[0:01] Welcome to Crash Tested.
[0:08] Hello everyone and welcome back to Crash Tested with Michael Cowan.
[0:13] Michael is the founder of Cowan Law, Car and Truck Accident Lawyers and is board certified
[0:18] in both truck accident law and personal injury trial law.
[0:22] He's nationally recognized for his work in truck accident litigation.
[0:26] Also joining us is Joshi Smont.
[0:28] She's the managing attorney of Pre-Litigation with the firm.
[0:31] I'm Sean O'Connor and today the three of us are talking about traumatic brain injuries
[0:35] after a crash and why their symptoms are often missed.
[0:41] Michael, Joshi, good to see you both.
[0:42] Great to see you.
[0:43] Hi, Sean.
[0:44] Good to be here.
[0:45] Traumatic brain injuries.
[0:46] I have a friend who had a traumatic brain injury and it took her months to realize she had
[0:51] a traumatic brain injury because it didn't seem that traumatic in the way we use the word.
[0:57] So I'm interested in this topic, Michael, define traumatic brain injury from your perspective
[1:04] and also why can't it be so difficult to recognize one after a crash?
[1:11] Sure.
[1:12] The textbook definition is an alteration and brain function caused by an external force.
[1:16] Well, that's a lot of words, but basically it's when the cells in your brain are damaged
[1:20] due to a crash or some other force, it doesn't have to be your head hitting something.
[1:25] It could be basically when the brain is shaken back and forth and it hits the skull and
[1:30] it could cause damage that at first might not seem so bad, but it can be lifelong damage
[1:37] and it can be damage that is really, really changing who you are as a person.
[1:43] And why is it so hard to tell you sometime?
[1:46] You know, there's some cases that are super obvious, if someone has a skull fracture, they
[1:50] have bleeding in the brain, they're immediately locked out.
[1:53] And that is a very small number of the kind of cases involve a traumatic brain injury, but
[1:59] a lot of times what happens is it's something that's at first seems more mild and it gets covered
[2:05] up by the fact that you have more immediate, like my neck really hurts and my back really
[2:10] hurts.
[2:10] And you go in, you know, the ambulance is taking you to the hospital and what they're looking
[2:14] for is, you know, do you have anything that's going to kill you or paralyze you today if
[2:18] we don't let you say in the emergency room?
[2:20] And so it's not just regular people that miss these things, but there's actually a study
[2:25] saying 56% of brain injuries are missed in the emergency room.
[2:30] So more than half the people that have a traumatic brain injury that later get diagnosed by a doctor,
[2:35] when they went to the emergency room, the emergency room doctors didn't catch it.
[2:40] And a lot of these things, because they, not only because they're subtle, but they're
[2:45] things that they're hard for the injured person to recognize.
[2:48] So let's start with memory loss.
[2:50] If you're forgetting things, how do you remember that you were forgetting things?
[2:54] Or if you're personality changes, are you noticing that you're getting a snap year?
[3:00] Are you noticing that you're becoming more emotional?
[3:03] Or is it the people around you that are noticing and how long does it take them to take two
[3:06] and two together, like, hey, they weren't like that before.
[3:10] And the days and weeks afterward is, is it the medication they're on?
[3:14] Is it the fact that they're in pain and they can't get any sleep?
[3:18] Or is it something that's going to continue lasting once those initial painful injuries
[3:22] are starting to get better, but then the confusion, the memory loss, the crankiness,
[3:28] whatever it might be, doesn't go away.
[3:31] And that's when people start to suspect, hey, is there something else going on here?
[3:34] Well, I'm curious.
[3:35] I mean, you mentioned the, like, say, the moodiness in that you may not recognize it, but say,
[3:41] a, you know, family member or friend might.
[3:46] Julie, I'm curious, you know, are there, are there warning signs that people, say,
[3:52] in the first hours or days, are there certain red flags that people should not ignore,
[3:58] that, you know, in order to like, oh, wait, get on, you know, find out early
[4:03] if you actually have an injury of this kind?
[4:07] Yeah, definitely.
[4:07] There's different symptoms that clients can be aware of or clients' loved ones can notice.
[4:13] If you are injured in other places in your body, sometimes you're not thinking about
[4:17] what might be going on if you did either hit your head or if you had some sort of trauma
[4:22] to your brain, one of the best ways for us as attorneys to find evidence of whether a client
[4:28] might be suffering from a TBI is to reach out to their loved ones.
[4:31] If they have a spouse, if they have children, you know, adult children, people that can give
[4:36] us information about them.
[4:38] And one of the biggest things that we notice is, you know, if you are having dizziness, if
[4:41] you are having headaches that were persisting, if you're dealing with memory issues that
[4:46] someone has told you about, if you're dealing with maybe mood swings, or you're finding that
[4:51] maybe you aren't handling situations the same way that you once did before, you're quicker
[4:56] to anger.
[4:57] Maybe if you're having issues sleeping things like that, these are all symptoms that we would
[5:01] want you to make your attorney aware of.
