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Simon Lewis on Traumatic Brain Injuries

Posted on Oct 17, 2008

By Simon Lewis

(Page 2)

Ultimately, the question of this book, the aftermath of TBI—and the potential for recovery of a damaged brain—remains one of science’s greatest puzzles.

From the book’s opening line—“The first thing I tell her is that I cannot help”—Mason gives the most limited answer: “I spend the last half hour of my evaluation explaining to Jake’s mother that this will take months at a minimum, but most likely a year or two—if anything happens at all.”

This mantra, that “you may or may not improve for the next two years,” is one this reviewer heard from doctors, many times over. Yet at the end of the book Mason recounts something quite inconsistent: “Marilyn takes me up to Spaulding Rehabilitation Hospital, where Debbie is currently receiving care. … More than thirty years after her injury, Debbie continues to make gains in her life, all because of the focus of one person, her mother.”

This is the knowledge gap which “Head Cases” leaves its readers. To address the paradox, Mason briefly references, as “mystery,” some new information: “In recent years neuroscience has revealed that the brain has a dynamic proclivity for self-recovery. In a global sense, the brain can actually relocate functions from one area of the brain to another. … The mystery of plasticity continues well into adulthood, allowing even elderly brains the capacity for restoration. Years after a brain injury occurs, adult survivors continue to make gains that surprise even the most optimistic doctors.”

It’s a shame that Mason doesn’t explore the treatments and hope derived from the medical fact that new neurons are created in the brain every day, even in people in their 70s, or mention to readers desperate for answers that neuroplasticity has been termed “one of the most extraordinary discoveries of the twentieth century.”


book cover


Head Cases: Stories of Brain Injury and Its Aftermath


By Michael Paul Mason


Farrar, Straus and Giroux, 320 pages


Buy the book


Similar to a book last year, “Train Your Mind, Change Your Brain: How a New Science Reveals Our Extraordinary Potential to Transform Ourselves,” which was Wall Street Journal science columnist Sharon Begley’s account of neuroplasticity, “Head Cases” offers few tips or guidance to this emerging paradigm shift in brain injury recovery.

“Head Cases” thus offers a schizophrenic approach to its central issue, the aftermath of brain trauma, in which at the book’s opening Mason gives his patient a time frame of one to two years, “if anything happens at all,” yet in the final pages describes an individual who, over 30 years after her TBI, continues to make gains.

Like the reader in search of knowledge, Mason lies awake in the dark beside his wife, ponders the mind’s mysteries as if the science of neuroplasticity still remains a complete unknown, and wonders “what it feels like to be waiting in between the world you left and the world you want.”

Perhaps it’s the mark of an important book that it leaves the reader hungry for more. Fascinated readers of “Head Cases” will finish the book eager for it.

Simon Lewis is a survivor of traumatic brain injury and is finishing “Rise and Shine: Finding the Hidden Path to Full Recovery,” his account of unexpected tragedy and regeneration. His Web site is

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By alexa123, August 21, 2011 at 1:48 pm Link to this comment

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By hinchliffes, June 20, 2011 at 2:31 am Link to this comment

Well written. A traumatic brain injury is very different from other injuries. Since our brain defines who we are, the consequences of a brain injury can affect all aspects of our lives, including our personality. A brain injury is different from a broken limb or punctured lung. An injury in these areas limit the use of a specific part of your body, but your personality and mental abilities remain unchanged. Brain injuries do not heal like other injuries. Recovery is a functional recovery, based on mechanisms that remain uncertain - no two brain injuries are alike. At this point, I must bring up an important point – health care insurance is a necessity. We must prepare ourselves for any emergencies, for the sake of our loved ones. In any crisis, injury claims and accident compensations can be made to alleviate the sufferings of the family financially, because family members have already been traumatized emotionally.

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By surgical technician salary, May 17, 2011 at 9:31 pm Link to this comment

I found this book points out the glaring inadequacy in the health care system and medical practice and raises a rich variety of philosophical questions about the nature of identity, perception and our connections with the people we know and love.  As a surgical practitioner, I’ve encountered cases similar to those mentioned in the book.  The stories are real and deserve to be read regardless of which school of thoughts one’s subscribed to.

