(56) Thick Headed and Fragile: About Traumatic Brain Injury

Molly, the service dog

Golly, Miss Molly

A blog about a service dog and her veteran with PTSD

(Supporting the veteran and the family caregiver)

Molly’s Thick-Headedness

My husband bought me a Fitbit, which is a small band worn on the wrist that counts your steps and intensity of exercise. The feedback instrument encourages me to increase my activity to reach a specific number of steps each day. I like to run in place, as I do not get out much since I am a full-time caregiver.

Although Miss Molly does not wear a Fitbit, she loves to join me when I run in place or race from room to room, doing chores. Molly slides across wood floors and fails to negotiate the tight turns around the fireplace or railing. Often she knocks herself silly. I want to rush her to the veterinarian for a possible concussion. My husband assures me that a dog’s cranium protects it from brain injury. “Thick-headed for a reason,” he tells me.

 Fragile Human Condition

While I’ve been accused of being thick-headed, I realize the human condition is frail compared to the canine. Our head was not created to withstand blows from incendiary devices, flying bullets, or other major trauma. Although our cranium protects the brain from some injuries, even with the added protection of a helmet, it cannot tolerate extreme blows.

In our last visit to the VA Hospital, many of the visitors were World War II and Vietnam War veterans and their spouses. I mentioned how devastating TBI is on the young men and women, returning from Afghanistan and Iraq.

“What’s TBI?” one woman asked. Others looked on with interest.

I realized that although WWII and Vietnam Veterans often suffered from brain injuries, the nomenclature “TBI” surfaced with the two most recent wars because of the common nature of IEDs (incendiary devices). There is so much we do not know about the brain and traumatic injury. It strikes me that those returning home with TBI are trailblazers just like my husband was with the first compensable diagnosis for PTSD. The VA estimates that 10 to 20 percent of our warriors returning from Iraq or Afghanistan have had at least one mild TBI. Lack of research leaves the veteran without many options for treatment.

 What We Know About TBI 

The Mayo Clinic website describes the impact of TBI. “Mild traumatic brain injury may cause temporary dysfunction of brain cells. More serious traumatic brain injury can result in bruising, torn tissues, bleeding and other physical damage to the brain that can result in long-term complications or death.”

The TBI.com website offers an excellent resource for the caregiver and those suffering from TBI. Its stated goal is to be the primary internet expert on TBI for victims, caregivers, and rehabilitation specialists. This organization gathers data to help diagnose, treat, and understand TBI.

VA Work on treatment options for TBI patients is the focus of research at the San Diego, California VA Hospital. Dr. Amy Jak leads the work in San Diego called cogSMART. Concurrently, researchers at the VA Hospital in San Francisco are “testing a cognitive rehab program called GOALS, for Goal-Oriented Attentional Self-Regulation. It teaches participants how to focus on goal-relevant information and hold it in mind while managing distractions and then to apply those skills in managing their own real-life goals.” This program is being developed by Dr. Anthony Chen.

The National Institute for Neurological Disorders and Strokes focuses its attention on research for TBI. It offers information for the caregiver and TBI patient such as:  What is TBI, What are the signs and symptoms, What medical care is available and what care should a TBI patient receive, What disabilities might result from TBI, and Where patients can go for further information. The Institute believes its focus and research gives hope to the TBI sufferer. It is committed to finding successful treatments.


While I have learned a tremendous amount about PTSD because of my husband’s condition, I do not know much about TBI. The more I visit with young veterans suffering from TBI, the more I want to learn and share. Early research on PTSD suggested that head injuries and PTSD go hand-in-hand. I know how debilitating PTSD is. Adding TBI to a veteran’s list of ailments must be extraordinarily overwhelming for the veteran and his/her family and caregiver.

TBI or Bust 

Miss Molly and I would like to share the journey with our readers of exploring avenues of hope for the veteran with TBI. We care and want to help make a positive difference in the lives of our veterans suffering from TBI.

Post your Comments:

Do you or someone you know suffer from TBI? Would you like to share TBI resources with Miss Molly? Please comment in the response section below or complete the following comment form.

About the Blogger

Dr. Penelope “Penny” Culbreth-Graft is a retired city manager and graduate professor. She lives with her disabled Vietnam Veteran husband, William, and his service dog, Molly, on Cheyenne Mountain in Colorado. She writes, paints, cares for her husband, and spends time with her grandchildren.