I saw Dr. D yesterday and discussed the problems with TAQ document creation. She offered a number of great insights and confirmed some of my interpretation of events. I am listing these from memory and my recollection is bound to be wildly imperfect, but I believe we discussed the following issues. When combined, all of these form a wall of psychological resistance I have difficulty overcoming.
Promise of Rehabilitation
In September, or October, of 2012, Dr H referred me to a public rehabilitation clinic. The referral was refused because I did not have an open and valid SAAQ claim. I suspect the clinic provides services and then back-bills SAAQ for services rendered. Absent an active SAAQ claim, I was deemed ineligible for any rehabilitation services.
This refusal played a major role in motivating me to complete the first SAAQ appeal document. This was drafted between November 2012 and early January 2013. It was an extremely difficult and arduous undertaking, harder than almost anything I had accomplished prior to that time (almost comparable to this effort). I forced myself into the work, constantly reminding myself that rehabilitation represented the only window of opportunity to recover from my injuries.
This desire to achieve the full recovery of my prior self was a huge motivating factor.
This motivation is absent from my current effort. I have learned (and this has been confirmed by another peer group support session participant) that this clinic is not equipped to assist persons with brain injury. I have also learned, and slowly come to accept, that a full recovery from mTBI is unlikely. The best that may be achieved is a series of adaptive lifestyle modifications to accommodate the injury and to reduce the life impact. Dr. D agreed that this more realistic self appraisal is likely a major factor in reduced motivation.
Recognition of Past Injured State
In reviewing documents written by me in the early phases of the injury, I have been struck by the manifold errors. I speak of first seeing Dr D in 1978 (when she would have been three years old). There are many similar errors. Reading these early documents drives home the degree to which I “was out of it.” As I explained to Dr. D, the experience is similar to going to a party and then learning the next day about all the embarrassing things you did. You might well recoil in disbelief at your own intoxicated antics, shudder at the risks taken, the rules broken, cringe at the degree of incapacitation. My reaction to my own injured past has been similar.
There is a second reaction which follows this line of thought. If four years ago I acted without being fully aware of my actions, or was unable to properly control myself, how can I be sure that today I am fully competent and self-aware? The result is a lingering doubt of my own competency, a mistrust of those “normal” bodily systems that an uninjured person takes completely for granted. With alcohol the effects of incapacitation wear off within 24 hours. With brain injury the cognitive impairment persists, possibly forever. I believe it is true that I am better now than I was in 2011. But it is also true that I am less capable than I was in 2010, prior to the injury.
The outcome is that I view myself as being “stuck” with the injury. If it has not improved in four years then it is unlikely to improve much in the future. No decision on the part of a Tribunal judge will serve to alter this fact. This awareness is a significant negative factor.
Lack of Succour
The other troubling aspect derived from a review of the past is an awareness of having been “out of it,” and having followed the direction of “professional helpers” and being misguided, and misdirected, by them. There is an awareness of my being heavily dependent on the actions of others and the fact that those others, most of them health professionals, failed me. Framing this another way, I have to give thanks to Dr. D for being the exact opposite of all of those uncaring, unconcerned others. I do not know how I can ever repay her.
This miss-treatment bears similarities with what I experienced as a youth when I was socially ostracized due to having imperfect miss-shaped arms. The present treatment echoes this earlier miss-treatment and the overall effect is negative.
Head in the Meat Grinder
This topic centres on the awareness of the effort required to create the submission documents (there is a lot of detail here and this will form the basis of a future post). Because document creation a is very negative experience, the outcome is akin to a B. F. Skinner experiment in aversion conditioning. I am more and more reluctant to put myself back in this particular meat grinder.
Dr. D asked how I will handle the outcome if I should lose the TAQ case. I have given this no thought. I am conscious of inhabiting an injured self and the need to deal with the issue, of the fact the accident occurred in a motor vehicle, in Québec, and I paid all my insurance premiums. I paid in advance for a service and I therefore view myself as being “covered.” The thought of failing in the litigation has not occurred to me. I need to focus on this possibility and draw up some form of contingency plan. I will do this once I complete the final TAQ submission.
Dr D thought part of my problem might be due to the open ended nature of the TAQ process. I am unaware of any fixed submission deadline. I have set my own deadlines and have consistently failed to meet them. I believe I would have great difficulty in working to deadline. I face major frustrations as it stands.
I described the fact of an interlude between TAQ submission events and how this time had been devoted to a needed clean up of all the scattered paper and the 1,001 other tasks that are neglected due to needing to place the entirety of my focus on the document effort. The interlude was a pleasant respite from the document tasks. I found I enjoyed puttering around engaged in activity with a low cognitive demand. The onset of fatigue and headache was delayed compared to when I perform cognitive intensive tasks. Dr. D thought this was a positive sign, that I was arriving at a realistic appreciation of my abilities, and that I was making appropriate accommodation to the injury.
Update April 8th, 2016
I am not a lawyer and cannot afford legal assistance. I am very conscious of the fact that I am operating in a sphere about which I have little knowledge and am highly disadvantaged by this fact. I do not think this factor was discussed with Dr. D but I sense it plays a significant role.