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Head Cases: Stories of Brain Injury and Its Aftermath
Head Cases takes us into the dark side of the brain in an astonishing sequence of stories, at once true and strange, from the world of brain damage. Michael Paul Mason is one of an elite group of experts who coordinate care in the complicated aftermath of tragic injuries that can last a lifetime. On the road with Mason, we encounter survivors of brain injuries as they struggle to map and make sense of the new worlds they inhabit.Underlying each of these survivors' stories is an exploration of the brain and its mysteries. When injured, the brain must figure out how to heal itself, reorganizing its physiology in order to do the job. Mason gives us a series of vivid glimpses into brain science, the last frontier of medicine, and we come away in awe of the miracles of the brain's workings and astonished at the fragility of the brain and the sense of self, life, and order that resides there. Head Cases "[achieves] through sympathy and curiosity insight like that which pulses through genuine literature" (The New York Sun); it is at once illuminating and deeply affecting.
322 pages, Kindle Edition
First published April 1, 2008
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Displaying 1 - 30 of 133 reviews
December 3, 2020
We may not know where consciousness arises from, but we can pin down personality and character to the brain. So any brain injury, tumour, stroke, war, assault, accident or infection can change not just physical abilities but also who we are. Calm people can become violent, the law-abiding criminals, those who never forget a face may never again remember one (prosopagnosia I have it mildly - but born this way).
The body is but a vehicle for the mind, when it is the body alone that is afflicted the mind still has no limitations. But when it is the mind that is damaged, people can become so different, their family do not know who the new person is and neither might really fit with each other any more. Extend that to friends and work and the world, and the whole of life as it was lived must change. Scary, right?
The book, in a sort of Oliver Sacks way, the author describes people as they were, what happened to their brain, the physical and mental effects and then how they must learn to live with who they've become with all the detrimental changes that they are going to have to work around. Treatments and therapy last a life time. Any healing is slow. Often all that can be offered is accommodations and workarounds. The author has a great deal of empathy, again like Sacks, and that's what makes the book such a good read. Each type of injury and change described is to a person, not just for the sake of describing 'interesting' conditions.
It was a good book. The author has a way with words that conveys feelings as much as concepts and actions. If he writes another book in this vein, I would definitely want to read it.
____________________
I thought I'd reviewed this book before, but there is no review here. Only comments, so this is weird. Maybe GR deleted the review?.I had concussion when I was a kid, or maybe it was the psychedelics when I was into the sex n drugs n rock n roll lifestyle? Maybe I'm a head case too?
Sex n drugs n rock n roll
The body is but a vehicle for the mind, when it is the body alone that is afflicted the mind still has no limitations. But when it is the mind that is damaged, people can become so different, their family do not know who the new person is and neither might really fit with each other any more. Extend that to friends and work and the world, and the whole of life as it was lived must change. Scary, right?
The book, in a sort of Oliver Sacks way, the author describes people as they were, what happened to their brain, the physical and mental effects and then how they must learn to live with who they've become with all the detrimental changes that they are going to have to work around. Treatments and therapy last a life time. Any healing is slow. Often all that can be offered is accommodations and workarounds. The author has a great deal of empathy, again like Sacks, and that's what makes the book such a good read. Each type of injury and change described is to a person, not just for the sake of describing 'interesting' conditions.
It was a good book. The author has a way with words that conveys feelings as much as concepts and actions. If he writes another book in this vein, I would definitely want to read it.
____________________
I thought I'd reviewed this book before, but there is no review here. Only comments, so this is weird. Maybe GR deleted the review?.I had concussion when I was a kid, or maybe it was the psychedelics when I was into the sex n drugs n rock n roll lifestyle? Maybe I'm a head case too?
Sex n drugs n rock n roll
January 2, 2019
After reading Mason’s “Head Cases: Stories of Brain Injury and Its Aftermath” which distinctly offers a variant perspective on “neurology” from that of a brain injury case manager---as I had become accustomed to the view from a neurosurgeon. Snowboarder case was gripping as is our commendable Air Force surgeons treating 10,000 traumatic head injuries during the war on terror. Mason quips “What are we other than our brains?”
"When a seizure involves only muscular stiffening, it's called a tonic seizure...when the tonic seizure is followed by muscle contractions, it becomes the most renowned and feared seizure: the grand Mal (tonic-clonic seizure)."
---Michael Paul Mason
Mason’s job as caseworker is one rife with frustration. At Balad hospital what he calls a normal day is actually a retinue of facial contortions coupled with seizures, and at times patients running with knives. One patient case speaks to a total loss of memory on how they arrived at the hospital in the first place. Another patient lost both short and long-term memory—-freight train collision. Many sad truths illuminated in these cases.
Patients of Mason include an amnesiac incarcerated for a crime he has no recollection of. Though this is only the “début,” tragedies commence when health insurance policy is exhausted. Riveting read of this painful landscape into the life of patients suffering from traumatic brain injuries (told energetically by advocate Mason). Not an elementary read nor is brain injury a simple issue to solve. Must read. Buy, consider and reflect.
"When a seizure involves only muscular stiffening, it's called a tonic seizure...when the tonic seizure is followed by muscle contractions, it becomes the most renowned and feared seizure: the grand Mal (tonic-clonic seizure)."
---Michael Paul Mason
Mason’s job as caseworker is one rife with frustration. At Balad hospital what he calls a normal day is actually a retinue of facial contortions coupled with seizures, and at times patients running with knives. One patient case speaks to a total loss of memory on how they arrived at the hospital in the first place. Another patient lost both short and long-term memory—-freight train collision. Many sad truths illuminated in these cases.
Patients of Mason include an amnesiac incarcerated for a crime he has no recollection of. Though this is only the “début,” tragedies commence when health insurance policy is exhausted. Riveting read of this painful landscape into the life of patients suffering from traumatic brain injuries (told energetically by advocate Mason). Not an elementary read nor is brain injury a simple issue to solve. Must read. Buy, consider and reflect.
December 27, 2024
Quite a good book, telling the stories of various people with brain injuries, whom the author met mostly through his work as a case manager who helps get people into an intensive rehabilitation program. I’m sure these subjects were chosen for variety, and there’s a lot of it: from the woman injured in a car accident who lost all episodic memory (meaning she can’t remember any events, either recent or distant—her procedural memory still works though, so she can remember how to do things, as well as some facts), to the boy who turned violent due to a tumor, to the man who suffers long periods of believing he is dead.
