Traumatic Brain Injury: Background information when reading The Dangerous Edge of Things

Traumatic Brain Injury

This article relates to The Dangerous Edge of Things

Tai's fellow investigator and sometimes-bodyguard, Trey Seaver, is coping with the cognitive changes resulting from Traumatic Brain Injury (TBI) that he received in a car accident which damaged his frontal lobe. While he has no lasting motor skill injuries, he is unable to display a normal range of emotions, and can be "triggered" into a violent state when threatened. In addition, while his memory of recent events has improved (in fact his memory seems to be near-eidetic), he often cannot think of a particular word, and has trouble remembering anything before the accident, including his own personality. The upside of the accident is that he has developed a new talent - the ability to read people's body language and know whether or not they are being deceptive; and, because he cannot remember what he used to like, or dislike, he has created a new snappier style lifted from the pages of a GQ magazine.

How realistic is this fictional portrayal?

While no two cases of TBI are the same, The National Institute of Neurological Disorders and Stroke notes that after brain trauma, "common disabilities include problems with cognition (thinking, memory, and reasoning), sensory processing (sight, hearing, touch, taste, and smell), communication (expression and understanding), and behavior or mental health (depression, anxiety, personality changes, aggression, acting out, and social inappropriateness).

The United States Centers for Disease Control estimates that 1.7 million people in the U.S. sustain a traumatic brain injury each year. While most of these are mild, about 20% of injuries require hospitalization and about 52,000 die as a result of the brain injury. Injury occurs because the brain is not anchored inside the skull but floats on fluid which, in the normal course of events, protects the brain admirably; but, in the event of a traumatic blow, is not sufficient to prevent the brain from hitting the inside of the skull leading to potential bruising, swelling and bleeding; which in turn can lead to countless secondary complications.

In the novel, Tai wonders about the term "Glasgow Coma Scale" when she spies it in Trey's purloined medical file. The Glasgow Coma Scale is a commonly used diagnostic tool that helps to determine the likelihood of a brain injury patient's survival, as well as their ability to function later. The patient's responses are rated in three areas: Motor Response, Verbal Response and Eye Opening. A total score of 9-12, for example, would indicate moderate disability, but a score of less than 3 would indicate a vegetative state. Although we do not learn what Trey's score was immediately after his accident, the book's description of his 5-day coma and lasting symptoms would probably put his injury in the moderate category.

However, Ms. Whittle seems to have exercised some creative license with Trey when it comes to his newly found ability to read body language and tell truth from lies. In particular, it does not appear to be common for TBI patients to develop new talents, especially if they did not have some level of skill in that particular area prior to the accident. In fact, many TBI patients with Trey's injuries find it challenging to learn new skills; although, of course, some (like Trey) do manage to surprise their own doctors with their ability to heal from a traumatic injury.

Filed under Medicine, Science and Tech

This article relates to The Dangerous Edge of Things. It first ran in the February 3, 2011 issue of BookBrowse Recommends.

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