A doctor asked me if I have any problems with my memory?  "No",  I replied.

It was a silly question.  If you forgot to remember, then how would you be aware that you forgot?

Days began to unfold the extent of my injury.  You see,  if something is wrong with your body, your brain tells you.  If something is wrong with the brain,  it cannot communicate that to you.  An injured brain can't interpret and analyze its own dysfunction

Sad fact.  . . Your behavior begins to change, and you don't have a clue !
" Say. . . what is this cup of coffee doing in the microwave !"

I forgot I was heating up my coffee.
                Entering the room.

"Well. . how did you like the show?  It was great, wasn't it."

Glancing at the TV

"Why did you switch channels?"
During commercials, I would forget what I was watching.

" Oh, it must not of been important", and I would switch stations.
                                              Executive Abilities

This is a very large category of cognitive functions and includes abilities such as: anticipating future needs and planning accordingly,  setting priorities,  regulating impulses and drives,  self-awareness and self-correction.  In essence,  these are the capacities which allow a person to use his/her mental power and specific cognitive abilities to meet social,  vocational and internal psychological needs.  Imagine you are at a computer that has state-of-the-art software (specific cognitive abilities),  a fast processor and lots of memory (mental power);  you still need executive abilities to decide what to do,  when to do it and what to do first.  Further,  you must use your executive abilities to decide if you have done well enough to go on to the next task, or if it is okay to play a game on the computer.

The primary cause of impaired executive functions is frontal lobe injury,  which is frequent and caused by bruising and/or bleeding in this region of the brain.  A number of persons with brain injury have good recovery of their mental power and specific abilities but may be left with executive deficits which limit their capacity to assemble such intact abilities into useful "packages" of behavior.  For example,  a person with brain injury returned to the rehabilitation hospital for a social visit and was observed on the elevator assisting a person using a wheelchair to get off the elevator.  Motor skills,  balance and coordination all showed dramatic improvement since discharge,  and the person showed excellent visual-spatial skills in manipulating the wheelchair in a crowded elevator.  The problem was that the person in the wheelchair had not been asked if this was the floor he wanted nor was he asked if he wanted help.  The help was done skillfully and with vigor,  but the results were poor.

The main point of the above discussion is that,  in many cases,  complaints such as "I can't remember things" or "I can't read anymore" are due to impairments in executive function or mental power.  Identifying the underlying cause of a complaint is important because it increases the precision with which we can target therapy.

Copyright 2001. Brain Injury Association.
I took this picture, it is a path I travel often
This is the park near me, I took this picture
I took this picture
I took these pictures.  This is a park near my home.

I receive joy, to walk down this path.
pause by the benches and rest up a bit.

The days of starring out my kitchen window. . .I grieved the loss of walking in my park.  Feeling the warmth of the sun.  Smiling as I became energized, at the beauty surrounding me.

My dear, & special friend, finally was able to take me down this path in my wheelchair.

I never told him the sadness I felt.  I grieved not being able to walk side by side.          Continued on Page 7
I took this picture of my dear friend
I watched him walk away, into the distance, down the path, I too had walked along.

Telling myself, it was thoughtful that he took me here.. . but I was sitting. . . . . . . . .
copyright © 2002-2010 Barbara Joan Gushin All Rights Reserved
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