Traumatic Brain Injury 161Collin is now in sixth grade, and with the help of resource teachers and speech, physical, and
occupational therapists, he is learning, walking, and performing other activities of daily living
very well. He goes to the resource room for special teaching and help with course assignments. The
physical therapist works on improving the range of motion in his right leg, arm, and hand, and
the occupational therapist has discovered clever new ways for Collin to button shirts, secure belts,
and tie shoes. The latest neuropsychological and communication tests show the power of a young
brain to compensate for bad baseball and driving judgments. Most of Collin’s communication
abilities are at age level, and on the tests of receptive vocabulary— that is, understanding words and
their meanings—he scored higher than his peers. On Saturdays, Collin is the neighborhood team’s
shortstop. Now as a left hander, he can hit the baseball into the right field, where the opposing team
puts its most awkward player. Collin is batting a thousand.
Case Study 8-7: Closed Head Injury Resulting From a
Motorcycle Accident
“He loves football,” the young nurse says, “and we leave the sports channel on all the time.” A
man in his early 20s lies on the hospital bed staring at the tele vi sion screen. He is tanned, mus-
cular, clean shaven, and looks as though he had stepped out of a surf board advertisement. “****”
is listed for his name on the medical chart. It is hospital practice for four stars to be given when
the patient is a public figure whose real name is to be kept confidential. It is also used when the
patient is a suspect in a major crime or a witness to it and guards are stationed outside the room.
But Patient Four Star, as he is called by the medical staff, is neither a public figure nor a crime
boss; he is simply an unfortunate motorcycle accident victim with no identification. According to
the rec ords, he has been in the hospital for more than 2 months, and all attempts to identify him
have been unsuccessful.
Early one morning, Patient Four Star and his crumpled motorcycle were discovered in a ravine.
No one knows how long he had been unconscious or what caused the accident. Apparently, the
high- powered motorcycle had been stolen, and the rider, helmetless and wearing only jeans, a
sweatshirt, and expensive running shoes, was found 90 feet away and nearly out of sight of the
police. He had no identification, or perhaps a thief had seen the accident and stolen it. Patient
Four Star’s fingerprints were run through every data bank in the state, his picture was shown
on tele vi sion newscasts, and a local private detective was hired to identify him. But it was to no
avail; the true identity of Patient Four Star remained unknown. As a last- ditch effort, the hospital
administrators and the county authorities, who are now responsible for him, have asked you to
help. You are authorized to see Patient Four Star and try to get him to volunteer his name or other
vital information. The neurologists and neuropsychologists think it a long shot but one worth
pursuing. After all, the nurses report that he is becoming more aware and that he particularly likes
watching the sports channel.