Head Injuries

This is a serious topic, and one that should be discussed;  the fact is, head injuries can be deadly. 

The big news today is about how actress Natasha Richardson died of a head injury received as a result of a ski crash on a beginner's slope. Initially she was fine, they tell us, but the other symptoms appeared.  And that's what happens. One minute someone is fine...the next...they're dead.  

In my first year as a Ski Patroller, I remember that one of our fellow patrollers took a serious spill on the bunny hill. It was a freak thing; he was an amazing skier, he and his wife were actually moving to Europe and were going to be patrolling there, in the Alps. Well, he took a headlong crash and I remember being on scene...it was pretty obvious he'd hit hard.  And yet...it was a bunny hill.  Never underestimate the force of a fall, even when it doesn't seem to make sense. 

I was also the patroller in charge of a scene on that very same bunny hill a couple years later,  where a little boy had taken quite a creative fall. And although over and over again, he said he hadn't hit his head at all...as it turned out, he DID have a head injury, although in his case it was a slight concussion.

Both of the above people recovered and went on with their lives, but witnessing the damage caused what what was later diagnosed as a "slight concussion" was quite daunting. In the first case, the patroller, "Bill" was bleeding all over the place as a result of a direct hit.  In the latter case, "Andy" had no outward sign of his injury, but he DID go downhill QUICK about 20 minutes later.

One of the scary things with head injuries is that although there are symptoms, they don't always match on every occasion. There are closed and open head injuries. There are direct hits, and hits that involve the brain being "rattled" even though the head has not taken a direct  strike.  There are immediate symptoms, and delayed symptoms.  And sometimes, the patient has to REPORT those symptoms because they can't otherwise be recognized.  (Actually, this would be the difference between Signs and Symptoms:  Signs are objective and can be outwardly recognized, such as an altered mental status, blown pupils, etc.,  Symptoms are subjective and must be reported, although sometimes can be guessed; i.e. someone who is drowsy can report being drowsy, but maybe it can be observed, too. But typically, symptoms MUST be reported due to their subjective nature.)

Personal Experience That Scares Me Now

I've suffered a few concussions; one from a direct hit, a couple others as a "secondary" injury. 

When I was 13, I was in a serious car accident, in which I had not been wearing a seat belt.  We rear ended another car, and I can STILL remember the collision.  As my head struck the windshield at 40 mph or so, my knees hit the dash, and I was thrown back against the seat, dazed, encased in darkness.  I remember shaking it off and looking over at the driver, who was asking me if I was OK. I said I was,  although I was not.  My knees hurt. My head hurt. I remember reaching up and palpating a bump on my head, surprised that was all I seemed to have. I remember trying to peer through a cloud of darkness and trying to grasp what had just happened and what was going on. 

I was really really tired, but got out of the car, wanting to be OK, thinking if I pretended I was, that would effect reality.   

When the ambulance arrived, I told the 'medic, when he asked, that I had not lost consciousness. In my mind, I hadn't. It had just "gotten dark" for awhile.  I didn't tell him even that.  

Uh...HELLO!  

At the time, I was still a pretty shy person, and he was a stranger; it stood to reason that I wouldn't just blurt out what I was feeling, because I didn't want to be the center of attention.   IN a way, because I wanted to avoid attention, I fled from the treatment I needed, and honestly thought I DIDN'T need. 

But I should have told him the other symptoms; the headache, which WAS severe, in spite of the brave face I tried to put on it.  I didn't tell him how tired I was, and in reality, I don't think I know those were symptoms.  They were just how I felt but meant nothing to me.  I didn't expect to feel GOOD after being involved in a fairly serious car accident.  I didn't expect, that if my noggin had cracked a windshield, that I'd feel good, but I didn't really think I was injured, either. 

On the funny side...the Sheriff himself was at that scene and offered to give me a ride home. I was a little intimidated at the time, and wondered if he'd walk to me to the door (which actually would have been proper).  But no, I said I was fine and would prefer a ride from my friend, thinking that if a cop brought me home, Mom would REALLY freak out!  

