JOEL BIEBER'S BLOG

What Are We Thinking?

     Virginians woke up to the news that its current Governor, Tim Kaine, will soon be appointed as Democratic National Committee Chairman. This news overlays the other, that former DNC chairman Terry McAuliffe is going to run for the position of Governor of Virginia. Sometimes, it would be nice to know what really motivates someone to be in these positions. With the right motives, they may lead more effectively. The wrong motives may lead to an Illinois type news story.

     I watched 60 minutes last night and was fascinated by one story on brain imaging. The story was on how technology may soon be able to read your mind.(CBS News) Part of my interest in the story was a possible look to the future. The other part related to my hope that some will consider what could happen to the brain in a car crash. That this technology shows the neurological pathways of our thinking which can obviously lead to an interruption of this information flow of thinking, when there happens to be a brain injury.   

     The fascination of knowing what someone is thinking can lead us in the fight on terrorism. The story recounts how it may be possible to see whether someone has recognition, through prior memories, which could show whether they had been to a terrorism training camp. It also would allow the ability to see if someone was telling the truth, according to the story, and based on the technology, the story may also make those studying Biblical prophecy think that this technology could relate to end times prophecy.

     In our brain injury cases, we constantly face skeptical defense lawyers and insurance adjusters, who just want to lessen any possible claim of an injured person, by calling a head injury, "just having your bell rung". If they can lessen the injury, they can lessen their responsibility for payment. This technology and what it may hold for the future may help show potential jurors what Science says about the injury. A scan will show problems, that even a hired defense expert will have a difficulty in ignoring. The attached story is an interesting look at future possibilities.    

The Unseen Damages

     The term of "diffuse axional shearing" meant nothing to me until I started handling brain injury cases. I used to think that brain injury cases only related to claims, where someone was non-responsive and ranked as not able to react under the Glasgow Coma Scale. I didn't know that someone hitting their head in a car crash could suffer trauma to their brain that caused an interruption of signals that control their executive function. They could look fine on the outside but actually be one of the "walking wounded".

     I was recently reminded of what we are learning about space. The Hubble Telescope has taken photos of something called Helix Nebula. It has been described as a million mile tunnel with glowing gases. At the center of this, the telescope has identified a star that appears to be burning out. The photos taken show something that looks like a blue iris of a human eye. It is so marvelous that some have dubbed it "The Eye of God".

     Explorers used to look for the fountain of youth or treasures of gold, and were afraid to fall off the end of the earth, because they thought that the earth was flat. We have learned differently and can jump in a big plane and zoom to those foreign destinations. Just because of ignorance, doesn't mean that the earth was ever flat. It was always round.

     New equipment called a Tesla MRI, now is able to scan the brain to see its connectivity. Currently, strength of 3.0 is being used in medicine but there are greater powers (9.4) that have not been harnessed yet for medicine. Insurance adjustors regularly scoff at the problems that some of my clients have, after hitting their head in crashes. They want documentation. The 3.0 has provided some of that but I believe that medicine will establish more documentation in the future.

     The Hubble Telescope showed us what has always been there. Just because we couldn't see it doesn't mean it didn't exist. In the same way, we continue to work to document and prove why executive function has been effected by a crash. Someday, these adjustors will be looked upon just as the early explorers. Hopefully, that day is coming soon so that clients are fairly compensated for their true injuries.   

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Cell Phone Use and Tumors

     The debate of cell phone use causing tumors, has received new activity as a result of three neurosurgeons who recently appeared on Larry King. One of the doctors was CNN's own Sanjay Gupta,who admitted that he does not put a cell phone up to his ear. He chooses to use an earpiece instead. The other two doctors on the program admitted to using a cellphone the same way.

     A recent article in the New York Times (article) recites authority to assure us that cell phones are safe. In the past, manufacturers have suggested that such an assertion cell phones as cancer causing agents, are nothing but the product of greedy trial lawyers. However, doctors now agree that we really don't have any studies to prove that cell phones are safe. That in fact, the only studies that have been done are ones that are assessing the use of cell phones after only three years of use.

     It's clear that the wireless phone providers are quick to defend their products.The FDA does not have enough information to unequivocally stand behind the cell phone products; Nor do they have research that would tell us otherwise. However, tumors like the one that Senator Kennedy is currently seeking treatment for are the type of tumor that may be caused by cell phone usage.

     I don't know what to make of this additional information. I do know that it gives me pause when three doctors admit that they are concerned enough not to use cell phones to their ears. They also claimed that there have been an increase in the type of brain tumors that would be caused by cell phone use. It certainly is something to think about. Maybe I will start using an ear piece. The only reason I haven't is because it was getting caught in my pocket.   

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Happiness and Brain Injury

    One of my earlier blogs dealt with the search of happiness. (blog). Then, through the miracle of Tivo this morning, I watched the Friday night show of 20/20. It dealt with the pursuit of happiness and certain variables that cause us to be happy.

     Part of the story dealt with the study of identical twins. The survey of the twins showed that one is extremely happy, and the other tested as unhappy. What causes the difference.(link)  Part of the reason that I found this story to be so interesting; it dealt with the importance of the brain's frontal lobe. Typically, with head injuries or car crashes that cause the head to impact with the windshield, it is the frontal lobe that experiences the trauma. As discussed in this story and supported by head injury doctors, our choices, dreams and goals are formulated in the frontal lobe. When we suffer trauma to the frontal lobe, that can effect our self worth and the choices that we make.

