Understanding Traumatic Brain Injuries: A Conversation with TBI Attorneys Part II

0:00:03 - Hi, I'm Shane from Shane Smith Law. We're here today with John, one of our attorneys in the Traumatic Brain Injury Group here at Shane Smith Law, and this is sort of part two of some of the areas of the brain that get impacted in a collision and other factors of a traumatic brain injury. So, john, where? Were we before we took a break.

0:00:21 - So we had just landed on a very, very important part of the brain called the frontal lobe. This part of the brain, Shane, is kind of what they call the governing part of the brain. It controls important things like decision making, motivation, problem solving, planning, attention, and the underlying factor of all those things is that that's what kind of makes someone a contributing member of society. Those are all important characteristics of the brain controls that makes you a successful employee, happy in a relationship, a good spouse, partner, father, mother. And when that's not functioning at full speed, everyone notices, the person notices, employers notice and it can have a real detrimental impact on the person who's injured.

0:01:10 - And when you say not functioning, is this like an all or none, or is it their spectrum on it and talk a little bit about that.

0:01:18 - Absolutely. So yeah, certainly, depending on the severity of the accident and just really the person who's injured. I mean these things, like I mentioned earlier, there's a lot of unknowns and things we're just totally not 100% on in the medical community regarding brain injuries, so it can range from a slight reduction to those abilities to them being completely wiped out. You know, there's cases where the part of the brain that controls memory where people will remember nothing of their short-term memory, and those are obviously the more severe accidents, or incidents, right.

0:01:53 - That makes me think of that, There was a movie about that one year where the person had no short term memory. After one day everything started over, kind of deal. They couldn't put anything into a longer-term memory. It was 50 First Dates, I think, with Adam Sandler in it and obviously that's a comedy movie. But there is memory issues that come into play and where people can't remember short term. They forget where their car keys are, they forget what they're in the car to go. They can't handle basic tasks at work. They can't remember anything at all. Or even some people who remember people they met years ago, but they can't remember anybody they met recently.

0:02:28 - Right, that's correct. And you know just one of the classic examples that you hear about this, because you know, when we're trying to explain this to jury members, to say, hey, this is why we're asking for an extraordinary sum of money. Because when you start thinking about the day to day, well, you know how much money would you put on it if your spouse couldn't be trusted to turn the gas burner off and they're leaving the home? Or would you be able to trust someone who you know couldn't remember if they left the child in the back seat when they're going grocery shopping? These things are scary and terrifying. And then you realize that like you know, if you're a spouse with someone with a brain injury, it almost becomes like you're the parent to two people. At that point it's not. You lose that support system, that structure, and you're now taking care of two people, you know versus one.

0:03:16 - So you lose your partner and you pick up a child.

0:03:18 - That's right and it becomes in and unfortunately becomes a huge burden. We see that in this statistic show that it has a huge detrimental effect on people with brain injury and the success of their marriage. You know they have higher divorce rates, things like that.

0:03:32 - And I would imagine, let's say, they do get divorced from that loving partner they had one time. Imagine it's hard to go find another spouse because you come with all these issues right.

0:03:42 - Absolutely, you know, and that's a hard undertaking for any new person who's had the picture to undertake, because it's a lot to the point where some people have to get, you know, assistance for their life, medical assistance to be able to do daily functions and daily tasks.

0:03:57 - When somebody living alone, who can't remember anything, like you, say leave the gas on, leave the burner on. I mean that is an easy way to get hurt or burn down your house or perish, and that's through no fault, you know. I want to say no fault to their own because they didn't mean for that to happen. But still happens and still doesn't fix the tragedy.

0:04:17 - Correct and you just don't know. And especially when you see issues with impulse control with the frontal lobe, like someone who previously had good judgment. Well, how do you put a price on not having good judgment for the rest of your life? Right, it's a non-tangible thing but it really adds up. And that's what we ask jurors to write to the occasion to be like look like. This person's life is different forever at this point.

0:04:39 - And yeah, and we've seen it like impulse control or emotion control, or they don't have a filter anymore, so they just say whatever comes to mind, which you know sometimes you get crazy thoughts about people that are totally you know you wouldn't say them to their face, but these people do say that. You know they, you know. The joke is somebody says how do my shoes look? And they're like they look terrible, you should never wear them again. You know. They say something like that and obviously that destroys societal interaction and I guess it's overall. It just compounds. Like you say, it's a bigger and bigger thing.

0:05:14 - That's right the shoe example you gave that. That filter, that soft filter that most people have there, unfortunately gets removed when people experience injury to the frontal lobe area.

0:05:24 - And we've talked about injury to the back of the head and we've talked injury to the front of the head, because those are the most common in a whiplash case when somebody gets rear ended. But what are the other big areas that most likely hurt?

