It’s March, the time of year when we begin to think about daffodils, Easter bunnies, Passover Seders, and, of course, day light savings time. The month of March reminds us to act on our thoughts, to effect change, to move forward; After all, March was named after Mars, the God of war. This doesn’t mean we should act through violence. Because Mars was also known as the God of agriculture and fertility, March is a time for new growth. How do we grow? Through awareness. So it logically follows that March has been designated as Brain Injury Awareness Month.

Every March, The Brain Injury Association of America leads the nation in observing Brain Injury Awareness Month by holding awareness campaigns. These campaigns aim to educate the public about an often misunderstood and misdiagnosed injury, including the incidences of brain injury, and ways in which we can help the injured and their families. It’s also an opportunity to work with communities on how to empower brain injury survivors without stigmatization.

To help you understand a little about brain injuries, here are some facts from the Brain Injury Association of America to get you started:

More than 2.5 million people in the U.S. sustain a TBI each year.

137 people die each day due to a TBI.

Most TBIs are due to falls.

5.3 million Americans live with disabilities as a result of a TBI.

Acquired brain injury (ABI) is an injury to the brain that is not congenital, hereditary, degenerative, or caused by birth trauma. Examples of causes include: electric shock, infections, near drowning, strokes, and tumors.

A TBI is a subset of ABI and is caused by trauma from an external source such as a bullet wound, falls, or car accidents.

To learn more about brain injuries, including the latest research, legislative briefs, and the social stigmas attached to having a brain injury, I encourage you read more by clicking on the following links:

Brain injury facts

Brain injury legislation

Brain injury awareness month

Differences between boys’ and girls’ brains

Inosine treatment for brain injuries may help motor function recovery

Scientists take big steps toward being able to repair brain injuries

To Share or Not to Share: Life after a Brain Injury

Marginalization of people with brain injuries

This past Saturday, at least fifteen thousand people marched through downtown Montpelier, Vermont, in the name of women’s rights, human rights, compassion, unity, and equality. I was among the thousands who sloshed through mud puddles and climbed over snow banks, each one of us determined to stamp out hatred and bigotry.

I’m not one for crowds, especially large crowds; if you have an anxiety disorder, like PTSD, you know what I mean. But I packed my Xanax – just in case – and drove the 40 miles with my step-daughter (thank you Rachel for being there with me) from Burlington to Montpelier, waited in five-miles of backed up traffic on the interstate before making an illegal U-turn (I can’t tell you how good it felt to break the law!) so we could exit onto an alternate route leading into town, then parked a mile from the state house. From there, Rachel and I took our first steps toward the center of inclusivity: the golden-domed state house.

Montpelier may be the smallest capital in the nation, but our voices here in Vermont are far from small. Yesterday, as we marched together, thousands waved signs reading, “Yes we still can … We should all be feminists … We the people … complacency is complicity.” We sang and chanted and shouted against oppression and injustice. We spoke out loud for what is right: helping the homeless and the poor, treating with dignity women, people of color, Hispanics, Jews, Muslims, gays, LGBQTs, the young and the old. And the disabled.

I give the disabled a sentence of its own, not because I believe they’re superior to others; I do so because I know too many disabled people, mostly those who have sustained traumatic brain injuries (TBI) and are now living with chronic side-effects, such as vision difficulties, chronic anxiety, sleep disorders, and rip-roaring headaches. Due to their injuries, some find it difficult to engage in substantial gainful activity, a social security disability insurance (SSDI) term meaning your medical condition prevents you from doing more than “insignificant” work. And if your disability prevents you from working twenty hours or more a week, the typical threshold for receiving employer-based benefits, this likely outcome is this: no health insurance. With the enactment of the Affordable Care Act, though, those with disabilities had options, and they didn’t have to worry about being discriminated against for having a pre-existing condition (a TBI for instance). The ACA offered increased accessibility to community health centers, and enacted a provision that axed annual and life time limits – a godsend for people with disabilities. For those who receive SSDI and Medicare under the program’s guidelines, they are (or should I say “were?”) protected.