[5:04] They may be different than your neck pain, than your back pain, than anything that you're
[5:07] having physically in your body, and they may be something that you are tending to overlook
[5:12] because other things are being prioritized, but it's something we want everybody to be aware
[5:17] of and notify your attorney because there might be something there that needs to be looked
[5:20] into further.
[5:21] And I'm curious, I mean, maybe there's action in other than just human nature to prioritize
[5:27] or deep prioritize things, but, you know, I think people might feel fine after a crash
[5:34] like, oh, I'm fine feeling, you know, but actual symptoms develop later.
[5:40] How do it, like, why does that happen?
[5:43] And then also, like, it sounds like it could actually undermine your case, so to speak,
[5:48] or maybe you never, like, developed a case because you're, they all in fine.
[5:51] Yeah, there's a couple of things, you know, again, a lot of times people don't realize
[5:55] it.
[5:56] A lot of times people think you have to be all the way knocked out, but do you have any
[6:00] period where you are, like, spacey?
[6:02] You don't, you're kind of out of it or you don't remember part of, like, either right
[6:08] before or right after the accident, there's like a gap in your memory.
[6:11] Those are all signs that you had an alteration of consciousness, which probably means you have
[6:15] some level of brain injury, now it may be so mild that it got better very quickly.
[6:20] But if you look at the anatomy of the brain, you have a part of the cell called axons.
[6:26] And when the axon gets damaged, it doesn't die right away, but the damage starts a chemical
[6:33] process that over a period of days leads to some of your brain cells dying.
[6:38] So a lot of times what you see is that right away, other than being a little spacey, maybe
[6:42] having a little bit of memory loss, seeing stars, you don't notice a whole lot else.
[6:47] But then as the days go by and this chemical cascade starts resulting in some of the brain
[6:53] cells dying.
[6:55] Now this is all happening got a microscope at level, but it makes the big difference.
[6:59] Then typically it's the people around you before you notice, like you're having more trouble
[7:04] remembering things or finding the right word or sound or light, you get really sensitive
[7:09] to it and it really starts bothering you or the, you know, we see a lot, a lot of personality
[7:13] changes, like things that used to be endearing with your children now, like you, they, you
[7:18] snap.
[7:19] And they sound like little things, but they're huge things in someone's life.
[7:23] And so, you know, it's one, it's really important to document them both.
[7:27] So you have evidence if you have a case, but two, you know, if your doctor knows about
[7:31] them, you know, our prayer is that you can get some early intervention and therapy and
[7:35] maybe you get better, you don't have a lifelong brain injury because our goal is not just
[7:39] to get money for our clients, but to make sure that people heal as much as you can, because
[7:43] you'd rather have a fully functioning brain than more money in the bank.
[7:46] Yeah.
[7:47] Yeah.
[7:48] Well, I'm wondering about that.
[7:49] That long tail, right, where, like your life is altered and, you know, maybe you can
[7:55] come back from it, but I'm thinking, you know, you see someone they look fine.
[8:00] There's no injuries.
[8:01] They were never unconscious, but like you said, what once was cute is now irritating.
[8:06] Yeah.
[8:07] Which may be a short-lived thing, but it could also be a long-term thing.
[8:12] How, like, why is that happened or what have you seen in that, that scenario?
[8:16] Yeah, one of the hardest things about suffering a brain injury is it's an invisible injury.
[8:22] And so from outside, you look normal.
[8:24] Yeah.
[8:25] And because you look normal, society expects you to act and react normally.
[8:30] But when you have an alteration and brain functioning, you can't, oh, like, you don't remember things.
[8:34] You don't react to things the same way.
[8:35] You might not have the same emotional control, depending on the type of brain injury.
[8:40] And so it can make it really hard to have great relationships with people you love.
[8:46] It can make it really hard to keep a job.
[8:48] I was going to say, like, it could alter like the work I do, right, or, or can do.
[8:53] It can.
[8:54] And sometimes you can do your work, but you don't get to, you know, you, you have to spend so much more mental energy
[9:01] on getting that work done, because your non-damage brain cells are doing double duty for the ones that got hurt.
[9:07] So by the time you get home, you are wiped mentally, and you can't go enjoy the things.
[9:12] And what we see is people isolating more and more, and you know, you end up like a dark room
[9:18] because the lights bothering you, with air plugs on because the sounds are bothering you.
[9:23] You know, a bunch of reminders on your phones and post-it notes everywhere to make up for the memory issues.
[9:27] And, you know, it's really tragic.
[9:30] And I'll be honest, a lot of times, you know, even as lawyers, we don't, we don't realize the full extent of what's going on
[9:38] until one, we talk to the people that love them and knew them before.
[9:41] But two, we go to their house and spend time with them.
[9:44] You know, these aren't the kind of injuries that your lawyer can just talk to you over the phone,
[9:49] or have you come into a conference room, but someone needs to take the time to know you and the people that love you
[9:55] to find out what was your life before and how has it changed after.
[10:00] It's kind of fascinating because there's that, I'm thinking about like, you get your body,
[10:09] like you have a limp to use as sort of a crude example, and your body compensates for it,
[10:14] and you kind of get used to it, and it's like, oh yeah, okay.