Well, as it was, I got a ride home from my friend's brother- in-law,  and Mom's immediate reaction, as I feared, was to overreact and bring me to the ER in a panic. I had a small cut on my head. As we were led back to an examining room, she said, "Oh, I hope she doesn't need stitches!"

I stopped in my tracks. "Stitches?"   (I've never been a fan of needles....)

I didn't need stitches. But somehow they coaxed me back and once I had a bed to lie on, I did so. I wanted to go to sleep. They didn't seem to pick up on that. The doctor asked me everything else, gave me the neurological tests, everything, even as I sat there wanting nothing more than to sleep. 

When we got home, I worked hard to stay awake, and when I finally DID go to bed, Mom spent the night waking me up every two hours to ask me "stupid questions."  I just wanted to sleep.  Of course, you realize that those "stupid questions" were quite necessary and thank God Mom did what she had to do and asked them. (And I got them all right!)  :-D 

(As an aside...I was glad she didn't ask me anything about algebra or geometry...)

At the ER they had given me a sheet of paper that said if the headache was ongoing, we should come back.  I actually put it away and said nothing.  The headache was so horrible that I couldn't do anything for DAYS, but I never told Mom how bad it was. In the afternoons, I would lie down hoping for some relief, and finally the pain would abate enough to allow me to function again. 

That was my first concussion.  Undiagnosed, but I know enough now that there's no doubt that I had one.  Fun.  

The second one happened when I was in the Ski Patrol's candidacy program. 

On a Saturday evening, as an Auxiliary Patroller (IE trained in Outdoor Emergency Care, the equivalent to EMT, had not passed the Hill Test, thus not wearing an identifying jacket), I took a bad fall.  I wasn't a great skier at the time, and was "ripping" down a slope.  At the bottom was a snow machine which caused the slope to go from icy to sticky with new, wet, manufactured snow. I turned to make my hockey-stop, recognizing the conditions, but misjudged the space and the snow, besides the fact my weight was on the wrong ski.  I crashed, hard, and in that crash there was no "slide" to absorb the impact. I think I almost felt my brain hit my skull.  

But I stood up,even in that piercing pain,  brushed myself off, and went on, with a headache that got worse and worse throughout the evening. 

I went home, and the next day got up and returned to the ski area for Hill Training, already fearing that maybe I shouldn't be driving, much less skiing. But I didn't want to say anything because passing the Hill Test was EVERYTHING to me. 

That day I was just "off" in general.  I had no balance. While skiing, I actually had a really creative crash that jammed my skis between  the snow and a little "cliff", causing a friend to have to help me disengage from the "trap".  While standing on flat ground near the lift, I tipped over very suddenly, and later that day, in a store, I quite literally just fell over.  It was the oddest thing; while I've never been a graceful person, it is NOT normal for me to be standing one moment and lying on the ground the next, with no memory as to how I'd gotten there. 

So you see the problem, don't you? 

None of me fellow patrollers recognized the signs because they hadn't seen the crash and had no idea that I had other symptoms, including a headache much like the one I'd had when I was 13.  How could they know? Even though I suspected at the time I might have a closed head injury, I said nothing, choosing to say nothing, thinking maybe if I did, they would pull me from training that day.  (Wisely, in fact.)  

I never experienced nausea, but I did experience a certain confusion, loss of balance, and the piercing headache. 

I should have been in the hospital;  that injury...both injuries, could have killed me.  

And a LOT of people experience this and live to tell about it. But every so often, we get an example of someone who doesn't.  

My heart goes out to Natasha's family, and she herself also remains in my prayers.  What they must be suffering is incomprehensible.  In one moment their dear one is present in their lives, and after something that seems so small...she's gone. 

None of us knows the day or the hour, but there is one thing this tragic accident brings to the forefront; and that is the reality that one doesn't NEED to die of such an injury.  We all need to be vigilant and recognize those things that could cause such an injury. It seems in her case she was given the proper advice and followed it, and really, that's all anyone can do. 

