Does My Spouse Have a Brain Injury?

Denver Injury Attorney Offers Support for TBI

Video Transcript:

Tom Metier:

The brain injury itself, unless it's pretty severe, may not be recognized. So it's not going to even be addressed often for sometimes days, weeks, or months afterwards.

Rob Rosenthal:

Did you know that traumatic brain injuries are sometimes called the invisible injury, and why that might that be? Well, we're going to find out today because that's what we're going to ask the lawyer.

Hi again, everybody. I'm Rob Rosenthal with askthelawyers.com, and my guest is attorney Tom Metier, who has lots of experience with brain injury law. Tom, we're going to get to you in just a second, but I want to remind everybody before we get into the interview that if you want to ask questions about your specific situation, just head over to askthelawyers.com, click the button at the top of the screen that says “Ask a Lawyer”, and we'll walk you through the process right there.

Tom, good to see you again. Thank you for making some time to answer our questions.

Tom Metier:

Rob, it's great to be with you today.

Rob Rosenthal:

So we started off saying that traumatic brain injuries are sometimes called the invisible injury. Explain why that might be.

Tom Metier:

Well, we can't see the inside of our head. Think about the fact that when somebody has a concussion at a sports event, we have to have trainers come over and see what it is about this person that's different. Now, if you're in a car accident or a motorcycle crash or some other event that caused a brain injury, it's not going to change the expression on your face necessarily. If it's severe enough it can change our appearance or it can change how we move; it can change our rate of speech; it can change how we talk. But in terms of being able to look at somebody and say, “That person's had a brain injury,” it's almost impossible. And you know, one of the great tragedies of a brain injury is that you can't see it, because that means that when we see somebody that has a brain injury, we expect them to be able to hear normally, to be able to see normally, to be able to conduct themselves normally in conversation or in other activities, when in fact they're struggling, but you can't see it. So an invisible injury is a very tough thing to have.

Rob Rosenthal:

It would seem to make it very difficult, especially in an emergency room situation. Let's say someone's in an automobile accident, they come in, obviously broken bones are going to get treated and whatever else that can be seen, but is it likely that brain injuries may, if not go misdiagnosed, just go undiagnosed oftentimes?

Tom Metier:

Very often. In fact, there are studies that show 50% to 60% of the time that a patient comes into the emergency department after an accident, the physicians miss the fact that there's been a brain injury. As you've just said, there can be a good reason for that, and the reason is that there are other injuries which are much more obvious and are not invisible. If you have a broken leg or a commutative fracture of an arm that needs to be reset; there may need to be a surgery right away. So the brain injury itself, unless it's pretty severe, may not be recognized; so it's not going to even be addressed often, for sometimes days, weeks, or months afterwards.

Rob Rosenthal:

Is it also the case, Tom, that sometimes the person who's injured... If I broke my leg, I can tell you my leg really hurts, but if I have a brain injury, I may not be able to tell you I have a brain injury. It seems like that might make diagnosis much more difficult too.

Tom Metier:

It is. There's something called anosognosia, which is where a person with the brain injury doesn't recognize that they have a brain injury; and one of the problems with being concussed is that we're not processing what's happening around us, therefore we don't know whether we've had a brain injury or not, and we're unable to express it. One of the other things is the last person in the world that knows whether they lost consciousness or not is the person who lost consciousness. Because if you think about it, it's like going to sleep; you're awake, then there's a blank space, and then you're awake again. But in our experience those two things are put right next to each other, so there's no blank in our memory unless we're specifically examined about that. Oftentimes in an emergency situation, an EMT on an ambulance or a physician at the emergency room, will say, “Did you lose consciousness?” And of course, the person will honestly answer either, “No, I don't remember that I did,” because they have no memory, or they'll even express an affirmative opinion that, “No, I didn't lose consciousness. I remember everything.” But when we actually get down to an examination of them, oftentimes referred to as a “Galveston Exam”, and take them second by second through what happened that they remember, versus what we're able to establish was actually happening through other eyewitnesses, through other activities that have been recorded and are recognized, then we realize they have a great big period of time in which they have no memory as to what was going on. That memory loss is just the beginning of what's called sequelae, or all the things that happen and that come with a brain injury.

Rob Rosenthal:

So if it's misdiagnosed or not diagnosed at all in the emergency room, what usually leads somebody to think there might be a brain injury? What might happen?

Tom Metier:

Well, it happens a couple of different ways, and I should say even more than that. But oftentimes it's another family member who recognizes that something's off about their loved one; it might be a spouse or a child, or a brother or sister that will say, “You know, Tom just isn't who he was before,” or “Susie seems to lose time. She keeps asking me the same question over and over again. I see her when she's cleaning house; she's cleaning the same room over and over and over again instead of moving from room to room, and that's strange,” or “I've noticed that she loses things. I opened the refrigerator and found the channel changer for the TV in there where the milk should have been, and found the milk sitting out on a counter getting warm. Something's not right.”

And I often hear those stories. I've been doing this now for well over 35 years, working with brain injured people and families. Families themselves have to learn to recognize what is a brain injury symptom and what isn't. So, for instance, oftentimes a person with a brain injury will have a very short temper; they have an easy frustration level. You might notice, if you think about it, that because the brain isn't operating as fast, it's called speed of processing, your loved one with a brain injury doesn't seem to follow more than the first half of a sentence, or the first couple of sentences in a story. They can't seem to keep up with watching what's going on in TV. They keep asking, “What did you say? What's going on?” And you realize that they're not keeping up with the speed of information.

