Neuropsychology and Rehabilitation Psychology Division Department of Physical Medicine and Rehabilitation.

Pat #2

DEAR PAT: Can a neuropsychiatrist critique the report of a neuropsychologist for a person who has suffered TBI ?

PAT'S RESPONSE:Yes. Neuropsychiatrists and neuropsychologists specialize in critiquing each other. What you need to keep in mind is the distinction between the two professions.

A neuropsychiatrist is a Medical Doctor (M.D.) who specializes in psychiatry for people with neurological dysfunction. The neuropsychiatrist is knowledgeable about human anatomy (e.g., the physical make-up of the brain) and human behavior. He/she conducts brief counseling or interview sessions with the patient, makes use of medical information on the patient’s condition, and dispenses medication to treat his/her patients.

A neuropsychologist is a Doctor of Philosophy (Ph.D.), a specialized psychologist who evaluates and treats people with neurological dysfunction. Neuropsychologists do not dispense medication, but instead conduct extensive testing and counseling. Neuropsychologists look at how brain injury affects a person’s behavior through the use of written tests, "performance" tests, and interview/discussion sessions.

The neuropsychiatrist offers a medical background, while the neuropsychologist offers testing, assessment, and counseling expertise. In the best of all words, these two professionals compliment each other, healing humanity together.

DEAR PAT: Pat, help! I need an expert witness to reconstruct my car accident -- someone who can testify that someone who does not hit his/her head can still have a brain injury. What leading experts do you know?

PAT'S RESPONSE:Pat knows everyone who is anyone. In fact, if you are not a close personal friend of Pat’s, then it’s time to take a good look at your social circle. To find someone to provide "expert testimony" in your case, you must begin by hiring an attorney who is experienced handling brain injury cases. Such an attorney will know which professionals to call as expert witnesses in your case. For example, your attorney should know and be prepared to call a neuropsychologist who is experienced in treating people with mild brain injuries. This expert witness will have credibility in court and be able to explain how someone could sustain a brain injury without hitting his/her head on the windshield. If you need an attorney referral, contact your state Brain Injury Association, Bar Association, attorney referral service, or the "Directory of Experts" on the National Resource Center for TBI.

DEAR PAT: Hi, Pat. I'm 40 years old and I can't remember the names of my family members. I have a heck of a time lifting my left knee and taking my right elbow down to my left knee at the same time. Thanks, Braindead.

PAT'S RESPONSE: And when you look at an ink blot do you see:

a) Dennis Rodman doing the Macarena?

b) An elephant in a bathtub full of jello?

c) Dennis Rodman and an elephant in a bathtub full of jello?

Regarding your inability to recall the names of family members, consider keeping a list with a photograph of each person and his or her name written beside it. "Quiz" yourself by looking through family photo albums and naming individuals. "Mnemonic devices" also can be useful. To commit a person’s name to memory, make up a little rhyme; connect the name with a memorable thought. For example, Aunt Mable fell under the table. In your mind, connect Mable with table and you may be more likely to remember it.

And, don’t do that knee-to-elbow thing.

DEAR PAT:Pat, help me understand my friend who was involved in an auto accident, has several broken bones, a tracheotomy (done at the scene), has been hospitalized for 7 days, has swelling of the brain which has been drained. Doctors are not saying or doing much until the swelling goes down. I guess he is on a breathing apparatus; he is not awake; he is in a coma. Do swelling and blood clots in the brain mean severe brain damage? Can a brain scan be performed on a swollen brain?

PAT'S RESPONSE: The first days following a serious brain injury are difficult for all involved: family and friends struggle with shock, hope, fear of the unknown, and doctors also struggle with the impossibility of predicting outcome. Tests can be performed on the damaged brain to assess its condition (e.g., CT scan, MRI); however, a sound diagnosis is too much to ask for in the early stage of trauma. Your friend’s injury sounds severe as you describe it. Technically, an injury that results in a coma or a period of unconsciousness that lasts more than 24 hours can be classified as severe (versus mild). For more information on severe brain injury, coma, and outcome, please take a look at the FAQ’s on this Internet site and consult your state Brain Injury Association. Several complex factors will determine your friend’s outcome. What you can do is be there for him; your presence and support will help more than you may think.


PAT'S RESPONSE: Thank you.

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