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By nikto, October 23, 2008 at 3:52 pm Link to this comment
(Unregistered commenter)

5.3 million Americans with brain injuries and every one of ‘em is a rightwing repugnican.

Healthy brains=NO GOPers

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By nikton, October 23, 2008 at 3:49 pm Link to this comment
(Unregistered commenter)


5.3 million Americans with brain injuries,
and every dang one of ‘em
is a rightwing Republican!

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By WildCard08, October 22, 2008 at 10:07 am Link to this comment
(Unregistered commenter)

I have wondered if alcoholic injury to President George W. Bush’s brain might have played a role in his inability to effectively deal with the Katrina/Rita catastrophes. And I further wonder if one day we will require presidential aspirants to submit to brain scans as part of an effort to ensure that occupants of the White House are sufficiently mentally healthy.

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By KDelphi, October 20, 2008 at 12:57 am Link to this comment

Da Bronx—well, excuse the [expletive deleted] out of me!

Youre rather touchy arent you?

If you dont want to defend your position fine. I am not an all out Obama supportr,. But I think MCCain is a sell out. He WAS an Independent. (the tax cuts, Medicare Rx drugs, McCain/Feingold, work he did with Kennedy).Rove and Bush screwed hin over in 2000. He shouldve told them to go to hell .Especially after they called his daughter , Bridget, a “child out of wedlock with a black prostitite”!!!!!(They adopted her in Bangladesh)

Can you actually imagine using Rove after they do THAT to you??!!

But, MCCain, who complained so loudly abour Rove and bush, succoumbed long ago to the lure of the presidency , against the honor of his own child.. In 2000, if it werent Al Goer, I might have voted McCain. I wouldnt do it now, if you water boarded me.

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By Da Bronx, October 19, 2008 at 2:49 pm Link to this comment
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By KDelphi, October 19 at 8:40 am #

Da Bronx—I am just curious—why woudl you choose to post this here

I was answering, directly, including quote, a comment by another poster. Frank Cajon, October 18 at 5:45 pm

since I’m NOT your student, I shall decline your homework assignment.

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By KDelphi, October 19, 2008 at 9:40 am Link to this comment

Da Bronx—I am just curious—why woudl you choose to post this here—in the article about brain injuries? I know one poster tried to turn it into an election discussion—but it is not.

I am not “sold” on Obama, either. But, please explain to me, one the issues you complained about, how McCain wil do better than Obama? You were pretty specific on what Obama had voted on, so , plesae be specific when referring to McCasin;s voting record.

Also, please include votes he has made AFTER his “transformation” to a neo-con—like, I know he voted agaist tax cuts for the wealthy—but now he supports them. He voted against Rx Medicare bill—now he supports it.

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By KDelphi, October 19, 2008 at 9:33 am Link to this comment

Frank—Agree on almost all…

BTW—You dont know who (?) the PhDs, MSs, MDs were who “advised” on the “treatments” at GITMO , do you? Dont you think that they should lose their license for life?

It is hard to belive that someone would use training to harm, when they had promised otherwise. I just think of it everytime I hear of GITNMO, Abu Gharib, and, to a much lesser extent, those idiots on FOX and such, who “diagnose” candidates , etc. by “interpreting body language”. Theyre usually so far off, it doesnt matter.

But, to USE it for political purposes that are wrong and harmful (like Frank Luntz) is unforgiveable.

I just wondered if you would agree.

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By Da Bronx, October 19, 2008 at 6:42 am Link to this comment
(Unregistered commenter)

“McPalin, the one who will start a land war with Iran”

“McPalin” is two, not one, and Obama has stated he’s not against “war” per se, just the one in Iraq. he wishes to add forces in Afganistan, proceed to Pakistan, and has made veiled references re our “intrests to the south” He has said Nothing, Nada, zip, about returning constitutional rights stolen over the last eight years (with Democratic complicity) The money his campaign has received from Citigroup makes me nervous, and his time in Indonesia (Under Suharto) gave him (as privledged class) a view of the “efficency of dictorial government”

I’m not thrilled with McCain, and care far less for his VP pick, but if I choose to vote for “The lesser of two evils” (yet again) the McCain camp will get that vote.

