Fatigue at Work after Concussion
My fortune cookie told me one day: “Your ability to juggle many tasks will take you far.” As I thought about being a trial lawyer – the memory, analytical ability and speed of information processing required to try a case in front of a jury – I realized that without the ability to juggle information, I could not do my job. Fatigue at work after concussion makes it very difficult for brain injury survivors to work effectively. Just one of the obstacles a survivor faces.
Then I thought of my professional clients. I thought of those still exceptional people, who were having such a difficult time coping with their jobs because of fatigue at work after concussion. Like a juggler, whose hand speed was suddenly reduced to “average”, they no longer could keep enough information balls in the air to distinguish themselves.
The most disabling aspect of the attentional/processing speed problems that come with diffuse axonal injury, is the cycle of overattending/fatigue at work after concussion. This is especially true with those whose jobs require intense concentration or fast paced decision making. The pattern that I see in my practice is highly successful individual before the concussion, who still has exceptional intellectual capacity, but whose ability to marshall that capacity has been slowed. When allowed to work in a quiet place, with only one input at a time, they function for several hours, at the same level they did before the injury.
The problem is that it is very difficult to be a successful executive, without having to deal with more than one input at a time. And even if they are able to insulate their work environment from multiple stimuli, they can only sustain concentrated work effort for a few hours at a time. If as Gronwall and Wrightson suggest, they are able to “rest for an hour or two”, in essence take a nap, they may be able to continue on, on the good days. But invariably, there are the bad days, the days when too much done the day before, or too little sleep, or too much other stress, makes it so that they don’t start the day renewed. On such days, they might as well stay at home.
There is unquestionably a vocational role for exceptional people with such disability to play in our economy, yet finding an employer who is willing to accommodate a midday nap for fatigue at work after concussion, a completely quiet work environment, and ONE-TASK-AT-A-TIME is difficult. Try to design a workable job for such person, it can be done. But remember, the employer will not be able to always RELY on person who in their good hours, might otherwise be their most valuable employees. Two things make this task more difficult:
- The ability to do the best work in the company, is what makes this employee worth fighting to keep. Yet when the work is that important to the company, it is hard to trust that type of work to someone whose work product may not be reliable because of fatigue at work after concussion.
- Memory. Going hand in hand with processing speed problems, perhaps causally, perhaps correlatively, is compromised memory as well.