September 1, 2000

About the author – A patient's journey

Jack Pilgrim began receiving treatment for mild traumatic brain injury (TBI) at the MGH in the summer of 1999. While working on a home improvement project, he was accidentally struck in the head with a hammer. Although his injury had occurred one year earlier, it wasn't until the summer of 1998 that he was referred to a neurologist specializing in brain injury, at which time he was diagnosed with mild TBI. Pilgrim had been experiencing debilitating headaches, chronic fatigue, impaired reasoning and strained social relationships. An initial emergency room CT scan had shown nothing noteworthy; however, further testing – including an EEG, MRI, sleep study and neuropsychological evaluation – would later reveal the signs of brain injury.

Having taken only a few days off immediately following the injury, Pilgrim continued working through the remainder of 1998. His effectiveness, particularly in communicating with others, steadily declined. In spring 1999, he finally took a medical leave of absence from work, underwent another neuropsychological evaluation and began individual cognitive therapy at the MGH Speech and Language Pathology Department with Sucheta Kamath, MA, CCC/SLP. He also received support through continued visits with the neurologist, family and individual counseling, as well as the love and support of family and friends.

Pilgrim began the "Steps to Success" cognitive rehabilitation program in July 1999 at the MGH. He has subsequently taken a third neuropsychological evaluation with measurably improved results and is continuing with individual cognitive therapy.

Although it is still uncertain as to whether Pilgrim will one day be able to return to the career from which he has been absent for more than a year, today he is able to pursue his love of literature and writing within the context of cognitive rehabilitation. Under the guidance and direction of Kamath, Pilgrim is working on several freelance writing projects. The conception, research, formulation, writing and re-writing edited drafts of an article, such as this Hotline story, now comprise a major component of his cognitive therapy.

It has been a long and winding road from the emergency room of a suburban hospital more than two years ago to where Pilgrim is today. What initially looked like a minor concussion was eventually reconsidered, renamed and has been responded to with equal amounts of medical expertise and compassion.