You have may have seen a few weeks ago the inter­view between for­mer US pres­i­den­tial con­tender John Edwards and reporter Bob Woodruff. All the result­ing media cov­er­age cen­tered on Edwards’ dec­la­ra­tions. How­ever, there is some­thing much more remark­able that sur­faced at that inter­view: Bob Woodruff’s spec­tac­u­lar recovery.

This is the same reporter who suf­fered a severe trau­matic brain injury when a road­side bomb det­o­nated next to his vehi­cle in Jan­u­ary 29th 2006 as he was cov­er­ing news devel­op­ments in Iraq.

Today we are for­tu­nate to inter­view Lee Woodruff, Bob’s wife and pil­lar through­out his recov­ery. Lee and Bob co-wrote the fan­tas­tic book In an Instant: A Family’s Jour­ney of Love and Heal­ing.

Alvaro Fer­nan­dez: Lee, many thanks for your time. I was amazed read­ing your book, where you share your jour­ney, and then watch­ing Bob inter­view John Edwards, the best dis­play I can imag­ine of his recov­ery. Can you please sum­ma­rize for us what Bob –and you– went through since Jan­u­ary 2006?

Lee Woodruff: As you know, Bob suf­fered a life-threatening trau­matic brain injury in Iraq. He was promptly taken under mil­i­tary care and under­went a series of surg­eries for head injuries, with a joint Army & Air Force neu­ro­sur­gi­cal team in Iraq, in a US Army Med­ical Com­mand hos­pi­tal in Ger­many, and at Bethesda Naval Hos­pi­tal, back here in the US.

Dur­ing this time, span­ning around 4 months, he spent 37 days in coma, and his skull had to be sur­gi­cally rebuilt. The cog­ni­tive reha­bil­i­ta­tion process started then, at a med­ical facil­ity closer home.

Can you please explain what kind of cog­ni­tive rehab Bob has gone though-both in a for­mal way, with a ther­a­pist, and infor­mally, on his own?

The first thing I’d like to say is that rehab is a long process. Doc­tors told me that Bob, despite the sever­ity of his injuries, had bet­ter chances to recover than other vic­tims, because of the reserve of neu­rons and con­nec­tions he had built thanks to an intel­lec­tu­ally stim­u­lat­ing and diverse life, includ­ing liv­ing in China for sev­eral years and trav­el­ing to dozens of coun­tries, hav­ing worked as a lawyer and as a jour­nal­ist, and his over­all curios­ity and desire to learn. It seems that more and more research shows how peo­ple who are men­tally active through­out their lives, either through their jobs, or doing puz­zles, sudokus…are, of course up to a point, bet­ter pre­pared to deal with prob­lems such as TBI.

Still, recov­ery is a long process. Bob had six months of struc­tured cog­ni­tive ther­apy focused on speech and lan­guages areas, because that was the part of his brain that had been most dam­aged. The ther­a­pist iden­ti­fied the main tasks for him to work on in a chal­leng­ing, yet famil­iar way, usu­ally ask­ing Bob, for exam­ple, to read the New York Times, then try to remem­ber what he had read, and write a short essay on his thoughts and impressions.

Since then he has, in a sense, used his work in the doc­u­men­tary To Iraq and Back and other projects at ABC as his infor­mal, but very effec­tive, way to keep improv­ing. I am amazed to watch in real time how, even today, how he gets bet­ter and bet­ter. To give you an exam­ple of his moti­va­tion to recover: he recently took on Chi­nese lessons to see if work­ing on that also helped him.

In the book, Bob says that, if he had to say in one word what he was expe­ri­enc­ing dur­ing much of the recov­ery, he would use the word “slower”. His brain was slower at pro­cess­ing new infor­ma­tion, at remem­ber­ing words. What progress has he experienced?

A lot. He is not exactly at the same level he was before the injury, but he is again an amaz­ing reporter, father, and hus­band. And I see progress every month, so we have hope that he will con­tinue get­ting bet­ter and better.

Some­times Bob tells me he is not the per­son I mar­ried. And then, as I men­tion in the book, I laugh and reply “I am not either. I’m older, wiser and more wrin­kled.“
I have learned to trust him. Espe­cially in the begin­ning, it wasn’t always easy to fully accept and fol­low his judg­ment, but I have seen how lit­tle by lit­tle he grew per­fectly able to recre­ate his role as a hus­band and as a father, and to recre­ate our respec­tive roles in the fam­ily. It has been won­der­ful to see that hap­pen. It has been a miracle.

