By Jesse Marx
By Chris Parker
By Jake Rossen
By Jesse Marx
By Michelle LeBow
By Alleen Brown
By Maggie LaMaack
By CP Staff
BOB AND MICHELLE Briggs met nearly 13 years ago while both were "cruising the strip," which for young people in Keokuk meant driving up and down the Main Street/Highway 218 drag—showing off, hooking up, waiting for something to happen. Bob and his buddies would cruise the strip in old beaters that Bob had patched up. In those days they all wore their hair long and blasted Guns 'N Roses on the tape player relentlessly. Bob and Michelle married 11 years ago. Ashlea came along six years later, in 2000, and Cody in 2004.
During the time Bob was in Iraq, Michelle Briggs took care of their two kids and worked out of the house, running a small pet-grooming operation that brought in a few extra dollars. They talked on the phone nearly every day at first, until it turned out that the $25/200-minute AT&T phone cards they bought were only good for about 14 minutes apiece. Then they wrote nearly every day, though it usually took about two weeks for their letters to arrive. After Bob was wounded, Michelle suspended her dog-washing venture and took the kids to her mother's house. In the months since, she has spent nearly every day at his side. She's been there through the meals, the physical therapy sessions, the sudden and tearful curtains of despondency that fall over him sometimes.
She is quick to point out, though, that he is still unmistakably Bob, the same guy she married, with the fast wit and twisted sense of humor. Throughout his recovery she has refused to treat him with kid gloves. The first time they were back home together on a weekend pass, Michelle brought him Thai takeout. "He said to me later, 'You'll never guess what I had for dinner.' I was like, 'You had orange chicken, Bob. I got it for you!' People think I'm mean to him," she admits, "but they don't know us. I'm like, come on! He's got to have fun. You have to be able to laugh."
A vast amount of her time with Bob in these months has been spent watching—sitting in on countless rehab sessions and offering moral support as needed. Their days have typically started at 7:00 a.m., when the nurses wake Bob for breakfast. Then they have some time together before speech therapy at 9:00. Though Briggs never lost his ability to speak (unlike many of the other 30 or so polytrauma patients the Minneapolis VA has seen), he needs the therapy to relearn the process of thinking and then speaking his thoughts. Here, he spends about an hour doing exercises designed to retrigger certain memory-related cognitive functions. The cognitive problems common to Briggs's type of diffuse brain injury are short-term memory loss, the inability to maintain focus, problems with multitasking, and some "comprehensive" loss of cognitive associations, like how to get from point A to point B, or what the relationship is of a hammer to a nail.
At 10:00, it's occupational therapy. The point here, Dr. Larisa Kusar says, is "livability" rather than "recovery"—that is, to help Briggs learn to compensate for the things he will never be able to do. These include most of the mundane tasks of daily life: dressing himself without any help from his left arm or leg, making coffee, cracking an egg into a frying pan with one hand. "We definitely know, given the severity of the injury and the weakness on the left side, that he's not going to gain full function of that side," notes Kusar. "It will not return to his baseline."
In one exercise, Briggs counts numbers backward, starting at 100 and then subtracting three repeatedly: 100, 97, 94.... He does this until the specialist throws him a random set of numbers and asks him to put them in ascending and then descending order. "It sounds childish," he says sheepishly. "But it really gets your mind going."
Another activity offers him a sentence or phrase such as "The sun is shining bright." Briggs then has to recite the statement in reverse, put its words in alphabetical order, and arrange the words according to how many letters each contains. "The goal," says Kusar, "is to restore function to those areas of the brain the best we can, but there are parts that aren't going to recover completely. With time, however, the brain can compensate and develop new pathways and connections, through what we call neuroplasticity of the brain."
Part of the point of all the repetition in the various mental and physical exercises Briggs does each day is to help those pathways heal as far as possible, and to increase the likelihood that new neural pathways will be blazed through other parts of the brain. Kusar says the first two years following a brain injury are the most crucial for any recovery of lost brain function—which is why Briggs's days, now and long into the future, are booked full of therapy sessions.
After lunch and some time to rest, physical therapy begins at 3:00. Here it's mostly about walking, regaining a sense of balance and of his body, and building strength in his left side. This is where all the simulated curb-stepping and walks down the hall take place. It's the most grueling hour of his day, and it's followed by recreational therapy at 4:00, where he continues to work on balance and body control, this time through activities like putt-putt golf.