Inside the closed head injury

Yesterday Phil Hughes suffered a closed head injury.

Anyone reading this will probably be aware of the circumstances, the shock, the confronting footage.

But now he is in intensive care with a closed head injury.

Critical condition.

It doesn’t get more tenuous than that.

 

Every day, people present to hospital intensive care with closed head injuries.

What does this mean?

 

I write this from my perspective of time in intensive care, critical condition, with a closed head injury. Months of rehab at the Royal Talbot Acquired Brain Injury Unit.

I’ve not a minute of medical training.

But I cautiously say this:

Every head injury is different.

Nobody really understands the brain and its plasticity.

A blow to the head causes brain swelling, which can lead to further damage to the brain as the swelling brain pushes against the inside of the skull.

Swelling can be controlled a bit through medication (and removing part of the skull via surgery, if required (not required for my injury – morphine did the trick).

But the original blow causes undoubted damage.

 

It’s not at all like the movies.

People tend not to just get up and dust themselves off.

Some people die.

Other people’s essential behaviours change.

They might not.

But they might.

Their essential character can change.

Speech can change.

Thought processing.

Emotions.

Coordination.

The lot.

To the sufferer, it may feel as though they are a Different Person.

 

As I write Phil Hughes is still in the most critical of situations in intensive care.

Nobody can know whether or not he will survive or with what degree of impairment.

 

In the Acquired Brain Injury world people know this.

In the wider world, perhaps not. Though some recent closed head injuries to high profile people have raised awareness. I’m thinking of David Hookes, Michael Schumacher, Molly Meldrum. There was an excellent story in last weekend’s Good Weekend about the ongoing (difficult) rehabilitation of Mitch Cleary after being king hit in Perth.

In the literary world I’m drawn to Fish Lamb, of Tim Winton’s Cloudstreet; brain damaged from a near-drowning.

So why such different outcomes?

 

Good management plays a part

Early intervention.

But moreso it’s down to luck.

No amount of “fighting spirit” makes a jot of difference.

(As an aside, and an opinion, the ubiquitous ‘fighting of injury/ illness’ narrative is unhelpful to sufferers and their families and friends. It suggests that if only they had fought harder, they would have beaten the circumstances. That’s often not true and can even sell the sufferer short. It implies a degree of control over the situation, which we would all like to assume we have, but which we don’t.)

Acceptance is all there is.

 

In terms of recovery from these things, I’m in the “luckiest of the lucky” category. But still, there are residual effects. (E. Regnans wrote about his experience earlier this year – Ed).

It’s tricky.

 

I’m sure we all wish Phil Hughes all the very best of luck with whatever comes next. And the same to his family and friends. It’s just awful.

It’s big news today. It will be for a day or two yet, I guess. But in six months’ time, in a year’s time, for the rest of Phil Hughes’ life, I suspect the effects of this injury will still be felt.

It is a long and tricky road to navigate from here.

David Wilson

[Thanks for this piece David – Ed]

 

For more sports stories by independent writers return to www.footyalmanac.com.au

About David Wilson

David Wilson is a writer, editor, flood forecaster and former school teacher. He writes under the name “E.regnans” at The Footy Almanac and has stories in several books. One of his stories was judged as a finalist in the Tasmanian Writers’ Prize 2021. He is married and has two daughters and the four of them all live together with their dog, Pip. He finds playing the guitar a little tricky, but seems to have found a kindred instrument with the ukulele. Favourite tree: Eucalyptus regnans.

Comments

  1. Sensitive and insightful. Thanks David.
    The use of war/fighting metaphors with most illness/recovery journeys is at best mindless wish fulfilment; and at worst ‘bone headed’ magical thinking. When our choices and control are severely diminished then our best intentions count for little.
    (I recommend Susan Sontag’s wonderful “Illness as Metaphor” and “AIDS as Metaphor” extended essays; and Australian doctor Tony Moore’s brilliant “Cry of the Damaged Man” about his recovery journey.)
    We don’t go to funerals; nursing homes and hospices to tut-tut “if he’d only shown a bit of fight…………..”
    Feeling loved and valued are essential to attitude and some of the qualitative aspects of life’s journey; but they count for very little in the harm/recovery equation that governs the quantitative side of the eventual outcome.
    For me, tragic events like this emphasise the impermanence of existence and the illusion of control we have over our lives. That is not to be fatalistic but highlights that we are not the sole architects of our future.
    Carpe diem.