But it’s 2017, and winter has arrived. “He who must not be named” plans to eviscerate the ACA, with no alternative other than the ambiguous executive order he signed just hour after he was inaugurated directing federal agencies to relieve individuals, state governments, businesses, and health insurance companies from “burdens” placed on them by the ACA.

Whatever that means? In the meantime, there are nearly 50 million people in the U.S. who have a disability, and about 8.8 million who receive SSDI benefits. Though “he who must not be named” promises Medicare for All, this is sheer talk from a man who, well, likes to talk. And, of course, “he” has to deal with the Republican controlled congress. What do the millions receiving Medicare under SSDI benefits – and those sixty-five and older – have to look forward to?

I wish I had a magic wand to make it all better, but I don’t. Yet, I do have my voice. I share my voice with you, sing and chant and cheer for you, keeping in mind the words that Martin Luther King Jr. spoke in 1965: “Our lives begin to end the day we become silent about the things that matter.”

The more we speak, the louder we speak, “about the things that matter,” the closer we come together, marching forward toward human progress and shaping a world in which every single one of us matters.

A few weeks ago, I stood on a stage in front of hundreds of people, shaking like a mother@#$%!&, and shared my story of “Surviving and Thriving” at the annual brain injury conference held by the Brain Injury of Association of Vermont. I also listened to others, including mental health providers and rehab specialists – share their experiences with TBIs. As the theme of the conference, “Surviving and “Thriving, came up over and over again, I began to think about what that phrase really means for TBI survivors, and others. I wasn’t looking for the “pull-yourself-up-by-your-bootstraps” kind of answer (I’d like to see someone take on that impossible task, literally.) Of course, precisely how each one of us survives and thrives differs, but I came away from the conference realizing that a common denominator does exist: Human emotion. Because we’re human, we’re vulnerable and experience grief, anger, jealousy, anxiety, and so on. That being the case, I’d like to share some takeaways from the conference, tidbits offered by Psychologist Laura Basili, which define, at least for me and hopefully for you too, the nitty-gritty of “Surviving and Thriving”:

 1) A willingness to remain vulnerable. Being vulnerable is part of “Surviving and Thriving,” though we tend to equate vulnerability with weakness, and who wants to be perceived as weak? But, alas, like I said, we’re all vulnerable, like it or not, and it doesn’t mean we’re weak at all. If you don’t believe me, maybe the poet David Whyte will be more convincing: Vulnerability is not a weakness, a passing indisposition, or something we can arrange to do without, vulnerability is not a choice, vulnerability is the underlying, ever present and abiding under-current of our natural state. To run from vulnerability is to run from the essence of our nature, the attempt to be invulnerable is the vain attempt to be something we are not and most especially, to close off our understanding of the grief of others. More seriously, refusing our vulnerability we refuse the help needed at every turn of our existence and immobilize the essential, tidal and conversational foundations of our identity.

The operative phrases, which are worthy of repeating, are in the last two sentences: To be invulnerable is … to close off our understanding of the grief of others. More seriously, refusing our vulnerability we refuse the help needed at every turn of our existence and immobilize the essential, tidal and conversational foundations of our identity.

So why not wrap your arms around vulnerability, walk alongside it, or invite it into your home?

2) We first need to understand grief before we can grieve what we’ve lost – maybe it’s the loss of independence after a brain injury or the death of a loved one from a TBI, or any other kind of loss. But grief doesn’t only come in the form of sadness; it also presents itself as anger, denial, guilt, fatigue, desperation, hyper-vigilance, resentment, and anxiety. So when you’re socked-in by one of those emotions in the aftermath of a loss, know that you’re doing what humans do: grieving. To grieve is to grow, meaning you’re “Surviving and Thriving.” As Laura does with some of her patients, if you’re struggling with grief, you might want to try drawing a picture of suffering, then drawing one that resembles hope. I’d love to see what you come up with.

