The article reports on information obtained by the Huffington Post in which former Packers VP Andrew Brandt questioned whether he had acted appropriately to combat the effect of concussions during his stint with the team.

According to Brandt, "The honest answer is: I don't know. ... I saw the fuzzy looks when some of our players came off the field. I took calls from wives, mothers, fathers and brothers of players who had suffered concussions. I watched players vomit in the triage of the training room after concussions."

The paper also reports that, Brandt, who now serves as a consultant to the Eagles (in addition to writing for the National Football Post), said teams must yield decisions about the playing status of concussed players entirely to doctors and not allow coaches -- or players -- to have a say.

With the current information about concussions now available to teams, coaches and trainers, there can no longer be an acceptable excuse for allowing players who have sustained a concussion or a suspected concussion to return to play in the same game or even in a subsequent game without proper medical clearance.

You can read the full story by clicking here.

WHEN IN DOUBT, KEEP THEM OUT!

The ThinkFirst National Injury Prevention Foundation has been focused on teaching children and teens the importance of making safe choices since 1986. Educational programs for first through twelfth grades have a major impact on impressing kids to “Think First” when it comes to safety. 

We all know that the best cure for brain injury is prevention and this organization has had a long standing commitment to head injury prevention programs. 

ThinkFirst was recognized for its work in providing meaningful, educational injury prevention programs to thousands of children and teens each year. One hundred and thirty national and 39 international chapters visit health, science and driver education classes to teach students how to reduce their risk for injury. Based largely in injury prevention departments within hospitals and medical universities, nurses, health educators and their sponsoring physicians schedule programs with schools to assure every child and teen in a given community learns simple measures for protecting themselves from the most common causes of injury: vehicle crashes, violence, falls and sports.

Formerly known as the National Head and Spinal Cord Injury Prevention Program, ThinkFirst was established in 1986. The American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) directed two neurosurgeons, to develop a national injury prevention program. ThinkFirst has since developed into one of the largest injury prevention programs in both the U.S. and Canada.

One of the most recent projects was the production of a new educational film for teens titled “Think About Your Choices,” with support from the Christopher and Dana Reeve Foundation. For more information on ThinkFirst visit the ThinkFirst web site. 

The AP concussion study interviewed a cross section of NFL players, talking to five players on each of the 32 teams, which amounts to approximately  10 percent of all players.  The interview results confirms what we all know, concussions are a bigger problem in football then the NFL or its players association wants to admit to.

Players reported feeling there head vibrate like a bell, but going back to play within minutes and never reporting their symptoms.   Another player said,
"You get back up, and things are spinning," but he didn’t tell anyone.
 
Now the NFL wants players to keep tabs on each other and tell their teams if they believe someone else has a head injury.

The NFL told the AP that they believe all concussion symptoms need to be reported and that team members should be encouraged to report observations of their team mates to the medical staff.

According to the AP,  “What emerged from the AP's interviews was a wide-ranging, unprecedented look at the way active players think about head injuries in a world where "getting dinged" and "seeing stars" — and the potential long-term effects of concussions — are deemed a frightening but perhaps inevitable consequence of their job.”

The NFL says its data shows an average of one reported concussion every other game — about 120 to 130 concussions per regular season.

Of the 160 players interviewed by the AP, half said they've had at least one concussion playing football; 61 said they missed playing time because of the injury.

Players acknowledged staying on the field despite feeling "dazed" or "woozy" or having blurred vision, because, "It's what you're taught."

One thing is clear, the efforts by the NFL and the players association to educate players about the dangers and long term consequences of concussions, to date, have not worked.  Much more is needed and needed now.  Merely handing out brochures to warriors in the locker room about the dangers of concussions is not doing the job.  More serious efforts must be undertaken.  In addition to educational films which should be mandatory of former players who describe their disabling injuries and the need for vigilance, player’s wives and mothers should also be told about the dangers faced by their loved ones.  Maybe it’s time that we bring in the heavy guns to tell players, WHEN IN DOUBT, STAY OUT!

The full AP story can be read by clicking here.

