Confronting Traumatic Brain Injury: Devastation, Hope and Healing
Author: William J Winslad
William Winslade presents facts about traumatic brain injury; information about its financial and emotional costs to individuals, families, and society; and key ethical and policy issues. He illustrates each aspect with dramatic case studies, including his own childhood brain injury. He explains how the brain works and how severe injuries affect it, both immediately and over the long term, pointing out how resources are often squandered on patients with poor prognoses but adequate insurance, while underinsured patients with better prognoses often do not receive the best care. He describes the lack of regulation in the rehabilitation industry and what federal and state legislatures are doing to correct the situation. And he recommends policy changes for lowering the instances of traumatic brain injury (such as raising the minimum driving age) as well as practical steps that individuals can take to protect themselves from brain trauma. William J. Winslade is James Wade Rockwell Professor of Philosophy in Medicine at the Institute for the Medical Humanities, professor of preventive medicine and community health, and professor of psychiatry and behavioral sciences at the University of Texas Medical Branch at Galveston. He is also Distinguished Visiting Professor of Law at the University of Houston Health Law and Policy Institute.
Stephen R. Latham
Each year over two million Americans suffer traumatic brain injury. Of these, 60,000 are killed, 90,000 require extensive rehabilitation services, and about 2,000 are left in persistent vegetative states (""PVS""). Americans pay around $2.9 billion annually for direct costs of medical care and rehabilitation for brain trauma, and lose an additional $4.7 billion in wages, taxes, and productivity. The author has produced a very readable book designed to promote public awareness of, and to propose measures to combat and deal with, this ""silent epidemic"" of traumatic brain injury. This book is aimed at a non-specialized audience. Although it is well-documented and contains some serious policy analysis, it is written in a journalistic tone. Its short chapters are often propelled by one or two core anecdotes. Chapter topics include a brief layman's overview of brain function and of the basic types of brain trauma, brain trauma emergency care, progress in research and rehabilitation, the experiences of families of the injured, fatality and PVS resulting from brain trauma, and quality-of-care issues for brain trauma victims. In later policy-oriented chapters, the author argues for devoting more resources to prevention of and research on brain trauma. He favors mandated insurance coverage for brain trauma, and proposes funding it, in part, with user taxes on activities which often lead to brain trauma: driving (especially by younger drivers), alcohol consumption, gun ownership, and boxing. The author's policy recommendations are often quite controversial. He favors a legal presumption against the provision of life support for persons in PVS; he would raise the driving age to 18; andhe would ban boxing, mandate the use of bicycle helmets, and ""outlaw the private possession of handguns and assault weapons."" This engaging book should appeal to the general reader, and particularly to those with an interest in public health and health policy.
Doody Review Services
Reviewer: Stephen R. Latham, JD, PhD (Northwestern University School of Law)
Description: Each year over two million Americans suffer traumatic brain injury. Of these, 60,000 are killed, 90,000 require extensive rehabilitation services, and about 2,000 are left in persistent vegetative states ("PVS"). Americans pay around $2.9 billion annually for direct costs of medical care and rehabilitation for brain trauma, and lose an additional $4.7 billion in wages, taxes, and productivity.
Purpose: The author has produced a very readable book designed to promote public awareness of, and to propose measures to combat and deal with, this "silent epidemic" of traumatic brain injury.
Audience: This book is aimed at a non-specialized audience. Although it is well-documented and contains some serious policy analysis, it is written in a journalistic tone. Its short chapters are often propelled by one or two core anecdotes.
Features: Chapter topics include a brief layman's overview of brain function and of the basic types of brain trauma, brain trauma emergency care, progress in research and rehabilitation, the experiences of families of the injured, fatality and PVS resulting from brain trauma, and quality-of-care issues for brain trauma victims. In later policy-oriented chapters, the author argues for devoting more resources to prevention of and research on brain trauma. He favors mandated insurance coverage for brain trauma, and proposes funding it, in part, with user taxes on activities which often lead to brain trauma: driving (especially by younger drivers), alcohol consumption, gun ownership, and boxing.
Assessment: The author's policy recommendations are often quite controversial. He favors a legal presumption against the provision of life support for persons in PVS; he would raise the driving age to 18; and he would ban boxing, mandate the use of bicycle helmets, and "outlaw the private possession of handguns and assault weapons." This engaging book should appeal to the general reader, and particularly to those with an interest in public health and health policy.
Library Journal
Medical philosopher Winslade has written a readable and broad overview of head injury: causes, treatment, rehabilitation, and health and public policy implications. The medicine and science of brain injury, however, are secondary in this book to discussions of rehabilitation and policy issues. The author survived a brain injury as a child, and that story, as well as high-profile cases such as Reagan aide James S. Brady and the Central Park "wilding" victim, inform the book and give it a personal touch. Hard to categorize, finally: this book will certainly be of interest to those who work with victims of head injury and their families; its readability, organization, and practical information make it a reasonable choice for community collections and collections in healthcare and social service settings. Mark L. Shelton, Univ. of Massachusetts Medical Ctr., Worcester
Booknews
Warning of a virtual epidemic in traumatic brain injury (TBI) in the United States, the author explains in layman's terms the causes of TBI, how it affects the brain, and ways of treating it. He offers a number of recommendations towards alleviating the problem, including increasing investment in basic and clinical research, redirecting research efforts towards a greater emphasis on rehabilitation, meshing broad federal guidelines with state latitude in instituting programs for providing and regulating brain injury-related services, and raising the driving age. Annotation c. by Book News, Inc., Portland, Or.
Rating
3 Stars from Doody
Table of Contents:
| Foreword | ix |
| Preface | xiii |
| Acknowledgments | xv |
| Introduction: It Can Happen to Anyone | 1 |
1 | Our Vulnerable Brains | 15 |
2 | Saving Lives: The Golden Hour | 30 |
3 | Hope on the Horizon | 42 |
4 | The Rough Road to Rehabilitation | 64 |
5 | How Families Become Victims | 89 |
6 | Facing Fatality--and Worse Fates | 106 |
7 | Protecting the Most Vulnerable | 125 |
8 | A Better Use of Resources | 141 |
9 | Policies and Priorities | 154 |
10 | Prevention: The Best Solution | 176 |
| Bibliography | 205 |
| Index | 217 |
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