  2. Yvette Wroby says

    Hi David another insightful and helpful piece from you. We are all in shock but his family and friends and Phil himself have a long journey ahead whatever the outcome. All we can do is send love into the stratosphere and hope together for the best possible outcome. Be well Yvette

  3. Nice work Big Dave.
    Watching a bit of the reporting last night, i can forgive the so called journalists/expert commentators for their use of fighting euphemisms given they are ex sportsmen in the main and have little other in the way of experience to fall back on. To them injury was simply somthing you overcame through effort and then continued on with your sporting pursuits.
    The primary wish is obviously Phil Hughes’ immediate survival following which I sincerely hope that your excellent article is highlighted as an editorial to placate expectations.
    Well done.

  4. David,

    Excellent and informative piece. I am glad you have shared you personal experiences to help inform others about the nature and effects of acquired brain injuries.

    I also have no medical experience but have been touched by acquired brain injury.

    My sister suffered a closed head injury due to a car accident. She was placed in an induced coma and had surgery to place a shunt in her skull to alleviate the swelling caused by bleeding on the brain.

    She was in an induced coma in the Intensive Care Unit of the Alfred Hospital for 3 weeks. When she was brought out of the induced coma it took a week for to be able to talk and comprehend what was happening.

    She spent several months at the Epworth Rehab Centre. The car accident was in July, she left rehab centre in December.

    As you say, brain injuries affect people in different ways and to varying degrees. They are not done and dusted in weeks or months the effects are felt years along.

    My sister is not the same person she was before her brain injury. It has been 4 years since her injury and the affects continue.

    Like all illnesses or injury, brain injuries affect deeply those who love and care for the person who has suffered the brain injury. Love, understanding, patience and caring from those close to the person are more important than ‘fighting spirit.’

    As you correctly say, high profile cases have raised awareness of acquired brain injuries, but I believe it is still generally not well understood.

    For Phil Hughes and his family, friends, team mates and loved ones, it will be a journey. Things won’t happen in days it will be weeks and months, maybe years. Phil may return to his previous functions and life, he may return to some degree or he may not. His life may not be the same again.

    Thankyou David.

  5. Very well written Dave. There are no answers and only time will tell.

  6. So beautifully and clearly written, Dave. Thank you for sharing and commenting.

  7. Melanie Wilson says

    Another great piece Dave. And your personal voice is important. I too winced at the use of the word ‘flighter’ in the article that I read this morning. But I guess this is a ‘go to’ term for people reaching out and wanting the best for someone in what is probably going to be a terrible situation.

  8. Ahh, thanks all.
    PB – thanks for your perspective.
    Yvette – thanks for your sharing
    Philo – thanks for your understanding
    Ross – gosh, Ross – thanks for all of it. And all the best for your sister.
    djlitsa – thanks for your summary
    Carly – thanks for joining in here
    Mel – thanks for your empathy.
    Thoughts with Phillip Hughes and his family.

  9. Keiran Croker says

    Thanks for your insight Dave. It is greatly appreciated. Best wishes to Phil, his family and friends.

  10. Mark 'Swish' Schwerdt says

    That “fighting” business, is it just that we don’t have a better word for it?

    Then again, who knows whether there are reserves of inner strength that their body can take advantage of.

    But the implication that someone in an induced coma is “fighting for their life” seems incongruous, doesn’t it.

    Thanks again E.r

  11. Luke Reynolds says

    Once again, thanks for the insight Dave. As a cricketer myself (at a VERY much lower level than P.Hughes) felt sick at hearing what had happened at the SCG. The entire cricket community is behind him.

  12. There – but for the grace of God – go I.
    It is such a fine line.

  13. David i have empathy with yourself, Phil Hughes and others re this predicament. I was run over on Saturday September 28 2002, suffering a range of injuries, including a bruised and swolledn brain. Luckily i did not have lobe damage. None the less i had 4 days in an induced coma, followed by another 8 days in iCU, fine tuned by a further 8 weeks in rehabilitation, getting myself back to scratch. Neurologically i’m fine, though having required skin grafts, a knee reconstruction and various other procudeures all worke dout well. In 2014 i’m ridgey didge.

    My thoughts go out to young Phil Hughes, he turns 26 this Sunday, 30/11, wishing him a speedy recovery.

    I recall Ewen Chatfield being hit in 1975. Quite different to Phil Hughes, but similarly it wa a sickening, life threatening episode. Ewen pulled through, having a long, productive career for New Zealand.

    Glen! .

  14. Good one Glen.

    The point of all this, of course, is to raise awareness.
    I was kind of tempering expectations a bit, too. People in the industry tell me there’s an unrealistic idea in the community that all people wake up after a coma and say “what day is it?”
    “ho ho ho, you’ve missed a fortnight there.”
    And off they go.
    In many (most) cases it’s not like that at all.
    Such a murky area.

    Your story is a heartening one.
    Good stuff.