Harry has devoted a great deal of time to alert the public and especially those participating in amateur athletics to the dangers associated with concussions. As Harry aptly observed while a guest of  honor at the recent Brain Injury Association of New York State Journey of Hope Gala, "According to the NFL and their physician, Dr. Ira Casson, they've been conducting studies for fifteen years.  How much longer do you have to extend your research to come up with any kind of definitive conclusion?"

Here are some more of his comments:

“It’s that train that’s coming down the track and it’s coming full speed and more and more players are being affected by lingering effect of concussions,”

“As a parent you really should be concerned,” -- “So if there is one thing that should come out of this thing, parents should have the information to determine whether they want their child to play a contact sport, football or not. Unfortunately for many of us who have played the game, there’s nothing really that can be done. The damage is already done."

Hopefully the league and congress will both hear these important messages and take appropriate steps to reduce the risk of permanent damage from concussions to all players, both professional and amateur.

Nov 4
Collaborative Approaches to Rehabilitation for Adults with Brain Injury
Omaha, NE
715-829-8055
click here

Nov 5
Cognitive Rehabilitation: Meeting the Challenges in The Treatment of Traumatic Brain Injury & Polytrauma
Grand Forks, ND
715-829-8055
click here

Nov 5-6
BIA of West Virginia presents "My Child Has a Brain Injury: Information for Families and Schools"
South Charleston, WV
click here

Nov 16-18
14th Annual Brain Injury Association State Affiliate Leadership Conference
San Antonio, TX
703-761-0750 ext. 622
click here
www.brain-injury.org/education.htm

Nov 17
2nd Annual Partners in Brain Injury Conference
Little Rock, AK
800-444-6433
click here

Nov 20-21
10th Annual Neuroscience of Brain Injury: Research Informing Medical Treatment and Legal Practice
Napa, CA
661-872-4903
click here

Health Care Reform Update

On Wednesday, October 28, 2009, House Democrats introduced their consensus health bill, HR 3962, at a rally on the Capitol's West Front.  According to House Majority Leader, Steny Hoyer, the bill could be considered on the House floor as early as November 5, 2009.

The consensus bill prohibits insurance rating based on health status or pre-existing conditions and prohibits annual or lifetime limits on medical spending. It also establishes important consumer protections, including internal and external appeal requirements, provider network adequacy requirements, and greater transparency by insurance companies.

BIAA will continue to monitor the situation closely and alert grassroots advocates if any action is necessary.

BIAA participates in Sports and Concussion hearing on Capitol Hill

On Wednesday, October 28, 2009, the House Judiciary Committee held a hearing on legal issues relating to brain injuries sustained while playing football.  Testimony was given from the National Football League, Commissioner Roger Goodell, and retired players, Tiki Barber and Merril Hoge, as well as Congressional Brain Injury Task Force Chairman, Congressman Bill Pascrell, jr. and the Co-Director of the Center for the Study of Traumatic Encephalopathy at Boston University and member of the Brain Injury Association of America board of directors, Chris Nowinski.

The Committee investigated the findings of a recent study done by the University of Michigan regarding the prevalence of brain injuries among former football players.  The study raised significant health concerns about concussions and how they may contribute to lasting effects starting at both the professional and amateur levels.

BIAA is committed to assisting in the awareness campaign to educate coaches, parents, and players regarding the dangers of concussion.

Appropriations Update

Consideration of an appropriations measure that would fund labor, health and education programs for Fiscal Year 2010 continues to stall in the Senate.  This week, Congress cleared a continuing resolution that will fund the federal government at the FY2009 levels through December 18, 2009.

BIAA will continue to monitor the situation and alert advocates when action is needed.

BIAA supports S. 801, The Caregiver and Veterans Health Services Act of 2009

BIAA and our friends at the Wounded Warrior Project are currently working towards enactment of legislation establishing a national program to provide training and critically-needed supports to family caregivers of veterans living with traumatic brain injuries and other severe wounds.

Reported in the Senate, S. 801, the Caregiver and Veterans Health Services Act of 2009, would provide comprehensive supports for caregivers of veterans who sustained severe injuries after September 11, 2001.  The bill has been approved by the Senate Veterans Affairs Committee and is awaiting floor action. 