0:05:35 - Sure, absolutely, and it varies depending on the type of injury. Sometimes we see T bone where there's side swipe style accidents, where someone hits the side of their head on a on the glass versus, like the airbag or the classic back of the seat. Then you start looking at other portions of the brain that can get injured, like the portion that controls actually hearing. We have had also and also vision as well. We've had clients that have had their prescription glasses change overnight due to an injury, so it can immediately change your vision overnight after the accident occurs. Also the portion of the brain back here. That is not as often but I do see sometimes with my brain injured clients that enter that portion of the brain. They lose the ability to find words in a sentence and put sentences together as well as recalling certain words. So that means imagine if overnight your vocabulary got cut in half. Wow, not great, not great at all. And it's really frustrating for a lot of people who are previously. I see it a lot with some of my high performing clients that are in, you know, very important jobs or roles or managerial roles where when you can't find the right words, it is just so frustrating for someone Because you knew how you used to be before the accident and now that's gone in the blink of an eye. A whole life of education and reading and learning. And now you just can't access that part of the brain that has all those important words you're trying to call.

0:07:08 - And it's got to be terribly frustrating for the individual who remembers how they used to be and now they're not that person anymore. I can't imagine how difficult that must be on that individual. And you know we talked one time about the imaging tests they can run. How have you found, do clients like to do that test? Do they not like to do it? Does it provide some results for them that make everything real? I mean, let's talk about that.

0:07:36 - Absolutely so. There's quite a few tests that are out there that help us diagnose these injuries and also the severity of these injuries. A lot of times when you go to the ER, they'll initially do a CT scan, which is kind of like the weaker scan but gives a good first impression of what the injury is. It's mainly there to document the big injuries to the brain.

0:07:57 - And make sure you're not dying. Right, exactly, you're not going to die in the next day or two.

0:08:02 - And it's a good thing, but it also sometimes we see a lot of our clients leave the ER thinking they dodged a bullet, so to speak, because the ER is basically just there too with some of their imaging to make sure you're not dying, right, but it doesn't get into the nuances of a more microscopic brain injury. That gives our clients these mild TBIs and all these weird symptoms.

0:08:24 - So you could leave the ER that could say the CT scan is fine, go out thinking, okay, I don't have a head injury, and start picking up all these symptoms and then think you're going crazy.

0:08:34 - That is the scary walk away, unfortunately. So it's our job to then if they weren't redirected to a neurologist which they rarely are from the ER then we need to stress the importance to our client of, hey, you need to see a neurologist to get the proper testing done. And that proper testing usually takes the form of a DTI, diffusion tensor imaging or neuropsych evaluation and some clinical correlation where a real professional who is looking for these more kind of nuanced injuries that are harder to pick up on in the ER room can really sit down with the client see what's going on. Sometimes they'll interview family friends, because these are the real front line eyewitnesses to the victim's brain injury. Yeah, you know who knows you better than a spouse or a son, or you know a teacher who sees you every day and then sees you before and after the accident.

0:09:29 - And they're like yeah, something's definitely changed. It's off.

0:09:29 - Right.

0:09:30 - And I've seen clients before where, once they get a test result like the DTI or something else, they're like, wow, okay, now I feel like I was worried, I was going crazy, I was worried, I was making it all up, I was worried all this. And then you can see the scan and they're like, yeah, you suffered an injury right there. And then they talk about what it impacts, like it makes perfect sense.

0:09:49 - Yeah, and that is just the benefit of the, the time and the age that we live in and our medical advancements is, you know, 15, 20 years ago Someone would have felt just that they were crazy and that would have really been the end of it, really. Um, you know there's very limited imaging but that with this new imaging, you know it's as clear as day where you can see, where you know one part of the brain doesn't match the injured side and the neuro Radiologist and the brain doctors can literally point to the part of the brain that doesn't match the other part and they can see when it's been damaged and then they can sync it up with whatever that part of the brain was responsible for Speech or vision. And you know, if those match the client symptoms, then it's it, it corroborates itself and it matches itself and that really gives our clients a ton of answers and in a ton of relief, at least knowing that they're not going crazy and that these Symptoms and injuries are very real.

0:10:50 - Well that's awesome or awesome information. That's what I'll say now. Obviously, uh scary that we even have to talk about it, but, like you say, thank goodness we have the technology here now to do that and I can only imagine it's going to continue to get better and better as more Attention is put on these head injury cases.

0:11:05 - Absolutely, and you mentioned scary there's, you know there's some other scary long-term consequences and you know part of this, you know Discussion we're having today is, you know why do these cases with firms? Why are these, sometimes these settlements in the tens of millions of dollars? Is it, is it that these people are Greedy and they need a lot of money? Is it plaintiffs large? It's not. It's it's really that the injuries warrant these types of settlements. One of the long-term Consequences is almost a four-fold increase in dementia, oh, wow. And sometimes it can cause an early onset, two to three years than it normally would. So when you say, hey, what price do I put on a four times risk for, you know, dementia and in losing my mental faculties, you can see why Jurors, when confronted, that place big value on on these types of claims.

