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After the fall, a whole new purpose
(by Karen F. Mrnarevic - July 30, 2008)
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Photo courtesy of Jane Concato
Jane Concato is pictured with her dog, Lucy, who is a certified Bright and Beautiful Therapy Dog. Jane and Lucy make weekly visits to the Kessler Rehabilitation Institute, where Jane underwent both inpatient and outpatient therapy, to bring comfort to others who suffer from brain injuries.
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Thump, thump, thump!
Joe Concato was dozing in bed early in the morning on March 15, 2004, when he was roused by a disturbing sound. He bolted to his feet. It wasn’t until he was in the hallway that he realized, with horror, what he had heard – the sound of his wife, Jane, falling down the stairs. She lay at the bottom, eyes wide open, but she wasn’t awake.
Inside of her Westwood home, on a day like any other, Jane sustained a traumatic brain injury that put her in a coma.
“It’s so totally weird,” Jane says of the events surrounding the accident four years ago that changed her life. “I don’t think you’re ever normal [after a brain injury].” But then again, she points out, “They should take that word out of the language. Nobody’s normal.”
In addition to the coma, the brain injury rendered Jane temporarily speechless and caused blood clots to form in her legs. She suffered a fractured wrist and skull, and an injury to her right temporal lobe referred to as “Coup-contrecoup.” This occurs when a blow to the head is so strong that it not only causes bruising to the brain at the site of the impact, but also forces the brain in the opposite direction, where it impacts the opposite side of the skull, causing a secondary injury. But Jane prefers the following description, which was suggested by one of her doctors: “like Jello in a shoebox.”
Immediately after the accident, Jane was transported to
Hackensack
University
Medical
Center and admitted to the Intensive Care Unit. Although she spent a short time in a coma, she was breathing on her own, which doctors told Joe was a good sign. The ICU was her home for three weeks, and though she was conscious for much of that time, she cannot remember anything about the experience, save for the last few days she was in the hospital. “It’s like a dream,” she says.
Once she was stabilized and conscious, doctors and therapists began to evaluate the severity of her injury, using the “Glasgow Coma Scale” to rate her progress as her speech slowly returned and her general cognition improved. Doctors would test Jane, asking her to identify things in the room, recognize faces in pictures. In the beginning, Joe says, “She was failing tests left and right.” It seemed as though her brain had gone through a time-warp and was trapped somewhere in the 1990s. “Apparently, [I thought] Bill Clinton was the president,” Jane says with a laugh. “I guess I like Bill Clinton.”
“I was making up stories left and right, which apparently is pretty common,” says Jane, who often follows her statements about her experiences in the aftermath of the accident with phrases like, “so I’ve been told.” Joe also points out that in those early days, Jane’s brain seemed to compensate for its loss of language function by filling in gaps with nonsense.
“There were some totally made up words that had no meaning to anyone,” says Joe, whom Jane still refers to as the “Word Police,” for his refusal to finish her sentences and his insistence on her finding the right words by herself. Before her accident, Jane was a dental hygienist, and apparently the professional terminology stuck with her somehow immediately following the accident. “As she got more fluent,” Joe recalls, “the word ‘amalgam’ [a silver filling] used to come out at random times.” At first they thought “amalgam” meant something specific. “But as it turned out, ‘amalgam’ was something [that] if the brain couldn’t find a word it took whatever was handy, and ‘amalgam’ came out. Sometimes it meant food, sometimes it meant bathroom, sometimes it meant the dog,” says Joe.
After leaving the ICU, Jane was transferred to the Kessler Institute for Rehabilitation in
East Orange , for weeks of inpatient therapy, followed by six months of outpatient rehabilitation. The rehabilitation process was slow, tedious and painful. “You’re very confused,” says Jane. She was afflicted with what neurologists call “slow speed of processing,” which she describes thusly: “If somebody said a bunch of sentences, by the time they got to the second sentence, I would be like, ‘I don’t get it.’” The confusion, she says, led to feelings of discouragement and isolation. “You’re very depressed.”
Jane considers herself lucky to have a husband like Joe, who was there all along, a stoic, yet tender sidekick who held Jane’s hand – and held their family together – throughout the whole ordeal. Joe seems built for stressful situations, an even-tempered firefighter with an open manner and a ready smile, he has a talent for looking at the bright side. “The first day [after the accident] was traumatic,” he says, point blank. “But starting with the second day, there was always something positive happening.” The couple, with the help of their friends, family and community, found a way to get through it.
Jane and Joe celebrated their 26th wedding anniversary while Jane was doing inpatient rehab at Kessler. That night, Jane recalls, the two of them sat in the center’s sixth floor cafeteria watching planes land at
Newark
Airport , and she felt as if their relationship was brand new again. Joe got down on one knee and put Jane’s engagement ring on her finger. “He said he wanted to marry me all over again, for better or worse,” she says, emotions flooding back to her.
It took about two and a half years before Jane began to feel more like herself. But she is quick to point out that she will never be exactly the same Jane that she was before the accident. Two years ago, for instance, she had a type of seizure, which made her unable to talk and left her paranoid and confused for a while afterward. She is now on medication that has successfully prevented additional seizures, but Jane is still aware that she is different. She finds herself crying at the drop of a hat. She was always an emotional person, but was never quite so sensitive. During support group meetings, everybody knows to “put the tissues by Jane,” and she admits that she has lost a certain “filter” that once moderated her emotional responses.
Fatigue has also been a problem for her since the accident. “Sometimes I’ll just have things planned and I’ll call people and say I just can’t do it. I have to rest,” she says with regret and a trace of embarrassment in her voice. She says she can’t help but wonder if people think she might be imagining certain symptoms, or blowing symptoms out of proportion. She thinks people may be of the opinion that “the brain injury is over.” Quite the contrary, she says, “It’s never over.”
But Jane has chosen to embrace her new self, embarking on new adventures and sharing her experience with others. Understanding the truth about brain injury, and wanting to bring relief to the silent sufferers and their sometimes uninformed caregivers has brought Jane and Joe to where they are today. The couple facilitates a support group for people with brain injuries and their care providers, something that happened almost by chance when the previous leader of the group, a nurse, could no longer participate. The group would have dissolved had it not been for the Concatos and their desire to keep it going.
In 2007, Jane had her 6-year-old Sheltie dog, Lucy, certified as a Bright and Beautiful Therapy Dog. Jane and Lucy visit the Kessler Institute every Wednesday, where Lucy, with her gentle, quiet way, brings relief and comfort to patients experiencing something few people can understand. Lucy doesn’t judge or fret or make them nervous; she just offers a soft, warm place for a hand to rest, becoming a living, breathing security blanket.
Jane’s efforts have not gone unnoticed. On May 14, the Brain Injury Association of New Jersey honored Jane with the Mimi Goldman Positive Achievement Award, which is given to only one person each year. The award is in recognition of her triumph over her own brain injury, as well as her tireless efforts to bring support and comfort to others who have had similar experiences.
Back when Jane was still relearning how to walk, when her word-finding aphasia was still quite severe, she says that she was plagued with thoughts that she would never be able to rejoin the community. Depressed and defeated, she says her reaction was: “I have no purpose.” But Jane has found her purpose. With Joe at her side, she will continue to raise awareness of how brain injuries change lives. She will offer hope to others like her that life does go on and is a thing to be treasured.
For more information about the Brain Injury Association of New Jersey, visit www.bianj.org. To find out more about Joe and Jane Concato’s Brain Injury support group, e-mail jjconc@optonline.net.
Karen F. Mrnarevic's e-mail address is Mrnarevic@northjersey.com.
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