Illegal Immigrants and Brain Injury

A hot topic in the past few decades, illegal immigration has now come to the forefront because of America’s current president and his border wall.  (For the past 10 years, the estimated number of illegal immigrants in America has stayed relatively stable at about 11 million.  During the presidencies of Bill Clinton and George W. Bush, it was steadily rising.)  As for brain injury and undocumented residents, there are many cause-and-effect questions that, when answered, are quite sobering.

To begin, what if the illegal immigrant is the culprit?  What if the illegal immigrant causes someone to have a brain injury, either intentionally or inadvertently?  First, the police or whomever is pursuing the case must find them.  Since illegal immigrants are largely undocumented, this can be a hard task.  For better or worse, depending on your political ideology, a number of states are now allowing an illegal immigrant to legally obtain a driver’s license and register their car.  In January 2015, for example, California signed into law AB60, which, “requires the [DMV] to issue an original driver’s license to an applicant who is unable to submit satisfactory proof of legal presence in the United States.”  New Jersey, with the support of Governor Phil Murphy, is now preparing for a similar bill, Assembly Bill No. 1738, to pass.  If this bill passes, it will make New Jersey the 13th state, plus the District of Columbia, to allow this.  (What the consequences are for an illegal immigrant who inflicts injury on another person, such as through a car accident and even if they are legally licensed, is unclear.  They are subject to criminal charges, but civil action may be more difficult.  As they are illegal, and many do not submit tax returns, which would show their yearly income, monetary consequences to cover such things as rehabilitation costs are not possible.)

More so, the government does not seem to account for the economic costs of brain injury:  For the victim, there will be a lose of future wages as, even if the victim is able to return to work, they will be away for a bit.  Additionally, when returning to work, a brain injured individual may have to pursue a career that is less cognitively and/or physically demanding and often less lucrative than their previous occupation.  For the Internal Revenue Service (IRS), this means less taxable dollars are earned.  Also, the brain injured individual may stay longer or indefinitely on Medicare and/or Medicaid.  The government then is required to help pay for their doctors’ visits, their medication, etc.

But, how about when the illegal immigrant is the victim?  No one wants to see a person, legal or not, suffer or even die due to lack of medical care.  All told, the government is financing about $18.5 billion a year for medical care of unauthorized immigrants.  Of this total, “federal taxpayers provided $11.2 billion in subsidized care to unauthorized immigrants in 2016.”  (“A relatively small number of undocumented immigrants, perhaps in the tens of thousands, obtain health insurance through private employers,” states a 2016 article.)  However, a page on the NIH website, written by an individual who had authored other pages on ethics, as it relates to illegal immigrants, notes that, “the Patient Protection and Affordable Care Act of 2010 ignored the health care of undocumented immigrants and will not provide relief to undocumented patients with catastrophic illness like ESRD, cancer, or traumatic brain injuries.”

There are local health clinics, hospital emergency rooms and free medical school clinics that must treat everyone, regardless of legality.*  Additionally, some doctors will treat undocumented immigrants, off the record.  Treatment for brain injury though, requires more than a brief trip to the doctor.  As an article from 2009, when illegal immigrants were treated differently by the government than now, is titled, “Struggling to find post-acute care for undocumented and uninsured immigrants.”  Should ethics trump legality, no pun intended?

*Another article recounts the story of an illegal man, without insurance, who suffered a stroke.  Though the hospital legally had to treat him, his care would be uncertain the second he stepped out of the hospital grounds.  Would receiving care for his stroke result in a “medical deportation”?  Ultimately, the hospital was able to find the man’s family in Mexico, but the trip to return him to his family cost $50,000 and was paid entirely by the government.

Note: The above post is not a personal comment on illegal immigration.

Advertisements

Magic Is An Illusion; Trauma Is Not

For me and many others, David Copperfield is the nation’s foremost illusionist/magician.  He even earned a spot on the Hollywood Walk of Fame in 1995.  From 1974 until last week, his magic has been just that; Copperfield could do what seemed impossible.

In 2013, an audience member was selected to participate in a trick called “Lucky 13”.  The trick required participants to enter a box which is then closed.  Miraculously, the participants would then appear at the back of the theater at the MGM Great Resort and Casino in Las Vegas.  (If you want to understand how the trick was performed, click here.)  The aforementioned audience member, Gavin Cox, had a slip-and-fall during the execution of the illusion and, “was taken to the hospital with a dislocated shoulder. After returning to Britain… he suffered chronic pain [and confusion] and a scan showed a lesion on his brain.”

