Laura M. Transcript

Hi, I am Laura Morgan. I’m a brain injury survivor and now a brain injury specialist.

I graduated with my master’s in speech pathology and a concentration in oral rehabilitation in the spring of 2012. I was very busy with my clinical fellowship in speech pathology and training for running races, and music activities, and activities through my church, when I was a buckled passenger in a serious motor vehicle accident. 

I was sitting in the back of the van with my seatbelt on when the van drifted off the side of the road. And normally you’d hit the rumble strips on the side of the highway and that would work to startle the driver awake, but parked right there was an 18-wheeler semi truck—so that’s what we hit.

Long story short, at that exact moment there were, driving in the opposite direction, two nurses—one who was an emergency room nurse. They pulled over and ran across the median. They were the first responders and they knew what to do, what not to do. They called 911 and they held my head in the medial position so I could breathe.

I was stabilized at a nearby emergency room and then held back to a larger hospital that was equipped to handle my serious injuries. My injuries were a moderate-severe diffuse axonal traumatic brain injury, as well as some broken bones, including my jaw, spinal vertebrae C1 and C2, which are the two highest in your vertebral column.

Then I spent 72 days in inpatient, which I don’t have any memory of. Then I was discharged home in a wheelchair and I started several years where my job was completing intensive rehabilitation.

Thank God, I did recover very well. I still had to complete tons of therapy, and I dealt with the normal consequences of brain injury, which include severe headaches—migraine-like headaches—as well as the cognitive deficits, such as short-term memory loss. That was probably the most major, significant injury—cognitive deficit.

Through my recovery, I became passionate about the role of compensatory strategies in cognitive rehabilitation. During that time, I became specialized in brain injury.

So cognitive rehabilitation can be broken down into therapeutic or compensatory methods. Therapeutic can be compared to physical therapy, where you are rebuilding a skill back to the prior level. Compensatory is making up for a deficit—so it’s using the tricks and strategies to bypass a difficulty.

In my own recovery process, I became interested—it could be argued, obsessed—with compensatory strategies because I experienced how frustrating therapy was when I felt like I was making all the wisest, best decisions I could, but I still had these challenge areas—deficits.

So I became really interested in the role of compensatory strategies, given that your patient is already doing whatever they can to be wise and proactive in their recovery. Compensatory strategies are the tricks that can help fill in the gaps.

For example, I take a picture every time I park. That’s a compensatory strategy. So after I am returning to my car, I can just look at the picture and know where to go.

I earned my Certified Brain Injury Specialist license. And I also—because I hadn’t finished my clinical fellowship within the two-year timeline—I had to redo my whole fellowship and retake and pass the big exam. I did pass those, and now I work with a lot of brain injury survivors—some traumatic brain injuries, some non-traumatic but acquired brain injuries.

And through my fascination with brain injury and the symptoms, I have learned a lot about concussions—which often concussions don’t get the recognition they deserve. They are also mild traumatic brain injuries. And with that sobering diagnostic title, I think comes the recognition of what strategies can be available and the therapy that may benefit survivors of mild traumatic brain injuries/concussions.

As far as the recovery of mild traumatic brain injury and use of compensatory strategies for concussion patients, I’ve become—some could argue—obsessed with what are called metacognitive strategy instruction, which are helpful acronyms that can be learned and applied to everyday situations.

Some examples are: for forming goals and completing/achieving goals, there’s the Goal-Plan-Do-Review sequence. For reading comprehension, there’s one that’s P-Q-R-S-T, which is Preview, Question, Read or Review the content, State the answers, and then Test yourself.

I have seen great benefits from concussion and mild traumatic brain injury survivors in learning these metacognitive strategies and applying them to everyday problems to solve.

I am passionate about the role of hope in cognitive rehabilitation, whether that be from a concussion or a moderate-severe or severe brain injury.

I think that as medical professionals or care partners, we should cultivate, encourage, provide hope for these clients—these survivors—if at all possible. And that doesn’t mean that promises need to be made. I know as professionals, we may shy away from wanting to provide false hope or get someone’s expectations up, but you can still encourage the survivor in the hope of returning to a meaningful life.

It may look a little bit different than it did previously, but it may be wonderful and beautiful in its own way. And I think my story is a good example of that.

The recovery is ongoing, and I don’t shy away from that fact—that brain injury survivors’ life may be slightly different from here out. It might be. But you can learn strategies that will help you overcome the cognitive challenges so that you’re performing at an equal or better rate/accuracy level than your peers.

I use the example frequently with my clients of parking.

The first time I went out after my recovery—once I was able to drive again and was able to go out—I met some friends in downtown Bethesda, Maryland, for dinner. I parked my car in the garage and went and had a great time at dinner. Afterwards, I returned to where I was sure I had parked, and my car wasn’t there.

And I got the kind parking lot attendant involved in the shocking theft, and he was starting to talk about reviewing the videotapes.

And long story short—my car was parked, waiting patiently for me in the garage next door.

And from that point on, I learned that, okay, now I need to use the strategy of every single time I park—anywhere that’s not right outside my house or work—I take a picture of a landmark and/or I write it down.

And at first, the necessity for doing those things was humbling to me. And I was kind of frustrated—“Oh, I didn’t have to do that before.”

But now I’ve come to a place of acceptance where, okay, so I have to write down where I park. But I’m prepared for the future—when maybe my peers are not in the habit of doing that and they’re shocked when they can’t find their car—but I have this strategy already in place.

So I like to use that as an example for my clients. I don’t belittle the grief that you may experience in accepting that life is different now, but I also like to empower survivors with the knowledge that, okay, maybe you have to incorporate some strategies you didn’t use before—but this is setting you up for success in the future.

I think that—I’ll be honest—brain injury recovery is really hard. And I don’t know how people do it when they don’t have this source of stability and hope that’s outside of circumstances.

So as much as I loved—I was a runner, rock climber, speech pathologist, cellist, banjo player before—yes, I’m back to work as a speech pathologist. But I can’t play because of my left hand being damaged. I have not been able to do the musical activities that I loved so much.

I think that my spiritual beliefs as a Christian—having that source of hope outside of circumstances—was invaluable.