Immeasurably lucky

Tonight, everyone will cheer the arrival of 2011. I'll be toasting a little Thanksgiving.

Mostly, I'm thankful to see this new year, to watch as 2010 well and surely ends.

Back in July, as some of you know, I took a header off a skateboard speeding down a long hill. I landed headfirst, broke some bones, tore up some skin.

I thought I'd had a concussion. Only recently did I find the courage and the clarity to ask the doctor. My injury was something worse, he said, something called a "traumatic brain injury."

That's probably more than you want to know, or than I want to share, but I hope it'll explain my reaction to Elizabeth Simpson's story in The Pilot this month about what happens to some people who damage their brains.

She quoted from a 2007 report from the Virginia Brain Injury Council: "There is virtually no system of care for individuals with behavior problems resulting from a head injury who cannot afford private care. As a result, such individuals may be placed in a nursing home or incarcerated in a local jail or state prison, where the person is unlikely to receive needed services."

It goes without saying that for much of six months, that was my greatest fear: That somehow, on the other end of recovery, I'd be somebody else. Somebody who'd need help I couldn't afford or find.

Simpson recounted the stories of men whose brains were damaged in car wrecks and other accidents. The physical damage was terrible. So was the financial devastation.

As I've said more times than I can count, I was lucky. My fog began clearing quickly, on its own.

Others with more severe injuries aren't so fortunate. Their fog may be permanent. They may have knocked out a part of the brain that controls impulses, or anger, or fear or any number of other things.

"An estimated 250,000 adults in Virginia have brain injuries," Simpson wrote. "Many families exhaust their income trying to care for them, forcing the victims onto Medicaid, the state-federal insurance for low-income and disabled Virginians."

In the weeks immediately after the accident, I asked questions: What happens if I can't work? What happens to the people who depend on me?

At the same time, I depended on everyone for everything. I couldn't drive myself, couldn't walk straight, couldn't think straight.

I got better. The injuries healed. I went back to work and resumed life.

But what if they hadn't healed? What if I'd been permanently hurt? What if I didn't have family and friends and coworkers to cover for me and care for me? What, more importantly, if you didn't?

Lost in 2010's lamentations about America's financial condition, buried beneath the demagoguery about people not deserving food stamps, or rent help, or unemployment payments or health care, remains a simple and devastating question: What happens if you and your family need those things?

Bootstrappy independence is what America is built on. But what happens if you can't reach your bootstraps? What happens, for example, if your brain is so broken you don't know what to do with them?

Some rely on charity. Perhaps you and I could. That's because we're lucky and immeasurably so. Not everyone is. Sometimes, simply, there is no charity. Especially in perilous, parsimonious times like these, when there is more suffering than we can ameliorate. When politicians and pundits demonize the poor for being poor, the unemployed for not finding work, the safety net because the people it saves can't make political contributions or won't vote or don't pay taxes.

Last month, I went for a final follow-up with the neurologist. It was the one where I asked him what had really happened and he told me.

So how will I know I'm better, I asked.

You can tell you're better because you'll think you're better, he said.

I think I'm better. I know I'll be better when 2010 is over. And I'm thankful.

Donald Luzzatto is The Pilot's editorial page editor. E-mail: donald.luzzatto@pilotonline.com.