0:11:56 - Well, I think I mean, when I look at Changing your spouse's personality and that's gotta be totally. I mean my wife. If she said Suddenly I'm a different person, she'd say you took my whole life away from me, you know. Or if my wife became a totally different person because of a head injury, I would say you destroyed my life. Because I love my wife, I married her. I didn't marry somebody else, you know. So to me I understand why jurors get big numbers on these kind of cases. Because it totally takes one life away and gives you a different one.

0:12:27 - Right absolutely, and some of the other things just in terms that we see for long-term consequences. I mean it can range from seizures to infection, nerve damage, the whole host of things. They even think now that there's, you know, real hormonal changes too that people experience during a brain injury, and these things are. We're just at the tip of the iceberg in terms of medical research. Every year it seems like we're learning something newer about the consequences and newer about the science Just a lot of things.

0:13:04 - So it's not just things like a seizure, there's a whole list of symptoms and things like that, which is one of the reasons I guess why we've got our brain injury group is so that clients can talk to you guys and you get better at identifying and making sure they're getting the treatment. When they say something offhand and you're like, oh, that's serious, alright, what else would you tell our listeners?

0:13:27 - Just, you know, this is one of those things where it's difficult when it happens to you, because it can seem confusing at first. It's difficult to understand as an outsider because it's an invisible injury. For the most part it's very much visible when we do the correct diagnostic test and imaging and clinical correlation. But that's why we have to get to that point, because before we get to that point we just don't know, because we like to see things on the outside and what the injuries are. You know, if you break your arm, that's very easy to see what's wrong. It's very hard when it's your brain and it's an invisible injury. Luckily, with modern advancements we can see very clearly now that it's a very real injury that's not invisible and it has real, lasting, serious consequences and outcomes for our clients. So really sometimes too, when we handle these cases, we like to get a certified life care planner on board Because the future damages are so immense and the cost are so hard to put a number on. These certified life care planners will actually take that task under their belt and essentially itemize reasonable future medical expenses, cost of potential medical assistance if they need it as well as we, for our clients sometimes get economists involved in what's called vocational rehabilitation experts, where we look at what sort of job they were doing that they can no longer do and say well, what can this person do? What do they do for the rest of their life. After this, moderate to severe brain injury.

0:15:06 - One. I think about the thing with no filter. I mean that alone could make it very difficult to employ you in anything where you have to do with other people. I mean, I can only imagine even taking orders in a fast food restaurant.

0:15:17 - Absolutely. Customer service and sales is probably right off the table if you snap at every person that comes by due to your brain injury.

0:15:26 - A life care planner. What does that mean? If you had to reword that to somebody, what would that? How would you simplify what that person does?

0:15:35 - is a person who literally specializes in putting a value on some of the injuries and future injuries that you're going to be needing to be compensated for.

0:15:46 - And so that person. But they've got the training that they know what your injury is, they know what's likely to happen in the future, versus if I just talk to you with a brain injury, you may not know or I wouldn't have known. Dementia is a huge issue, you know, but that's what they're trained to do is to say, yeah, but this is, this increases the chance that this is higher. This is higher, or yes, almost certain, this is going to happen in 10 years.

0:16:08 - Yeah, absolutely, and that's the real key walk away for people not familiar with the legal system is that a legal case can't really go on for 50 years, the rest of person's life. That's not how it works. We usually have a finite time where we've got to take care of the case, and so well, how do we, how do we account for all those future expenses that you know the victim is going to have to deal with for the rest of her life? We do it through life care planner a lot of the times, who, through data and studies and you know prior outcomes of other people with similar injuries can then predict out to a certain degree of medical certainty what the injuries and medical expenses are going to be, within reason.

0:16:49 - And is that same person, taking into consideration that things cost differently. You know, go back 10 years ago things were one price. Now they're different prices, that the person handles all that or said somebody else.

0:17:01 - Absolutely so you know the cost. The rising costs of medical expenses, which we're all very familiar with, does get factored in typically with these, in that you know what an injection or some form of therapy today is definitely not going to be what it costs. You know, 20 years from now, gotcha.

0:17:19 - All right, I mean a lot of great information. Anything else about the long-term effects of injuries and things like that you would want to talk about today, John?

0:17:29 - I think we've covered just about everything. Shane, I certainly appreciate your time today.

0:17:33 - No thanks. And for all our listeners, hit, like and subscribe to catch next week's episode as well. We're going to continue talking about traumatic brain injuries and the impact on our clients but also other individuals as well. So it's not just legal stuff here on the TBI podcast. Thanks a lot. I'm Shane from Shane Smith Law.

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