by Nancy Bauser, MSW, ACSW

ABSTRACT: Nancy Bauser describes her experience as a brain injury survivor and her quest to recover. After surviving an automobile accident in 1971, Bauser relearned how to walk, talk and function independently. Despite her physical limitations, she completed undergraduate studies and her graduate degree in social work. Her current work includes peer counselling and conducting acceptance groups with survivors of brain injury and other traumatic disorders at outpatient treatment facilities.

KEY WORDS: surviving brain injury, head trauma, peer counselling.

On November 11th, 1971, I was a passenger in a car that was in a head-on collision in the Ann Arbor area. In that split second my career changed from one of a special education teacher to an entry level position in the field of head injury recovery.

I got an impressive set of credentials that afternoon. My right wrist was crushed, my left eye dangled from its socket, and I sustained a severe brain stem injury. Fortunately, the driver of the other car was a doctor who immediately began mouth to mouth resuscitation to restore my breathing. I was rushed to the University Hospital in Ann Arbor where I was placed on life support.

I don't remember anything from November 1971 to February of 1972. I don't recall anything of the visits from my friends or the vigil of my mother who spent her days talking and reading to my comatose form. I recall nothing of my transfer to the Rehabilitation Institute in Detroit that December.

My first recollection is waking up in my bedroom at my parents' house wondering why I wasn't at University of Michigan where I was a student. I had scars on my body and a cast on my arm. "Rehabilitation Center" and "catheter" were suddenly in my vocabulary. I was terrified of my surroundings. I was confused. There was snow on the ground and everyone was asking me how I was feeling. I had no idea why.

I continued outpatient physical, occupational, and speech therapy at the Detroit Rehabilitation for three months. I was frightened by that place, because I hadn't yet realized that I had been in a bad car accident, so I had my mother sit where I could see her at all times. The doctors and therapists had done all they could and they told my mother that she could expect to see improvement in my condition over the next five years.

My mother then took over. Guided by her own beliefs, she developed a program. She took me shopping, where I had to evaluate and make choices about clothing, which she returned afterwards. She took me swimming every day to strengthen my body and to re-establish my coordination and sense of balance.

My mother's strong achievement orientation made me achieve goals. She insisted that I try to do things for myself so I would develop some degree of self-sufficiency and confidence. If I tried and failed, then she would assist. She always believed that I could do more and I learned to believe it too!

In 1972 I was concerned with learning to walk without using furniture for support, go up and down stairs, cook my own meals and set my hair. Things that I unconsciously do today were very difficult and required deliberate efforts.

I could only do one thing at a time. I couldn't eat and carry a conversation at the same time. I used to hesitate between groups of words so often that I was told that I sounded retarded. I didn't like that at all, so I started listening to how mainstream people talked and I copied them. I also had no idea how to interact with people after my injury, so I watched how others did it wherever I went. Different people who I liked and respected became my role models. My role models changed as my needs changed. I decided to be the kind of person who got treated the way I wanted to be treated. Somehow I knew I had to treat others the way I wanted to be treated.

I had no work experience before my accident. Nobody told me that I couldn't or shouldn't succeed. I was a student and my job was to study and get that undergrad degree. So nine months after my injury I went back to school.

In 1973, I got my Bachelor of Science degree in special education. I never went after my teaching certificate because I knew I couldn't deal with thirty little sources of stimulation coming at me at the same time in a classroom. I continued to live in Ann Arbor and by simply doing it, I learned to care for myself.

After graduation, I got my first real job and was fired within two weeks. I was mortified! The job required a lot of things that I wasn't very good at. I had to do a lot of phone work, which required me to speak, exchange and record information very quickly. I also had to keep myself well organized and I had to prioritize.

After failing at my first job, I decided to do what I did well. So I decided to go to graduate school out of state, far from the safety of my parent's home. I applied to schools in social work where I wanted to live, and that didn't require the graduate record exam, because I wasn't very good at taking tests. I was accepted at two schools, and I chose the University of Wisconsin-Madison.

Graduate study posed few problems. As long as I could concentrate on one thing at a time, I did fine. I did have difficulty with establishing and maintaining friendships because I didn't know my own boundaries.

Six months after graduation, I got my first social work position at a suburban Detroit hospital. I was an alcoholism intake therapist. Six weeks later, I was laid off. Nine months later, I got another position in alcohol treatment and was fired from that one too.

You see, I could present a very capable, qualified image but just couldn't live up to it. I wasn't aware of my deficits, and I believed I could do anything I set my mind to. From that point in 1977 until the end of 1979, my job expectations and experiences deteriorated. I either quit or was fired from jobs that I didn't like or couldn't do.

