Check out this video on youtube: https://www.youtube.com/watch?v=jkbxaukavHs

Traumatic brain injury (TBI), according to the World Health Organization, will surpass many diseases as the major cause of death and disability by the year 2020. With an estimated 10 million people affected annually by TBI, the burden of mortality and morbidity that this condition imposes on society, makes TBI a pressing public health and medical problem.  (NeuroRehabilitation. 2007;22(5):341-53. The impact of traumatic brain injuries: a global perspective. Hyder AA1, Wunderlich CA, Puvanachandra P, Gururaj G, Kobusingye OC. Department of International Health and Center for Injury Research & Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. ahyder@jhsph.edu; http://www.ncbi.nlm.nih.gov/pubmed/18162698)

According to research published by the World Health Organisation (WHO), approximately 54 to 60 million people are victims of traumatic brain injury world wide. 2.2 to 3.6 million of these are moderate to severe. In Germany, more than 280,000 people are injured, 73,000 of these children (see also: http://www.pharmazeutische-zeitung.de/index.php?id=1522 and http://www.nachsorgekongress.de/download/nachsorgekongress_presse/2010_Einleitung/nachsorgekongress_presse_2010/2010_ergebnisse_studie/).

To clarify, and I had to look that up myself: A traumatic brain injury (TBI) is an injury to the brain caused by an external force after birth. Common causes of a traumatic brain injury include gunshot wounds, motor vehicle crashes, assaults, or falling and striking your head. An acquired brain injury (ABI) includes all types of traumatic brain injuries and also brain injuries caused after birth by cerebral vascular accidents (commonly known as stroke), and loss of oxygen to the brain (hypoxic brain injury) (http://www.biausa.org/FAQRetrieve.aspx?ID=43913). This means that there are many more people who suffer an ABI than a TBI annually.

Now – what are the figures for Ireland you might ask. I asked, and did a bit of research, asked some of the voluntary organisations involved, checked Government strategy papers, and, guess what? Nobody knows.

I don’t know whether this is ‘scientific’, but if you assume that Ireland has 1/20th of the population of Germany, then 1/20th of 280,000 of TBI victims in Germany could mean 1,400 TBI victims in Ireland annually.

1,400.

For the first time in almost a week, Pádraig went out to the roof terrace to get a bit of fresh air. He also went back to have a bit of chocolate pudding (which, surprisingly, didn’t go down that well) and stewed apples (which he seemed to like much more). We only staid out for three quarters of an hour or so and went back to his room early.

Of course, this is not Pádraig but it’s the same gadget I used today to wash his hair.

Since we had a bit of time on our hands, I decided to cut his hair. That worked out much better than the last time. I got a bit over-enthusiastic and decided to wash his hair. It’s something most of us do a few times a week, I have heard of people doing it even every day! Hospitals are different.

For a change, Pádraig was lucky. His nurse had a bit of time and gave me a hand. Only when I did it, did I realise that I would most likely have set not just Pádraig and his bed, but his complete under water had I been on my own. The result: a real clean head of beautiful hair, and Pádraig apparently being the most relaxed person on the ward (much more than myself), with a record heart beat of 62 (I was waiting for the alarms to go off, ‘smelling’ hear failure) and an oxygen level of 98.

Finally, this morning I spent some time checking out a device used, amongst others, by gamers to control the characters and actions in the computer games they are playing. It’s a gadget that works like an EEG, only that it costs just a few hundred dollars. Watch the video: https://www.youtube.com/watch?v=jkbxaukavHs on EMOTIV.

I’m getting one and will try out to which extend it will help Pádraig to interact with the environment surrounding him.

Looks like today was Pádraig’s last day in the ICU. Unless anything unforeseen happens, he’ll move up to his ‘old’ room, where he (and us) will be in much more familiar surroundings – though, as I’m writing this, I can’t believe my own words.

Maiden dancing at the crossroads

There were two visitors there today who stopped by on their way from Berlin to Dublin to see Pádraig. Berlin – Hamburg – Dublin. The only way to go. What I couldn’t believe was Pádraig’s face when he realised who was coming in through the door. And it got better, when they told him that they didn’t want to make him jealous but that they were on a paid trip: free flights and the funkiest five star hotel in Berlin, because they had won this competition, there was the broadest smile on his face. He hasn’t lost his sense of humour. And he really tried to talk and say ‘take it easy, see you soon’, I’m sure, when they left.

People dancing at the crossroads in the Schanzenviertel. Not a long tradition, but they did today.