Bob has been a very for­tu­nate sur­vivor of trau­matic brain injury. There are over a mil­lion cases every year of TBI. Many of them are military-related (a recent RAND study esti­mates that over 300,000 US ser­vice mem­bers have sus­tained TBI dur­ing assign­ments in Iraq or Afghanistan), but also hap­pen in civil­ian life, mainly due to traf­fic acci­dents or sports con­cus­sions. What do we know today about how to pre­vent and treat TBI?

The Iraq War is lit­er­ally re-writing the book, the way researchers and doc­tors see and tackle the prob­lem. Most of the progress is hap­pen­ing in the mil­i­tary, but I hope that trans­fers into ben­e­fits for civil­ians, too. From a pre­ven­tive point of view, the mil­i­tary has been step­ping up to improve the body armor of sol­diers, and I can now see why wear­ing seat belts as we drive and hel­mets as we bike can make a big difference.

From the recov­ery point of view, there is much more opti­mism and hope today than only a few years ago about how many TBI patients can improve, if given the oppor­tu­nity to, through a sup­port­ive envi­ron­ment and phys­i­cal and cog­ni­tive ther­apy. The mil­i­tary has rec­og­nized the prob­lem of the so-called “Walk­ing Wounded’, and is devot­ing sig­nif­i­cant resources to ana­lyz­ing best options and treat­ing them. As we chat­ted ear­lier, the Army recently announced that from now on sol­diers will get a cog­ni­tive screen­ing before they get deployed to the field, so that in case there are prob­lems that screen­ing can serve as a good base­line to com­pare func­tions to.

But the improve­ment in the area is only start­ing. We need to see much progress.

Can you now tell us more about the Bob Woodruff Foun­da­tion for Trau­matic Brain Injury? What are your main priorities?

Bob and I are devot­ing much time to rais­ing aware­ness of the prob­lem and the need to find and imple­ment good solu­tions for cog­ni­tive care. Our foun­da­tion sup­ports com­mu­nity, grass-roots approaches to help­ing TBI sur­vivors and their fam­i­lies. Given the huge scale of the prob­lem among the mil­i­tary, and the fact that Bob sur­vived thanks to the excel­lent care he received from the mil­i­tary along the way, we are focus­ing first on help­ing mil­i­tary victims.

For exam­ple, we recently funded four schol­ar­ships for TBI-related research, and also bought 300 mat­tresses for a small non-profit that helps patients and their spouses rebuild their lives once they have to leave Army bases-many of whom can­not afford to move all their belong­ings, includ­ing beds and mat­tresses, out of the bases.

And there are many more things to do. For exam­ple, while many more sol­diers are  get­ting bet­ter care, that is not always the case with National Guard reservists who, despite hav­ing a ded­i­cated branch of the armed forces over­see their progress, are often at more at risk of liv­ing with unde­tected TBI since they don’t have to report at bases once they are back.

It is also not clear that the mil­i­tary (as well as insur­ance com­pa­nies) are always will­ing to pay for the long-term costs of care.

What are some spe­cific ways peo­ple can sup­port the work of your foundation?

They can visit our new web­site, Bob Woodruff Foun­da­tion (http://remind.org/), to learn about the prob­lems and to donate funds, no mat­ter how big or small. We are also hold­ing a fundrais­ing event in NYC in Novem­ber to raise awareness.

But prob­a­bly the most impor­tant thing every one can do is to rec­og­nize the sac­ri­fices the sol­diers have made, and find active ways to look for them and help them in their own com­mu­ni­ties. Sol­diers and their fam­i­lies often have grown in a cul­ture of self-reliance, of not ask­ing for help, so here we all need to take the ini­tia­tive to fig­ure out how we can help. Ask your­self, how can I help the TBI sur­vivors in my neigh­bor­hood? Per­haps by giv­ing them a job, or offer­ing them help or train­ing, so they can secure one? How can I help their spouses and fam­i­lies main­tain healthy and happy envi­ron­ments? Per­haps by offer­ing them free movie tick­ets? A massage?

Lee, many thanks for those sug­ges­tions. I do have friends at a local Vet­eran Affairs hos­pi­tal, and will follow-up on those great ideas. I hope our read­ers can also think of ways they can help (and exer­cise their brains along the way). Is there some­thing else you would like to add, that you would know every­one to be aware of?

I’d say never give up. We have seen how Bob has recov­ered, which I think is a mir­a­cle. Let’s sim­ply try our best to help every­one out there.

For fur­ther infor­ma­tion:

- Book: In an Instant: A Family’s Jour­ney of Love and Heal­ing
– Foun­da­tion: Bob Woodruff Foundation.

Related inter­views:

- Build Your Cog­ni­tive Reserve — Dr. Yaakov Stern

- Dr. Elkhonon Gold­berg on Cog­ni­tive Training

- Cog­ni­tive Sim­u­la­tions: Inter­view with Prof. Daniel Gopher

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