Jeff was just a couple of months from completing his national service in one of the armed forces units. It was early one morning, as he was making his way back to camp on his motorbike, when a car suddenly shot out from a side-road, hitting him. He was flung 20 metres from his bike and knocked unconscious. It was a week later that he regained consciousness in an intensive ward. Despite his protective helmet, he had suffered diffuse axonal brain injury. He also broke several ribs.
The primary injuries to the brain in an accident of this nature would occur to the frontal lobe (which involves higher mental functions like the ability to recognise future consequences resulting from current actions, to choose between good and bad actions or better and best, override and suppress unacceptable social responses, and determine similarities and differences between things or events, and hold long-term memories) and temporal lobe (which involves auditory perception, and is home to the primary auditory cortex. It is also important for the processing of semantics in both speech and vision. The temporal lobe contains the hippocampus and it plays a key role in the formation of long-term memory), the corpus callosum (which involves several functions of the body, including communication between brain hemispheres, eye movement, and maintaining the balance of arousal and attention, and tactile localisation), the brain stem (which coordinates motor control signals sent from the brain to the body and life supporting autonomic functions of the peripheral nervous system, including alertness, arousal, breathing, blood pressure, digestion, heart rate, and relays information between the peripheral nerves and spinal cord to the upper parts of the brain), and the axons (they are long, slender projection of a nerve cell or neuron, which typically conducts electrical impulses away from the neuron’s cell body). Normally, 90% of casualties who had diffused axonal injuries remain in a vegetative state, with 50% who eventually die. For survivors, it is the most common cause of chronic vegetative state and severe disability until death.
Jeff was under the care of an excellent team of doctors, psychologists, and staff at the hospital. Prior to his accident, he had secured a place at the university to study life sciences on a scholarship, after his national service. Following the accident, his academic future seemed highly questionable. However, Jeff made remarkable partial recovery of his mental functions, but due to his traumatic brain injuries, his overall mental capacity remained diminished. His brain injuries became an increasing burden to him, as he developed personality changes, became anxious and depressed. His mother, Cheng, who had been Jeff’s principal caregiver after his discharge, had also slipped into depression and was referred for counselling. For caregivers in such a situation, this is not unusual, especially when a suicide watch was initiated over Jeff. His church’s care group volunteered to be with him round the clock, and even stayed over with him some nights. One afternoon, almost a year after his accident, while Cheng had gone out for a few minutes to do some marketing, Jeff leapt from his tenth-floor bedroom window. Cheng was devastated!