Most simply described, a brain lesion is an injury or disease affecting the brain.  The cost of the two fusion surgeries, plus a diagnosed traumatic brain injury, has been more than $400,000 for the plaintiff.  (I have found no information regarding the non-surgical treatment Cox received for his tbi.)  Cox filed a multi-million dollar negligence lawsuit in 2014 to cover these medical costs and his pain-and-suffering.  In addition to Copperfield, MGM Grand, show producer Backstage Employment and Referral, and building firm Construction Management were named as defendants in this suit.

Given Copperfield’s popularity, this suit has gained a lot of press.  (I even found an article about it in Golf Digest.)  Two other past participants of the trick have since come forward claiming injury as a result of participating in this trick.    Despite this controversy, though, Copperfield is still performing, albeit without this illusion.

mTBI, Not So Mild for the Older Generation

Last month, Rep. Louise Slaughter (NY) fell, resulting in a trip to the hospital.  “The Congresswoman is tough as nails and she will bring that same spirit to the recovery,” said her Chief of Staff at the time.  A Google search of “Louise Slaughter brain trauma” results in many links, including one entitled “Rep. Slaughter Announces Nearly $13 Million to Address Traumatic …”.  When clicking this link, however, one is directed to a now defunct personal webpage.  (A further search shows that Rep. Slaughter was a member of the Congressional Brain Injury Task Force, with particular attention paid to military weaponry.)

First elected to office in 1986, Slaughter was assuredly “tough as nails”, as she had to be, working in Congress and dealing with publications/broadcasters for so many years.  The first female chair of the House Rules Committee and the dean of the NY congressional delegation, Slaughter was planning on running for her 17th term.  “Louise was a trailblazer,” said Nancy Pelosi.  Unfortunately, the 88-year-old woman couldn’t recover from the intracranial hemorraging that resulted from the fall and passed away in mid-March.

Besides Rep. Slaughter, other politicians and others involved in politics have suffered such negative results from intracranial hemorraging.   Roger Ailes was a media consultant for President Richard Nixon, President Ronald Reagan, and President George H.W. Bush, as well as for Rudy Giuliani’s first mayoral campaign.  Most recently, he was CEO of Fox News until 2016 and served as a media consultant to Donald Trump’s presidential debates, before he passed away from intracranial hemorraging (subdural hematoma) in May 2017.  Additionally, one of the most respected past Presidents, Franklin Delano Roosevelt, died of intracranial hemorraging that was either caused by cancer or by high blood pressure.

Intracranial hemorraging is an all-encompassing diagnosis for bleeding within the skull that can be further categorized as an epidural hematoma, subdural hematoma, subarachnoid hemorrhage or intracerebral hemorrhage.  It is a form of mild traumatic brain injury (mTBI), that isn’t mild at all.  A concussion, for example, is a mTBI.

In 2012, the CDC reported that, “in the United States, the number of TBIs that occur each year among older adults, ages 65 years and older, is estimated at 237,844.”  Falls, as what happened to Rep. Slaughter, are the primary cause of TBI among the 65+ age range.  Additionally, it’s hard to assess how severe a brain injury is the older generation, because of other age-related issues.  Is a person’s memory loss due to a brain injury or simply a consequence of age?  The number of elderly Americans suffering a mTBI keeps rising, but the reason for this increase is unknown.  Perhaps it is because Americans are living longer?  Perhaps because Americans are living in their homes and generally staying active later in their lives?  Maybe it’s because new research and talk about such issues as sport-related injuries are being more broadly researched and discussed?

Rep. Smucker Joins Congressional Brain Injury Task Force

The Congressional Brain Injury Task Force states that its mission is, “to increase awareness of brain injury in the United States, supports research initiatives for rehabilitation and potential cures, and strives to address the effects such injuries have on families, children, education, and the workforce.”  This seems that it would be a unifying goal, going beyond political partisanship, and for that reason, most states have one or more Congressman serving on the Committee.  At the beginning of this year, Pennsylvania had 5 Congressmen serving as members.  Now, during Brain Injury Awareness Month and just after the Congressional Brain Injury Fair, Rep. Lloyd Smucker (PA-16) joined.  (Congressman Lou Barletta, who represents Carlisle, PA in the 11th district, where the Brain Injury Association of Pennsylvania is located, is not a member, though that does not mean that he does nothing to support those with tbi.)  At the moment, Smucker’s website does not mention his involvement with the task force and critics cite his support for and from the NRA as an indication of his disregard for American lives.  However, Smucker is a Congressional Republican, so his support for the NRA should be of no surprise.  He should not be told he cannot help brain injured Americans for that reason.   (More members may mean more ideas and more action from the Committee.)