Some of the interesting and important information on the prevalence of disabilities in the school system and children receiving services under IDEA: 

2.6 Million specific learning disability 43.3%
1.1 Million speech/language impairment 19.2%
624,000 other health impairment 10.6%
487,000 mental retardation 8.3%
438,000 emotional disturbance 7.4%
257,000 autism 4.3%
131,000 multiple disabilities 2.2%
88,000 developmental delay 1.5%
71,000 hearing impairment 1.2%
60,000 orthopedic impairment 1.0%
26,000 visual impairment 0.4%
24,000 traumatic brain injury 0.4%
1,300 deaf/blindness 0.02%

You can download the entire disability report by clicking here.

Congress needs to go further and also needs to address the protection afforded to the league in erroneous decisions in regard to granting players disability benefits for the chronic and long term consequences of traumatic brain injury.  Injured players deserve access to the Federal court's to present their legitimate claims to a jury.

The following proposal to save the game of football and reduce the incident of concussions and other types of brain damage was presented at today's hearing by Chris Nowinski, president of the Sports Legacy Institute and co director of the Center of Traumatic Encephalopathy of the Boston University School of Medicine.  Chris is also the author of Heads Up, a book which provides a detailed look at the issues of concussions in athletes.

Here is the proposal presented at today's hearing:

10 Point Plan to Save Football:

In the past few years, former football players have begun being diagnosed with Chronic Traumatic Encephalopathy (CTE), a progressive neurodegenerative disease caused by repetitive trauma to the brain
which eventually leads to dementia. Some were famous NFL Hall of Famers like Mike Webster and Lou
Creekmur. Others, like Mike Borich, only played through college. All died sooner than they should have,
and all suffered terribly in their final years.

Since the discovery of CTE in 1928, the disease has been seen almost exclusively in boxers, which is why
it is often referred to as “punch drunk” syndrome. However, it is now diagnosed regularly in ex‐football
players, and in the past year, the Center for the Study of Traumatic Encephalopathy at Boston University
School of Medicine (CSTE) has diagnosed CTE post‐mortem in 11 of 11 former college and professional
football players that died at ages ranging from 37‐82 years. This is significant, as the disease should not
naturally exist in a single human being. The early stages of the disease have even been seen in an eighteen year‐old former football player. In 2009, it is clear that football is in the midst of a brain trauma
crisis.

The game of football has not always been played as it is today. In fact, the most consistent aspect of the
game has been change. In 1905 the game was so dangerous, regularly killing participants, that President
Theodore Roosevelt summoned the coaches of Harvard, Yale, and Princeton to Washington D.C. for a
summit on how to make the game safer and threatened to take action in the absence of significant
reform.

From this meeting the American Intercollegiate Football Rules Committee was created, and that Committee, among other things, legalized the forward pass and made other changes to eliminate dangerous collisions. Over and over, football has had to be changed to be made safer. Now it faces a new challenge.

CTE is a deceptive, quiet killer. The disease begins during a player’s career and then hides, slowly
killing brain cells until the athlete begins showing symptoms years later. Football has evolved into a something it was never intended to be. Football collisions may now be more dangerous for the brain than ever. With the combination of bigger, stronger, and faster players and hard‐shelled helmets that are often used as a weapon to initiate contact, we’ve created a type of repetitive trauma to the brain that has never existed before.

The discovery of CTE inside the brains of so many ex‐football players has shown us that it is again time
for change, and a new Committee. Only this time, it is a Committee to Save Football. Among high school
students, football is the most popular sport in America, played by one in eight American boys. While
football was first played by colleges, today football is a children’s game, with 95% of participants under
the age of 18.

These children are not old enough to make informed choices. Therefore, in light of the new evidence of
CTE in 100% of players studied at Boston University, it seems appropriate that we again reevaluate how
“Solving the Sports Concussion Crisis” we play the game of football before the 2010 season and at all levels of play: youth, high school, college, and professional.