[10:18] And over time, you've got a completely, I don't say different person, but I mean,
[10:24] I'm hearing in this scenario, this same thing, where suddenly you're just making adjustments,
[10:29] lifestyle adjustments in the wake of the accident, but it turns out that these are potentially permanent,
[10:35] could be permanent altercations, I guess, or alterations rather.
[10:40] They can't be, and there's no way to tell at the beginning, and it's really some people get a
[10:44] 100% recovery. And sometimes it's because the damage isn't bad enough to keep the brain
[10:50] from regenerating. Sometimes it's because there are enough healthy brain cells where the brain can
[10:55] kind of rewire and reprogram itself so that what's left is over, is compensating for what got damaged.
[11:03] Other times, unfortunately, something seems like a more mild injury, but it never goes away.
[11:08] And there's a substantial number of cases where people get a head injury that at first
[11:13] seemed fairly mild, but it's permanent and it's awful. And then once the brain is damaged,
[11:19] even worse, the chances of dementia and Parkinson's later in life drastically increase
[11:27] because the brain doesn't have as much residual function. So when you start getting to that natural
[11:32] age, the generation that we all get, it doesn't have as much capacity to lose before it starts
[11:38] having real problems. That's you know, it's wondering if maybe even in your own, if you have a
[11:44] case study of your own where the brain injury wasn't immediately recognized, maybe
[11:49] okay, a little something, something, but then it turned out to be a much more serious issue than
[11:56] anyone realized. Yeah, I can think I can't name names because of client confidentiality about how to
[12:00] client. She was a not just a nurse, but she was the charge nurse. She was like, you know, in charge of
[12:05] a whole floor and wing of a hospital, you know, so you have to have a great brain to do that.
[12:10] Yep. And she was injured and at first everybody was just focusing on the physical injuries because she had
[12:15] a bad neck injury. She had a back injury, but she had personality changes. She had memory problems.
[12:22] She could not do the work anymore. She couldn't remember what medication, whether the client had
[12:26] patient had been given the medication or not. She couldn't remember what the orders were. She couldn't
[12:31] deal with the people in the high stress environment because that's a very stressful environment to be
[12:36] dealing with people in it. Yeah, it was an oncology ward. People cancer, you have a lot of emotions
[12:41] when you start losing your ability to control your emotions. It's really bad. And so even though at
[12:46] first all the doctors were just looking at her neck and her back, you know, that stuff healed up. Yeah,
[12:53] but she was not able to go back to work because of the brain injury that was missed at first. And,
[12:59] you know, luckily we were able to get a recovery to make up for that lost income the rest of
[13:03] her life, but it was a really hard fight because the insurance company was saying, well, look,
[13:07] don't even say you had a brain injury for day one. It took a while for your doctors to figure
[13:10] that out. And we had to really go get all the science. And that's the case. We actually had to try it
[13:15] for five days before it settled. And when we brought the science literature and showed the jury,
[13:21] and we talked to the jurors afterwards, they all understood, no, this woman had a serious brain injury
[13:25] and just because it wasn't caught at the beginning doesn't mean it wasn't real.
[13:29] Well, and just interesting to that context in her role, you know, her career and being a medical
[13:34] professional, right? And then, you know, sort of the meta, the meta-concent of that case.
[13:40] And that's the last thing she wanted to do. I mean, her dream or whole life was to be a nurse.
[13:45] She was a candy stripper when she was in high school and, you know, her mom was a nurse and
[13:50] that was her identity and losing that was so much worse than the money she lost from not, you know,
[13:56] being able to work as a nurse anymore, but it was, you know, who she was as a person. And,
[14:00] you know, it was horrible, but then on top of that to be accused of lying and faking when someone
[14:05] took away your dreams and hopes that it was just really a tragic case and I was so proud of
[14:10] who she was and all the fight that she had in her and that we were able to help her.