Oh, I almost forgot one more tidbit, something that brain injury survivor Hannah Wood shared during her keynote address: Do one thing every day that scares you. That doesn’t mean you have to free climb up the face of Half Dome in Yosemite or go skydiving. Maybe it’s applying for that dream job you’ve been telling yourself you’re not qualified for because you’re afraid of being rejected. Maybe it’s making that phone call to a certain individual who has experienced a similar traumatic experience as you, but you’ve held off, afraid she’ll tell you she doesn’t want to talk about it. Whatever the scary thing might be, go for it! After all, as Laura shared with the audience from one of her clients, “The suffering is in the waiting.”

What is it like to live with a traumatic brain injury (TBI)? Maybe you feel as if you know longer know who you are. You might say that your identity has been “stripped” away, that your independence has been ripped from you. You feel utterly lost. In an interview with marketing consultant Angela Treat Lyon on Daring Dreamers Radio, this is exactly how Nathalie Kelly, a TBI survivor, describes how she felt in the days, months, and years after her sailboat toppled over during a storm on Lake Champlain in Vermont and smacked her in the head, leaving her bobbing in the cold water for forty minutes, until the coast guard arrived.

A brain injury advocate, writer, inspirational speaker, and board certified hypnotherapist, Nathalie speaks with eloquence and candor about her post-TBI road-blocks, set-backs, growth-spurts, and more. The motto of Daring Dreamers Radio is “to dare you to live free, inspired, and in constant delight.” And that is precisely what Nathalie does in the interview: She has come to understand that living with a TBI means learning to accept that you are “perfectly imperfect,” and, though our culture frowns upon anything less than perfection, she “dares” us to embrace it, to “embrace vulnerability,” to let yourself be the person you are now, to shed all expectations of others. “That’s living an authentic life,” Nathalie says.

To be inspired and awakened and free, I dare you to listen to Nathalie’s interview at Daring Dreamers Radio.

You’ve heard of “burnout,” right? Your work environment is making you miserable, so miserable that you feel unfulfilled, depleted of energy, stripped of all motivation to effect change in the workplace. If you’re a healthcare professional, undoubtedly, you know all too well about burnout. But then there’s “compassion fatigue.” While individuals working in any kind of job setting can experience burnout, compassion fatigue is unique to those exposed to trauma while working in a helping profession: nurses, firefighters, police. Because you’re in the helping profession, you feel the onus is on you to save peoples’ lives, to make them better, to alleviate their pain, so you sign up for extra shifts, and, if you’re a nurse, offer to take care of the sickest patients. But what happens when your patients have little, or no family support, or are constantly ringing the call bell, making demands (get me water, I need more pain meds, I need something to help me sleep)? You feel like Sisyphus – no matter how many times you push the boulder up the hill, it keeps rolling back down into your weakened arms. You’re worn down, irritable, angry. That’s compassion fatigue, when you can no longer muster the sympathy to care for your patients because you’ve been exposed to the same kinds of patients again and again, and have answered an uncountable number of call-bell dings, but the bells keep dinging, and you want to keep helping, but, at the same time, you want to run.

It’s worth noting, however, that compassion fatigue doesn’t necessarily mean individuals experiencing it lack compassion, not at all. They still care about their patients. Instead, as a nursing professor at the College of Nursing at University of Arizona says, compassion fatigue is more like feeling too “full,” and even suggests a different name for it: “emotional saturation.”

Not only are healthcare professionals at risk for compassion fatigue, though, family members caring for loved ones with, say, a traumatic brain injury or dementia, are at risk too. Even those who hear about another’s traumatic experience over and over again are affected. I bring these scenarios into the mix because, sadly enough, I suffered from compassion fatigue when I worked tirelessly to navigate my father’s emotional swings, and, as he slipped into Alzheimer’s, made sure he was safe at home because he had insisted he never be put in a nursing home. And I’m witnessing compassion fatigue again, as my husband and his siblings stumble then pick themselves each day, determined to keep their aging mother safe from the ravages of dementia.

But it is possible to care too much, so much that it hurts. When I say hurt, I mean really hurt, as in traumatized hurt. Being pre-occupied with others’ suffering can cause “secondary traumatic stress” for the helping individual. It’s not unusual to experiences symptoms of post-traumatic stress disorder: anxiety, hyper-vigilance, irritability, impatience, withdrawal, poor concentration, sleep disturbance, nightmares, the list goes on.

