WASHINGTON – Bob remembers the Chevrolet Silverado pickup truck that caused the crash in August 2006. He remembers his car rolling three times.
A year and half earlier,Justin,a Marine lance corporal,survived an explosives attack in Iraq's Anbar Province. His cargo pockets,filled with his own video equipment,saved his left leg from amputation but couldn't protect the rest of his body from shrapnel.
Bob and Justin's physical injuries often hide the psychological struggles they go through every day. Their mental health problems have led to their enrollment in a pilot program aimed at helping those with traumatic brain injury called the Hope Project.
They share two hours every Monday through Thursday morning with eight other men,half military veterans and half civilian,listening to each other's experiences with traumatic brain injury.
The Hope Project is the first to combine people with military and civilian injuries and the first to set up on a college campus,where those recovering from traumatic brain injuries are treated as students,rather than patients.
A reporter was allowed to join the Hope students for one class on the proviso that only students' first names be used and no photos be taken.
Three months after his accident,Bob,58,of Baltimore,couldn't remember where he had been the day before. He wasn't diagnosed with traumatic brain injury until he called his doctor to apologize for missing an appointment he hadn't missed. He lost some fingers and can raise his left arm only halfway.
Justin,24,of Centreville,Va.,was diagnosed with traumatic brain injury after the explosives sent him into a four-day coma. His physical injuries attest to the severity of the bomb; 986 staples were used to piece his head together,his left leg is shattered and his left side is paralyzed. He walks with a cane.
The Hope Project encourages students to help each other increase their self-sufficiency and independence,a new approach to helping people cope with traumatic brain injury. By calling participants students,the project takes the emphasis off of healing and onto learning.
And that's also why the program is at Virginia Polytechnic Institute and State University's Northern Virginia Center,said Hope Project Director Dr. Marianne Talbot. Funding for the $245,000 program comes from state government,rehabilitation groups and memorial funds,but Virginia Tech is the biggest donor.
“The theory was that most individuals are in rehab facilities in places where people are sick,” Talbot said. “But patients aren't physically sick at this point; they're just trying to learn more about how to learn.”
Talbot relies on the group's discussions to help students readjust to society.
“As a whole … we can help each other out,” Talbot said. “It's developing insight with individuals through a group process.”
Terry,55,of Fairfax,Va.,has Wernicke-Korsakoff Syndrome caused by alcoholism that has resulted in short-term memory loss,a common symptom of traumatic brain injury.
“Group participation is probably the biggest thing,” he said. “Everybody in the same situation does something differently that I haven't tried myself or wouldn't think of doing.”
One student,Steve,43,of Arlington,Va.,who was in a head-on collision in 1991,had trouble sleeping at night. The other students suggested he drink less coffee.
Steve,who said it helped him,was more willing to listen to his classmates than Talbot and other staff members.
In addition to group discussions,the nine-month project includes book reports and outings. In December,the Hope students will speak about their experiences to occupational therapy students at Shenandoah University in Winchester,Va.
Because the project has just begun,most students couldn't say if it is helping. Bob likes it,especially the book the class is reading together,”Who Moved my Cheese?” by Dr. Spencer Johnson. The book features mice in a maze as a parable for finding success in life amid unexpected change.
“I think I'm getting something out of this program,” Bob said. “The book is challenging my mind. These are things at home that I wouldn't be doing.”
But Justin wasn't so enthusiastic,calling the book stupid,cursing often and finding it more interesting to turn his Coke bottle upside down than to listen to staff members.
“This program includes nothing that I haven't been told 100 times before,” Justin said.
Despite Justin's occasional negativity,the group had an open atmosphere in which everyone seemed comfortable talking about just about anything,and the atmosphere was sometimes jovial.
The class laughed about a recent outing to a grocery store,where they were given $20 to buy lunch for the group. Steve wanted brie they couldn't afford. Justin joked that the lunch “sucked” without it. Bob said they made the $20 limit only because Terry brought tiny condiment packages from fast food restaurants.
Life skills therapist Charlene Kelly said the atmosphere has changed. At first,students were scared or aggressive in social situations. Others cursed all the time.
“It was a challenging setting to start educating in,but that's changed,” Kelly said. “People are being respectful of others and are socially integrating,and that is our goal.”
Because the program combines those with civilian and military backgrounds,students learn quickly about proper social behavior,Talbot said.
“Those who have been injured in the military are grouped together during rehab,so they have a very narrow view that you get a brain injury only because of war,” Talbot said.
Twenty-two percent of wounded American soldiers from Iraq and Afghanistan have traumatic brain injury,a total of 5,940. Yet,no programs for reintegration into family and community life are available through the departments of Veterans Affairs or Defense.
In 1999,5.3 million Americans were living with traumatic brain injuries. In 2004 alone,1.4 million Americans sustained a traumatic brain injury.
Whatever their backgrounds,Hope students understand each other's struggles,both the physical and cognitive – to perform everyday activities that before required no effort – and,perhaps more important,the psychological.
So far,their injuries have prevented any of them from working,though one is job-hunting.
“I wasn't supposed to live through my accident,” said Bob,an engineer whose employer has paid for his rehab. “Sometimes I wish I hadn't.”
He said he knows he won't be able to return to his former job.
Steve had to quit law school at Pepperdine University after his crash and has felt apathetic since.
“I've lost that motivation,that drive to do things,” Steve said. “I figure,I'm getting old and it doesn't matter anymore.”
The students don't talk much about the past.
“We might as well forget about it because it's not who we are now,” Bob said. “Justin still talks all that military talk,but that's not what he's going to be anymore. We're trying to challenge ourselves to change.”
Talbot said she thinks students have been making changes.
“All we can do is help them understand who they are,” Talbot said. “The remarkable part has been so far that the light bulb is going on.”