The Fate of the Helmet: When a Brain Injury Lasts a Lifetime

Citibike represents, in theory, a wonderful effort and one that will bring efficient means of exercise and transport to many New Yorkers. What's a shame, though, is that the bicycles come without helmets.
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Recently, the city sold part of its citizen's birthright for $41 million by granting a city-wide bike contract to an outside franchise. The initiative represents, in theory, a wonderful effort and one that will bring efficient means of exercise and transport to many New Yorkers. What's a shame, though, is that the bicycles come without helmets and that rental is not dependent on allegiance to the appropriate safety measures.

According to the Centers for Disease Control (CDC), over 1.7 million Americans suffer brain injuries every year, many caused by bicycle accidents, bringing billions in unnecessary medical bills and unquantifiable emotional pain. I am one of the victims of this oversight by our municipal governments. My mother spent 10 years of her life in a coma because she did not wear a bike helmet.

***

The tragedy came in 1957. I was four years old, riding on my father's back as we bicycled. My mom followed behind us on her own bike. We were all without helmets. We came down Pontiac Trail, just outside of Ann Arbor, Michigan, and turned right, then left, down in front of the train station. A pile of bricks jutted into the road and my father swerved suddenly to avoid them. Tragically, my mother couldn't react quickly enough. She hit the bricks, flipped over the front of the bike, and landed on her head. My father was sure she had died instantly. She was barely breathing and it was only after what felt like an eternity that an ambulance finally arrived to take her to the hospital.

We were luckier than we thought that day. At the hospital, we learned that my mother needed stitches and, over time, her scar contracted and eventually disappeared. But I think we all sensed things might be different after the accident.

She was a woman of pure genius, a gifted special education teacher who bonded particularly well with troubled students. She became well known for her work with difficult kids, first in Ann Arbor and then in the tougher Flint schools. Throughout her initial recovery, and despite our highest hopes, there were signs of brain trauma. Occasionally, she would have an emotional outburst. Before an incident, there would be physical warning signs -- a flushed face and a look of surprise. Over time, her outbursts became more frequent, sometimes lasting an hour or two. Unbeknownst to us, a massive tumor was shifting and growing, magnifying the intensity of each outburst. One day, the tumor drove her into a seizure in our living room. My brother rushed her to the hospital, where they discovered a tumor the size of a fist, right underneath the accident's point of impact on her skull. She seemed to be getting better and recovering a bit that weekend. I left for New York City and, soon after, she had a grand mal seizure. This time, she would not recover and instead slipped into a coma.

She spent the next ten years in a nursing home in Grand Blanc and never regained consciousness. Fed through a stomach tube, she managed to stay alive for 10 years. The family became expert caregivers, too familiar with the challenges of tending to those in long-term comas. Prevention of tooth decay, the preservation of bones -- there were so many health issues and points of concern. And, although we knew she was unconscious, it was hard not to imagine her experiencing this new life in a state of constant torture. My father went to see her every day for ten years and would sit in the room, reading her favorite books aloud to her. I never went into her room at the nursing home -- I found it was too painful. I went to visit and I sat outside. With bloody teeth gritting, I cried inside. Financially a serious brain injury is devastating, many times costing over three million dollars for something that can never be fully fixed.

In 1996, home for a weekend visit to Michigan, I received an unexpected phone call. It was a former student of my mother's, someone who knew her as Ms. Mason. He had written a best-selling book called No Child Left Behind. He had written a whole chapter on Ms. Mason, his teacher in 1940s Indiana. According to him, she had saved his life. When he had gone astray, she had been kind enough to help him find himself. I told him I would stay put if he could mail it immediately. Two days later, a copy of his book arrived and, this in hand, I finally entered my mother's room. Grasping her hand for the first time in 10 years, I read the chapter aloud.

I was exhausted and left immediately for the airport, flying first to Detroit and then onto Madrid, where I was meant to speak at an international conference on at-risk youth. As I was preparing to speak, I was handed the phone. "It's an emergency," my Spanish guide said. My mom had died. She had finally let go.

After receiving the news, I gave my talk and ran out and down the street in total euphoria. She was free. She would no longer suffer. I went right into a bar and ordered a bottle of champagne. The bartender asked me why I was so happy and I replied, "My mother just died!" This didn't go over too well until I explained, revealing that she had been unconscious and in a coma for 10 long years. The bartender nodded knowingly.

Three days later, at my mother's funeral, my father and I hugged. We cried, lamenting the loss of such a great human being and educator -- my mother, his wife. I said to my father: "Perhaps we should have let her die 10 years ago." And, in an honest moment of deep grief and euphoria, he responded truthfully, "I wish you had told me that 10 years ago."

***

What I have learned from this tragedy is, for one: always wear a helmet. A solution so simple, it's almost laughable! I often see people riding bikes without helmets in Manhattan. When I visited the Netherlands, I saw babies riding along by their mothers and neither with helmets. I wished I could tell them the story of my mother and that they might pause to reconsider the risk they are taking. All it takes in one misstep and the course of not only your life, but also those of all those who surround you, is radically changed.

A brain injury truly lasts a lifetime. It is passed onto the next generation. Brain injuries end lives and hurt families, and we know, as noted in a recent article from the New York Times, that too many are caused by bicycle accidents. If we are to have such easy access to bicycles in this city, it should be with the appropriate and necessary safety measures in place. With the bicycles should come helmets or, at least, the absolute requirement of responsible use. To allow for cycling without making bicycle helmets mandatory, is simply reckless; it is an act that will precipitate countless personal tragedies, not to mention significant financial burden.

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