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Define Improvement

I hit a milestone the other day. It was a major win. It is probably my first major win since the accident eight years ago. Most of the medical community agrees that major improvements don't occur over five years out for a traumatic brain injury survivor. But maybe they don't know what the definition of improvement is.

We were pretty excited when we arrived. Things were looking good. It hadn’t rained on the drive, so a migraine hadn’t started behind my eyes. No traffic jams, either, so only minor nausea. There was a disabled parking spot in the closest lot. Friendly volunteers stood outside giving people directions.

My husband immediately jumped out of the truck. I sat tight, knowing this was just the beginning. I watched as he scouted the sidewalk and the building entrance, eventually disappearing inside. I knew he was looking for the shortest, simplest route. And checking the stairs versus the elevator. Elevators are nice but very much a gamble. They can stop on every floor, increasing my nausea with every movement. It can also be packed with people, half of whom are wearing competing perfumes. And then there's the people coughing away without covering their mouths. Don't get me started.

A few minutes later, he came jogging back to the truck. “I think you can go in,” he said breathlessly, a smile on his face. “I think we're going to be able to do this!”

I nodded happily and began to armor up. I put on my biggest sun hat, a dark colored one with a four-inch brim. My sunglasses followed, dark lenses that wrapped all around my cheeks. Next were my Loop ear plugs. Then, I downed Acetaminophen and anti-nausea meds (Granesetron). There was no use in pretending they wouldn’t be required. At the last minute, I dabbed a small amount of lavender essential oil below my nose (we had to use the elevator).

We navigated to the high school auditorium and took the seats my husband had pre-paid for. Ten minutes later, we were watching our nephew singing and dancing across the stage. Surrounded by friends, he belted his way through song after song. He had been a part of his drama club for years, but I had never been to a show.

For years, I had struggled to see my nephews at their events. Baseball games, soccer games, and plays all passed us by. We had gone to many of the venues, staying fifteen minutes here and there. Get a wave in, maybe a hug, and headed home. That was all I could tolerate. The headaches and neural fatigue were always intense afterward. Eventually, we stopped trying.

But this was different. My brother and sister-in-law had scouted the space. We exchanged countless texts. It was a small stage in what is commonly called a “black box” theater. The floor, walls, ceiling and stage were all painted pitch black. There could not be a better space for someone who has light sensitivity and a vision impairment from a traumatic brain injury.

Halfway through the performance there was an intermission, and we quietly made our exit. It is always better to leave with a small victory than face going backwards again. This felt like we had a huge achievement. It had taken an hour to get there and my energy was flagging. But it did not matter. Our happiness could not be contained. We had waited years for this.

I had started going to plays and musicals in college, scrimping together cash for the cheapest student seat. As an adult, I had sought out local community theater and then larger productions in downtown Minneapolis. After my injury, I spent years thinking that part of my life was over. Now, I am not so sure. With one small victory, you build another. And another.

Medical professionals often say that eventually TBI survivors reach “MMI”, maximum medical improvement. This is the term I hate the most went speaking about TBIs. Improvements can be found through hope and discipline, though they may not be recordable by the medical community. They are the tiny steps forward that that no one sees but the survivor and their caregiver.

Eight years of therapy for thirty minutes of music? It was totally worth it. 

   ~ Sara Scott


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