If we can agree that the game is broken and needs to be fixed, we have an incredible number of paths to
a safer game without fundamentally changing football. If we know that practice collisions account for
over 50% of brain trauma, the proposals below could easily eliminate over 75% of brain trauma and
concussions today – it is simply a question of leadership.

Below are 10 paths to a safer game that can and should be used to reduce brain trauma. This would
serve as the basis for evaluating the options available to the Committee to Save Football.

1. Reevaluate how the game is practiced
• Greater than 50% of hits to the head occur outside of games. NFL teams rarely hit in practice due to risk of injury. Youth teams could only be allowed to have full‐contact once a week. Dangerous drills could be banned or used less frequently.

2. Encourage mandatory brain trauma and concussion education  for coaches, athletic trainers, parents, and athletes
• Coaches, athletic trainers, and athletes cannot diagnose concussions if they aren’t trained to look for them or know how to recognize them. Coaches, athletic trainers, and athletes will not voluntarily choose to rest concussions and reduce overall brain trauma if they don’t understand why it is good for the athlete’s short and long‐term health.

3. Reevaluate protective equipment
• Investigate changes to helmets, shoulder pads, and other types of protective equipment to reduce brain trauma.

4. Develop better methods of concussion detection and diagnosis
• The CDC provides clipboards with concussions diagnosis protocols on the back at no cost. Coaches could be required to carry them. We can invest more in research to find simple, objective ways to diagnose concussion that can be utilized in any program.

5. Develop better methods of concussion management
• Return‐to‐play too soon after concussion can result in more extensive brain damage, and can actually result in death. It is now law in Washington state that players are required to see a medical professional with brain trauma expertise before return‐to‐play. Minimum return‐to‐play standards should be enforced at all levels.

6. Consider minimum medical resources
• Football is a dangerous game. Minimum medical resource standards, like having an athletic trainer or doctor on the sideline, should be considered.

7. Reevaluate techniques of tackling and blocking
• We can teach and enforce different methods of tackling and blocking that minimize contact to the head.

8. Reevaluate the rules
• Recently the NFL banned the wedge on kickoffs to reduce trauma. Many other rules could be changed, at all levels of football, to reduce brain trauma.

9. Reevaluate rule enforcement and the role of referees
• The NCAA recently began suspending players for intentional helmet‐to‐helmet hits. Referees could eject players for illegal hits to the head. Referees could be trained to identify concussed players on the field.

10. Reconsider the culture of the game
• Television announcers could stop glorifying illegal hits. Children could stop being pressured to play through concussions.

The evidence now exists to support immediate and radical change to the game of football to dramatically reduce brain trauma. Let us not let this opportunity pass.

Last week, neurologists and pathologists associated with the Center for the Study of Traumatic Encephalopathy announced their findings that even college athletes who received multiple concussions were found to have this brain damage.  Dr. Ann McKee, an associate professor of neurology and pathology at the Boston University School of Medicine and co-director of the Institute is quoted in the New York Times as saying, "I've looked at more that 1,000 brains and I've never seen this in any individual living a normal life--it's only through head trauma. "

The health care crisis goes for beyond professional football players.  Evidence of this disease in younger athletes raises serious safety concerns and again raises the issue, is the NFL and their poor decisions setting the wrong example for younger athletes and leading to more brain injuries and permanent brain damage?

Here are some additional comments by Dr. McKee: "The fact that we are seeing this disease, it had a devastating effect on their lives, mow in a 42 year old who never played in the N.F.L. indicates that it's a more pervasive problem that we recognize.  What are we doing with our kids?  Are we doing enough to protect against their developing this awful condition?"

Tomorrow's hearing will focus on these issues.  Among those invited to testify are Dr. McKee and neurosurgeons, Robert Cantu and Julian Bailes who have also down extensive research on concussions and the effects of cumulative concussions in athletes.  Another witness, David Weir from the University of Michigan recently published research sponsored by the NFL that suggested that professional football players had rates of cognitive disease several time higher then the general population.

