“Ah, Ma-a.” How many times have I heard that phrase? With a downswing of tone on the final “a,” it’s my kids’ exasperated reply to any of the dozens of reminders that I (and millions of other mothers) issue every day. “Where’s your helmet?” “Buckle up, everybody.” “Don’t push your brother.” “Be careful in the shower.” When undiluted by the thousands of other more interesting things said in a day, the list does seem a bit much. The kids accuse me of being a worrywart and overprotective. I think I’m only keeping them safe.

It’s an occupational hazard, this worry about safety. The consequences of not doing those things (wearing a helmet, buckling up, rough-housing safely, being careful, etc.) are vividly before me every day. I work in a mental health clinic. Every day, I’m confronted with what brain injury can do to an individual and a family.

Life Can Change in an Instant

The files of any community mental health clinic are full of cases in which ordinary life has been transformed by a trauma to the brain. In a split second, a fall, an auto accident, a sports injury, or an act of violence can change someone’s life forever. Every 15 seconds, someone in the United States sustains a brain injury. My colleagues and I see cases like the ones described below (with details and names changed to protect privacy) far too often to be complacent about being careful.

Take Greg, for instance. When he was 10, he was hit by a car while riding his bike home from school. He has such complex mental and physical disabilities that his family can’t manage him at home. At 20, he lives in a residential setting with 24-hour staffing.

And then there’s Loni, age 88, who fell while walking to her roadside mailbox, striking her head on the curb. Before the fall, she was active and sharp. Now she has trouble concentrating, can’t keep up with a conversation, and has trouble finding the words she wants. Old age didn’t get her down. A brain injury did.

Earl’s story is far too common. Twenty-five years old and feeling invincible, he refused to wear a seatbelt. He refused once too often. What could have been a minor accident became a tragedy. Hit from behind, he put his head through the windshield. Now his moods and behavior are unpredictable and confusing to himself and those around him. His outbursts of rage made his wife and three-year-old daughter too afraid to live with him. They enjoy time together when they can.

Cici was only six months old when her mother’s boyfriend shook her violently. She’ll never be the bright, successful woman she was meant to be.

And Mike, age 17, received a concussion when a ball hit his head during a soccer match. This was the third concussion he’s had in the past two years while playing the sport he loves. He’s now having some difficulty in school.

A Range of Limitations

Brain injury can result in a wide range of limitations. Mike’s difficulties may be serving as an important “wake up call.” He and his family need to make a decision about whether whatever benefits he gets from his sport are really worth the price he is starting to pay.

For many others, like Earl or Loni, there is a painful awareness of how an injury changed everything. For them, there is the daily struggle to do the best they can and the daily struggle to manage their own and their families’ anger, sadness, and feelings of loss. Generally, they find a way to manage with courage and optimism. But it’s also a very human response to go through periods of frustration, anger, and depression.

Most severely brain-injured people, like Greg, don’t know what they could have done or might have been. They live in the now that they have. Thanks to residential programs, good job programs, and supports from family and human service agencies, most severely brain- injured people in the U.S. live decently, have a support network of helpers and friends, and have something to do everyday. Nonetheless, their lives are a tragedy to those who love them.