One thing that surprised me was how serious and long-lasting some of these symptoms are, despite the people involved not having had any period of unconsciousness after the injury (popular culture of course heavily associates knocks to the head with unconsciousness, and also makes head injuries out to be far less serious than they are), and often despite their surviving without any immediate medical attention. There’s the snowboarder who just continued down the slope after ramming his knee into his head but began to suffer progressively worse seizures, and the construction worker hit by a board who lost all memory of the following week and continues to endure periodic fugue states, where he has no idea what he did (he winds up incarcerated for a robbery he may or may not have committed—my guess is he’s less culpable than the courts think, as it was all too easy for the supposed accomplice to pin everything on him). Seizures, memory loss, and personality changes (often with anger and/or violence) seem to recur most, though every case of amnesia is different. One man, weirdly, loses all memories starting six years before hanging himself.
The author tells these stories in a compelling way; generally each story gets a chapter, in which the person’s history is often interwoven with facts or the author’s story of meeting this person. He comes across as thoughtful, compassionate and well-informed, making a good guide for often very dark material. And he gets to visit places few people see—for instance, scoring an invite to the American military hospital in Iraq where injured soldiers were treated, with an incredible success rate compared to regular U.S. hospitals… though he winds up spending most of that chapter discussing how much worse the plight of injured Iraqis is, which was unexpected but appreciated.
My other big takeaway from this book is just how bad the American medical system is at dealing with brain injuries, despite their frequency: often needed medical resources are not available, and though one might hope (given the 2008 publication date) that things have improved, it seems just as likely they’ve gotten worse. One story is of a man who founded a rehabilitation center long after a teenage car accident landed him in the hospital for more than three years: “I would be dead,” he says, when asked how he would have fared today. Another involves a man (these stories are disproportionately of men, perhaps because their brains are more often injured) stuck in a psychiatric hospital and sedated on medications, because his state has no appropriate facilities for him. Although interestingly, there’s also the story of a woman who remade herself after her car accident (going from an ambitious corporate type to a caring advocate for people with brain injuries) providing mindfulness-based training, which turns out to be quite effective. Again I’m reminded that neuroplasticity means just because an illness or injury is physical doesn’t mean healing is always about surgery or drugs.
At any rate, heavy reading but definitely interesting stuff, and a worthwhile read for those interested in this sort of thing.
One thing that surprised me was how serious and long-lasting some of these symptoms are, despite the people involved not having had any period of unconsciousness after the injury (popular culture of course heavily associates knocks to the head with unconsciousness, and also makes head injuries out to be far less serious than they are), and often despite their surviving without any immediate medical attention. There’s the snowboarder who just continued down the slope after ramming his knee into his head but began to suffer progressively worse seizures, and the construction worker hit by a board who lost all memory of the following week and continues to endure periodic fugue states, where he has no idea what he did (he winds up incarcerated for a robbery he may or may not have committed—my guess is he’s less culpable than the courts think, as it was all too easy for the supposed accomplice to pin everything on him). Seizures, memory loss, and personality changes (often with anger and/or violence) seem to recur most, though every case of amnesia is different. One man, weirdly, loses all memories starting six years before hanging himself.
The author tells these stories in a compelling way; generally each story gets a chapter, in which the person’s history is often interwoven with facts or the author’s story of meeting this person. He comes across as thoughtful, compassionate and well-informed, making a good guide for often very dark material. And he gets to visit places few people see—for instance, scoring an invite to the American military hospital in Iraq where injured soldiers were treated, with an incredible success rate compared to regular U.S. hospitals… though he winds up spending most of that chapter discussing how much worse the plight of injured Iraqis is, which was unexpected but appreciated.
My other big takeaway from this book is just how bad the American medical system is at dealing with brain injuries, despite their frequency: often needed medical resources are not available, and though one might hope (given the 2008 publication date) that things have improved, it seems just as likely they’ve gotten worse. One story is of a man who founded a rehabilitation center long after a teenage car accident landed him in the hospital for more than three years: “I would be dead,” he says, when asked how he would have fared today. Another involves a man (these stories are disproportionately of men, perhaps because their brains are more often injured) stuck in a psychiatric hospital and sedated on medications, because his state has no appropriate facilities for him. Although interestingly, there’s also the story of a woman who remade herself after her car accident (going from an ambitious corporate type to a caring advocate for people with brain injuries) providing mindfulness-based training, which turns out to be quite effective. Again I’m reminded that neuroplasticity means just because an illness or injury is physical doesn’t mean healing is always about surgery or drugs.
At any rate, heavy reading but definitely interesting stuff, and a worthwhile read for those interested in this sort of thing.
December 13, 2022
This book is a solid addition to popular medical literature, but wasn't quite what I was looking for.
Human brains are fascinating, and if you don't agree with this statement, then you've wandered into the wrong review. I guess the most astonishing thing, given the abuse we dish out to ourselves on a daily basis, is how many people's brains actually function as intended. Still, a sizeable number of people each year suffer a traumatic brain injury. Michael Mason tells some of their stories; enough that we get a sense of the magnitude of the problem, as well as a general sense of how difficult life becomes when the brain is injured.
Science weenie that I am, I was hoping for some in-depth information relating the details of the trauma to the physiological affect on the brain, and how this impacts cognition and behavior. But cognition and behavior is pretty much all we get in this book, plus a large dose of the difficulties these patients have in securing the care they need. The cognition and behavior part is interesting, but absent any detailed explanation of how the brain came to be this way, the story seems unfinished, to me. And as for their poor prospects of getting care (the author is a social worker dedicated to assisting brain-damaged individuals), it's just further depressing evidence of how deeply flawed our societal priorities are.
There's no real arc here, just eleven examples of brain damage and how it impacts the sufferer's life. The writing is general clear and occasionally soars, but I can't really think of anybody who would particularly enjoy this.
Human brains are fascinating, and if you don't agree with this statement, then you've wandered into the wrong review. I guess the most astonishing thing, given the abuse we dish out to ourselves on a daily basis, is how many people's brains actually function as intended. Still, a sizeable number of people each year suffer a traumatic brain injury. Michael Mason tells some of their stories; enough that we get a sense of the magnitude of the problem, as well as a general sense of how difficult life becomes when the brain is injured.