I also heard that Dr. Eleanor Perfetto, the wife of former lineman Ralph Wenzel who was institutionalized for dementia is also scheduled to testify.  I had the privilege of meeting Dr. Perfetto last week at the Sports Legacy Institute awards dinner in Boston, Mass. She has fought a long and hard battle with the NFL over this injury had has been a great friend and advocate for other football families who face the uphill battle with the league's disability plan to obtain benefits that these players are entitled to.

Chairman Conyers and the House Judiciary Committee must press NFL Commissioner Roger Goodell as well as players executive director Maurice Smith on why the league continues to try to minimize this serious condition and why players who suffer from traumatic brain injury can't obtain benefits that they bargained for as part of their collective bargaining agreement.

In addition to cognitive evaluations there is a great recognition of the psychological component to mild head injury.  Here is an interesting description of the evaluation that is performed:

“When we evaluate drivers, we evaluate whether a driver is a sponge or is waterproof,” Ceccarelli said. “Waterproof means it is raining but you don’t absorb it. A sponge means it is raining and you absorb it. If you are a sponge, all the details — everything that’s wrong and everything you believe is wrong and everything that you feel around you is negative — affect your mentality and your enthusiasm and your mood.”

The driver who absorbs will have a harder time recuperating from an accident, he said. But another key to how a driver will be affected is whether he was responsible for the accident.

When in doubt--Keep them out!

House Judiciary Committee Chairman John Conyers, Jr., D-Mich., said that the committee will hold its hearing Oct. 28.

The hearings will look at the lasting impact of head injuries, how to limit them and how to compensate players and their families.

The decision to hold the hearings follows a preliminary study which suggested retired pro football players may have a higher rate than normal of Alzheimer's disease or other memory problems. The study was done at the University of Michigan.

Here is a brief excerpt from the show:

You can't separate violence from football - it's part of the thrill of the game. Players know what they're risking when they hit the field, including injuries such as torn ligaments and broken bones. But what about a blow to the brain? According to the Centers for Disease Control, concussions from sports are an epidemic in this country.

As many as three million sports related concussions happen every year.

And new research shows that their effects can be frighteningly long-lasting, even leading to permanent brain damage and the early onset of dementia. While concussions happen in many sports, most happen in football. They can happen to kids, to the pros, and as we saw recently, to one of today's top college players.

Watch the entire 60 minute concussion broadcast

Unfortunately, again the wrong example is being set for parents who watched the Gator's decision to allow a concussed player to prematurely return to play.  The talk now is hey, he could throw the ball, he must be OK.  This is a simplistic and unfortunately inaccurate way of assessing concussive injuries and their life long consequences.

Parents and coaches take heed:  When in doubt, keep them out!

Here is what the Times has to say about even thinking about letting Tim Tebow play tonight after sustaining a concussion that left him unconscious:

The devastating effects of concussions are no longer a secret.  In the last five years, mountains of evidence have been compiled about the long-term impact, especially on football players.  There have been proof and loud warnings: don't play around with concussions.

Meyer has said he will leave the decision up to the team's medical staff.  But why wait for the physicians? Meyer should announce before Saturday's game that regardless of what the doctors say, Tebow will not play.

I say, When in doubt, keep them out!

FY10 National Defense Authorization Act

On Wednesday, October 7, 2009, the House and Senate Armed Services Committees announced that they had reached an agreement on a conference report to H.R. 2647, the Fiscal Year 2010 National Defense Authorization Act.

In a major victory for the brain injury community, the report included an amendment that authorizes the Secretary of Defense to carry out a pilot program for providing cognitive rehabilitation therapy services under TRICARE.  BIAA worked with the Congressional Brain Injury Task Force to preserve its status as part of the final conference report.  We are thrilled to have contributed to this important step towards providing better access to care for returning service members.

A link to the full text of the amendment can be found here .

The condition, destroys brain tissue and causes dementia.  According to neuropathologists who have investigated this condition, the only known cause is trauma.  While most commonly found in the brains of boxers, recent autopsy findings show that the condition is also found in the brains of retired football players and other sports figures who have routinely sustained multiple concussions.

The Sports Legacy Institute has been instrumental in bringing this new research to the public's attention.

You can watch a short video preview of the CBS segment A Blow to the Head.