  15. Ta David, you’re so right it’s not like the movies when you wake up, wondering what day it is, then it all falls back into place. For a few weeks i suffered Post Traumatic Amnesia, and though i have some, albeit scant recollections of that period, my loved ones saw me through, and they were conscious that i was on a totally different wave length, from them, and my old self. The recovery is a graduall process. When Phil Hughes regains consciousnes it wil be the same. I only hope his recovery is as full as mine.

    Glen!

  16. Dave,
    You mean it doesn’t happen like in that old Steven Seagal film (was it Hard to Kill?, I’m not sure)?? Where our hero lies in a coma for six months, with the nurse coming into his hospital room, lifting up the sheet to look at his appendage and exclaiming “Please wake up!”
    As glen rightly points out, it is so different from the movies. An uncle of mine was accidentally shot in the head at close range. He spent the best part of 2 years in Royal Talbot learning to walk and talk again. The period when he was permitted to come home for weekend visits were a progression, but harrowing in a way – the drive back to Kew on Sunday nights were wrenching for everyone.

  17. RIP Phil Hughes. Too,too sad.

  18. Can’t belive it. Devastating.

  19. Very sad to hear of Phil Hughes’ death. A vibrant young bloke gone – just like that. Puts a lot of things into perspective. I feel greatly for his family.

  20. Steve Fahey says

    Terrific piece of writing Dave.

    Horrible, sad news re Phil Hughes’ death.

  21. Paddy Grindlay says

    Cannot even begin to process the incredibly sad news of Phil Hughes’ passing. RIP Phil Hughes, and all our prayers and love are with his family. Spare a thought for poor Sean Abbott. The poor guy needs all the support he can get at the present time.

  22. well.
    I don’t quite know what to write here. But it feels necessary somehow.

    With a logical mind I’m not surprised. Such a dangerous injury. Living the Acquired Brain Injury life, my eyes are very wary of these situations.
    With an emotional mind I find it difficult to cope with. Such a presence. Such youth. In such awful circumstances.
    With a philosophical mind I can only accept this as fact. It just is.
    Phillip Hughes has gone.

    Thoughts always for his family and friends, and as you say Paddy, to Sean Abbott.

    Love them, those around you. Let them know it. Love to you and yours.

  23. What a shocking event. I have memories of Martin Bedkober dying in a Brisbane district match back in 1975-76, but Phil Hughes has become , tragically the first cricketer to die in a first class match on Australian soil. What a shocking first,a first no one ever should have been. His death casts a huge pall over this noble sport. Good on the cricketers from Aoteaora and Pakistan who called of the days play as a mark of respect. Deepest thoughts to all of those involved with Phil Hughes.

    Glen!

  24. Earl O'Neill says

    My condolences to the family and friends of Phil Hughes, especially Sean Abbott.
    I copped the ‘Michael Hutchence’ injury six years ago. Years later friends told me that I was weird for months afterwards and feared I’d never recover. I’d no idea, brain injuries are like that. Part of my brain controlling visual associations was damaged so I’d walk up the street and think “Gee, they painted pub overnight!” The impracticality of that never occurred to me.
    Two years later a neurologist showed me the scans. A third of my brain was full of blood.
    It’s a matter of a fraction of a millimetre…

  25. Like most of us I did not know Phillip Hughes. Unlike most Knackers, I also did not know the cricketer as over the last 15 years I have drifted away from the game and living in Asia means expensive cable channels to watch the game. I would not know what many in the current test team look like let alone the ODI and T20 teams.

    Yet in some ways I think I did know Phillip Hughes as he was living my boyhood dream. He was the person I dreamed of being all those summers back as a child. The person most, if not all of us dreamed of becoming. A young debutant, bringing up his maiden ton with a four and two sixes – who did not dream of that and enact it 1000 times over in the backyard.

    It is with these childhood memories that I will think of him and it is his early death with so many dreams left to be fulfilled that brings a tear to my eye.

    Vale Phillip Hughes.

  26. Well said David and those on this thread. The unspeakable has happened. When Australia and India do play their first Test, the opening over is going to be horrible, beautiful, shattering.

  27. Yes Mickey how do we envisage the opening over (delivery). If David Warner is on strike for that opening delivery , goodness knows what will be going through his mind.

    glen!

  28. Glen- the first ball, the first over, the hour of a Test are all events to be celebrated- normally. The opening morning of the Adelaide Test is going to be invested with such complexity, and such sadness, but let’s hope that it’s also a tribute to Phil Hughes too. It will be a highly significant moment for the global cricket community, and I think, for us as a nation.

  29. Malcolm Ashwood says

    David as some 1 who was a nurse assistant for 13 yrs you are spot on re the fighter aspect I too wonder like Swish if it is there is just not a better term but you are so correct it does not help . I have really struggled re Phil Hughes it is just so tragic , thank you for another thoughtful brilliant article

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