Category Archives: History

At Home Brain Care

Last week, the University of Arkansas for Medical Sciences received a three-year, $450,000 grant from the U.S. Department of Health and Human Services Administration for Community Living, in addition to the $75,000 annual gift they are receiving from the Arkansas Department of Health.  The federal grant is to be applied to the University’s Traumatic Brain Injury State Partnership Program State Funding Opportunity.  “Among the goals of the program… are incorporating telemedicine and other technologies into TBI services to survivors, raising awareness of clinical and educational services for survivors, caregivers and families…”  Telemedicine increases healthcare access for all, particularly those is rural areas and others that cannot easily visit medical facilities, such as those with tbi who need aid in transportation.

Although it may seem to be a relatively modern invention, forms of telemedicine have been in existence since man could verbally communicate.  The more modern view of telemedicine, involving both verbal and visual communication with the medic, was first seen in 1924 in, “an imaginative cover for the magazine Radio News foreshadowed telemedicine in its depiction of a ‘radio doctor’ linked to a patient not only by sound but also by a live picture.”  Though at the time, the ideas of television and telemedicine were merely fantasies, the first television transmission occurred only 3 years later.  Video communication between doctor and patient, however, is usually first dated to 1959.  1959 is also the year of the first neurologic examination through telemedicine, occurring at the University of Nebraska.  Five years later, means to treat patients with brain injury and neurological disorders were found, as, “they established a telemedicine link… to provide speech therapy, neurological examinations, diagnosis of difficult psychiatric cases, case consultations, research seminars, and education and training.”

The above paragraph primarily comes from information in a 1996 article that can be found on the site of the National Academy of Sciences.  In 1996, the government recognized that there was a vast need for telemedicine, since its envisionment to the present day.  With both new technology and increased forms of communication, telemedicine has gone far above what could have been imagined 22 years ago.  For example, a 71-page report penned by the Undersecretary of Defense to the House Chair of the Committee of Armed Services, states that, “the Department of Defense views telemedicine as an important set of tools to improve access to Psychological Health and TBI care services in both deployed and non-deployed settings.  In June 2018, the FDA approved the distribution of MindMotion GO, a type of mobile therapy that focuses on speech and task therapies.  As far as brain injury diagnosis, while CT scans and other such tests may need to occur at medical facilities, medical professionals are now using communication technology to diagnose another neurological disorder (autism) and to evaluate others (computerized concussion assessment).
 

Revolutionary Treatment in the 18th Century

When one thinks of Revolutionary War combat injuries, one tends to think of physical trauma or even death.  Head injury is generally not considered, even though when one thinks of war injuries, head injuries are known to occur all too often.  Because of this reality, during the War of Independence, American doctors began to study neurosurgery and treat soldiers accordingly.  A manual, titled Plain Concise Practical Remarks on the Treatment of Wounds and Fractures and authored by Dr. John Jones, was published in 1775, “to give the young unexperienced Surgeon, fome general and clear ideas of the nature and treatment of this difficult and dangerous brain of chirurgical difeafes” sic.  Dr. Jones’ experience included founding King’s College Medical School, now known as Columbia College of Physicians and Surgeons.  (Manual chapters include: Of Blows on the Head, Of Injuries Arifing from Concussion or Commotion, Of Injuries Arifing from Fracture of the Skull.)

New Perspective: How Lincoln’s Brain Injury Shaped a President

February 20 was President’s Day.  Before the end of the month, it is good to honor one of America’s most lauded presidents and brain injury survivor, Abraham Lincoln:

During his younger years, although he had little formal education, Lincoln was an avid reader.  He would have rather spent a day reading a book than outside riding a horse.  Perhaps because of his comparable inexperience with outdoor activities, Lincoln was thrown off a horse as a child.  Though the specifics of this event are murky (some articles/posts claim he was 9-years-old during the incident, some say 10.  Some say he was hurt by a horse, others say a mule), what is clear is that he remained unconscious for at least the rest of the day.

Later in his life, Lincoln had two bouts of malaria, in 1830 and 1835.  When parasite-filled blood cells block blood vessels, malaria can cause brain damage.  Also in 1835, some claim that Lincoln had the sexually transmitted disease syphilis.  Syphilis can cause neurological problems.

While both contracting malaria and syphilis may have heightened the severity of Lincoln’s brain injury, the most severe occurrence to Lincoln’s brain was, most likely, the aforementioned fall off a horse at a young age.  Given this historical information, it is clear the Lincoln had some sort of brain damage.  His recorded behavior further exhibits this.  Specifically, Lincoln is known to have had a prolonged struggle with severe depression.  Depression is, unfortunately, a common side effect of brain injury.

Whether knowing that Lincoln had some sort of neurological problem affects people’s views of him positively, negatively or not at all, is irrelevant.  People simply need to know that the president who brought our country back together had a brain injury.  Knowing this, the public may question and change their underestimation of and negative behavior towards brain injured classmates, neighbors, fellow employees, etc.

NDEAM: The Beginning

On September 2, 1945, WWII officially ended.  However, for many of the 670,846 wounded in the war, the struggle did not end there.  Discrimination, often unintentional, unknowing discrimination, was rampant against the disabled, meaning that their job prospects were limited.  (Discrimination was much more pervasive than it is now, though that is not to say that current job prospects for the disabled are good.)  Because of this, on September 21, 1945 by Act of Congress and Presidential proclamation, President Truman declared October 7-13, 1945 as National Employ the Physically Handicapped Week.  In Proclamation 2664, the President wrote, “I ask the governors of States, mayors of cities, heads of the various agencies of the Government, and other public officials, as well as leaders in industry, education, religion, and every other aspect of our common life, during the week and at all other suitable times, to exercise every appropriate effort to enlist public support of a sustained program for the employment and development of the abilities and capacities of those who are physically handicapped.”

In response to this, many Senators and Representatives expressed their support.  Given the number of wounded veterans returning home and others with physical disabilities, many of those in Government had a personal interest in aiding those who they knew to be capable individuals.  In particular, Representative Earl C. Michener expressed on the Congressional Record, “Just because one cannot see as others do, or walk as others do, or talk as others do, or hear as others do, is no indication that this person does not have a mission in life and a definite productive place in society and in our economy.  However, it is easy for the American people to forget, and the celebration of this particular week will not only stimulate the memory, but will impress the necessity of remembering that there are in every community some physically handicapped persons.”  When you eliminate the word “physically” from this remark, so that it applies to today’s broader definition of disability, Rep. Michener’s statement is just as relevant now, as it was over 70 years ago.