She came to her first Williamsburg/Newport News Survivors Support Group meeting on December 19, 2013, and told us about her car crash. She was young, talkative, funny, and full of energy. A person you knew you liked right away, even though she told us she was going nuts.
Sara always tried to get to meetings and sent me e-mails if she couldn’t make it. She always wanted to come, but she couldn’t get off from work or maybe there was a family conflict. I suppose she came to about six meetings all together. Each time she was stressed out, but in a lovable way.
The last time we saw her was at the July meeting and this time she was more stressed than ever before. The statute of limitations had run out on her and her stupid lawyer hadn’t done anything to help. She was angry because no one but her mom was there for her. No one in her family believed anything was wrong. She had alienated all of her friends, she said. She had lost her job and now her insurance was about to run out on her.
It was a cry for help. We told her about the Affordable Care Act. Someone tried to get her to call a lawyer he knew. Everyone was giving her advice, but she was panicked.
The next day, Lisa tried to call her and e-mail her, but there was never an answer. I called once and got a message that the mailbox was full. We asked each other for a couple of weeks, “Have you heard from Sara?” or “Have you heard from that girl who was so upset last time?”
Then, on Sunday, yesterday, I was wasting time by breezing through Facebook when her name popped out at me from a local newspaper posting. Sara Beth Reissig. Pedestrian. Dead. The blood drained from my head and I couldn’t breathe.
Yes, I know that suicide is one of the primary causes of death post TBI. Yes, I know that I’ve thought about it. Yes, I know that other members of our Support Group have been suicidal. But this is the first time someone has pulled the trigger.
“A 41-year study published in JAMA Psychiatry on Jan. 15  shows that people who suffered head injuries were more likely to die prematurely,” says a Reuters news flash. In total, o.2 percent of people die prematurely; the rate is three times that for people who had a TBI. “Those who died early and had a TBI were more likely to have committed suicide, be a victim of an assault or have a fatal injury.”
Everyone who deals with patients with TBI knows the risk. Yet do we do enough to thwart tragedy?
“Current guidelines do not recommend assessments of mental health or suicide risk in TBI patients, instead focusing on short-term survival,” lead author Dr. Seena Fazel, a Wellcome Trust Senior Research Fellow in Oxford University’s department of psychiatry explained.
It may make more sense to treat some TBI patients as suffering from a chronic problem requiring longer term management just like epilepsy or diabetes. “TBI survivors should be monitored carefully for signs of depression, substance abuse and other psychiatric disorders, which are all treatable conditions,” said Fazel.
Yes, TBI is a chronic problem. So what’s to be done?
In a 2008 Informa Health article, “An overview of traumatic brain injury and suicide,” the authors said, “This paper concludes that increasing awareness of depression and suicide risk assessment in the TBI population should be aimed towards staff involved in neuro-rehabilation as well as other professionals who are involved in the care of patients with TBI, because psychoeducation of those most likely to come in contact with at-risk individuals have been shown to increase identification of suicidal patients, lowering suicide rates.
The suicide risk factors include loss of self-esteem and social role, economic problems, job loss, loss of friends, maladjustment to disability, social isolation and withdrawal, and executive function deficits, deficits of reasoning and judgement and the like. Sara exhibited these risk factors.
I’m sorry, Sara. I’m sorry that we didn’t help you enough. The legal and healthcare systems failed you and we were your last hope. We didn’t do enough.
In my anguish, I posted the newspaper article about Sara’s death and I told others that I knew she was crying out for help. I heard a reflection of despair, of support, of blame, of anguish. I include a sample of the replies I received below.
“Truly sad and part of the ongoing tragedy that TBI can be when there is a lack of support and understanding.”
“This is the reason we need to educate everyone about TBI so better support is given when needed.”
“There but for the Grace of God go I.”
“Lack of understanding is the same for us all. I have thought in the past of doing similar.”
“No surprise. Poor Sara. You can blame society as we know it and more importantly, our sub-standard MEDICAL PROFESSION.”
“I do understand her pain as I live with it every day however when i look into my sons eyes i see the reason I’m still here.”
“Sadness fills my soul. This is why TBI’ers need to vent in a private place & have support of others. Even if it is over & over & over.”
“This is heartbreaking. I do understand her pain – it is a lonely place that people who are supposed to love you do not understand. In my case – isolation and no help.”
“As one who lives in recovery from alcoholism/addiction and brain injury, I get it. We still have a lot of work to do.”
“I fight every day not to just end it all.”
We hear you, my friend Sara. We love and remember you. Rest in peace.