I encourage everyone to become educated in these things, if not to use them professionally then at least to be able to help those you love if they ARE ever injured.  When in doubt, take your friend to Urgent Care or the ER. It's better to be seen than not.  

Even in my case, I suspected an injury, but didn't take the initiative to go;  but had someone insisted, I would have. Of course, they would have had to drive me.  I shudder to think, now, that I was driving a few hours between the ski area and home when I shouldn't have been driving at all!  

Our brains are very sensitive and it doesn't take much to kill us. Please take any kind of head injury very seriously, and know the symptoms, or even the possibility. If one seems likely...get to the doctor.  As soon as possible. And tell them every symptom, even if it doesn't seem important, because at that point, everything is. 

Please keep Natasha Richardson in your prayers, and all of her family, as well as the families that are living out this very same thing right now. 

Recruitment?

This article and law firm just SMACKS of "recruitment":

Lawfirm denied access to bridge site for lawsuits

ST. PAUL (AP) - A federal judge has denied a law firm's request for access to the 35W bridge collapse site to gather information for possible wrongful death and personal injury lawsuits.

Judge Patrick J. Schiltz says the government has "an urgent interest" in recovering victims, clearing the wreckage, reopening the river and rebuilding the bridge as sLawfirm denied access to bridge site for lawsuits oon as possible. The judge says those challenges are daunting enough without turning loose potentially dozens of lawyers, expert witnesses and investigators on the site.

The firm of Schwebel, Goetz and Seiben says it's representing three people severely injured in the collapse and the families of two people who died. It was trying to gain access to the site for two of its experts and some attorneys.


(Copyright 2007 by The Associated Press. All Rights Reserved.)

AP-NY-08-15-07 1841EDT

As you know, I recently left my job with an insurance company. While I didn't handle injury claims - recently - part of my job was to handle bodily injury claims if it was proper to do so, and I've settled a good number of them in my time at that company. It's part of the insurance business, and some people specialize in handling these types of claims. Personally, I hated them, which is why I became a non-medical investigator.

Minnesota is a "No-Fault" state, which is a term often miused and misunderstood. What it means is that if you are involved in some kind of vehicle accident, you must go through your own vehicle insurance company to handle your medical bills, up to the policy limit (which is often only $20,000 but can be doubled with "stacking" insurance if you insure more than one vehicle on the same policy). However, "No Fault" has nothing to do with negligence; typically SOMEONE is at fault (negligent) when an accident occurrs. It can be both drivers, it can be a pedestrian, it can be a manufacture defect. And when negligence is determined, meaning that someone is majority at fault for the accident, then if the injured party does not bear the majority of negligence, that person may hav a bodily injury (BI) claim.

For example; if a semi truck rearrends a stopped Pinto at 50 mph if said Pinto is legally stopped, waiting for the light to change, said driver of the semi is negligent, and in all liklihood, the Pinto driver is injured, or dead. That person certainly has a Bodily Injury claim. Certain "thresholds" may apply as claim of an injury does not, in Minnesota, automatically entitle someone to a BI settlement. In MN, those thresholds are: treatment over $4,000 (not inluding diagnostic tests such as MRI's), serious injuries such as fractures and scarring, death or dismemberment, or permanent injury. Insurance companies are well aware of these thresholds and immediately prepare to handle them, which requires the cooperation of the injured party, that party's own insurance carrier, and, of course, any attorneys who may be involved.

So, many of the people on the bridge, especially those who were killed or were severely injured, have bodily injury (BI) claims. They are not at fault for the bridge collapse, but clearly, SOMEONE, SOMEWHERE is liable. Attorneys and Insurance Companies have to determine WHO is responsible via their investigators, expert witnesses, and the findings of the Federal investigators and MNDOT investigators as all the details are sorted out. The attorneys will go after all the negligent parties, focusing, of course, on those with the deepest pockets.

