Early in the course of Ben's injury I would refer to positive signs of improvement as a "flicker" of hope.  In spite of all the serious complications and signs of disability, I would see, briefly, that "my Ben" was still in that healing body. As we move into the fifteenth month after his injury, the "flickers' aren't occasional, they are blinding flashes. Ben is remembering more and more. His personality is returning. His sense of humor is great. Ben calls us CONSTANTLY on the phone. If I don't answer quickly enough, he calls  Jim or the house phone. Importantly, he remembers all of our numbers. Ben's other memories are not perfect, but what encourages me is the constant evolving mental status. Something is happening in that brain. It has to be good.

A conference with all of Ben's therapists was held on Tuesday of last week. I listened to each story unfold with amazement. Ben has achieved so many of the goals listed in his therapy plan that a completely new plan has been laid out with new goals. His balance and walking gait require only infrequent reminders to look for obstacles ahead. Ben is now able to orient himself to date and time using cues in the environment without help. He is answering most questions correctly on listening comprehension exercises.

It was a beautiful day at the Texas ranch where Ben lives and receives the necessary therapy for his traumatic brain injury. The day was cool and pleasant after the summer rain and Ben and I took a walk to pet the horses in an adjacent field. Even though Ben walks unaided with excellent balance, an attendant is close by at all times for assistance and therapeutic companionship. After the walk, Ben and I played a game of "Sonic the Hedgehog, Unhinged" on the X Box for the first time. He loved it and amazingly remembered the control maneuvers with little instruction. We played about an hour. It may seem like a small thing, but to learn, retain, perform the motor skills, and remain attentive for this length of time is a huge victory.Afterward Ben worked on applying a wood stain to a birdhouse that I purchased for him. Cognitively, he is struggling. Ben has to be reminded that he is not at camp or school and that the therapeutic staff members are not counselors. Often what he says is nonsense. Often what he says is true. Ben is getting better and better. It was a good day.

Jim and I continue to be impressed by the diligent and specific care Ben is receiving at the current neurorecovery center. One year ago Ben was just starting to specifically response to commands, could only stand with help and was on tube feedings. Last Thursday Ben went to the grocery store with others from the treatment center. He had to locate 4 items on a list which were important for the evening meal. HE DID IT! Ben is walking with very little help for balance. The wheelchair is gathering dust. The therapy team has Ben folding laundry, sweeping floors, and taking out trash. He loves sanding and painting signs for the garden that the facility is installing. Ben also helps care for the garden plants.

Jeffrey and I visited Ben this weekend. As usual, he was anxious for us to get to the house where he is living. He tells me that he wants me there to talk about plans. These plans always involve activities with the family. Even when Ben needs a bathroom break he says, "Please don't move, mom. I still have you close to my heart." There are some subtle differences in his cognition since my visit two weeks ago. Ben is much more aware of his appearance. He is asking for collared shirts and khaki pants. Ben also is handling many personal care issues, like shaving, with very little help.  He continues to have attention problems which affect his ability at times to participate in therapy. He often confuses past, present, and future events into a statement about what is happening currently.

As I listened to Jim's report from his recent visit with Ben, I was hoping to hear more stories of remarkable progress. Typically, however, brains do not heal quickly after a serious TBI.  I have to keep reminding myself of this fact. "Slow" is a word that I do not care for. The progress we are seeing in Ben's condition is common. Some days he is changing rapidly with improvements in thought processing, physical recovery, memory and attention. Other days are frustrating when we see the same struggles over and over again.   TBI is a chronic disease. Even milder injuries to the brain often take months, even years to heal. Many never heal completely. Even individuals who are recovering from a TBI  look fine, but are  often are overwhelmed and can be confused with even simple tasks.

I returned this evening from a weekend with Ben.  He is in an amazing, restful, beautiful place. I know this is exactly where he needs to be. The progress he is making is slow and steady and SIGNIFICANT!  Conferences on Wednesday with Ben's care team lasted about an hour. Each therapist gave an accurate assessment of Ben's current status, plus concrete goals and a plan to achieve those goals. Physical therapy described Ben's walking gait as "unsteady, wide based, with not enough heel contact". She followed with specific strategies to improve his gait and mentioned that Ben's tolerance of the exercise bike has increased from 30 seconds to 10 minutes.