"Unless I see I will not Believe"
Patricia Hart Pettit
Sunday, April 15th 2007

In today’s gospel, we hear the story of Christ’s first appearance to His disciples. All but Thomas were present. When they told him what had happened, he remarked “Unless I see the nail marks in His hands and put my finger into the nailmarks, and put my hand into His side, I will not believe.” What if others had also not been present? Would they have believed? Would you? Especially considering the media bombardment that we live with in today’s world. How often have we said seeing is believing?

Today I am going to speak about a silent and invisible epidemic – brain injury. It is the 2nd most prevalent injury and disability in the US affecting 10 million Americans, but how many of us have heard of it?

It is silent because the person often does not realize they have it. It is invisible because we cannot see the brain. The dramatic changes in a person’s life can occur long after leaving the hospital or doctor’s office – if the person even went to the doctor. Few people know that you don’t need to lose consciousness in order to sustain a brain injury.

TBI or Traumatic Brain Injury is caused by an external force, a blow to the head. The leading cause is Falls. Until 2005, Motor Vehicle Crashes were the leading cause. Fortunately, people have started using seat belts and that has reduced the number of injuries. Other causes include sports, assaults, domestic violence. Unfortunately, brain injury is the signature wound of the operations in Iraq and Afghanistan due to the blasts that are so prevalent. 6 out of 10 returning vets have brain injury.

Brain injury can also occur from tumor, stroke, lack of oxygen, neurotoxic poisoning and infection. The secondary injury from swelling, bruising and axonal shearing often cause more damage to the brain than the initial injury.

Because the brain regulates everything in our bodies, when it is damaged, functioning is affected, often irreversibly. Some changes might be difficulty with executive functioning like attention and concentration, learning, problem solving, short-term memory loss. There may be difficulty with emotional and psycho-social functioning. Personality changes occur. There can be seizure activity, headaches, balance and sensory problems. The sleep/wake cycle may be affected. Who we are and how we behave may be altered. Chronic pain may be a consequence, and Depression and Anxiety often follow a brain injury.

I would like you to try an experiment. It is too crowded to do now, but later when you have a chance, raise you leg and turn it clockwise from the knee. While you are turning your leg, write your name in cursive. After that, still turning your leg clockwise, write the number 6 in the air. Your body will not respond the way you want it to. Imagine this occurring 24/7 365 days a year.

Every brain injury is complex and unique, and there is no cure – only prevention. Seat belts save lives and so do helmets. Drinking and driving often result in motor vehicle crashes that cause a brain injury.

Brain injury is not a Mental Illness, but there is a great deal of overlap in symptoms like Depression, Anxiety, Post Traumatic Stress Disorder and Schizophrenia. It often looks like Mental Illness and many suffer from these illnesses after a brain injury. The difficulty is that unless the brain injury is addressed, treatment for Mental Illness is ineffective. Medication may be contraindicated and suppress systems already suppressed by the brain injury. So it is very important that brain injury is identified and addressed. Yet Brain Injury often does not show up in a CT Scan or MRI.

Minnesota has some wonderful resources for persons with brain injury. First is the Brain Injury Association of Minnesota. Among other services, they have developed Resource Facilitation that has become a National Model, and assist individuals in finding the resources that they need. They produce a Consumer Guide, Training and an online Library with a great deal of information about Brain Injury. Materials can be found on the tables just outside the door.

We have many excellent hospitals but I will mention a few – HCMC has a Mild to Moderate Brain Injury Clinic. Mayo Clinic is one of 16 TBI Model Systems in the US. And the Veteran’s Administration has one of four leading TBI centers in America.

There are many community based services including the Courage Center, the Vinland Center, Rise, Accessible Space, Restart, Integrity, TBI Residential in Duluth, Beechwood, ProAct , and Opportunity Partners, to name a few.

These services are available for people who receive Medicaid or Medical Assistance, from Workers’ Comp, or private pay. Their clients have been determined disabled through a lengthy and bureaucratic process. What about those who have been forgotten and abandoned, not knowing they have a brain injury? Without a family or advocate to assist them in the process, those who don’t know they have a BI but know that their lives are out of control?

