog lover, writer, and former scientist who now teaches at a University in an almost-square state out West somewhere. http://www.logarchism.com | http://www.sevendeadlysynapses.com
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14 Responses to Is It Appropriate?

  1. Mr. Universe says:

    Monotreme is being polite by not mentioning just which of us asked for him to weigh in on Representative Giffords potential for returning to a life of policy. I will go ahaed and admit to making this request for a couple of reasons: 1. Treme is more qualified to have an opinion than I am and 2. I am eventually going to write about Senator John Kyl’s vacated seat for the Senate Seat Series and the topic will come up out of necessity.

    There are a couple of other reasons as well one of which is kind of selfish. I love a great comeback story and I also think the best thing to do for any injured person is to return them to doing what they do best. Representative Giffords loves working for the people of Arizona.

    Perhaps I’ve gotten my hopes up but I’ve been buoyed lately by reports of her miraculous recovery. At any rate, it will be interesting to hear what the readers of 538Refugees think about the matter.

  2. Max aka Birdpilot says:

    Mono,

    I recognize the couple of studies on which the 360,000 number is based, but I have serious problems with the relevance of including “minor concussions” from any source while serving in the two battle theaters in that number. Hell’s bells! by not making clear the source, we’d be passing out Purple Hearts for hangnail and listing those injuries in the casualty reports. Based on actual casualty reports, less than 20 percent of that number could possibly be battle related. Your comment does not make that clear.

    If you took the other 300k and divided by the 10 years, you’d have 30k/year. Of a population of about 2 million, how many people possibly sustain at least a “minor” concussion per year? So how many service people statistically would have had a minor head injury whilst safe and warm here at home?

    A a responsible scientist, I as you to please keep from conflating, for whatever reason, what would APPEAR, by your quote, to be battle injuries, along with the other 5 million folks.

    Context.

    Thanks

    Thanks

  3. Mainer says:

    Mono while I am interested in knowing how the Rep. is doing and some of the whys involved I would actually have a greater interest in understanding about this because of the other group you mentioned. I spend on average one day a week taking a good friend to our VA hospital for treatment (not associated with a brain injury) in the prochess I have met far too many young and some not so young soldiers that are suffering from bad head injuries and it does not seem like they are progressing too well. Along with former students I communicate with on a regular basis on Facebook that have similar issues I keep wondering what the future holds for them.

    Giffords progress makes me hopeful that many of these other victems have a future as well, but what kind of a future can we or they realistically expect?

  4. filistro says:

    Well, the Freepers, who represent a goodly portion of America, have no such delicacy.

    They are busy wondering why she’s allowed to retain her seat in Congress. (They also fear the Dems will run her for Senate in Arizona and she will win on the “sympathy” vote even though she’s a “vegetable.”)

  5. Mainer says:

    Fili I saw some of those comments and worse. Also some pretty out there stuff on a couple of Fox threads I have checked out.

    Max, a couple of things. I believe you will find that the vast majority of soldiers that have had even serious concusive injuries have not and will not receive the Purple Heart unless there were more conventional injuries with it. I have nothing in writing on that but base it on people I actually know or that are friends of my son. I would like to think 360K is way high but I’m not sure. Other figures from DOD have seemed equally as low so it would be any bodies guess at this point.

  6. mclever says:

    I appreciate that we’re asking the right question first. Should we be delving into the private life of someone who is going through a deeply personal medical crisis, even if they were a public figure?

    Let me start by saying that I do not think her medical records should be made generally available. I agree that she’s entitled to a certain measure of privacy. So, the news reports say she’s talking and walking with assistance and should be stable enough to see her husband’s shuttle launch next month? Great! That’s probably more than any of us should really know about her recovery so far.

    However, I don’t think it’s wrong for us to engage in some speculation for the purposes of learning more about traumatic brain injuries with Rep. Giffords’ case as a model for starting the discussion. Perhaps without delving too deeply into the specifics of her case—obviously, since none of us have access to her actual medical records, none of us actually know any specifics—our resident brain expert could speak more generally about realistic expectations for recovery in response to what we’ve all seen in the press this past week. As I was reading those stories, I got a strong whiff of “wishful thinking.” How much can we realistically expect from someone who was shot in the head? Maybe it would be useful to have some worst case, likely case, best case projections that are informed somewhat by the scant details that we’ve heard about her recovery so far. We can thankfully assume that worst case won’t be permanent vegetable or paraplegic, for example. But is full recovery a realistic possibility?