In January of 1979, I "ran away" to another state, where I knew no one, to see if I could start a new life. I tried to leave all my terrible accident related experiences in Detroit and start over. But I couldn't do it. My injury had become the dominant factor controlling my life. I returned home in early 1980.

My former Department of Vocational Rehabilitation counselor, who had become a Michigan Rehabilitation Services counselor, sent me a therapist who did occupational, vocational and psychological therapy in my home for two or three hours, twice a week. She helped prepare me for a secretarial position which I held for 11½ months. I hated the work and got into a disagreement with my boss, who fired me.

After exhausting my unemployment benefits, I started a private practice in social work so that nobody could fire me. This is about the time I attended my first Michigan Head Injury Alliance meeting. I felt I could help other physically handicapped people reintegrate into the mainstream because I was getting pretty good at that myself. The practice was sporadically successful for two trying years. When my last automobile insurance client terminated, I fell apart and the practice collapsed.

I finally realized that I couldn't do everything I wanted. I became clinically depressed and began to grieve the loss of a life I would never have.

Another M.R.S. Counselor sent me to a sheltered workshop as an evaluator aide. I stayed there for 3½ years, because I could do the job, and I was unaware of other opportunities. The staff changed at the workshop and so did my job responsibilities. I found myself trying to develop the skills that my new responsibilities required. The strain of trying to meet these radically changing requirements at the rate at which they occurred finally took its toll.

One morning I got up for work and the next thing I knew, my boyfriend (who is now my husband) was picking me up off the floor. I'd had a seizure. He took me to the hospital where they put four stitches in the back of my scalp. My neurologist put me on Phenobarbital. I had to find a new way of life. I also needed a new place to work.

Frustrated by the isolation imposed upon me by my deficits and those that came from being plucked from the life that I had expected to live, I reluctantly acknowledged that I was depressed. I was able to care for myself, I could do certain tasks in the mornings and I could socialize on a limited basis, but I was always sad.

Again, I sought the help of M.R.S.. The head injury specialist there sent me to my first head injury rehab program in 1989. I learned a lot. I learned what behaviors I could reasonably expect after a head injury. I realized that I wasn't losing my grip but that I had a head injury. What a relief that was! There were things beyond my control that contributed to my losing so many jobs. I could take myself off the hook.

Also in 1989, I was married. After my wedding I began speaking to survivors of brain injuries about what empowerment meant to me. I wrote a speech entitled “MY LIFE SINCE MY HEAD INJURY.” This experience proved to be a pivotal point in my life.

I did some soul searching and found that my greatest strengths were in communication and group work. So in 1990, while working as a rehabilitation associate for an outpatient clinic, I created the format for “Acceptance Groups for Brain Injury Survivors”. This group’s primary objective was to create an environment where survivors of brain injuries could talk to one another about problems living in the mainstream and develop attitudes and skills necessary for successful independent living.

Encouraged by clients’ positive responses to participation in the group, I began to offer my peer counseling services to other agencies. I spoke at facilities and support groups around the state. After giving a presentation to outpatients at a local hospital, I developed another group and called it “Acceptance Groups for Disability Survivors.”

In 2001, after collaboration with a professional medical writer I published my book “Acceptance Groups for Survivors: A Guide for Facilitators (& all those who wish to gain peace of mind.)”. In 2002, my website, www.survivoracceptance.com, was completed and began sharing my experiences, books, general information regarding disabilities and providing a site at which visitors could get support.

In the beginning of 2003, my husband and I moved into a new home. I do not have the words to describe my state of bliss and contentment with my life today. My personal life has fallen into place and I am working in my chosen field of interest, with clearly defined guidelines and goals. My employment in these peer group sessions is not based solely on my being a head injury survivor of over thirty years. It is also because I have developed my skills and have evolved into a competent, effective peer counselor who carries unprecedented credibility with this population. I have been living the experience of attaining personal and professional goals post-injury. In group, I encourage my peers to learn and relearn the skills necessary to achieve their goals. We share the struggle toward independent living.

My recovery process began November 12, 1971, and it continues today. Three things that stand out in regards to empowerment as it relates to me are:

1. I chose one goal at a time on which to concentrate my efforts and I was able to put a lot of small successes together to make them into large, encouraging triumphs.
2. I chose role models so I could try out new ways to do things.
3. I set realistic goals, believed I could achieve them and refused to listen to those who wanted me to lower my expectations of myself.