I am speaking of persons experiencing homelessness with unidentified brain injury. Every three years, Wilder Foundation Research Department conducts a survey of the Homeless. In 2003, they included a question about brain injury – 29.8% responded positively. In 2006, this percentage rose to 33%, a significant number.

I have been blessed in my work with persons with brain injury with what I call God Moments. I would like to share a few of those with you. One day in a homeless shelter, a man walked into me. Staff told him to watch out for the woman and he replied “what woman?” I thought that he might have a left vision cut, so I asked him if he had ever had a serious blow to the head. He answered that he had had several. The next day we spoke for 1 ½ hours as he told me about the four TBI’s that he remembered. He also said that he had never told anyone else about this because everyone thought he was crazy. Two weeks later he remembered that he had been hit by a car when he was five, been in a coma for three weeks, and had taken Dilantin for Seizure Disorder. He showed me the scar on his forehead. 5 brain injuries, seizures, and 14 years homeless. By the way, he had Masters Degree in Psychology.

Through this man I met a friend of his, a veteran who had many blows to the head and had been diagnosed as Bi-Polar. I learned that he had sustained a high fever for two weeks when he was 15, and afterwards, his behavior became unmanageable. He had been homeless for 25 years, camping out because he couldn’t deal with the noise and crowd of the shelters. Our God moment occurred when the Neuropsychologist told him that he had severe cognitive impairments and couldn’t continue living the way he was. I saw his face brighten and the shame and blame that had accumuolated over the years lifted off of his shoulders, as I was able to say, “It’s not your fault – you have a brain injury.” The next day he told me he was trying to think of a way to tell his mother so that she would not feel guilty.

Then there was the man who sustained a brain injury at the age of 17. He and his cousin were drinking, doing drugs and driving. When the car hit a tree, he went through the windshield and hit the tree. He was pronounced dead on arrival, but later his hand moved. Twenty years later, he wanted to reach out to high schools students and warn them about the dangers of drinking and driving and not wearing a seat belt. He would shave his head so they could see the scars, and didn’t wear an eye patch over his missing eye. He walked into the room and said, “I’m here to show you that, yes, it can happen to you.” Once a student asked what he thought of his life since it was twenty years since the accident. He replied,” I have no choice. God sent me back.”

This is why Hart Community Services, Inc., a non-profit organization, was founded: to reach out to the invisible, the abandoned and the forgotten. HCS fills the needs of homeless individuals living with brain injury. 85% of our clients experienced a brain injury before becoming homeless, and every day I am humbled by their endurance and ability to survive in spite of their injury. We work to identify brain injury, and then assist the individual in accessing what they need. We also have supportive housing where we assist individuals with learning compensatory strategies for cognitive and functional impairments, develop routines that will maintain their safety and assist them in reintegrating into the community as active participants.

I had the opportunity to live abroad for many year. When I returned to the states, I noticed two things: 1. Americans identify with their vocations “Hi, my name is, what do you do? The culture I lived in identified with geographical region and family. The second thing I noticed is that American's believe that behavior is purposeful and intentional. But that isn’t always the case, especially after brain injury.

So today I challenge you.

I challenge you to start seeing brain injury, learn more about it.

I challenge you to give the benefit of the doubt to people who may act differently, even inappropriately. When someone acts this way, try to understand if there is an underlying reason. I recall the story of a man with four children in a restaurant, and the children were running wild and misbehaving. Another customer walked over t the man and asked why he wasn’t controlling his children. He replied that the children had just lost their mother and they had been in the hospital the entire day.

I challenge you to ask why a person might be homeless. I have yet to encounter a person who wants to be.

After all, He behaved inappropriately – He cured the sick. He drove out demons. and even did it on the Sabbath!

He had an anger outburst. He attacked the money changers and they were in the Temple!

And He was Homeless…

Thank you.