That's what this article is about; the attorneys are working on gathering evidence for their cases, as will be the insurance companies. However, as those in the insurance industry know, access to such disasters isn't automatically granted. I was an investigator and often had to wait out "holds" before I could really start following threads. It's hard for everyone, but it's extremely important to let the authorities do their job and maintain the integrity of the scene.

That's part of why the attorneys are trying to gain access; they are looking to either breach the integrity of the scene, or prove that something has been breached, so as to weaken any defense that may be taken by the negligent parties. They are also making a play for publicity, as they know well that they would not be allowed access to the collapse scene just yet. Especially considering that not all of the deceased have been recovered and laid to rest. It's also a pre-emptive move that gives them a position of strength no matter what happens in court. Because they are using the courts to request access, and the courts have shut them down (for now), they will later be able to argue in court that the "rights" of their clients were quashed by this decision and they will do whatever they can to play upon the conspiracy theorists in the jury to be chosen at a later date. That makes the government look bad; it makes those working at the site to recover the remains of the still-missing people look like bad guys while the law firm gets to look like heroes to people that are gullible enough to fall for this public relations scam. And, of course, when this goes to court or to closed-door settlements, the real reason they were denied access to the scene and the fact that, if they were allowed to enter would have compromised the scene and would have been detrimental to recovery efforts will be completely ignored or glossed over.

And of course, the law firm gets their name out there, which brings in both related and unrelated business for them.

It is not surprising that a law firm is involved; this is expected. Given what I know, I would not be likely to get an attorney if I were injured in a vehicle accident, unless an insurance company was not doing their job. I know what their job is, so perhaps I'm in a good position to be able to ascertain when something is wrong. (Overall, insurance companies DO handle their injury claims well, but there are times when they don't, and then it's time to be represented.) Many peple think that claims are handled differently with attorney representation; this is complete fallacy. Typically, if someone told me they were going to get an attorney, I'd yawn and tell them that I looked forward to this event and that the attorney would be far more reasonable and professional that they would be. (That latter was saved for especially arrogent and threatening customers). I spoke truly, for there were some difficult customers we just PRAYED would get an attorney so that we could get the job done and it would be wonderful to deal with someone who knew what we needed and wouldn't wait for us to ask. Because when the customer gets paid...they get paid.

And pay...that's another reason I wouldn't want to get an attorney; they take 1/3 of the settlement, and in many cases, that means that the customer would actually be paid less (directly) than if they were unrepped. Additionally, an analysis of customer surveys revealed that of those people who were represented by attorneys and those who were not, those who were not represented were far more pleased with how their claim was handled than if they had gone through a law firm. This is VERY telling.

But none of that is why I'm disturbed about the above article. As I said, I would expect to have law firms involved in this, and if I were that seriously injured, or I'd lost a loved one, it would be easier to get the attorney as I'd be tied up with other things such as serious recovering or grief.

Here's what disturbs me:

The firm of Schwebel, Goetz and Seiben says it's representing three people severely injured in the collapse and the families of two people who died

The SAME firm is representing a high percentage of the people directly impacted in this incident. That defies statistcs and speaks of "recruitment". Perhaps that recruitment was one family to another. Or perhaps it's a class-action type of thing (I'm not sure what constitutes class action). If so, then no problem.

But typically, anyone injured in an accident. when that info is made public, they are INUNDATED with Personal Injury attorney spam. It's completely ridiculous. Even where injury is not indicated, these vulturs crowd in to convince them they are injured and some even suggest what to do in order to cross a treatment threshold if they don't qualify under any other category. That's one of the inherent flaws in the No Fault law; the abuse entailed. We spend a LOT more on bodily injury claims in Minnesota than do Tort states such as Wisconsin where, from the first dollar spent on an injury constitutes a bodily injury claim.

But something about this just rubs me the wrong way. It could be completely legitimate, but at the same time, the statistics that the same firm would represent so many (if not class action) indicates someone was "recruiting", which is a bit unethical.

Just my humble opinion. But then again, I'm not fond of PI law firms, and even as I would consider seeking employment with a law firm, they would be excluded from my consideration.