(Above picture, originally published on March 29, 2018, is courtesy of the Facebook page of the Brain Injury Association of Pennsylvania.)

Caring for Man’s Best Friend

The benefits of dog ownership are well-known.  “Owning a dog can lift your mood or help you feel less stressed.”  For veterans and others with disabilities, the benefits of have a dog, specifically service dogs, go beyond this: dogs can serve by helping or even doing certain tasks that the handlers cannot do themselves.

However, what happens when the dog is the one with a brain injury?  Yes, dog’s skulls are harder than humans and surrounded by protective fluid, both of which make brain injuries less common in them.  (This is definitely beneficial for animals that play/fight for fun, may bump into coffee tables as they chase after toys, etc.)  Canines though, can get brain injuries in the same ways that humans can: a car accident, a fall, etc.  The possible symptoms are also similar to those of humans:  bleeding from the nose or ears, coma, confusion, death, disorientation, facial weakness, lethargy, loss of consciousness, paralysis, pupil dilation, seizures, and stumbling.

Once these symptoms begin to occur what do you do?  For these members of the family, seeking medical help should be the next step.  Going to the local veterinarian is definitely the appropriate action, but there are also neuro-veterinarian specialists.  While this is a very limited profession, it’s not impossible to find.  It is fortuitous to an injured canine if their owner lives in Arizona, as they have access to this professional expertise.  (For example, Lucky, a dog found shot in the Arizona desert by border control officers earlier this year, was relatively fortunate that such help was available to him.)

One thing not to do is to abandon the dog.  This is what happened earlier this month to one dog in Sacramento, CA .  A woman, assuredly not the owner, found an injured dog on the streets and brought him to the Sacramento County Bradshaw Animal Shelter.  The dog, now named Thomas, has gone through multiple tests, yet the doctors still do not know what happened to him, just that it resulted in a severe brain injury.  “He is such a fighter… Baby Thomas wants everyone to know he is determined to heal, grow up and live a long, mischievous life!”  This and so many other examples show the need for Sacramento Counties non-profit T.E.A.M. – Teaching Everyone Animals Matter.  (As of March 16, the owner of Thomas has still not been found.  T.E.A.M. is now offering a $1,000 reward for information that leads to an arrest.)

(Most states have laws prohibiting animal cruelty.  For example, 3 weeks ago, a 27-year-old man was sentenced to 12 years in prison for abusing his boxer puppy.  Most of these states also have a law prohibiting animal abandonment.)

Giffords Shows Support for McCain

Gabby Giffords may be a Democrat, but she also is an Arizonian and brain injury survivor.  Her husband, Mark Kelly, is a former astronaut who presumptively knows many fellow astronauts who have had a brain injury from their travel.  Politically, they differ from Senator McCain.  However, as fellow Arizonians, his friend and his former colleague, she and her husband have expressed their hope for McCain’s recovery.

Kelly expressed the importance of maintaining a positive outlook, just as McCain did during his 5+ years detained as a prison-of-war during the Vietnam War.  Giffords tweeted, “You’re tough! You can beat this. Fight, fight, fight! I am proud to call you my friend.”

Prayers for Senator McCain

As has been widely reported, Senator John McCain was diagnosed with brain cancer on Friday of last week.  As if having to undergo brain surgery to remove what were thought to be benign brain tumors wasn’t enough, now that they are known to be malignant, McCain can look forward to a host of symptoms.  These symptoms can include vision problems, seizures, difficulties with concentration and thinking, difficulties with speech, etc.  In essence, the symptoms of brain cancer largely mirror those of brain injury.  In fact, the National Institute of Health has published the results of a study that shows that there is an, “association between traumatic brain injury and the subsequent risk of brain cancer.”

Despite his medical issue though, McCain has chosen not to stay idle: “Just hours after news broke of McCain’s brain cancer diagnosis, the Arizona senator blasted President Trump amid a report that the administration decided to halt a CIA training program for moderate Syrian rebels fighting Bashar al-Assad’s regime.”  Additionally, his diagnosis has produced an almost unheard-of-now bipartisan show of support, which could perhaps open the door for further cooperation.