Science weenie that I am, I was hoping for some in-depth information relating the details of the trauma to the physiological affect on the brain, and how this impacts cognition and behavior. But cognition and behavior is pretty much all we get in this book, plus a large dose of the difficulties these patients have in securing the care they need. The cognition and behavior part is interesting, but absent any detailed explanation of how the brain came to be this way, the story seems unfinished, to me. And as for their poor prospects of getting care (the author is a social worker dedicated to assisting brain-damaged individuals), it's just further depressing evidence of how deeply flawed our societal priorities are.
There's no real arc here, just eleven examples of brain damage and how it impacts the sufferer's life. The writing is general clear and occasionally soars, but I can't really think of anybody who would particularly enjoy this.
September 1, 2008
Each chapter in Head Cases is a vignette of a particular traumatic brain injury: the person before, the accident, the effects on the brain, the losses/changes, and the person's struggle to overcome/deal with those changes. The gist of the stories is that these are real people with real families and real struggles.
Several of the stories are not for the weak of heart and some are not for the weak of stomach. The hells in which some of the patients live made me doubt whether I could make it into Chapter 3; they made me thankful for the fragile life I have. There are also some brief descriptions of actual injuries, skull removal, etc., which might bother some people. If you've ever been to a neuro ICU, don't worry, you're well prepared, but you may have flashbacks.
I loved the writing style-- it was so easy and enjoyable to read, you fly right through it, but despite the ease with which the writer writes, it packs a punch of information and compelling story. I plan to look up more writing by this author, I believe he writes for Discover magazine, and I would certainly read another book.
Having had two traumatic brain injuries in my family, both with life-altering and far-reaching consequences, the book was informative and humane. As the author points out, brain injuries are a huge and varied lot; no one book could cover them all. That being said, I felt as if my family's TBIs were comparatively mundane, and I was waiting to identify with one, but it did not come. What about the brain injuries where the patient goes home, thank goodness has adequate health care (patients in the book do not), but things are just not quite the same? Those that are not quite as hellish as those in the book, (but don't tell that to the spouses, families, friends, or survivors themselves) but also traumatic? Like I previously wrote, no one book could cover it all, and the book probably wouldn't be as popular if the author wrote about more ordinary TBIs. The book (future editions) could also use a few basic brain diagrams in an appendix to help the identify brain parts and their functions.
Unlike other reviewers, although I craved updates on the patients, I did not expect them. Maybe this is due to my family experience with TBIs-- things probably have not changed that much. The manner in which the author ended each chapter made the readers feel as if the struggle/story is ongoing, and this made some reviewers uncomfortable, but I identified with it.
Several of the stories are not for the weak of heart and some are not for the weak of stomach. The hells in which some of the patients live made me doubt whether I could make it into Chapter 3; they made me thankful for the fragile life I have. There are also some brief descriptions of actual injuries, skull removal, etc., which might bother some people. If you've ever been to a neuro ICU, don't worry, you're well prepared, but you may have flashbacks.
I loved the writing style-- it was so easy and enjoyable to read, you fly right through it, but despite the ease with which the writer writes, it packs a punch of information and compelling story. I plan to look up more writing by this author, I believe he writes for Discover magazine, and I would certainly read another book.
Having had two traumatic brain injuries in my family, both with life-altering and far-reaching consequences, the book was informative and humane. As the author points out, brain injuries are a huge and varied lot; no one book could cover them all. That being said, I felt as if my family's TBIs were comparatively mundane, and I was waiting to identify with one, but it did not come. What about the brain injuries where the patient goes home, thank goodness has adequate health care (patients in the book do not), but things are just not quite the same? Those that are not quite as hellish as those in the book, (but don't tell that to the spouses, families, friends, or survivors themselves) but also traumatic? Like I previously wrote, no one book could cover it all, and the book probably wouldn't be as popular if the author wrote about more ordinary TBIs. The book (future editions) could also use a few basic brain diagrams in an appendix to help the identify brain parts and their functions.
Unlike other reviewers, although I craved updates on the patients, I did not expect them. Maybe this is due to my family experience with TBIs-- things probably have not changed that much. The manner in which the author ended each chapter made the readers feel as if the struggle/story is ongoing, and this made some reviewers uncomfortable, but I identified with it.
June 11, 2010
So after a year and a half we finally finished this book. I'm so glad not to have it listed under my "currenly reading" section anymore.
We read a this a few chapters at a time as part of the journal club we have at my work for our certified brain injury specialist program. This book is a collection of case histories of various people who have suffered brain injuries written by a brain injury case manager (whatever the hell that is!)
The book presents some interesting though harrowing stories of brain injury and the toll it takes on everyone involved, not just the person with the injury. I've worked with people with brain injuries for almost 10 years so I've heard a lot of horror stories but this book was still a bit much even for me. I think the hardest thing about this book was that basically every story was about someone who suffered a horrific brain injury who then received horribly inadequate care because of insufficient funds, insurance, or service availability. Maybe these are the only cases the author is called about and maybe his message was the need for better brain injury services but it was still hard to take.
Whenever someone hears where I work I always get "that must be so hard" and I always say that it can be, but that with brain injury there is always hope. You see progress and changee even years later. Granted the changes might be small but they're there and they come to mean a lot to everyone involved.
Mason didn't focus enough on hope and as a result, the book ended up being pretty depressing.
We read a this a few chapters at a time as part of the journal club we have at my work for our certified brain injury specialist program. This book is a collection of case histories of various people who have suffered brain injuries written by a brain injury case manager (whatever the hell that is!)
The book presents some interesting though harrowing stories of brain injury and the toll it takes on everyone involved, not just the person with the injury. I've worked with people with brain injuries for almost 10 years so I've heard a lot of horror stories but this book was still a bit much even for me. I think the hardest thing about this book was that basically every story was about someone who suffered a horrific brain injury who then received horribly inadequate care because of insufficient funds, insurance, or service availability. Maybe these are the only cases the author is called about and maybe his message was the need for better brain injury services but it was still hard to take.
Whenever someone hears where I work I always get "that must be so hard" and I always say that it can be, but that with brain injury there is always hope. You see progress and changee even years later. Granted the changes might be small but they're there and they come to mean a lot to everyone involved.