Traumatic brain injury and concussions often lead to speech and language difficulties.  This on line conference sponsored by the American-Speech Language Hearing Association is scheduled for October 13th to October 26th 2009.  You can get more information by clicking here.

BTF’s Lunchtime Lectures are a monthly, one-hour online lecture series taught by top neurotrauma care experts on various up-to-date topics related to traumatic brain injury (TBI).  An excellent opportunity for all healthcare professionals, these live, interactive lectures are complete with slides and audio and easily accessible through an Internet

Lecture Description: Traumatic brain injury is the leading cause of death under age 45 in the Western World. Despite the efforts of investigators worldwide, no phase III clinical has yet been successful. However, recent advances in clinical trial design and implementation leverage lessons learned from past failures. At present, several promising interventions are being tested through multicenter clinical trials, including progesterone, citicholine, and anti-apoptotic agents. This lecture will discuss clinical trial design factors as well as describe current and impending clinical trials for the treatment of traumatic brain injury.

 Learning Ojbectives: 
• Discuss the current active multicenter clinical trials in traumatic brain injury.
• Discuss limitations of clinical trial design impacting recent clinical trial failures.
• Discuss clinical trials in traumatic brain injury set to launch in the next year.

You can access registration information by clicking here.

You can listen to the program by clicking here.  (The NFL segment begins at 14.41 and runs until 18.40) 

The player’s association concussion and traumatic brain injury committee will address diagnosis, treatment and prevention of concussions and brain injuries in active players; and the long-term cumulative effects of isolated or repetitive traumatic brain injuries in NFL players as patients.

At the same time,  the chairman of the House Judiciary Committee says he will hold hearings on head injuries among NFL players. The hearings will look at the lasting impact of head injuries, how to limit them, and how to compensate players and their families.

Both of these events are encouraging news in efforts by many including myself to bring attention to the epidemic of traumatic brain injury and to increase public awareness of the dangers of repeated concussions and ill advised decisions to prematurely allow athletes to return to play.

With new leadership in the NLF as well as the player’s association, perhaps a new rationality can be brought to bear on the issue and an honest recognition that concussions are serious and must be treated as a life threatening condition.

Perhaps the player's association will contact me and ask for my involvement in these important efforts. 

Further, injured players who submit competent proof of concussions and cognitive disorder should be properly compensated for their injury under league collective bargaining agreements. If they are not, then the courthouse door needs to be opened to these players to seek proper legal redress.

Read about the NFL players commiettee plans to study head trauma .

Read about the congressional hearings on concussions: Congress to hold hearing on NFL head injuries.

Today's story, Players Face Injury Risk Before NFL asks the all important question, what are the risks to high school and college athletes?  Are they at increased danger of permanent brain damage following concussions?  The story also explores the bias of the NFL against admitting the link between concussions and permanent brain injury and the lack of good faith by the league,many of its team physicians and teams in dealing with this problem. The Times and its reporters need to be commended for keeping this story in the public's eye and asking the important questions.

I have repeated stated that I am concerned that the poor example set by the NFL will cause unnecessary injuries to school athletes who look to the league for guidance.

The growing body of literature shows that when in doubt, keep them out.  This must be the rule without exception in determining when to allow a concussed player to go back to active play. 

I say when a professional player is injured, send a letter to that player's wife, mother or significant other and tell them about the prospects that face their loved one if they are permitted to go back and sustain a re-injury.  Make it mandatory that schools send letters to parent's concerning the risks associated with repeated concussions.  A little truth on this subject may wake some people up cause them to realize that ALL concussions are serious matters.

On Saturday morning, NPR is planning a segment on their program, ONLY A GAME  dealing with these important issues.  I had the honor of being interviewed yesterday for this story and asked to comment on my views concerning the ability of players to bring legal action against the league for improperly denying disability benefits following traumatic brain injury.

WHEN IN DOUBT, KEEP THEM OUT! 

The Academy is composed of both plaintiff and defense trial lawyers from throughout New York State dedicated to protecting, preserving and enhancing the civil justice system. I am a proud member of the Academy's Board of Directors and support the academy's efforts to protect the right of trial by jury in all civil matters.  

