Cold Cold Heart (36 page)

When I was a child of ten, I got bucked off a pony and landed on my head in the street. In those days, no one wore helmets when riding anything—horses, bicycles, motorcycles, whatever. I was incredibly lucky not to have been killed. I was doubly lucky in that my head is as hard as a block of granite. I lived in a very rural place with no hospital, no helicopter to whisk me off to a trauma center. We had a cranky old town doctor who was none too happy to be called to his office on the Fourth of July. He came in complaining and smelling of what I would later come to recognize as whiskey. He held fingers up in front of my face and asked me how many I saw. I guessed two, and he sent me home. No X-rays. CT scans and MRIs were the stuff of science fiction. My mother sat in my bedroom that night waking me up every time I started to fall asleep because that was what she had been told to do with someone who had taken a bonk on the head.

The reality of that situation was that I had a concussion, something that was regarded very differently in 1969 than it is today. I had suffered a mild traumatic brain injury (TBI) that was never diagnosed, let alone treated, and I have suffered with the effects of that injury my entire life. While the severity and frequency of my headaches have lessened over the years, I still get them. I have one right now as I write this note. Over the decades I sought help from
a number of doctors, none of whom diagnosed me with TBI. My headaches were blamed on allergies, sinuses, eye strain, stress, hormones, and, my personal favorite, my imagination. I don't deny having a vivid imagination, but I don't know anyone who would choose to imagine the feeling of an axe cleaving his or her skull for hours and days at a time.

The fact is that many people who suffer mild and even more serious traumatic brain injuries often go undiagnosed and misdiagnosed even today. Closed head injuries are not always obvious. They may present themselves in ways that can be minimized or rationalized away. After all, the person has no outward signs of injury, and they can be very clever in compensating for the cognitive deficits caused by the injury. Every TBI is as unique and mysterious as the brain it impacts. A fellow competitor of mine in the equestrian world took a fall on soft footing that would not have been considered serious by any of us but for the fact that she bumped her head. She was in a coma for weeks and suffered severe physical and cognitive deficits that ended her riding career, which she struggles to overcome to this day, years later. Meanwhile ol' Ironhead here was thrown with force onto concrete, and the only lasting aftereffects I have are headaches.

The good news is that great strides have been made in the study of TBI in the past ten years. The bad news is the major reason for these advancements: war. The U.S. Department of Defense reported new TBI cases among military personnel in 2013 alone at 27,187, with many of those injuries incurred by deployed active-duty personnel. I have personally witnessed the result of TBI incurred in war by a friend's husband. The ongoing struggle of the wounded warrior is a heartbreaking thing to watch. The post–brain injury person is often not—and often never will be—the pre–brain injury person remembered by friends and family, and the reality of that is difficult to accept for all involved.

Compounding the struggles of those injured in war is
post-traumatic stress disorder, as if one or the other affliction is not hell enough by itself.

While I was writing this book, and had already immersed myself in the research of both TBI and PTSD, a serendipitous thing happened. I had taken a break one evening to watch my passion: mixed martial arts. One of the fighters in particular caught my attention as he was being introduced. MMA fighters don't wear shirts in competition, and the majority of them have often-elaborate body art in lieu of a uniform. This particular fighter had a lot of script taking up the full length of his back. I couldn't read the fine print, but I was so intrigued, I decided to do some research to find out what the tattoo was all about. The fighter's name was Shane Kruchten. The tattoo was a list of nineteen names and dates, bracketed by the words
ONL
Y THE GOOD DIE YOUNG
. The names are of the United States Marines he served with in Iraq, along with the dates they were lost in the war.

As I read Shane's story, I realized that Shane's experiences with PTSD and the military bureaucracy mirrored the experiences of my character, John Villante, and the experiences of my friend's husband. As a nod to Shane, I gave John a similar tattoo on his back, the names of fallen comrades and the dates their lives were ended by war. Shane's story is one of tragedy and struggle with PTSD, drugs, and alcohol, and ultimately his triumph over a tremendous amount of adversity. I encourage readers to look up Shane's story for a true account of what can happen to our soldiers fighting this terrible internal battle long after the war is behind them. There are tens of thousands of veterans in this country who each have a story of their own and struggles that will plague them for the rest of their lives.

Thankfully, there is help available to these men and women through various organizations, some of which I've listed at the end of this note. It's also important to know that PTSD is not exclusive to veterans of war. PTSD is an equal opportunity affliction that torments victims of crimes and other tragedies. People like Dana
Nolan, who have suffered and survived unspeakable evil but who will forever live with the memories and nightmares. The following is a list of just a few of the many organizations helping victims of crime, PTSD, and TBI, including several organizations that provide service dogs to veterans struggling with PTSD.

About PTSD organizations: http://search.about.com/?q=PTSD+organizations

Brain Injury Association of America: www.biausa.org

Defense and Veterans Brain Injury Center: www.dvbic.org

Fisher House Foundation: www.fisherhouse.org

Intrepid Fallen Heroes Fund: www.fallenheroesfund.org

National Center for PTSD: www.ptsd.va.org

The National Center for Victims of Crime: www.victimsofcrime.org

Office for Victims of Crime: www.crimevictims.gov

The Battle Buddy Foundation: www.tbbf.org

K9s for Warriors: www.k9sforwarriors.org

Paws for Veterans: www.pawsforveterans.com

And for veterans struggling to find employment post-service: www.hireheroesusa.org

Tami Hoag's novels have appeared on national bestseller lists regularly since the publication of her first book in 1988. Her work has been translated into more than thirty languages worldwide. She is a dedicated equestrian in the Olympic discipline of dressage and is an avid fan and student of mixed martial arts. She shares her home with two English cocker spaniels in West Palm Beach, Florida.

Find Tami Hoag on Facebook at www.facebook.com/TamiHoag and on Twitter at www.twitter.com/TamiHoag, or at www.tamihoag
.com.

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