[14:14] Well, I'm interested too in, you know, a lot of times these injuries, I know, you know, they're not
[14:19] shown up on X-rays or scans and that sort of thing. And I'm thinking the case you just mentioned with
[14:25] the nurse, the charge nurse, and all of those, she comes into contact with so many people, you know,
[14:30] in a busy hospital environment. How did you go in and, like, gather proof? Was it, that sounds
[14:36] like an interview-intensive, I would say, you know, in a sense of, you need to, you know, you were
[14:41] talking earlier about having to visit someone's home. Well, in this case, the work environment was,
[14:46] I'm sure, just a huge proving ground, so to speak. Yeah, so there's multiple things we have to make
[14:53] sure get done. And one is to make sure that the doctor, that you see the right doctors,
[14:58] that know what tests to run. And so there are what's called neuro psychologists that could run a
[15:04] battery test to find subtle changes in your thinking, your memory, your processing that might not be
[15:11] as obvious when you're just having a conversation with someone but really affect you in life. So that's
[15:16] part of it is doing the scientific part. The other part is that a lot of CT scans, X-rays, even MRIs
[15:24] can't see some of this damage because it's too small. It's just like if you got like a,
[15:27] let's say I got some water out of a pond. And I looked at it with a microscope. Why don't
[15:32] say any germs? I don't see any amoeba. It's kind of drink this. No, you want to get a microscope. You
[15:36] know, you want to make sure there's nothing in there that's going to hurt you. Well, there are some very
[15:40] advanced types of brain scans now, really, really strong magnets in the, in a special type of MRI,
[15:46] they can see with more detail in something called diffusion-tenthed through imaging where you're looking
[15:50] at the, the movement of water through the through the axons or the brain cells where you can see where
[15:56] brain cells aren't functioning properly. A lot of different tests that can be done. And so we did
[16:02] all that. So that was one part of it is getting the, making sure we had this scientific proof. But the
[16:06] other thing is absolutely going to our house and spending time with her, talking to her, you know,
[16:11] significant other, talking to her family members, talking to her coworkers and really getting the truth
[16:17] of this is who she was before, this is who she was before, this is how she's changed. And then
[16:22] getting with doctors to find out, okay, how can we make this better? And what is it going to cost
[16:28] to get her the kind of therapy, the kind of support so she can live the fullest life and the tea,
[16:33] you know, get back as many of those dreams as possible? And unfortunately, a lot of those therapies
[16:38] and sometimes you even need someone to help you around the house to do the things you can't do anymore,
[16:41] they cost money. And so we had to go fight hard to get her that money. Well, speak to, maybe,
[16:46] Joshua, I know you have experience with this. We only have a couple of minutes left. What about,
[16:51] I mean, talking about that, like she now has, you know, decades of of accommodations and support
[16:58] that she needs and treatments, how are the insurance companies typically respond in these scenarios?
[17:03] Because again, it's kind of this invisible injury. They are going to fight it. They fight the visible
[17:08] injuries where we have, you know, different forms of evidence that is, you know, maybe more well received
[17:16] by insurance companies, they will fight every aspect of your injury. And to speak to one of the
[17:22] things that you had mentioned, Sean, sometimes we have clients where at the scene, they're adrenaline
[17:25] is pumping. They're overstimulated by everything else they have to deal with after being involved in a
[17:30] truck crash. And they seem fine. You know, it's invisible, but also they may not even recognize it,
[17:36] because they are so preoccupied and prioritizing making sure that they're okay. Maybe if they have
[17:41] family members making sure that they're okay and that they get the information that they call the
[17:45] police, they do all these things. And so they will fight and they will make it seem as though that
[17:50] injury is not real. They will question it. They will question family members. They will question
[17:54] everything that we produce in forms of evidence. So it is very difficult and very important to prioritize
[18:02] the type of evidence that proves a traumatic brain injury. We've had cases where we've taken into trial
[18:08] and even we've had to show the jury specifically what a TBI is. You know, you and I are talking about
[18:13] it here. And so if we are having a hard time, you know, fully grasping it, then it's something that
[18:18] needs to be very thoroughly explained to jury members to the clients, it's suffer from them. And in
[18:24] so much that we have to explain it to these insurance companies to be able to prove our clients'
[18:29] injuries, how their lives are affected, and what their life may look like moving forward even after
[18:34] the case resolves. It's our jobs as their advocates to make sure that we put that forward to make sure
[18:39] they're taking care of not just now, but whatever the effects of that injury are going to be moving
[18:45] forward. Excellent. Thank you. Thank you. Yeah, a lot of a lot of research, a lot of detail that
[18:52] whole like crystal balling of like, okay, what are the next 40 years of this person's life look like?
[18:57] Or you know, obviously depending on their age and all of that calculation involved. Well,
[19:04] my only final notes from you, we're going to we're going to have to wrap this up. We're coming up
[19:08] against time, but not to put you on the spot per se, but before we say goodbye. Yeah, just really
[19:15] if you have a traumatic brain injury, it's really important to get a lawyer that understands the science
[19:20] and medicine. There is such a learning curve. Yeah. And what the insurance companies will do is they'll
[19:25] hire a doctor to say you're faking it. And what we have to do is we have to go get the medical literature
[19:29] and show that they're misrepresenting things or twisting things out of context. And unless you
[19:34] have a lawyer that has spent those hundreds of hours to actually read all these studies and then
[19:39] be able to digest them and use them in court, you're really at a disadvantage. Yeah, that's good.
[19:46] Good advice. Thank you both. Again, for sharing your expertise on this fairly complicated topic,
[19:52] really appreciate it. And look forward to seeing you both for a next future episode. Thank you, Sean.
[19:58] Thank you. You bet. That's it for this episode of Crash Tested with Michael Cowan.
[20:04] If you or someone you love has been injured in a truck or serious vehicle accident, visit cowanlaw.com.
[20:12] Maybe you're sitting here thinking, hmm, maybe traumatic brain injury is something you're dealing with
[20:17] and you didn't even realize it. Go to the website. You've got an opportunity there at a schedule of
[20:23] free consultation with Michael and his team. As always, we appreciate you listening. Leave a review,
[20:30] subscribe, share a link with someone in your world who you think might be interested in this kind
[20:34] of information always appreciated. I'm Sean O'Connor. Have a great day. Thanks for watching. Be sure to
[20:45] hit that like and subscribe button and leave us a review in the comments.