You can read the full Times story N.F.L Study Finds Links to Dementia

You will also be able to listen to Conan's fascinating description of all the difficulties that he slowly began to develop following the incident. Although he is now joking about it, this is far from a funny matter.  You can hear his slurred speech, listen to his description of his confusion, poor judgment and short term memory problems. 

Hopefully, Conan who now can appreciate that a concussion is no laughing matter will take the the time to learn about the long term consequences of concussions and become an advocate for the 5.2 million americans who suffer the life long effects of a traumatic brain injury. 

You can watch the clip by clicking Conan O'Brien reveals concussion, injury  video. 

The artlcle is entitled, Sorting Out Differences in Helmet Standards and reviews the debate between Federal Department of Transportation helmet standards, the Snell Standard and an new safety standard being introduced by Snell.

While this is all very confusing, one thing is clear, any helmet is better than no helmet at all and all states need to impose helmet requirements for motorcycle riders as well as those riding bicycles, roller-blading, skate boarding, skiing and ice skating, 

The Wizard of Oz has been utilized in many of my presentations to illustrate the journey that one goes though following a  traumatic brain injury.   On many occasions I have discussed the meaningful ways that the film has inspired many family members and persons who have sustained a traumatic brain injury. 

After all, The Wizard of Oz is a film about traumatic brain injury and the long journey back home that follows.

Here are just some themes and thoughts from the film and its relationship to brain trauma.
 
The film begins with Dorothy being caught in a tornado and suffering brain injury.  When Dorothy finally arrives in Oz she meets up with her social worker and traumatic brain injury case coordinator, Glinda the Good Witch, who advises her that to get back home to Kansas, she needs to meet with the great and powerful neuropsychololgist, the Wizard of Oz at the Emerald City Brain Injury Rehabilitation Program.  On her way to Oz, Dorothy meets other individuals suffering from disabilities, (no brain, no heart, no courage).  Each one of these individuals is an inspiration to others suffering from a disability. When Dorothy finally reaches Oz, she is initially  turned away from receiving the rehabilitation services she so badly needs until she proves that she has sufficient insurance coverage  (the ruby slippers) and the correct referral (Glinda the Good Witch).  

When Dorothy and her friends finally meet with the great and powerful neuropsychologist, the Wizard of Oz, he provides them with their first community based task completion assignment, (bring back the broom of the Wicked Witch).  But when they return from completing their task, the busy doctor refuses to see them.  Being a good self-advocate, Dorothy admonishes him on his attitude towards those who are in desperate need of his services.  

With help and support and counseling from her social worker, Dorothy finally returns home where she proclaims, "There’s No Place Like Home", a particularly meaningful comment for those who seek community and home based services following a traumatic brain injury instead of being forced to being confined in a long term nursing home or similar type of facility.

The Wizard of Oz has inspired many family members and persons who have sustained brain injuries that a meaningful life after a traumatic brain injury is possible.

So, we're off to see the Wizard!  More to come in the days ahead.

The web based lecture will be held on September 23, 2009 from 12:00-1:00 PM EDT.

Lecture Description: This lecture will discuss the latest guidelines on infection prophylaxis in head injury regarding external ventricular drains and nosocomial infections.  In addition, prophylaxis for open and basilar skull fractures will also be discussed
.
Learning Objectives: 

• Describe the reasons for infection prophylaxis in severe head injury patients focusing on the advantages and disadvantages.
• Understand the current recommendations for providing prophylaxis for external ventricular drainage in regard to antibiotic administration and catheter exchange
• Become familiar with the recommendations for prophylaxis in regard to preventing systemic nosocomial infections including those recommendations for antibiotic administration and early tracheostomy.
• Assess the literature in terms of prophylactic antibiotic use in basilar and open skull fractures.

Speaker: Jamie Ullman, MD, Director of Neurosurgery at Elmhurst Hospital Medical Center, Assistant Attending Neurosurgeon at Queens Hospital Center, and Associate Professor of Neurosurgery at the Mount Sinai School of Medicine

Webinar Registration  click here .