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By Frank Cajon, October 18, 2008 at 6:45 pm Link to this comment

KD, You and I are on the same side of this one. I stepped out of my midlatelife (age 60) vicarious re-birth as a socialist writer and back into the clinic after 8 months, but end up in the same place: This latest sociogovernmental manipulation (the Great Theft/Bush Bailout) is by design a great way to insure an endless supply of RPG fodder, kids who will never walk into a college without signing away their lives to be life takers and heartbreakers in some fake mideast War. I just hope that McPalin, the one who will start a land war with Iran, doesn’t get the other guy lynched, because if he gets in, our young men and women are doomed.

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By KDelphi, October 18, 2008 at 12:57 pm Link to this comment

Frank—You will not find me disagreeing with the idea that we need a very radical change in out “culture”. If younger people knew—but, I find that you cant much tel them, any more than my dad could tel me. That doesnt mean that we shouldnt try.

I am anti-war, anti death penalty, pacifist (I found myself hitting back, from time to time—I’d have died if I didnt),anti-gun, and vegetarian (occasional chicken, fish). Our govt becomse more fascist every day, if you ask me.

Another “problem” is that, with so many more people surviving—not that we shoudl NOT do all we can to help people survive—but, I think that we are running up against nature, in terms of what we wil be able to cope with (as well as what the patient can learn to cope with—alot more than most peoplpe think). And, youre correct that, as long as we have a guns economy (weapons supplier to the world) there will be no butter, health care, VA care that is worthwhile., etc. If you treat a kid like he is worthless—and allow recruiters to start JROTC in junior high—it gives hte military state plenty of dispoasable warriors.

If we , the people, dont do something to stop this fascist oligarchy, we are all screwed. So are the children. And, with our huge “consumer” influence, the entire planet, I am afraid.

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By Frank Cajon, October 18, 2008 at 12:28 pm Link to this comment

KD: I worked down the hall from a chief of neurosurgery for 11 years. He was brilliant, but his motto was: ‘Do not touch the brain’. I of course realize that TBIs occur from all sorts of causes, and some are unavoidable, from umbillical issues at birth to freak accidents. In my state, motorcycle helmets are legally required-a good first step. ATVs are insane, but big business. Football players wear helmets-and suffer debilitating concussions all the time anyway, it is the most popular sport in school and pro athletics, so that won’t change. I have side airbags in my two four-cylinder cars and feel every car sold in the country should be similarly equipped, but that isn’t going to change the fixation, even as the country is mired in a depression, with having a gas-guzzling, V8-powered SUV-heavily advertized on pro football games.

You should know that I am a committed pacifist and anti-gun rights. The US is the land of the formerly free and home of the Saturday night special, brainwashing our young males into gun worship with video and cinema that glorifies violence and then at puberty either socializing them into a gangster subculture or a suburban/rural amphetamine tweaker lifestyle, both with handguns as god. The tacit approval by our war-worshipping fascist government and the sheep parents has cranked out twenty years of generation zero kids. These have stuffed the mental health care system with dual diagnosis speedfreaks and sociopath gangbangers, and their parents often have similar maladaptive patterns of behavior. Treating them is like climbing a mountain of sand. TBIs are heartbreaking, because they are often a child, or a young adult who in an instant is transformed, usually with little or no chance of significant improvement. The overburdening of the system in other areas makes focusing on these unfortunate infividuals difficult, and this book hopefully will raise awareness of their situation.

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By KDelphi, October 18, 2008 at 9:30 am Link to this comment

Frank—I agree with most of what you say. My mother had Wierneke’s syndrome, and I have had a severe contusion induced coma (hours not days)

I was unconscious many times, to be honest, while I was running around trying to find a reason to live, at 19, with a divorce under my belt (and a broken, nose and jaw) and a junior high education.

I decided that Harleys were fun—they are. But I rode one one night without a helmet in shorts, and, the guy driving it hadnt had a wreck in his 18 yrs.A drunken asshole broadsided us.