Mason didn't focus enough on hope and as a result, the book ended up being pretty depressing.
June 21, 2013
This could have been a much better book. The author can write well and he had a plethora of cases to pick from. However, Mason couldn't decide if the book should be a compilation of case studies (which is what the title implies) or a memoir of his job as brain injury case manager. So he tries to do both and the results are very incomplete. In case after case, Mason gives a lot of details about a brain injury victim but then, suddenly, ends that chapter. The reader does not find out how the person's case was resolved, the help he or she received (or not), nor how the family and patient adjusted to the changes in life brought about by the injury. Further, Mason's vignettes about himself added very little to each chapter. It was tolerable in the chapter about a man who survived a suicide for Mason to talk about his friend's suicide since they happened at roughly the same time. However, Mason's visit to a Buddhist monastery did not seem to help him process his friend's death and took away from the case history of the brain injured suicide survivor. Mason also wrote about going to a Native American sweat log, but other than listing what happened, he did not seem to learn much from the experience. There are probably books about traumatic brain injuries that are a lot better than this one.
April 24, 2016
I couldn't put the book down as this is my area of vocation for over ten years and I'm always interested in learning more. A gifted writer that describes each case accurately and respectfully. Shocking stats such as 1 in 5 of us have a tumor presently residing in our brains that may sit dormant. While often rewarding to assist a client in rehab with an ABI, it is also challenging, as Michael explains, a sudden unpredictable mood swing or outburst can occur with the comorbid psychiatric issues and lack of self awareness. Often a group home will resemble a dysfunctional family residing under one roof, where very different personalities clash and clients fight for the attention of staff, and the kitchen is usually the hotspot for turf wars.
January 11, 2021
The book was well written engaging the reader with not only telling the stories of how people are affected by brain injuries and how their close ones are affected but how they got them and how the author became involved. Just the same i was glad to finish this book as it was a series of sad stories that happen too often. Some of the sadness comes from the doctors involved not realizing soon enough the extent of the damage from an incident, memory loss being a common causality.
P60 Words vanish from the front of a paragraph; when watching a movie, every scene is the opening scene.
P104 > 40 to 60 percent of people treated for brain injuries were not properly treated
P201 > one dcotor suggested headaches were coming from bad teeth - total removal of the teeth had no effect on his headaches
Then there is the battles against the insurance companies who don't want to pay out and medical expenses go uncovered.
Six years ago I was hit in the head with 50 pounds of plywood. It took 18 months for doctors to diagnose the problem and prescribe a remedy. I still get episodes of pain but nothing as serious as the cases mentioned in the book.
P60 Words vanish from the front of a paragraph; when watching a movie, every scene is the opening scene.
P104 > 40 to 60 percent of people treated for brain injuries were not properly treated
P201 > one dcotor suggested headaches were coming from bad teeth - total removal of the teeth had no effect on his headaches
Then there is the battles against the insurance companies who don't want to pay out and medical expenses go uncovered.
Six years ago I was hit in the head with 50 pounds of plywood. It took 18 months for doctors to diagnose the problem and prescribe a remedy. I still get episodes of pain but nothing as serious as the cases mentioned in the book.
May 27, 2017
Fascinating and devastating. I learned a lot about TBI and enjoyed the detailed, almost fiction-like writing style.
I ended up giving it four stars mainly for one issue that really hit me hard, which is that in his chapter on suicide, the author repeatedly uses the word "suicide" to refer to "a person who attempted suicide." As in, "The suicide was found in his room..." It's extremely dehumanizing and really contrasted with the rest of the book, which is written in a way that respects and emphasizes the survivors' humanity. I'm sure the author doesn't think of his word choice as stigmatizing and dehumanizing, but it was awful to read as a survivor of depression and a mental health professional.
I ended up giving it four stars mainly for one issue that really hit me hard, which is that in his chapter on suicide, the author repeatedly uses the word "suicide" to refer to "a person who attempted suicide." As in, "The suicide was found in his room..." It's extremely dehumanizing and really contrasted with the rest of the book, which is written in a way that respects and emphasizes the survivors' humanity. I'm sure the author doesn't think of his word choice as stigmatizing and dehumanizing, but it was awful to read as a survivor of depression and a mental health professional.
June 19, 2017
12 cases of people who have had brain injuries. I thought this book was really well done and I learned a lot about what can happen, and how your head can change afterward.
I loved the compassionate nature that the author showed toward his subjects. I think I will write a column/review of this one.
Thanks Michael. I'm not sure what my favourite chapter was, but I loved the way you talked about John.
I loved the compassionate nature that the author showed toward his subjects. I think I will write a column/review of this one.
Thanks Michael. I'm not sure what my favourite chapter was, but I loved the way you talked about John.
July 23, 2008
What makes you get up in the morning? Sustain your job? Helps you breathe? Makes sure your heart beats every day? It's frightening to think how much the brain is responsible for (essentially everything in your body), yet its only protection is a few thin layers of membrane, fluid, and bone. A simple tap on the head in the wrong place can create damage that will change your life forever.
Mason, a brain injury case manager, tells the stories of several of his clients: how it happened, how they and their friends/family were affected, and how isolated they become in what we think is an advanced medical society. What scared me the most after reading this was how much we DON'T know about how the brain works. Mason states there are very few facilities that specialize in treating traumatic brain injury; and of course, the few that do are usually working at capacity. But the most important part of this book are the stories of each person. Each "case" is heart-wrenching, hopeful, and real.
An excellent book that tells the stories behind the "client case files". Definitely one of my best reads of 2008.
Mason, a brain injury case manager, tells the stories of several of his clients: how it happened, how they and their friends/family were affected, and how isolated they become in what we think is an advanced medical society. What scared me the most after reading this was how much we DON'T know about how the brain works. Mason states there are very few facilities that specialize in treating traumatic brain injury; and of course, the few that do are usually working at capacity. But the most important part of this book are the stories of each person. Each "case" is heart-wrenching, hopeful, and real.
An excellent book that tells the stories behind the "client case files". Definitely one of my best reads of 2008.