John Glenn: Astronaut, Politician and TBI Survivor

This past Saturday, December 17, was the memorial service for aviator, engineer, astronaut, and United States Senator from Ohio, John Glenn.  The first man to orbit the Earth, metaphorically left the world on December 8, 2016.  What many are not aware of, though, is that beyond his time in space, Glenn’s success in the U.S. Senate occurred after he had suffered a traumatic brain injury.

In the past, I have written about the issue of space travel and brain injury.  “On February 20, 1962, [Glenn] flew the Friendship 7 mission and became the first American to orbit the Earth and the fifth person in space.”  However, reports and profiles show that Glenn did not suffer any mental calamities during his time working at the National Aeronautics and Space Administration (NASA). In 1964, however, Glenn started his political career, announcing his candidacy for Senator in his home state of Ohio.  Soon after, though, he withdrew his candidacy, as he was injured in a bathroom fall in his Ohio home.  Glenn’s hit to his head was not a mere bump because, as a biography on the Ohio State University website says, “The injury left him bedridden with severe vertigo and unable to campaign.”  Presumptively, vertigo was not the only issue the Glenn had after his fall, even ten years later New York Times referred to it as a “serious head injury”.  However, at the time, the media was not as intrusive as it is now, so even celebrities had some degree of privacy.*

Glenn devoted his life to government service.  Before his time at NASA, he served in the Marines in World War II and the Korean War.  After his time in space, and after his recovery from a TBI, he was a Senator for Ohio for 25 years.  As NASA writes in Glenn’s online biography, “John Glenn, became a national hero and a symbol of American ambition,” after he became the third American in space and the first to orbit the Earth.  The fact that he embarked on a successful political career following a traumatic brain injury makes Glenn an inspiration to the disabled population, too.

*For example, “in 1970, Glenn ran a campaign that relied on his celebrity and patriotic image to draw crowds to his stump speeches. He lost…”  As a personal note that you may disagree with, I ask:  Using celebrity, instead of substance, as the cornerstone of a campaign – who does that remind you of?  (In his later, successful campaigns, Glenn campaigned with celebrity AND substance.)

Republicans Do Care: John Kasich

John Kasich does not have any known personal experience with disabilities, but as Governor of Ohio he has shown support to the disabled population.  One of the goals of Ohio’s current budget is “Better Support For Ohioans With Disablities”.  To that end, “the budget makes historic new investments to ensure that every Ohioan with a developmental disability who wants to live and work in the community can do so. [His] budget invests $286 million over two years to increase home- and community-based services, support community work opportunities and create new options for individuals who want to leave institutions.” 

In 2012, Kasich signed Executive Order 2012-05K, which launched Ohio’s Employment First program.  (Watch video where Kasich expresses his support for the program.)  The program, a cooperation between seven state government departments, explains well its purpose through its subtitle, “Every Person.  Every Talent.  Every Opportunity.”  Specifically, Employment First helps, “young people with developmental disabilities [learn] about employment options and planning during their school years. Adults with developmental disabilities… have support teams that assist in learning more about how abilities and interests can match opportunities in the workplace.”  Kasich continues to support those with disabilities, as in June, he signed a law that legalized medical marijuana in the state for certain medical conditions, including traumatic brain injury.

Republicans Do Care: Sarah Palin

Sarah Palin, the former governor of Alaska and 2008 Republican vice-presidential nominee, often addressed and championed special needs children during her presidential campaign, as she has personal experience with it.  Her son, Trig, was born with the neurological disorder, Down syndrome.  Through parenting and advocacy she says, “what’s been confirmed in me is every [person] has something to contribute to the world, if we give them that chance.”  As Governor of Alaska, “[she] succeeded in securing additional funding and assistance for students with special needs.”

In 2010, she publicly chastised Family Guy creator Seth MacFarlane for an episode in which, “Chris Griffin, the show’s awkward teenager, goes on a date with Ellen, a girl with Down syndrome… [whose] mom is the former governor of Alaska.”  (A scene that features Stewie singing a song about “Down Syndrome girl,” as he continually calls her, is particularly offensive.)  Obviously, and by MacFarlane’s own admission, the governor Ellen is referring to is Palin.  The actress who provided the voiceover, who has Down Syndrome herself, said Palin should have a sense of humor.  In response, Palin said “The world is full of cruel, cold-hearted people who would do such a thing.”  (My view is that someone with a neurological disorder can make fun of themselves, but if someone else makes fun of that person, it’s a completely different story.)