I took my college courses in the hospital on tape for about 6 mos. (FINALLY eligible for Pell grant!)(the guy driving the motorcycle taped them and, ended up going to college—he liked it so much!) I got my MSW in a wheelchair, but I walk ok now. Still leg length diff (broken in 72 pieces)

I cannot ride a motorcycle now—I tried. My CNS just wont allow it (I can see why) I tell other people that it is not worth it, but I didnt listen either, at the time.. But, I am not sure we can legistlate this stuff as thoroughly as youd like. I know you realize that. I think boxing and fighting (poor guys get brain damage while rich guys bet on it) (done enough of that, with a 6’7” man!who jockied standardbreds for living so his arms were lethal weapson),all these No FEAR! sports are nonsense.  It seems to me, if we can mandate seatbelts , we can mandate other things. But,warning young people to not take risks is as old as time.

My dad used to do human factors product safety work (like Ford Pinto), as an expert witnes. He also testified against ATV (those three wheel things that kids ride around on), but NOT before trying it out!!! (at 73 yrs. old! They gave him one to check out, and he tried it out !! and ended up on the bottom of our pond, trying to pull the gd thing off of hisself!) But I digress…I guess!!

So, I agree, largely, but , as you well know, people are going to do what people are going to do. How do you tell a guy you sent to get his ass blown up not to ride an ATV, drink whiskey or box?

Maybe we should ban doorjambs

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By Leisure Suit Larry, October 18, 2008 at 6:42 am Link to this comment
(Unregistered commenter)

By Folktruther, October 17 at 11:29 am #

Leisure suit Larry- do you happen to have documentation for your assertion

The 70% figure came from a Newsweek magazine (within the last ten years) it was the cover story, so not hard to find… I just don’t have time. 

There is this on the net using   search words:

Head injury juvenile homicide;

As I recall from the Newsweek article, “brain injury” as discussed, could result from active trauma such as beating, fall, or auto accident or passive such as chemical ingestion, through inappropriate use of medication, or toxic substance such as lead paint. There was also the brain injury through deprivation of oxygen to the brain through smothering, drowning, or traumatic impact of the esophagus.

In the Seventies I had two foster children convicted of “Juvenile delinquency” for murder. One killed a neighbor child, and the other killed his father. This is where my interest in this subject began, as the child (14.6 years) who killed his father had multiple skull fractures,(as well as other broken bones) The child (12.3 years) who killed his next door neighbor had no fractures, but did have brusing of the brain (similar to Alzhimer’s) and professed no memory of the act.

The issue is muddied because often the brain injury is coupled with other mitigating factors such as chronic child abuse, poverty, or dangerous living conditions and exposure to familial violence at a very young age.

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By Frank Cajon, October 17, 2008 at 7:37 pm Link to this comment

I spent the last 35 years working with individuals whose brains and nervous systems had disorders, including individuals with open and closed head TBIs. I have an axe to grind here, I will admit up front; but after saying that my position is this: If the public, if indeed the general medical community outside of the realm of neurology and psychiatry really understood the delicate nature of the brain and our society allowed sane social policies to protect it there would be some major changes in the way all of us live.

For beginners, there would be no alcoholic beverages sold stronger than dinner wine. There would be no contact sports-boxing, football, hockey; we would need something besides gladiators beating one another to entertain us. There would be no motorcycles, and people that ride in automobiles (which would have governors that would limit them to 55 miles per hour) would wear protective helmets.

I have seen a woman bump her head into her front door jamb and lapse into a vegitative state from which she was taken off life support in her early 30s. This 3-pound, cantaloupe-sized piece of fatty neurons is the individual; our society has treated it like it treats livers, as a garbage dump. We have a rampant amphetamine addiction epidemic overloading our mental health system with dual-diagnosis, demented patients who have fried their brains on speed, often along with alcohol. College kids are taking stimulants and hallucinogenics that can cause psychotic breaks.