July 1, 2008
This book is a compilation of stories about different people who have brain damage. It's written by a guy who is a case manager, he goes around the country meeting people with brain injuries and damage from tumors and such to see if there are any programs out there to help them. For most there is nothing to be done for them, they aren't brain damaged enough, they don't have the right kind of brain damage, they are too high functioning, they have too many behavior problems associated with their brain damage......it was depressing. It made me feel so sad to know there are people out there with basically no hope of getting the help they need to recover. The author paints quite a bleak picture...perhaps there is no other picture to paint. I truly felt for these people and their families. I also felt bad for the author who seems to have lost hope.
July 26, 2012
Michael Paul Mason shows the inner workings of and political red tape involved with brain injury care and rehabilitation in our country while introducing his readers to real-life people and their families whose lives have forever been derailed. This book is powerful and informative and infuriating all at once as the reader discovers how laws, insurance providers and institutional guidelines determine just how much a person will be allowed to recover from a brain injury. We live in a time of amazing medical advancements where people can survive injuries never before imagined and a time where laws and regulations restrict access to the appropriate and necessary rehabilitation for these survivors.
May 7, 2021
I really enjoyed this book for personal reasons. I think anyone who has been affected by traumatic brain injury (whether directly or through a family member/friend) will find a lot of stories resonating with their own experiences. Sometimes I thought the author rambled a little, but I did enjoy reading this book (although it was also depressing at times). The author really highlights how prevalent brain injuries are across the US (and the world) and how our healthcare system is just too expensive for people to be treated adequately. Brain injuries truly make up an epidemic that is not spoken about. And since the brain is so complex and fragile, every injury is very unique and very difficult to diagnose and treat properly.
June 30, 2020
Michael Paul Mason is a brain injury case manager and a wonderful storyteller. He shares with us some of his most perplexing and unusual brain injury cases but does so with a side of ethics and philosophy. What makes us human? Are we still human when every last memory is gone? When we can no longer shed a tear? Mason makes the case that while “their brains have undergone irrevocable change, their humanity abides.”
December 29, 2020
A great read for those who are interested in brain injury. I am the caretaker to my husband who is a high functioning brain injury survivor. We are 11 years post injury. I’m glad I read this book. It was an insightful, interesting and informative read.
April 5, 2019
I don't usually read non-fiction, but I enjoyed reading the different case studies presented in the book.
July 12, 2018
I throughly enjoyed this book! Each chapter is someone’s emotional, and often heartbreaking story. I had no idea the extent of struggles those with brain injuries endure; very eye opening. Mason does an incredible job of portraying the reality of brain injury case management, I commend him for the work he does.
December 8, 2010
This was a quick read; Mason's tone was different than that of most non-fiction authors. I like to read the first few pages of a book before checking out the author's picture on the inside back flap; it's interesting to see how they compare to a quick mental picture that's created in the first few pages. With this book, I could tell right away the author was younger; not from any context clues, but just from his style. Which is intereting, since he comes across as almost weary; his work as a brain injury case manager - finding help for those afflicted with a TBI, Traumatic Brain Injury - seems to have nearly burned him out at times. Not that I can blame him; Mason paints a heart-rending and indignation-stirring book with his various tales of patients he's encountered.
While the stories blurred together for me by the end, I was left with Mason's intended message - something has to be done to help those with TBI. Our healthcare system has no avenues for these people; there are very few healthcare centers that can focus on TBIs and their resulting hell and they're perpetually full. And as a result, they are shuffled around the mental health system, from nursing homes to psychiatric wards. The thought of losing one's mental capacity - being able to read and understand a short story, knowing your history, your friends, and family - the thought of all that just disappearing is utterly terrifying. Adding to the fear is the inadequacy of the medial systems available and so much that is still unknown about the human brain. How can someone who is in a terrible auto accident walk away unharmed but someone who slips on some ice has their memory erased? The strain it puts on family is heartbreaking; becoming a full-time caretaker to someone who doesn't remember you and is prone to angry outbursts - there are just no words to describe.
One thing that really amazed me was the discussion of war injuries soldiers are sutaining in Iraq. As Mason so succintly puts it, "you can survive more than you care to know". If you were to get a brain injury in the US, you have a 71% chance of being alive 1 month after your ER visit. If you find yourself in Iraq however, specifically at Balad Hospital, your chances soar to 98% - the highest rate of survival for any trauma hospital in history.
This is an eye-opening read.
While the stories blurred together for me by the end, I was left with Mason's intended message - something has to be done to help those with TBI. Our healthcare system has no avenues for these people; there are very few healthcare centers that can focus on TBIs and their resulting hell and they're perpetually full. And as a result, they are shuffled around the mental health system, from nursing homes to psychiatric wards. The thought of losing one's mental capacity - being able to read and understand a short story, knowing your history, your friends, and family - the thought of all that just disappearing is utterly terrifying. Adding to the fear is the inadequacy of the medial systems available and so much that is still unknown about the human brain. How can someone who is in a terrible auto accident walk away unharmed but someone who slips on some ice has their memory erased? The strain it puts on family is heartbreaking; becoming a full-time caretaker to someone who doesn't remember you and is prone to angry outbursts - there are just no words to describe.
One thing that really amazed me was the discussion of war injuries soldiers are sutaining in Iraq. As Mason so succintly puts it, "you can survive more than you care to know". If you were to get a brain injury in the US, you have a 71% chance of being alive 1 month after your ER visit. If you find yourself in Iraq however, specifically at Balad Hospital, your chances soar to 98% - the highest rate of survival for any trauma hospital in history.
This is an eye-opening read.
June 19, 2008
The first thing I'll say about this book is that I expected it to be a good deal more clinical than it is, which for a lay reader like myself turned out to be an excellent thing.
Mason brings his cases to life for the reader with compassion and skill. I noticed another review that criticized the way in which the stories seemed to end abruptly, which I just don't understand. Human stories, epic, tragic, triumphant and ordinary, don't typically wrap up neatly. The fact that they don't conclude neatly serves to emphasize that the struggle these patients and families are dealing with isn't something to be easily solved, even should they manage to get the treatment they need.
It's chilling to consider the ways in which the health care system is failing many if not most of these patients; it's also terrifying to realize how vulnerable any of us might be to an injury that could alter the things we think of as being fundamental to our nature.
My brother is starting a residency in neurosurgery. We had a conversation last year in which he bemoaned his natural empathy, wanting to suppress or eliminate it in order to be a better surgeon. While I found it ridiculous at the time, part of me now understands how allowing yourself to fully feel the weight of responsibility for each patient might cripple a doctor attempting to make the right decisions.