Another great example is when they'll say, “You know, Dad was in that accident a few weeks ago, and he got behind the wheel of the car and he was driving down the street at 10 miles an hour in a 45 mile per hour zone, and it scared me to death.” Well, the reason is because the dad with this brain injury isn't able to absorb the information as fast as it's being presented to him, so his perception is that he's doing 45 miles an hour, even though he's only moving at 10. You'd be surprised at how often I hear these stories.

Rob Rosenthal:

It seems like outwardly, to just anybody that doesn't know the person, they may seem fine, but these are some things that could really affect their lives and an ability to make a living or school, all sorts of effects. What are some of the effects you see after a brain injury that people may not realize?

Tom Metier:

You may find somebody that—in normal conversation and life around the house—seems just a little off, but generally seems to do pretty well, and then they go back to work. I remember years ago, I was representing an accountant who was a very successful business owner, multiple employees and other accountants working for him, senior partner in the firm, and he would go in to his desk when he returned to work, and he's got the computer in front of him with a lot of numbers in it, the phone and other devices that he has to operate under; so you can imagine that he's got to process accounting information, a lot of numbers, the phone rings and he picks up the phone, but now the phone has taken his attention, and now he's talked to that person and he puts down the phone, and he looks back at the computer and he has no idea what he was working on.

He can't seem to hold more than one thought in his mind at the time, instead of putting all these numbers up here, kind of floating above his head like a cartoon, and being able to pick all that and add it all up. He can't maintain those things in his memory at the same time. So not only is he thinking slower, not only is he diverted every time somebody interrupts him and he forgets what he was doing, but he can't even hold those facts in his mind in order to do his work. So he's going into his office every day, he's not accomplishing anything, but he looks normal because it's an invisible injury.

Many times we hear that somebody will come into the doctor's office with a spouse, and the doctor will ask questions about how they're doing, and the person whose brain is injured will say, “Oh, things are great. I do have a headache, and I get a little dizzy, but as far as everything else, I'm doing fine.” And this happens in my office too, when the spouse is over there going, “Oh no, that's not what's going on at all. I have to tell my spouse to take a shower in the morning because he forgets. I have to make sure that he's got everything to take with him to go to work because he forgets his sunglasses and his keys and his briefcase. He doesn't seem to be aware of a lot of what's going on around him. And then he has anger, so if I remind him not to forget something, then he gets mad at me, even though he's never been like that before. His personality is really changing.” Those are the kinds of things that we often see after a brain injury.

Rob Rosenthal:

So, Tom, for someone who has a family member, a loved one, suffering from a traumatic brain injury caused by someone else's negligence, what's the advantage to hiring an attorney such as yourself who has so many years of experience, as opposed to someone else who may not have as much experience handling brain injury cases?

Tom Metier:

Well, there are a number of reasons, Rob. One is—and this has happened many times in my career—we live in a world in which medical providers will give you 15 minutes for an appointment, and that's not the doctor's fault, that's the insurance companies and the regulation of how much time they can spend. So the doctor isn't getting enough time to really diagnose and deal with the brain injury if the doctor is trained in brain injuries at all, many doctors aren’t. It takes specialists to really understand this. So I may be the first one to see in my office somebody who suffered a brain injury, but they're in because they broke a leg or their back, and I’m the first person with some knowledge to say, “You know what? We need to send you to a neurologist or a neuropsychologist to make an assessment as to whether you've suffered a brain injury and investigate those things.”

Now, for somebody that has a brain injury, if they're making legal claims in which it's a very complicated subject matter, the attorney needs to understand how the brain works, to really understand neurology and brain science, to understand what imaging can be done—imaging being radiology of one kind or another, like PET scans—and understand what the medicine is, because as the attorney we have to talk to doctors, have to cross-examine experts on the other side really needing to understand the context of what the brain injury means for the lives of these people, to understand how brain injuries are measured when they can truly be measured as well as when they can't be measured; and perhaps most importantly, having all that information then understanding how to tell an honest, clear story about what's happened to the brain-injured person and their family, and what it means in the context of their life. So you can imagine if you had an attorney who didn't understand brain injury, how in the world could that attorney properly represent you? This is something that's near and dear to my heart because of all the experience I have in it, and all the people that I've loved myself who suffered brain injuries, and it's a wonderful calling to be able to help people with these invisible injuries. It means a lot to me.

Rob Rosenthal:

Fascinating topic. Lots of great information. Tom, thank you so much for taking some time to answer our questions. I appreciate it.

Tom Metier:

Rob, thanks so much. I appreciate you talking with me today.

Rob Rosenthal:

That's going to do it for this episode of AskTheLawyers™. My guest has been attorney Tom Metier with the Metier Law Firm who has a lot of experience handling brain injury cases. Don't forget, if you want to ask questions about your specific situation, head over to askthelawyers.com, click the button at the top of the screen that says, “Ask a Lawyer,” and you can ask away right there. Thanks for watching, everybody. I'm Rob Rosenthal with AskTheLawyers™.

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