    As the article points out, until recently, scientists were more concerned in what makes us depressed rather than studying what makes us happy. Antidepressants don't make happiness, they just serve to hide the sad emotions. In the story, a scientific study of several monks in a monastery demonstrated that they are extremely happy. This, despite their lack of personal accumulation of wealth and self denial. The premise of their happiness, according to the researchers, is that they take at least 30 minutes per day to focus on meditation of positive things.

   This article shows that there is no magic pill for happiness.  However, there are exercises that accentuate the positive that can make a difference. Consequently, those that have suffered head trauma are in a difficult position to find happiness because they are physically impaired through the neurons of the brain, because of trauma. To make a jury understand the damages and appreciate their value pinpoints the need to show the opposite effect that can be achieved, as discussed in the linked 20/20 story. 

Virginia Helmet Laws and Advertising

     Today, I got a little bit of a late start on my blog. Unfortunately, I had put off writing some new television ad scripts. On Wednesday, I fly to Miami for a shoot and needed to get my scripts done for production. It took the pressure of a phone conference to make sure that I got these knocked out. While working on the scripts, I kept getting sidetracked with ideas like Emmit Smith's proclamation during football that,"you can't change a leopard's stripes". Somehow I think he was seeing spots when he said that.

     Anyway, in working on the scripts,I was determined to write some dog bite and job injury spots.(now you see the Emmit Smith connection. I guess that's the subconscious working) While writing, I also decided to do some public service scripts. One important topic relates to helmet laws in Virginia. In fact, Virginia Beach has enacted a city ordinance that makes it an offense, a $25 fine, if a child does not wear a helmet while riding a bike. In doing research for this script, I came across a great article on bicycle helmet laws, that recites the importance of wearing a helmet with corresponding statistics.(Bike article) In the article, the Bicycle Helmet Safety Institute advises that studies show 75% of disabling injuries that occur on bikes could have been prevented by wearing a helmet. This article shows the importance of kids getting involved in helmet safety. In reading this, it challenged me to cut a public service ad about helmets to include statistics.   

Seeing is Believing

     You know the old saying, "if a tree falls in the woods and no one is there to see it, did it really fall?"   I face a version of this argument in most of the brain injury cases that I handle.  The client comes in to describe their accident; the client describes seeing the crash about to happen and the next thing they remember is someone standing next to their window.  In probing the facts in between, they then realize that there is a period of time that they don't remember.  They don't remember the crash and they don't remember the car coming to a stop. Their medical records from the Emergency technician do not reference head injury and the emergency room doctor has not noted head injury.

     Not surprisingly, if you originally had asked the client if they had suffered a head injury or had been knocked out, the answer is usually no.  For that reason, the original medical records are not supportive of a head injury. However, in probing the facts, it is clear that there was a loss of consciousness. Dr Greg O'Shannick of the Brain Injury Association states that routinely, emergency room doctors are missing head injuries.  It is his observation that most ER doctors are treating immediate trauma that includes bleeding and fractures and may be completely missing possible head injuries. However, in presenting the head injury claim, most defense attorneys are quick to point to the original records and discount the brain injury as being created by the lawyer.   

     Analogous to this is the recent announcement that scientist have now discovered another possible planet known as an exo-planet, dubbed Gliese 581. The new discovery would not have been possible without a new Planetary Searcher which is now known by scientists as the most precise spectrograph in the world. This technology is allowing scientist and astronomers to make new solar discoveries like never before.

     Using the defense attorney argument, these solar discoveries never really existed because we had not seen them for all this time. Now that they can be seen, they now exist. Obviously, this flawed reasoning is as crazy as the argument about brain injury. Fortunately in medicine, new technology is also allowing better documentation of brain injury. What is known as diffuse axonal shearing is tiny structural changes in the brain that are consistent with trauma. In several cases that I have worked on, because there is a stronger MRI to document these changes with greater magnification, it allows doctors to make better informed diagnosis and treatment recommendations in injuries that were previously going undiagnosed. With the advancement of medicine, more patients will receive the care that they need and more attention will be paid to the injuries of these walking wounded. Those who have suffered a head injury from a crash and are suffering from undiagnosed conditions.      

Brain Injury and Memory

     Yesterday in church, the minister took me down memory lane by discussing his life and memories, going all the way back to first grade. That took me back to the days of my strapping ladhood. I remember my teacher, Miss Walton.  My principal was Mr Berniner.  I'm not sure if that is his correct spelling but we used to scare ourselves with stories of how he would "burn" you with a paddle that had holes in it, for better force against the western hemisphere.  We didn't use "western hemisphere", though.   These long term memories brought a smile to my face. The thought of recess and standing in line first, for lunch.

     One of the joys that we can experience are the remembrances of years past. We also enjoy recent memories such as what we just read, and how that may apply personally. This is our short term memory.  Unfortunately, some people who have suffered some blow or injury to the head experience a problem with their short term memory. Imagine not being able to remember the first paragraph of my blog or having it run together because you can't concentrate long enough to read these three paragraphs. Imagine not being able to stay focused in a grocery store to remember why you came in there, or trying to focus on counting the change that a cashier just gave to you at the register, while the "ten item only" crowd is breathing down your neck.

     In brain injury cases, these events happen to people in their daily lives.  They are called the walking wounded because they look normal on the outside but are dealing with tremendous limitations in daily life.  Insurance companies and defense lawyers scoff at such injury. Unfortunately, they are very real to the victim.  As a lawyer that represents brain injury victims, my job includes making sure that my clients get to doctors who specialize in the treatment of brain injury and can document long term effects of hitting the head.  Memories, both short term and long, are part of the human experience that should bring smiles to our faces.