I'm still going to ask him to read this book.
Mason brings his cases to life for the reader with compassion and skill. I noticed another review that criticized the way in which the stories seemed to end abruptly, which I just don't understand. Human stories, epic, tragic, triumphant and ordinary, don't typically wrap up neatly. The fact that they don't conclude neatly serves to emphasize that the struggle these patients and families are dealing with isn't something to be easily solved, even should they manage to get the treatment they need.
It's chilling to consider the ways in which the health care system is failing many if not most of these patients; it's also terrifying to realize how vulnerable any of us might be to an injury that could alter the things we think of as being fundamental to our nature.
My brother is starting a residency in neurosurgery. We had a conversation last year in which he bemoaned his natural empathy, wanting to suppress or eliminate it in order to be a better surgeon. While I found it ridiculous at the time, part of me now understands how allowing yourself to fully feel the weight of responsibility for each patient might cripple a doctor attempting to make the right decisions.
I'm still going to ask him to read this book.
June 27, 2016
This is a sympathetic set of narratives about people with traumatic brain injury (TBI). It's a little bit like Oliver Sacks's books, except he dealt with brain anomalies often diagnosed by peculiar mental states, beliefs, or behaviors. This book deals with the most unfortunate kinds of victims of any brain disorder, TBI, and how they are often overlooked by hospitals and clinics and abandoned by their insurers. The author is a victim of TBI himself, and his job is to assess cases of head trauma to see if he can find a place of healing for them. It's both fascinating and sad.
He holds out some hope for the improvement of treatment of TBI sufferers, but says that funding is low. He is cheered by the successful recoveries of the TBI patients he was able to get treatment for. The writer is a very compassionate man.
He holds out some hope for the improvement of treatment of TBI sufferers, but says that funding is low. He is cheered by the successful recoveries of the TBI patients he was able to get treatment for. The writer is a very compassionate man.
March 18, 2015
[3.5 stars]
"Head Cases" was much less clinical than I expected. The book is a collection of anecdotes/case histories that help to humanize traumatic brain injuries for the reader. They're very well-written and interesting, but I've found it's better not to dwell on the possibility of someone I love suffering such an injury because there is so much due to chance -- a brain in the wrong place at the wrong time.
It's not an uplifting or optimistic book. The author points out many of the hardships that TBI patients endure, both as a direct result of their injuries and due to a lack of specialized services. It's tragic in so many ways.
"Head Cases" was much less clinical than I expected. The book is a collection of anecdotes/case histories that help to humanize traumatic brain injuries for the reader. They're very well-written and interesting, but I've found it's better not to dwell on the possibility of someone I love suffering such an injury because there is so much due to chance -- a brain in the wrong place at the wrong time.
It's not an uplifting or optimistic book. The author points out many of the hardships that TBI patients endure, both as a direct result of their injuries and due to a lack of specialized services. It's tragic in so many ways.
May 16, 2009
This book gives back to a charity. It is difficult to understand a person with a brain injury and what life is like afterwards, and it is hard to put it into the words as easily as it is for this author. As a TBI patient, I was grateful for this book, and could relate. I highly recommed it for anyone who knows someone with a TBI.
September 13, 2013
A case manager for the brain injured shares his tough cases in this book. The main thing: we do not do enough for the survivors of brain injury. It's expensive, demanding, and challenging. Meanwhile, these people are living in a health care purgatory of sorts. Terribly sad.
June 22, 2024
This brain injury anthology poignantly navigates individual profiles, factual analysis of symptoms, and available rehabilitation.
July 3, 2025
I thought I could hit two birds (overcome my reading slump and my hypochondria) with one stone (this book), but unfortunately not. But noooo. Instead, I read some relatively interesting stories peppered with some really ignorant comments and unsubstantiated claims about doctors/scientists/medicine (he is a social worker!). This is like if I, an astronomer, wrote a book about my case studies on aerospace engineers (uncomfortable social interactions with men in college), and then threw in some shit like "the rocket science industry says the carnot engine can't be made in real life...but they sure enjoy the profits made from less efficient energy conversion processes".
Because I love a good list:
1. Of one patient who is "a gyroscope of motion" (not even going to address this rn), he says "An American doctor would be eager to diagnose her with ADHD, but I remind myself that the Dalai Lama has a face that cascades with emotion, too, and no one's writing him Ritalin prescriptions" (102). So actually, nothing about that makes any sense. TBI is literally one of the differential diagnoses that has to be ruled out in an ADHD evaluation. That is one of the reasons a PYSCHOLOGIST (PsyD or PhD, NOT an MD) does neuropsych testing as part of said evaluation. And then on top of that, being squirmy will not get you an ADHD diagnosis. You have to be squirmy AND failing to function in every day life due to symptoms, like me (sorry folks! You can't hate from outside the club). And then your PSYCHIATRIST (an MD) can prescribe you Ritalin.
2. There's one anecdote where a kid has very obvious brain damage from biking into a wall, but her parents sign her out of the hospital AMA because they don't trust doctors, and he says "before we presume [her] emergency care was the result of bad advice and subsequent effects of a dilapidated triage system..." (104). Sir her parents refused the recommended treatment and signed an AMA, I presumed that's why she was "not properly treated" tf
3. In one story, a kid stays in the hospital for 40 months in 1981 after his TBI, and he discusses how now the average hospital stay is 30 days, blaming this on the corporatization of healthcare. Certainly, profit-driven healthcare is a factor, but this seems overly simplistic. How has the treatment and understanding of this type of injury changed since then? Has the decline of the single-income family limited how many TBI survivors can take 40 months off work to recover?
4. The random digs at SSRIs/RFK-esque "we don't even know if serotonin shortages cause depression" nonsense. It's giving the dad at AstroNight who told me "scientists don't really think dark energy is real" (brooo take a basic cosmology class I beg you, we named it that so the DOE would give us more funding). Also, I think the more interesting question about SSRIs from an ignorant layman (like me) is why tf more serotonin in your brain makes it forget how to nut.
