A hidden trauma
Sunday, 2 July 2017
VetScript Editor's pick - July 2017
Brain injuries can leave veterinarians and veterinary workers outwardly unmarked but struggling to cope with the daily pace of work – and with the reactions of colleagues. Naomi Arnold reports.
Jonathan Spencer feels lucky to be alive after a car crashed into him while he was out riding his bike one evening, leaving him with a brain injury that has had lasting effects.
All that Jonathan Spencer remembers about the accident are the moments before it happened. It was 4 May 2016, just five minutes into his normal route. Dusk was falling quickly, but Jonathan was wearing his usual reflective gear and his bike lights were flashing. He remembers riding along the quiet rural road, but that's it. The next memory he has is of being in hospital, two days later.
A woman driving a car had hit him from behind and sent him flying, splitting his helmet and knocking him out. He presumes, from the helmet, the car’s smashed windscreen and the sizeable dents in its bumper, bonnet and roof, that his head took much of the impact. It was a few days before his 62nd birthday, which he would celebrate in intensive care.
He was in hospital for 10 days, and after tests revealed he’d suffered a severe brain injury – later downgraded to moderate – he was transferred to Ranui’s Acquired Brain Injury Unit for treatment, then put in the care of an occupational therapist.
He was forbidden to drive and spent eight weeks away from his job as a dairy veterinarian at Inglewood’s Energy Vets Taranaki. After that he began a phased return, going in three mornings a week, with ACC providing most of his salary – and a skullcap to protect his damaged head, which he wore religiously. “It’s a conversation starter,” he says.
It was six months before he was back on the after-hours roster, on call after a full day’s work. But the headaches, memory loss, slow speech, fatigue and slow thinking remained – indeed, they still affect him to some degree.
“Even six months in, I’d be feeling pretty good, and then halfway through the afternoon my brain would just stop working.”
His workplace was supportive, but he struggled with fears, as well as the physical symptoms.
“One of the big things is being taken seriously,” he says. “There’s nothing to see on the outside, and you worry that people are thinking, ‘There’s nothing wrong with him, why is he so slow? What’s he making a fuss about?’. Or worse: ‘That guy makes no sense’.”
Acquired brain injuries include not just those from car accidents and falls, but also strokes, aneurysms and tumours. Ninety New Zealanders sustain brain injuries every day, and no two recoveries are alike.
As well as the symptoms experienced by Jonathan, others include nausea, vomiting, blurred vision, deafness, tinnitus, insomnia, dizziness, vertigo and mood disorders, and it’s important that employers understand how to support their workers in what can be a long recovery.
Jonathan wants to raise awareness of brain injury and to emphasise that people need time and space to recover. “If you try to rush, you won’t get better,” he says.
Catherine Close suffered from severe vertigo after a heifer trampled her on the job. She advises other sufferers to take the time they need to heal.
“Veterinarians are in a high-risk job, and I think there are probably a few people out there who’ve slipped over, been kicked, or banged their heads on pipes in the milking shed.”
One of those is Jonathan’s former colleague Catherine Close. Now at Patea’s Vetfarm, the 26-year-old was working on a farm three years ago when a heifer crushed her, denting her skull and knocking her out.
“I came right a couple of days later and was about to go back to work when I got post-concussion syndrome and was back in hospital,” Catherine says. “It was pretty horrible. I couldn’t stand without falling over and I had vertigo.”
She took three weeks off and gradually returned to full time hours, but was still feeling the effects a year later, and believes she went back to work too early. She was initially given small animal work, after being instructed to be on 'light duties'.
“When work is busy and it’s all hands on deck, it’s easy to say ‘I’ll deal with it’, and push through. But the exhaustion was huge. After working four hours a day for three days a week, I’d go to sleep for the rest of the day. I was shattered.”
She says there was a lack of awareness around the ongoing consequences of a head injury – including in her colleague Jonathan, who would come to understand several years later.
“After his accident, he said he had no idea what I was going through until he did. The hardest thing is that physically you are okay, but people don’t realise how much you are suffering,” she says. “You can still do the jobs, but you have to push much harder.”
Today, she’s learned to manage it. “As long as I’m not overly tired I’m okay, but if I do get tired, I can feel it.”
Jonathan has learned to manage the ongoing results of his injury too. Today he sleeps a lot more than he used to, and knows his memory isn’t as good as it used to be.
”My balance is slightly inferior, and although outwardly people say I’m okay, I know I’m not quite right,” he says. “My brain has been given a real shake-up, and it frayed some of the nerve connections. When I try to remember things, messages have to take the long way around. They will slowly come 10 or 30 seconds later.”
He still cycles, but he’s bought a stronger helmet. “I mountain bike now – but not to a dangerous level,” he says. “I have no wish to go back on the road.