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Heidi Lerner, Author House, Bloomington, IN, 2006, 240 pages, $19.95, ISBN: 978-1-42-592971-8


The author, who herself sustained a traumatic brain injury, states that this book is for both the patient recovering from a traumatic brain injury and to educate the public. However, the family member who cares for and lives with the person recovering from a brain injury may, in fact, reap the greatest benefits from this book. The reader will gain much insight into the thought processes of the patient with traumatic brain injury (TBI). TBI changes linear thinkers into nonlinear thinkers, and Gray Matters is written in a nonlinear way. Topics of sudden importance interrupt didactic sections, leaving the reader with a sense of how the TBI patient thinks. Chapters on posttraumatic stress, aphasia, and impulsivity are interspersed with chapters on meltdown, self-importance, and the "O" word (organization-a dirty word to the brain-injured person!!).


As the author states, intelligence is not affected, and TBI is largely an invisible disability-albeit involving huge numbers of the population-and likely under diagnosed. (Ever had a pretty good knock on the head and felt dizzy and disorganized for a day or two afterward?) Lerner proves the point about the persistence of intelligence after a brain injury: she completed her master's degree in special education at George Washington University-a program designed specifically for survivors of brain injury.


The book is geared toward the rehabilitative process, which the author says is a full-time commitment. Lerner also notes that the patient involved in rehabilitation goes through a positive psychological development process, learning things that would not have been learned without the benefit of the rehab process, such as acceptance, finding previously undiscovered strengths, and more present-centered living.


Lerner's poems and drawings are woven throughout the text in the book and serve to reinforce the written content. Her poems and drawings underscore her premise that "creativity enhances cognition." Many lists are used in the book, including "What Survivors Want in a Support Group," "Advantages of Having a Head Injury" (a long list), and "What Can Help a Brain Injury Survivor." In a section titled, "Special Education for Brain Injury," several helpful techniques are enumerated, with "repetition" listed three times, emphasizing its importance.


A very special section of the book is titled "Nature's Touch." In this section, Lerner gives a personal narrative of an amazing encounter with a sea otter and touches on interspecies communication-and the healing power of nature. How often in nursing do we encourage this aspect of healing?


This book will give survivors of TBI hope and reassurance that they are not alone in their rehabilitation process. It will help family members understand the thought process of the brain-injured patient. It also will guide the healthcare provider in giving optimal rehabilitative care.


Reviewed by Marie Lasater, MSN RN CCRN CNRN, Neurosciences Division at Barnes-Jewish Hospital, St. Louis.