[0:08] Hello everyone and welcome back to Crash Tested with Michael Cowan.
[0:13] Michael is the founder of Cowan Law, Car and Truck Accident Lawyers and is board certified
[0:18] in both truck accident law and personal injury trial law.
[0:22] He's nationally recognized for his work in truck accident litigation.
[0:26] Also joining us is Joshi Smont.
[0:28] She's the managing attorney of Pre-Litigation with the firm.
[0:31] I'm Sean O'Connor and today the three of us are talking about traumatic brain injuries
[0:35] after a crash and why their symptoms are often missed.
[0:41] Michael, Joshi, good to see you both.
[0:42] Great to see you.
[0:43] Hi, Sean.
[0:44] Good to be here.
[0:45] Traumatic brain injuries.
[0:46] I have a friend who had a traumatic brain injury and it took her months to realize she had
[0:51] a traumatic brain injury because it didn't seem that traumatic in the way we use the word.
[0:57] So I'm interested in this topic, Michael, define traumatic brain injury from your perspective
[1:04] and also why can't it be so difficult to recognize one after a crash?
[1:11] Sure.
[1:12] The textbook definition is an alteration and brain function caused by an external force.
[1:16] Well, that's a lot of words, but basically it's when the cells in your brain are damaged
[1:20] due to a crash or some other force, it doesn't have to be your head hitting something.
[1:25] It could be basically when the brain is shaken back and forth and it hits the skull and
[1:30] it could cause damage that at first might not seem so bad, but it can be lifelong damage
[1:37] and it can be damage that is really, really changing who you are as a person.
[1:43] And why is it so hard to tell you sometime?
[1:46] You know, there's some cases that are super obvious, if someone has a skull fracture, they
[1:50] have bleeding in the brain, they're immediately locked out.
[1:53] And that is a very small number of the kind of cases involve a traumatic brain injury, but
[1:59] a lot of times what happens is it's something that's at first seems more mild and it gets covered
[2:05] up by the fact that you have more immediate, like my neck really hurts and my back really
[2:10] hurts.
[2:10] And you go in, you know, the ambulance is taking you to the hospital and what they're looking
[2:14] for is, you know, do you have anything that's going to kill you or paralyze you today if
[2:18] we don't let you say in the emergency room?
[2:20] And so it's not just regular people that miss these things, but there's actually a study
[2:25] saying 56% of brain injuries are missed in the emergency room.
[2:30] So more than half the people that have a traumatic brain injury that later get diagnosed by a doctor,
[2:35] when they went to the emergency room, the emergency room doctors didn't catch it.
[2:40] And a lot of these things, because they, not only because they're subtle, but they're
[2:45] things that they're hard for the injured person to recognize.
[2:48] So let's start with memory loss.
[2:50] If you're forgetting things, how do you remember that you were forgetting things?
[2:54] Or if you're personality changes, are you noticing that you're getting a snap year?
[3:00] Are you noticing that you're becoming more emotional?
[3:03] Or is it the people around you that are noticing and how long does it take them to take two
[3:06] and two together, like, hey, they weren't like that before.
[3:10] And the days and weeks afterward is, is it the medication they're on?
[3:14] Is it the fact that they're in pain and they can't get any sleep?
[3:18] Or is it something that's going to continue lasting once those initial painful injuries
[3:22] are starting to get better, but then the confusion, the memory loss, the crankiness,
[3:28] whatever it might be, doesn't go away.
[3:31] And that's when people start to suspect, hey, is there something else going on here?
[3:34] Well, I'm curious.
[3:35] I mean, you mentioned the, like, say, the moodiness in that you may not recognize it, but say,
[3:41] a, you know, family member or friend might.
[3:46] Julie, I'm curious, you know, are there, are there warning signs that people, say,
[3:52] in the first hours or days, are there certain red flags that people should not ignore,
[3:58] that, you know, in order to like, oh, wait, get on, you know, find out early
[4:03] if you actually have an injury of this kind?
[4:07] Yeah, definitely.
[4:07] There's different symptoms that clients can be aware of or clients' loved ones can notice.
[4:13] If you are injured in other places in your body, sometimes you're not thinking about
[4:17] what might be going on if you did either hit your head or if you had some sort of trauma
[4:22] to your brain, one of the best ways for us as attorneys to find evidence of whether a client
[4:28] might be suffering from a TBI is to reach out to their loved ones.
[4:31] If they have a spouse, if they have children, you know, adult children, people that can give
[4:36] us information about them.
[4:38] And one of the biggest things that we notice is, you know, if you are having dizziness, if
[4:41] you are having headaches that were persisting, if you're dealing with memory issues that
[4:46] someone has told you about, if you're dealing with maybe mood swings, or you're finding that
[4:51] maybe you aren't handling situations the same way that you once did before, you're quicker
[4:56] to anger.
[4:57] Maybe if you're having issues sleeping things like that, these are all symptoms that we would
[5:01] want you to make your attorney aware of.
