St. Patrick’s Day news came in the form of an approval by my neurosurgeon to return to work. Earlier this week I had been discharged from out-patient therapy. They said I’d made the sort of recovery one just does not see with that type of injury. What type of injury is that, exactly? Well, now after all of this, I can tell you with some degree of understanding.

There are three general bits of information most commonly used to evaluate the severity of a head injury: Glasgow Coma Score, time spent unconscious, and a CT or MRI score.

The GCS was devised by doctors to assess head trauma and, importantly, to help keep track of patients’ progress over a period of time. The scale is comprised of three tests: one for eyes, one for verbal response and one for motor response. The three values separately as well as their sum are considered. The lowest possible GCS (the sum) is 3 (deep coma) whilst the highest is 15 (fully awake person). When this test was first administered to me in the emergency room, I scored a 7.

Doctors use time spent unconscious to rate the severity of a head injury. Generally speaking, longer time spent unconscious means a more severe injury. Anything over about twenty-five (25) minutes is considered at least a moderate injury. In my case I was knocked out at the scene, and stayed that way for at least a couple days. At some point I started to wake up, but the doctors decided it was best to keep me in a drug-induced coma for a longer period of time, to aid the recovery. All together I was in that coma for nine days.

CT and MRI scans are often employed to examine the brain and skull. It is possible for nothing to show on these scan and for a patient to have symptoms of a brain injury. But usually, if a scan shows a hematoma or other type of injury the likelihood of brain injury symptoms also occurring grows considerably. In my case, a large subdural hematoma was clearly visible on the first CT scan.

About that time is when they drilled into my skull to try and reduce it.

So, the initial diagnosis — which does not change — is that of a severe traumatic brain injury. Serious stuff. Whirl had several conversations with doctors about long-term care for me. But I seem to have broken the odds. Most of the symptoms I was suffering — and it was a long list, let me tell you — are now gone. What ones I’m still experiencing, are certainly at a level where they’re not interfering with a normal day. At least not most of the time. I can walk and talk. I can even do those things at the same time. My sense of balance that had been knocked for a loop is steadily returning thanks to some rigorous therapy and a double set of exercises I do.

So here I am. I shouldn’t be here. But here I am. — And I got to tell you, it’s good to be here.

We’ll see how work goes, tomorrow.

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