    Our pursuit of this topic is naturally driven by our concern for Rep. Giffords, but, for the sake of the many soldiers (and police officers) who also get shot (or hit) in the head, it would be interesting to know how many people make a full recovery from an injury like that, what that recovery looks like, and what a “partial” recovery might look like. Maybe some “if the bullet went here, then… but if the bullet went there, then…” explanations for those of us who barely remember where the medulla oblongata is. Can one recover all mental functions but remain physically impaired? Vice versa? How likely is it? How adaptive is the brain to working around those sorts of injuries and re-learning things? Are some people’s brains naturally more adaptive than others?

    I, personally, would enjoy reading such a treatise from “Dr.” Monotreme.

    🙂

  7. filistro says:

    @mac… I, personally, would enjoy reading such a treatise from “Dr.” Monotreme.

    Me, too. Partly for selfish reasons, since one of the dearest people in my life is an 11-year-old who suffered hypoxic brain injury at birth. He is an utterly beautiful child, and I adore him (we have helped with his physical care since he was born.) The injury to his brain is so slight that it shows up only as a tiny “shadow” on CAT scan and MRI. Yet his disability is profound (he can’t walk, sit, stand or speak) not because of widespread trauma but because the damaged area, albeit tiny, is in a vital part of the brain (the basal ganglia) where impulses are processed and sent from brain to body.

    I’m particularly interested in knowing how far stem-cell therapy has advanced, and how much help it will eventually be to victims of TBI (traumatic brain injury) like all the injured soldiers, gunshot victims like Ms. Gifford… and my own little sweetie.

  8. Max aka Birdpilot says:

    Where, how and when are great determinants of recovery. Did I not read in the literature several years back of a girl that had an entire hemisphere removed and was performing reasonably “normally”?

  9. Mr. Universe says:

    Antonio D’Amasio wrote a book about catastrophic brain injuries. One of the earliest was the case of Phineas Gage, who had a tamping rod made of steel blown through his frontal lobe. He survived the ordeal but his behaviour became erratic. He developed a peculiar propensity for obscenity. He became quite offensive. His case is one of the earliest on record for brain damage.

    There will likely be some unusual consequences from Gifford’s brain trauma. What those may be are still a mystery. Will she suffer from speech impediment? Ambulatory problems? Cognitive dysfunction?

  10. Max aka Birdpilot says:

    I thought so. Check out Scientific American, May 24 2007 article.

    http://www.scientificamerican.com/article.cfm?id=strange-but-true-when-half-brain-better-than-whole

  11. Monotreme says:

    Had a race this morning so I was out of pocket for a while. Thanks, everyone, for their comments.

    I might need to break that into several articles, or decide which aspect to discuss first. Maybe I can get something ready for Sunday afternoon.

  12. Armchair Warlord says:

    If I may weigh in on that 360,000 figure,

    Traumatic Brain Injury is no joke – I know soldiers who have suffered serious long-term effects from having multiple minor concussions. This generally comes from being in close proximity to IED detonations but outside of the immediate zone where you would seriously injured or killed. Most soldiers shake it off immediately and carry on, but the long term effects can be serious. The Army has recently instituted mandatory rest periods following exposure to blasts that have reduced TBI rates in areas they are in place almost to zero.

    In short I wouldn’t be particularly surprised if the number of soldiers suffering from some form of TBI approached that figure, although I have no medical figures on hand to compare it with.

  13. Monotreme says:

    Thanks, Armchair Warlord.

    That was one of the points I wanted to make in my post. Even “minor” brain injury is a big deal. Anything that produces a loss of consciousness causes some degree of permanent damage.

  14. Mainer says:

    Thanks Armchair. One of the staff memebrs I talked to at the VA hospital likened what is happening with our soldiers to that witch all too often happened to over the hill prize fighters with too many hits to the head and the resultent concusions and the cumulative effect it has. It took the military way too long to figure this out. I can point out young men in their 30’s around here that did 4 and 5 deployements and that were exposed time after time to heavy concusive effects that shuffle around like old friends of my dad’s that boxed professionally with him in the 30’s and 40’s. One can but hope that with time comes some amount of recovery but then I keep hearing that the early on set of Parkinsons like issues is also showing a spike with many of them.

    We are also holding our breath for the girl friend of one young fishing friends. She was in a horrible car wreck earlier this winter and suffered severe head injuries. While she is home now she has a very long way to go and many functions and abilities to recover so I suspect I will see how this plays out closer to home than I might other wise. As Armchair has said head injuries are nothing to make light of regardless the cause.

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