[5:04] They may be different than your neck pain, than your back pain, than anything that you're
[5:07] having physically in your body, and they may be something that you are tending to overlook
[5:12] because other things are being prioritized, but it's something we want everybody to be aware
[5:17] of and notify your attorney because there might be something there that needs to be looked
[5:20] into further.
[5:21] And I'm curious, I mean, maybe there's action in other than just human nature to prioritize
[5:27] or deep prioritize things, but, you know, I think people might feel fine after a crash
[5:34] like, oh, I'm fine feeling, you know, but actual symptoms develop later.
[5:40] How do it, like, why does that happen?
[5:43] And then also, like, it sounds like it could actually undermine your case, so to speak,
[5:48] or maybe you never, like, developed a case because you're, they all in fine.
[5:51] Yeah, there's a couple of things, you know, again, a lot of times people don't realize
[5:55] it.
[5:56] A lot of times people think you have to be all the way knocked out, but do you have any
[6:00] period where you are, like, spacey?
[6:02] You don't, you're kind of out of it or you don't remember part of, like, either right
[6:08] before or right after the accident, there's like a gap in your memory.
[6:11] Those are all signs that you had an alteration of consciousness, which probably means you have
[6:15] some level of brain injury, now it may be so mild that it got better very quickly.
[6:20] But if you look at the anatomy of the brain, you have a part of the cell called axons.
[6:26] And when the axon gets damaged, it doesn't die right away, but the damage starts a chemical
[6:33] process that over a period of days leads to some of your brain cells dying.
[6:38] So a lot of times what you see is that right away, other than being a little spacey, maybe
[6:42] having a little bit of memory loss, seeing stars, you don't notice a whole lot else.
[6:47] But then as the days go by and this chemical cascade starts resulting in some of the brain
[6:53] cells dying.
[6:55] Now this is all happening got a microscope at level, but it makes the big difference.
[6:59] Then typically it's the people around you before you notice, like you're having more trouble
[7:04] remembering things or finding the right word or sound or light, you get really sensitive
[7:09] to it and it really starts bothering you or the, you know, we see a lot, a lot of personality
[7:13] changes, like things that used to be endearing with your children now, like you, they, you
[7:18] snap.
[7:19] And they sound like little things, but they're huge things in someone's life.
[7:23] And so, you know, it's one, it's really important to document them both.
[7:27] So you have evidence if you have a case, but two, you know, if your doctor knows about
[7:31] them, you know, our prayer is that you can get some early intervention and therapy and
[7:35] maybe you get better, you don't have a lifelong brain injury because our goal is not just
[7:39] to get money for our clients, but to make sure that people heal as much as you can, because
[7:43] you'd rather have a fully functioning brain than more money in the bank.
[7:46] Yeah.
[7:47] Yeah.
[7:48] Well, I'm wondering about that.
[7:49] That long tail, right, where, like your life is altered and, you know, maybe you can
[7:55] come back from it, but I'm thinking, you know, you see someone they look fine.
[8:00] There's no injuries.
[8:01] They were never unconscious, but like you said, what once was cute is now irritating.
[8:06] Yeah.
[8:07] Which may be a short-lived thing, but it could also be a long-term thing.
[8:12] How, like, why is that happened or what have you seen in that, that scenario?
[8:16] Yeah, one of the hardest things about suffering a brain injury is it's an invisible injury.
[8:22] And so from outside, you look normal.
[8:24] Yeah.
[8:25] And because you look normal, society expects you to act and react normally.
[8:30] But when you have an alteration and brain functioning, you can't, oh, like, you don't remember things.
[8:34] You don't react to things the same way.
[8:35] You might not have the same emotional control, depending on the type of brain injury.
[8:40] And so it can make it really hard to have great relationships with people you love.
[8:46] It can make it really hard to keep a job.
[8:48] I was going to say, like, it could alter like the work I do, right, or, or can do.
[8:53] It can.
[8:54] And sometimes you can do your work, but you don't get to, you know, you, you have to spend so much more mental energy
[9:01] on getting that work done, because your non-damage brain cells are doing double duty for the ones that got hurt.
[9:07] So by the time you get home, you are wiped mentally, and you can't go enjoy the things.
[9:12] And what we see is people isolating more and more, and you know, you end up like a dark room
[9:18] because the lights bothering you, with air plugs on because the sounds are bothering you.
[9:23] You know, a bunch of reminders on your phones and post-it notes everywhere to make up for the memory issues.
[9:27] And, you know, it's really tragic.
[9:30] And I'll be honest, a lot of times, you know, even as lawyers, we don't, we don't realize the full extent of what's going on
[9:38] until one, we talk to the people that love them and knew them before.
[9:41] But two, we go to their house and spend time with them.
[9:44] You know, these aren't the kind of injuries that your lawyer can just talk to you over the phone,
[9:49] or have you come into a conference room, but someone needs to take the time to know you and the people that love you
[9:55] to find out what was your life before and how has it changed after.
[10:00] It's kind of fascinating because there's that, I'm thinking about like, you get your body,
[10:09] like you have a limp to use as sort of a crude example, and your body compensates for it,
[10:14] and you kind of get used to it, and it's like, oh yeah, okay.
