Shifting Perspectives: Rediscovering Life Through Grief After Brain Injury

Acknowledging the sense of loss allows individuals and their families to heal and get back to the business of living

By Jennifer Russo, MD, Kessler Institute for Rehabilitation, a Select Medical hospital

Image of Dr. Jennifer Russo. She has long brown hair and glasses. — Dr. Jennifer Russo is a staff physiatrist at Kessler Institute for Rehabilitation specializing in the care of individuals with brain injury.

The Merriam-Webster Dictionary defines grief as “deep and poignant distress caused by or as if by bereavement.” It is alternatively defined as “the anguish experienced after significant loss,” “a very great sadness,” or simply, “deep sorrow.”

On a societal level, grief makes us uncomfortable. We encourage each other to look on the bright side, trust in a greater plan, and move on to better things. But how are we supposed to “move on” when some essential part has been lost?

I spend a lot of time in the outpatient acquired brain injury practice at Kessler Institute for Rehabilitation thinking about and discussing grief. Frequently, I find that my patients and their care providers don’t feel entitled to the word grief when the loss is not tangible. Their loved one lived. They survived. But the limit of grief is not death. Grief is ever-present in our lives. We grieve ideas we have outgrown, faith we have lost, and beliefs that no longer serve. We grieve unexpected change, love lost, and friendships gone cold. We grieve the body of our youth and its endless potential.

Graphic of puzzle pieces that say "New life" and "Old life".

Throughout human existence, grief has been a shared experience, an action taken to allow a community to heal. It is an action which unites. And it is an action necessary to make space for life. So often in brain injury, the focus is on the “before” and “after” of the injury. But a brain injury is not a before-and-after event. It is a life lived. Recovery does not occur outside of time and life cannot be waited for. It is “now.”

Grief unanswered keeps people entrenched in the before and the after, and always at a distance from now. The challenge to all those affected by brain injury is to allow grief, to look grief in the eye, and to give it its name. Because only by taking the action of grieving are people able to get back to the business of living.