5. The obsessive-compulsive woman can't have OCD because "her meticulous ways may actually support a sense of comfort" (61). Correct me if I'm wrong, but isn't that...the purpose of compulsions?? If you wash your hair seven times every day, it comforts you to know you're saving the lives of your loved ones?? Oh wait, by obessive-compulsive he meant her "linens are folded and stacked" and her "clothes all hang in the same direction". Only a straight man would think that is neurotic behavior lmao
6. When discussing why crashing a racecar is safer than crashing a personal car (side note - why is this even relevant? DUH you need to up your safety game when your car is going to be likely to driven into other cars at 200mph) - "the five-point harness is regarded as a far safer seat belt, but it's also more restrictive, with burgeoning body sizes becoming an issue" (54). You're right, the five-point harness is completely unsuitable for someone with a rack of my caliber, guess I'll just have to DIE the next time I get hit by a train
Lastly, this man has lost his metaphor privileges after choosing to write and publish shit like "[The brain's] texture evokes funnel cake" (68). You can either have awkward sentence structures OR awkward metaphors, not both!!
Because I love a good list:
1. Of one patient who is "a gyroscope of motion" (not even going to address this rn), he says "An American doctor would be eager to diagnose her with ADHD, but I remind myself that the Dalai Lama has a face that cascades with emotion, too, and no one's writing him Ritalin prescriptions" (102). So actually, nothing about that makes any sense. TBI is literally one of the differential diagnoses that has to be ruled out in an ADHD evaluation. That is one of the reasons a PYSCHOLOGIST (PsyD or PhD, NOT an MD) does neuropsych testing as part of said evaluation. And then on top of that, being squirmy will not get you an ADHD diagnosis. You have to be squirmy AND failing to function in every day life due to symptoms, like me (sorry folks! You can't hate from outside the club). And then your PSYCHIATRIST (an MD) can prescribe you Ritalin.
2. There's one anecdote where a kid has very obvious brain damage from biking into a wall, but her parents sign her out of the hospital AMA because they don't trust doctors, and he says "before we presume [her] emergency care was the result of bad advice and subsequent effects of a dilapidated triage system..." (104). Sir her parents refused the recommended treatment and signed an AMA, I presumed that's why she was "not properly treated" tf
3. In one story, a kid stays in the hospital for 40 months in 1981 after his TBI, and he discusses how now the average hospital stay is 30 days, blaming this on the corporatization of healthcare. Certainly, profit-driven healthcare is a factor, but this seems overly simplistic. How has the treatment and understanding of this type of injury changed since then? Has the decline of the single-income family limited how many TBI survivors can take 40 months off work to recover?
4. The random digs at SSRIs/RFK-esque "we don't even know if serotonin shortages cause depression" nonsense. It's giving the dad at AstroNight who told me "scientists don't really think dark energy is real" (brooo take a basic cosmology class I beg you, we named it that so the DOE would give us more funding). Also, I think the more interesting question about SSRIs from an ignorant layman (like me) is why tf more serotonin in your brain makes it forget how to nut.
5. The obsessive-compulsive woman can't have OCD because "her meticulous ways may actually support a sense of comfort" (61). Correct me if I'm wrong, but isn't that...the purpose of compulsions?? If you wash your hair seven times every day, it comforts you to know you're saving the lives of your loved ones?? Oh wait, by obessive-compulsive he meant her "linens are folded and stacked" and her "clothes all hang in the same direction". Only a straight man would think that is neurotic behavior lmao
6. When discussing why crashing a racecar is safer than crashing a personal car (side note - why is this even relevant? DUH you need to up your safety game when your car is going to be likely to driven into other cars at 200mph) - "the five-point harness is regarded as a far safer seat belt, but it's also more restrictive, with burgeoning body sizes becoming an issue" (54). You're right, the five-point harness is completely unsuitable for someone with a rack of my caliber, guess I'll just have to DIE the next time I get hit by a train
Lastly, this man has lost his metaphor privileges after choosing to write and publish shit like "[The brain's] texture evokes funnel cake" (68). You can either have awkward sentence structures OR awkward metaphors, not both!!
April 13, 2018
This was a very interesting book. Michael Mason is a Brain Injury Case Manager, which I learned is basically a patient advocate for people seeking rehabilitate care after their injuries, but actually its more like a patient advocate for people who have slipped through the cracks of our current health care system because as a nation we are ill-equipped to handle brain injury.
It is really sad to learn that people suffering from brain injury are volleyed from psych wards to nursing homes, never really getting the intensive cognitive, behavioral and rehabilitative therapy necessary not to get better, because one does not get better from a brain injury but learn to cope and learn how to live with what their life entails now. My experiences this year has got me thinking a lot about brain injury. I spent some time in the summer performing eye exams at VA in TBI Clinic/Polytrauma Clinic on vets from Afganistan. The way warfare is carried out with extensive use of IEDs coupled with our advancement in emergency medicine has led to the fact that people don't die in war anymore, but they do come home with injuries that are not seen by the naked eye, something even harder than losing a limb is trying to explain why you look normal but can't handle the fluorescent lights in a grocery store, or why crossing a street is next to impossible because the cars seems to appear and disappear out of nowhere.
Soapbox alert: so much of vision requires a brain that has not been jostled around in your head shearing the axonal connections you've developed over your lifetime. Your brainstem controls your eyemovements and if the pathway from brainstem to cranial nerves is affected, or even some of the axons linking the system are compromised you can find yourself unable to move your two eyes as one. This is something you can re-learn, but in the way you can you can relearn how to walk after a really bad car accident, it takes a lot of effort, repetition and time and you aren't running a marathon after.
Thats just the nuts and bolts of moving your eyes to take in information, interpreting that information is another difficulty. There are two diffuse pathways in your brain that process visual information, one for motion (where) information and another for visual recognition (what) information. Either pathway can fall victim to a traumatic brain injury, changing the way and speed at which you perceive your visual world.
Brain injuries, particularly traumatic or concussive, can affect a whole host of systems, vision just being one part. I know so much now since I've been spending time in the Head Trauma Clinic within my Optometry School in the past few months, it is scary thinking about how one day something happens and from there on out your entire life and life of those who love you are completely different forever, and not for the better.
Anyways, this review got away from me. Interesting "case studies" the author isn't a doctor so its not really so much a pop-science book, but more of a humanities kind of deal. He donated some of the profits to the TBI Association of America though, so he seems to be a pretty ok guy.
