Head Cases: Stories of Brain Injury and Its Aftermath

Author Mason, Michael Paul
ISBN 978-0-374-53195-9
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Review

When I picked up Head Cases, I was expecting a book on the science of brain injury: The terrible but fascinating aphasias resulting from damage to Broca’s or Wernicke’s area, or injuries inducing conditions like prosopagnosia: Things that have helped neuroscientists understand the functioning of the brain by looking at what goes wrong when it gets damaged in specific locations. This is not the kind of book Head Cases is, or attempts to be, so my disappointment was in part because I got the wrong book. (The book I really wanted was Ramachandran’s Phantoms in the Brain, q.v..) Rather, it’s about the people who have suffered brain injuries, and the difficulties they face. There’s nothing wrong with stories about people, or raising awareness: It just wasn’t what I was looking to read.

Still, as a book about the people, how does it rate? I’m afraid I didn’t much like it, for an array of reasons. The largest and most pervasive reason was that it was just trying much, much too hard. Talking about, say, a patient whose short-term memory is so utterly destroyed that she can remember no more than a minute or so into the past, or someone who blanks out and loses large chunks of his life, should inspire sympathy if you simply tell the tale honestly: After all their conditions are genuinely tragic. Mason is not quite content, though, and makes sure to tell every story in a voice that fairly drips with sympathy. It’s too much, and ends up almost parodic.

The style also bears witness to an author with little experience, or perhaps an editor with a tin ear. Having introduced a boy with a brain injury, his brother, and his parents, Mason goes on to describe the mother,

Kathy, who in her blue jeans and comfortable sweatshirt looks like the mother of two boys.

Apart from the fact that I don’t find that particularly descriptive—what distinguishes a mother of two boys from a mother of a boy and a girl, for instance?—it seems rather inane and redundant to describe the mother of two boys as looking like a mother of two boys.

By far the most aggravating thing about the book, however, is the negative picture it paints—grotesquely and gratuitously hateful—of doctors. The author is an advocate and case manager for brain injury cases. It’s his job to help when medical providers or the medical system fails to serve brain injury patients. Of course he will be frustrated with them, and of course his job will put him in contact selectively with bad ones—brain injury patients with good doctors will have no need for people like Michael Mason. This is to his credit—I’m sure he does a great job.

But this does not mean that all doctors are monsters, and that’s the picture he paints. Doctors are people, not monsters; and their job is to help people. It is certainly true that doctors are often rushed (because of the way healthcare systems work, not their own choices), that they may be impatient and exhausted, and of course that just like members of other professions, some of them just aren’t nice people. But I find it difficult to believe Mason when his book is full of anecdotes like this one:

The neurosurgeon…told the [parents] that Rob was going to be okay, that he would recuperate well, and that the sky’s the limit for your boy. It sounded like great news to Kathy, so she probed the surgeon more.

You mean he’s not going to be a quadriplegic? she asked.

I didn’t say that. The surgeon grimaced. he closed the chart and excused himself.

I’m supposed to believe that a surgeon tells a set of parents that their child will likely become a paraplegic, then just grimaces and walks away without so much as a single word of sympathy? Or how about this: A patient is told that he has a scar on his brain and will suffer various horrible consequences. The patient, of course, buries his face in his hands and cries:

The doctor rolls his eyes and looks at Cheyenne as if he were something that had just been scraped off his shoe. He mumbles a few things about putting Cheyenne on an anticonvulsant, which may or may not help, who knows. Then the doctor shoves the films under his arm and closes the door behind him.

And I am omitting all kinds of doctors callous, dismissive, or delivering bad news while hardly glancing at the victims’ parents. Note that these horrifying stories of astonishingly poor bedside manners are not presented as at all unusual. Rather, to hear Mason, that seems to be the way doctors treat patients. I have no doubt that there are unpleasant doctors, and that Mason’s line of work puts him in touch with particularly bad ones, but this beggars belief.

I’m also tempted to point out a certain hypocrisy: He is fond of complaining how there is no room for brain injury patients anywhere, but amidst lavish words of praise for the hospital where he works admits that it only has a few dozen beds and virtually no one is admitted. Brave parents are lauded for their hard work, even when they fall terribly short: Doctors are demonised for every failure and every sign of stress. Failure to accommodate brain injury patients with institutional space is criticised—so is lack of time, energy, and resources spent on each patient, with no mention of the fact that these are conflicting requirements, and only massive increases in spending can fix it. I think those increases should be made, mind, but it all forms another part of the picture Mason paints of doctors as the enemy—rather than, say, the funding of the medical system, or the amount of time a doctor is given to work with each patient.

All that said, it’s by no means a terrible book. Mason sets out to illustrate the plight of brain injury patients, and how insufficiently they are cared for, and he does achieve these goals, even if I dislike his tone and the way he slanders doctors as a group. Brain injury patients deserve better care. I just can’t help but think that they also deserve better books to raise awareness.

Notes