A TBI patient often will lose immediate recall first. They will act and seem normal except completely forget what they just said five or ten minutes ago, or who they are speaking to, and can become disoriented. We need research on post-concussion syndrome to determine long-term effects and links to later demylenating disease, Parkinsonism, and to see if there is genetic predisposition. As long as we exist in a guns over butter system, with most people who really need mental health care either unable to afford it, or the system overloaded with too many patients because of dual diagnosis patients whose conditions are chronic and complicated by compliance issues, we will not be able to adequately improve our understanding and care of TBI, Alzheimer’s Dementia, or other chronic disease of the central nervous system.

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By Folktruther, October 17, 2008 at 6:02 pm Link to this comment

Sorry, KDelphi, but I forget the title of the piece in the NEW YORKER the 2002 article in NATURE.

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By KDelphi, October 17, 2008 at 3:59 pm Link to this comment

Looks like brain coral. I dunno. Brain coral looks like a brain,hence the name, no?


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By Jojo Mojo, October 17, 2008 at 3:10 pm Link to this comment
(Unregistered commenter)

Sorry, but isn’t the image brain CORAL? Just sayin’

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By Xntrk, October 17, 2008 at 1:35 pm Link to this comment
(Unregistered commenter)

I hit myself in the head with some garden loppers about 7 years ago. I blacked out momentarily, but went back to pruning, when I didn’t spring a leak or pass out. If I went to the doctor every time I had some minor accident, I’d spend my time sitting around a doctor’s office instead of living my life.

Anyway, a few years down the road, I started visiting a parallel universe - or so I thought. Once again, I didn’t faint or lose consciousness, but I would return to discover I had been elsewhere for half an hour or so.

That did send me to a doctor, and it got his attention. I got a brain scan, and an EEG, etc. The good news was that I actually have a brain, and no tumors or anything scary.

The bad news is that I also have an injury to the left temporal lobe, which is causing partial brain seizures [rather then full blown epileptic seizures]. I have been taking KEPPRA since being diagnosed.

I’m supposedly taking 250mg twice a day - which really blew my mind. With some experimentation, I have found that 125 mg in the morning is all I need to prevent my time travels.

That said, brain injuries are much more common then most of us think. It doesn’t take a terribly forceful blow to do damage, if it is in the right place [I still have a ‘bruise’ on my temple]

Kids fall, athletes get hit, pedestrians and drivers both have accidents. I’d bet that if we did brain scans [MRIs] on the general public] we would discover large numbers have brain damage they are unaware of.

We are damned lucky that most of these injuries do not incapacitate the victims.

OTOH, society pays the price. Who knows how many people with ‘anger management problems’ or other unsocial behavior are victims of TBIs?

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By KDelphi, October 17, 2008 at 12:58 pm Link to this comment

Folk—Fascinating, isnt it? And so hopeful—in a real sense. Do you have any links for that?

There is also ample evidence that the psychotropic drugs they give “schizophrenics” (shrinks do—psychologist collaberate) CAUSE tardive dyskinesia ie. a form of Parkinson’s disease.(dyskinesia is spastic, dystonia is flacid)  It is NOT a “side effect”. It is the MAIN effect. If paralyzes people and makes them easier to keep in line. They used them in Nazi camps, Pinochet used them—they have a horrible history. I had clinets on them that I thought would NEVER comeback! But, the will is often stronger—isnt it Steve(standing right here)

The soldiers with such injuries need to be treated very quickly, to allow re-connection of the dendrites and possible “heailng” of the injury, or , to let other parts of the brain take over. This works especially well in the young (yes, even up to ageg 30). If you give them brain damaging drugs, and, throw them back into combat—you hugely increase the chances that they wil never be happy or productive again.

They have found out alot more about these injuries recently, but, it is not like they did not know. They know. They do not care.

I could go on and on about this stuff. But, the worst thing you can do to another human being is to take away their brain and their mind. It is torture in the worst sense. I cant remember the movie, but I always remember Penn saying, “Because it is my HEAD!! It is ME!!!”. And, it is the only one you will ever have.

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By Folktruther, October 17, 2008 at 12:29 pm Link to this comment

Leisure suit Larry- do you happen to have documentation for your assertion that seventy percent of juveniles convicted of homocide have significant head injuries.  My wife is an criminal appelant attorney and I’m sure she would be interested in spreading this news around.  Since her office suprvises fifteen hundred attorneys, she can.