It is really sad to learn that people suffering from brain injury are volleyed from psych wards to nursing homes, never really getting the intensive cognitive, behavioral and rehabilitative therapy necessary not to get better, because one does not get better from a brain injury but learn to cope and learn how to live with what their life entails now. My experiences this year has got me thinking a lot about brain injury. I spent some time in the summer performing eye exams at VA in TBI Clinic/Polytrauma Clinic on vets from Afganistan. The way warfare is carried out with extensive use of IEDs coupled with our advancement in emergency medicine has led to the fact that people don't die in war anymore, but they do come home with injuries that are not seen by the naked eye, something even harder than losing a limb is trying to explain why you look normal but can't handle the fluorescent lights in a grocery store, or why crossing a street is next to impossible because the cars seems to appear and disappear out of nowhere.
Soapbox alert: so much of vision requires a brain that has not been jostled around in your head shearing the axonal connections you've developed over your lifetime. Your brainstem controls your eyemovements and if the pathway from brainstem to cranial nerves is affected, or even some of the axons linking the system are compromised you can find yourself unable to move your two eyes as one. This is something you can re-learn, but in the way you can you can relearn how to walk after a really bad car accident, it takes a lot of effort, repetition and time and you aren't running a marathon after.
Thats just the nuts and bolts of moving your eyes to take in information, interpreting that information is another difficulty. There are two diffuse pathways in your brain that process visual information, one for motion (where) information and another for visual recognition (what) information. Either pathway can fall victim to a traumatic brain injury, changing the way and speed at which you perceive your visual world.
Brain injuries, particularly traumatic or concussive, can affect a whole host of systems, vision just being one part. I know so much now since I've been spending time in the Head Trauma Clinic within my Optometry School in the past few months, it is scary thinking about how one day something happens and from there on out your entire life and life of those who love you are completely different forever, and not for the better.
Anyways, this review got away from me. Interesting "case studies" the author isn't a doctor so its not really so much a pop-science book, but more of a humanities kind of deal. He donated some of the profits to the TBI Association of America though, so he seems to be a pretty ok guy.
March 5, 2019
I don't know what to say after finishing this book.
A collection of accounts of the people he met, Michael tells us about his job as a TBI (traumatic brain injury) case manager. It's so heartbreaking, hearing how the injury affects each of their lives and families. What is even more horrifying is the almost negligent funding of healthcare catered to TBI. It's almost nothing. It's pathetic. It's so tragic. But from it arises people, laymen, who were forced to arise from their trgedies and establish foundations so much more successful than the qualified, professional people who AREN"T DOING THEIR JOBS.
A lot of times the things they went through, the environment and downright unjust situation they were in I found my face frozen in perpetual shape of horror and disgust, my eyebrows scrunched up, tense, as if a reflex to minimise the blow of heartache, lips parted and corners pulled down, mirroring what i was reading. It's terrible. It's so so terrible.
And it's even more terrible to know that as if their chronic injuries aren't Sisyphus' boulder already, it bloody well screams how incompetent and how little shits the government/healthcare system gives about TBI.
I am so horrified at the suffering of each person he mentions, particularly Jessimin. And Cheyenne.
The fact that they are thrown into mental institutions. Their behaviours labelled as a mental illness. It enrages me. It. enrages. me.
It's to terrifying that the brain is so fragile, Michael states that since the brain contains billions upon billions of synapses and cells, each injury is never the same and derives to a unique cocktail each time, so to speak.
It scares me so much that "I" is my brain, this brain that really seems to be just a puppet, a lump of clay for the world, in which they find joy in deforming in mockery at humans and their important selfish upright sense of importance and individuality.
A collection of accounts of the people he met, Michael tells us about his job as a TBI (traumatic brain injury) case manager. It's so heartbreaking, hearing how the injury affects each of their lives and families. What is even more horrifying is the almost negligent funding of healthcare catered to TBI. It's almost nothing. It's pathetic. It's so tragic. But from it arises people, laymen, who were forced to arise from their trgedies and establish foundations so much more successful than the qualified, professional people who AREN"T DOING THEIR JOBS.
A lot of times the things they went through, the environment and downright unjust situation they were in I found my face frozen in perpetual shape of horror and disgust, my eyebrows scrunched up, tense, as if a reflex to minimise the blow of heartache, lips parted and corners pulled down, mirroring what i was reading. It's terrible. It's so so terrible.
And it's even more terrible to know that as if their chronic injuries aren't Sisyphus' boulder already, it bloody well screams how incompetent and how little shits the government/healthcare system gives about TBI.
I am so horrified at the suffering of each person he mentions, particularly Jessimin. And Cheyenne.
The fact that they are thrown into mental institutions. Their behaviours labelled as a mental illness. It enrages me. It. enrages. me.
It's to terrifying that the brain is so fragile, Michael states that since the brain contains billions upon billions of synapses and cells, each injury is never the same and derives to a unique cocktail each time, so to speak.
It scares me so much that "I" is my brain, this brain that really seems to be just a puppet, a lump of clay for the world, in which they find joy in deforming in mockery at humans and their important selfish upright sense of importance and individuality.
June 30, 2019
The writing was okay and the information interesting. But, the patients themselves are rarely heard and mostly talked about. Some are in such bad shape that they can’t speak for themselves but many can, but the writer included very little from their perspective. The perspective of the writer and the caregivers was given much more space. This has the, perhaps unintentional, effect of leaving out the humanity of the patients. Because of this, I was very disappointed with this book.
Sometimes the writer took opportunities to talk about himself that just didn’t fit with the stories of the patients. The sweat lodge scenes didn’t elucidate the experience of Pony Soldier, and it took away from that man’s story. Honestly, a lot of the times the author wrote about himself felt like a whoa is me kind of thing. And the tone with which he talked about the soldiers in Balad felt out of place, like he was playing at being an intrepid war reporter. And the way he described the one female soldier and sexist and lazy.
Now that I write all this down, I kind of hate this book.
Sometimes the writer took opportunities to talk about himself that just didn’t fit with the stories of the patients. The sweat lodge scenes didn’t elucidate the experience of Pony Soldier, and it took away from that man’s story. Honestly, a lot of the times the author wrote about himself felt like a whoa is me kind of thing. And the tone with which he talked about the soldiers in Balad felt out of place, like he was playing at being an intrepid war reporter. And the way he described the one female soldier and sexist and lazy.
Now that I write all this down, I kind of hate this book.
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