What’s the cure for compassion fatigue? Boundaries and self-care. In other words, set limits, say no even when you want to say yes, remind yourself to take time out, meditate, go for a walk, keep a journal, draw, listen to your favorite music, dance, do yoga, take a bath, read a novel, watch a funny movie. Watch the sun set. Watch the sun rise.

For more resources on how to evaluate whether or not you have compassion fatigue and how to prevent/treat it, go to compassion fatigue and healthy caregiving.

As you read this blog post, is your smartphone on speaker, playing bad “hold music” while you wait for a “live” voice to answer? Or maybe you’re glancing back and forth from the computer screen to your phone, responding to text messages in between reading a few sentences of this post. Multi-tasking is in vogue; it’s hip, cool. And how many times do you see “ability to multi-task a must” in help-wanted advertisements? But while we believe we’re multi-tasking, the truth is we’re not at all. A neuroscientist at MIT says that what we’re actually doing is “switching from one task to another very rapidly.” And, though we believe multi-tasking means greater productivity, each time we do this, he adds, there are “cognitive costs.”

Multi-tasking increases levels of the stress hormone cortisol, and the flight-or-fight hormone adrenaline, both over-stimulating the brain and creating what I call “brain fog,” causing loss of focus. To make matters more complicated, multi-tasking creates an addictive-like feedback loop in the pre-fontal cortex, ironically, the area of the brain responsible for helping us stay on task. In other words, our brains are rewarded for losing focus. Multi-tasking is like using cocaine; the more one uses it, the more one wants it, needs it. So when you talk on the phone, check your email, send a text message, boil water for tea, your brain is stimulated by a rush of endogenous opioids. (“More, please!”) Think of potato chips, ice cream, candy – they taste good going down, but the empty-calorie effect brings your brain, and you, to a crashing halt. And making the brain shift from one task to another causes it to burn extra oxygen and glucose, the very ingredients needed to stay on task. When this happens, you might feel wrung-out, ready for a long nap. What happens when you lose steam? You get frustrated, and anxiety ensues, triggering another blast of cortisol to your brain. You can’t think straight. You become more frustrated, and angry. Maybe you get so angry you take it out on others.

And the more you multi-task, the more decisions you need to make: should I answer that phone call, text, or email? Should I go to the grocery store now or later? Which apple should I buy: a Fuji or a Delicious? When making these decisions, you consume so much energy that you end up making poor decisions when it comes to more important issues, like loaning money you don’t have to an unreliable family member, or going out for drinks and getting so drunk that you can’t get out of bed the next morning to make it to that job interview your father-in-law hooked up for you. (Now you’re in trouble.)

Also, researchers have found that multi-tasking can reduce one’s IQ by as much as fifteen points. This decrease is similar to what researchers would expect from smoking pot or staying up all night. If you’ve ever pulled an all-nighter studying, or smoked pot, you know what it feels like: your brain might as well be stuffed with gauze.

Enough of the harsh truth. Instead, here are some tips to help you resist the temptation to multi-task. Shut off your cell phone when working, and place it far out of reach. If you can’t bring yourself to shut off your phone, envision a stop sign each time it rings or buzzes, and say to yourself, “No, I’m not responding.” Make a list of priorities each day and check them off when complete. Dedicate time each day to complete mindless tasks, like folding the laundry or emptying the dishwasher.  Keep your office door closed so others know you don’t want to be disturbed. Put a do not disturb sign on your door. Plaster your office door with yellow caution tape, set up a trap, eat a lot of garlic. Tie yourself to a ship’s mast – it worked for Odysseus, even though he did put up quite the fight.

Of course, I’m thinking big here with these tips, and you might be laughing at this post, saying, “She’s got to be out of her mind to think I can give up multi-tasking. Tell my boss this, and I’ll be fired in a New York minute.” The key is to guard against multi-tasking whenever possible; start small. Maybe it’s shutting off your cell phone for an hour each day for a week, then two hours the next week. Believe me, I too am victim to multi-tasking. In fact, while writing this post my cell phone rang. (I forgot to shut it off.) Guess whose name lit up on the screen? “Mom.” Yep, I answered it.