You know,KDelphi, that for a century or so, mainstream biology maintained that brain cells couldn’t be regenerated.  But investigators noticed that after accidents in which brain tissue was destroyed, they were regenerated.  However there was a famous neurobiologisst at Yale who refused to believe the evidence and helped get the investigators barred from the discpline. 

Then a woman at a lab in, I think, MIT began COUNTING the brain cells at various times, and their was an increase over time.  She was subjected to enormous pressure from the learned conventional biologists but she held out, and her results were finally legitimated.

Now they are intentionally growing and stremgthening brain cells.  I have a psychologist friend who is activing lengthening and thickening dendrites by various learning exercises, which is positively amazing.  It makes one’s dendrites stand up in astonishment and refuse to pass the message on to the neighboring axons.

Pscyholotgists have also been active in torture, with the approval of their professional associaation the APA.

Which way the biological revolution goes depends on what happens to the power system in the next several decades.

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By Paul Perkal, October 17, 2008 at 11:08 am Link to this comment
(Unregistered commenter)

Though it’s not a cure-all, the homeopathic remedy Arnica is often helpful for head injuries, even older ones. Early treatment with is best, but it’s usually worth trying with old traumas, too. Details are in books on homeopathy and on the Internet.

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By KDelphi, October 17, 2008 at 10:34 am Link to this comment

Everything is not about this election. Gawd.

I worked with brain injured clients for some years. Most of them have “been around” for awhile, so , they have crappy insurance.

In Iraq, they are attempting to “diagnose” PTSD and TBI asd “personality disorders”, so that they wont have to pay them disability, and, they can be sent right back out. This virtually ensures long lasting effects and disabliity. They give them anti-psychotics (or whatever) and, they are sent back out to MAKE SURE the injury becomes permanent!

With concussions, (esp. contusions) the person should be given rest and rehab immediately, for months or years. But as Rummy said, “why not get rid of dead wood”. That is what he said.

Alot of Vietnam vets PTSD was also TBI. But, they wil not study it, diagnose it, etc, unless they have to. If you do not have money for a good lawyer (even if you do) , you will get some other diagnosis.

We are going to have a world of shit on our hands with al this disablity. We best be getting ready to raise taxes for it, because , we cannot let them down again.

I know that some think that this war is “voluntary”. One coudl say that. If one does not take into account the chances that someo of these people had, where they were living, the STOP-LOSS policy,. the fact that it is illegal to send the Guard and Reserve to even fight this thing,etc.

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By Purple Girl, October 17, 2008 at 8:15 am Link to this comment

Immediately, long term or Eventually.
Not to diminish the Seriousness or this issue, nor be ‘snarky’ but this is truely another issue in McCains medical Records we must evaluate. He has had several accidents and the liklihood of Head injury is Realistic.
Head injury patients can have changes in behaviors, personality, Temperment and Impulsiveness. Sound like anyone We Know? Head injuries may not have immediate ramifications, but appear later with advancing years.
Did you See his agitation? Did You hear the contradictions to his previous statements,His ‘interruptions’ (outbursts). John McCain can not Control John McCain.
So the Question who is the Real John McCain must be put in the context of the present, not a historical retrospect ( although that is suspect too).
I’m not sure if the Reason I don’t feel I Know who this Candidate is due to a Long held Cleaver disguise,an alter ego , or the effects of latent Brain injuries…None Denote ‘Fit for Duty’.
There are Millions of Lives on the Line in this election, I am not comfortable putting them in this mans hands with So many Questions yet unanswered About This John McCain.
My deepest regards to those who have suffered a Brain injury, their families and all those who work so diligently to help them in Rehab.

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By Leisure Suit Larry, October 17, 2008 at 6:23 am Link to this comment
(Unregistered commenter)

Over seventy precent of Juveniles convicted of homocide have significant head injuries. There is (at the current time) no interest in persuing a study to determine if the high precentage is a mitigating factor. Since many o these head injuries stem from child abuse, there may be other causesal effects, however it should be studied.

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