[10:18] And over time, you've got a completely, I don't say different person, but I mean,
[10:24] I'm hearing in this scenario, this same thing, where suddenly you're just making adjustments,
[10:29] lifestyle adjustments in the wake of the accident, but it turns out that these are potentially permanent,
[10:35] could be permanent altercations, I guess, or alterations rather.
[10:40] They can't be, and there's no way to tell at the beginning, and it's really some people get a
[10:44] 100% recovery. And sometimes it's because the damage isn't bad enough to keep the brain
[10:50] from regenerating. Sometimes it's because there are enough healthy brain cells where the brain can
[10:55] kind of rewire and reprogram itself so that what's left is over, is compensating for what got damaged.
[11:03] Other times, unfortunately, something seems like a more mild injury, but it never goes away.
[11:08] And there's a substantial number of cases where people get a head injury that at first
[11:13] seemed fairly mild, but it's permanent and it's awful. And then once the brain is damaged,
[11:19] even worse, the chances of dementia and Parkinson's later in life drastically increase
[11:27] because the brain doesn't have as much residual function. So when you start getting to that natural
[11:32] age, the generation that we all get, it doesn't have as much capacity to lose before it starts
[11:38] having real problems. That's you know, it's wondering if maybe even in your own, if you have a
[11:44] case study of your own where the brain injury wasn't immediately recognized, maybe
[11:49] okay, a little something, something, but then it turned out to be a much more serious issue than
[11:56] anyone realized. Yeah, I can think I can't name names because of client confidentiality about how to
[12:00] client. She was a not just a nurse, but she was the charge nurse. She was like, you know, in charge of
[12:05] a whole floor and wing of a hospital, you know, so you have to have a great brain to do that.
[12:10] Yep. And she was injured and at first everybody was just focusing on the physical injuries because she had
[12:15] a bad neck injury. She had a back injury, but she had personality changes. She had memory problems.
[12:22] She could not do the work anymore. She couldn't remember what medication, whether the client had
[12:26] patient had been given the medication or not. She couldn't remember what the orders were. She couldn't
[12:31] deal with the people in the high stress environment because that's a very stressful environment to be
[12:36] dealing with people in it. Yeah, it was an oncology ward. People cancer, you have a lot of emotions
[12:41] when you start losing your ability to control your emotions. It's really bad. And so even though at
[12:46] first all the doctors were just looking at her neck and her back, you know, that stuff healed up. Yeah,
[12:53] but she was not able to go back to work because of the brain injury that was missed at first. And,
[12:59] you know, luckily we were able to get a recovery to make up for that lost income the rest of
[13:03] her life, but it was a really hard fight because the insurance company was saying, well, look,
[13:07] don't even say you had a brain injury for day one. It took a while for your doctors to figure
[13:10] that out. And we had to really go get all the science. And that's the case. We actually had to try it
[13:15] for five days before it settled. And when we brought the science literature and showed the jury,
[13:21] and we talked to the jurors afterwards, they all understood, no, this woman had a serious brain injury
[13:25] and just because it wasn't caught at the beginning doesn't mean it wasn't real.
[13:29] Well, and just interesting to that context in her role, you know, her career and being a medical
[13:34] professional, right? And then, you know, sort of the meta, the meta-concent of that case.
[13:40] And that's the last thing she wanted to do. I mean, her dream or whole life was to be a nurse.
[13:45] She was a candy stripper when she was in high school and, you know, her mom was a nurse and
[13:50] that was her identity and losing that was so much worse than the money she lost from not, you know,
[13:56] being able to work as a nurse anymore, but it was, you know, who she was as a person. And,
[14:00] you know, it was horrible, but then on top of that to be accused of lying and faking when someone
[14:05] took away your dreams and hopes that it was just really a tragic case and I was so proud of
[14:10] who she was and all the fight that she had in her and that we were able to help her.
[14:14] Well, I'm interested too in, you know, a lot of times these injuries, I know, you know, they're not
[14:19] shown up on X-rays or scans and that sort of thing. And I'm thinking the case you just mentioned with
[14:25] the nurse, the charge nurse, and all of those, she comes into contact with so many people, you know,
[14:30] in a busy hospital environment. How did you go in and, like, gather proof? Was it, that sounds
[14:36] like an interview-intensive, I would say, you know, in a sense of, you need to, you know, you were
[14:41] talking earlier about having to visit someone's home. Well, in this case, the work environment was,
[14:46] I'm sure, just a huge proving ground, so to speak. Yeah, so there's multiple things we have to make
[14:53] sure get done. And one is to make sure that the doctor, that you see the right doctors,
[14:58] that know what tests to run. And so there are what's called neuro psychologists that could run a
[15:04] battery test to find subtle changes in your thinking, your memory, your processing that might not be
[15:11] as obvious when you're just having a conversation with someone but really affect you in life. So that's
[15:16] part of it is doing the scientific part. The other part is that a lot of CT scans, X-rays, even MRIs
[15:24] can't see some of this damage because it's too small. It's just like if you got like a,
[15:27] let's say I got some water out of a pond. And I looked at it with a microscope. Why don't
[15:32] say any germs? I don't see any amoeba. It's kind of drink this. No, you want to get a microscope. You
[15:36] know, you want to make sure there's nothing in there that's going to hurt you. Well, there are some very
[15:40] advanced types of brain scans now, really, really strong magnets in the, in a special type of MRI,
[15:46] they can see with more detail in something called diffusion-tenthed through imaging where you're looking
[15:50] at the, the movement of water through the through the axons or the brain cells where you can see where
[15:56] brain cells aren't functioning properly. A lot of different tests that can be done. And so we did
[16:02] all that. So that was one part of it is getting the, making sure we had this scientific proof. But the
[16:06] other thing is absolutely going to our house and spending time with her, talking to her, you know,
[16:11] significant other, talking to her family members, talking to her coworkers and really getting the truth
[16:17] of this is who she was before, this is who she was before, this is how she's changed. And then
[16:22] getting with doctors to find out, okay, how can we make this better? And what is it going to cost
[16:28] to get her the kind of therapy, the kind of support so she can live the fullest life and the tea,
[16:33] you know, get back as many of those dreams as possible? And unfortunately, a lot of those therapies
[16:38] and sometimes you even need someone to help you around the house to do the things you can't do anymore,
[16:41] they cost money. And so we had to go fight hard to get her that money. Well, speak to, maybe,
[16:46] Joshua, I know you have experience with this. We only have a couple of minutes left. What about,
[16:51] I mean, talking about that, like she now has, you know, decades of of accommodations and support
[16:58] that she needs and treatments, how are the insurance companies typically respond in these scenarios?
[17:03] Because again, it's kind of this invisible injury. They are going to fight it. They fight the visible
[17:08] injuries where we have, you know, different forms of evidence that is, you know, maybe more well received
[17:16] by insurance companies, they will fight every aspect of your injury. And to speak to one of the
[17:22] things that you had mentioned, Sean, sometimes we have clients where at the scene, they're adrenaline
[17:25] is pumping. They're overstimulated by everything else they have to deal with after being involved in a
[17:30] truck crash. And they seem fine. You know, it's invisible, but also they may not even recognize it,
[17:36] because they are so preoccupied and prioritizing making sure that they're okay. Maybe if they have
[17:41] family members making sure that they're okay and that they get the information that they call the
[17:45] police, they do all these things. And so they will fight and they will make it seem as though that
[17:50] injury is not real. They will question it. They will question family members. They will question
[17:54] everything that we produce in forms of evidence. So it is very difficult and very important to prioritize
[18:02] the type of evidence that proves a traumatic brain injury. We've had cases where we've taken into trial
[18:08] and even we've had to show the jury specifically what a TBI is. You know, you and I are talking about
[18:13] it here. And so if we are having a hard time, you know, fully grasping it, then it's something that
[18:18] needs to be very thoroughly explained to jury members to the clients, it's suffer from them. And in
[18:24] so much that we have to explain it to these insurance companies to be able to prove our clients'
[18:29] injuries, how their lives are affected, and what their life may look like moving forward even after
[18:34] the case resolves. It's our jobs as their advocates to make sure that we put that forward to make sure
[18:39] they're taking care of not just now, but whatever the effects of that injury are going to be moving
[18:45] forward. Excellent. Thank you. Thank you. Yeah, a lot of a lot of research, a lot of detail that
[18:52] whole like crystal balling of like, okay, what are the next 40 years of this person's life look like?
[18:57] Or you know, obviously depending on their age and all of that calculation involved. Well,
[19:04] my only final notes from you, we're going to we're going to have to wrap this up. We're coming up
[19:08] against time, but not to put you on the spot per se, but before we say goodbye. Yeah, just really
[19:15] if you have a traumatic brain injury, it's really important to get a lawyer that understands the science
[19:20] and medicine. There is such a learning curve. Yeah. And what the insurance companies will do is they'll
[19:25] hire a doctor to say you're faking it. And what we have to do is we have to go get the medical literature
[19:29] and show that they're misrepresenting things or twisting things out of context. And unless you
[19:34] have a lawyer that has spent those hundreds of hours to actually read all these studies and then
[19:39] be able to digest them and use them in court, you're really at a disadvantage. Yeah, that's good.
[19:46] Good advice. Thank you both. Again, for sharing your expertise on this fairly complicated topic,
[19:52] really appreciate it. And look forward to seeing you both for a next future episode. Thank you, Sean.
[19:58] Thank you. You bet. That's it for this episode of Crash Tested with Michael Cowan.
[20:04] If you or someone you love has been injured in a truck or serious vehicle accident, visit cowanlaw.com.
[20:12] Maybe you're sitting here thinking, hmm, maybe traumatic brain injury is something you're dealing with
[20:17] and you didn't even realize it. Go to the website. You've got an opportunity there at a schedule of
[20:23] free consultation with Michael and his team. As always, we appreciate you listening. Leave a review,
[20:30] subscribe, share a link with someone in your world who you think might be interested in this kind
[20:34] of information always appreciated. I'm Sean O'Connor. Have a great day. Thanks for watching. Be sure to
[20:45] hit that like and subscribe button and leave us a review in the comments.