We gave them a lift to the Schanzenviertel – we hadn’t been there before ourselves in the evening before. We got out of the car and had a drink with the visitors and discovered that the Germans aren’t really that different from the Irish: both celebrate at the crossroads. So there was a mixing table, two big speakers, a stand selling food and drink, and a couple of hundred people having fun. At the crossroads. Literally. And up the road was the ‘Rote Flora’, an occupied theatre, with the homeless sleeping on its steps.

Tomorrow, Pádraig will be able to sit out again in the wheelchair, the therapists will have much better access to him, we’ll be able to give him real food again, and, if the weather stays as nice and warm as it was today, we’ll sit back out on the roof terrace.

Today’s German Music Tip
Tangerine Dream, Zeit (1972). This is (was?) one of Germany’s internationally best known music groups. If you think that this album is 42 years old, it’s really amazing. Certainly not everybody’s taste, some will not even think that this is music, but it’s really brilliant – whether you like it or not:)
What’s hot
Sternschanze
What’s cold
Wandelhalle
The German word/phrase/verse of the day

Just when you think: ‘no need for an ICU anymore, isnt’t that great?’, life turns around with a big grin and gives you a taste of its cruel side, as if that was necessary.

It had to happen and today was the day.

Pat went in early this morning to assist Pádraig’s physiotherapy session. She arrived just before the physios and noticed that he was moving his left arm and leg. It stopped after a few seconds. When the nurse came in, it happened again. When the physios arrived, they called the doctor.

What followed then was a bit of controlled panic.

He was apparently having a series of (or one long) seizures, not dramatic ones (to Pat they looked more like spasms) but still worrying enough for the whole ward to really kick into action. Loads of checks and samples. Eventually down to another building to get a CT and an EEG.

None of these, nor the half a dozen of other tests they conducted, showed up any ‘bad’ results. Notwithstanding, instead of his ‘normal’ room, he ended up in the hospital’s main ICU in Haus 7 this afternoon where he got a cocktail of three different drugs at a dose that would have put the doctor and myself, both of us, to sleep until the weekend (the doctor’s words, not mine).

Pádraig, however, when we were finally allowed in to see him, looked asleep but was able to answer ‘yes’ and ‘no’ with his right and left feet. When we told the doctor, he said ‘fair play to him, amazing’ and then started to wonder about the dose he had administered… When a nurse was preparing him for the night, we were sent out for half an hour. When we came back and Pádraig heard Pat’s voice, he moved his head around towards her.

We should know by now that there is nothing that Pádraig is not picking up on his way to recovery. We had been told that one side effect of the make-me-more-alert drug could be seizures, but they had only started to give this to him last Tuesday and only a small dose to start with. A small dose that was to be increased over the coming weeks. They’re going to re-evaluate this next week.

Over the past months, we had been told that most patients with injuries like Pádraig have seizures and that the fact that he hadn’t had one was surprising, but really good. While the fact that he had an episode today is worrying, at least we know that it was not caused by anything really serious, thanks to the quick and decisive action by his doctors. It looks like a side-effect of one of the drugs he’s been taking, so this has been stopped.

It was a tough auld day for Pádraig. He didn’t really need this. I’ve stopped wondering how much more is going to happen to him and setting him back while he is recovering from this accident and his injuries. But sometimes I think: he’s had enough, really. It’s bad enough as it is. No need for more stuff to happen. We know by now, and don’t need to be told or shown anymore, that life can be cruel.

Repeat after me: no more ICU, no more ICU, no more ICU.

We’ll see what tomorrow will bring.

Hand auf’s Herz: did you believe last night’s figures about us (Germans:) eating 1,097 animals a year – or three animals a day? If you did, you’ll have to revise your view of the Germans! We’re not that bad! The figures as they referred to the number of the animals were correct, but – they did not refer to the number of animals Germans eat in a year, but in a lifetime. Life expectancy at birth in Germany is currently 80 years. Assuming that even German babies don’t eat that many pigs and that we are talking about average figures (some Germans are, whether you believe it or not, vegetarians or don’t eat that much meat at all), it’s still an awful lot of animals, even in a lifetime…!

Anyhow. Since we are talking about food and numbers of people, here is a little quiz for you. It’s part of a questionnaire that the Swedish professor Hans Rosling put together and called the “Ignorance Survey” because it demonstrates how little we really know about the world we life in – and how much of what we think we know is incorrect.

It’s about the distribution of the approximately 7 billion people living on our planet between the different continents of America, Europe, Africa, and Asia. Which of the following is correct: a, b, or c?

Read on for the solution…

Day 2 of the visit from Dublin. We made it out to the roof garden, though it was a pretty fresh day. Sitting outside, with music in the background, and Hamburg far down below us, brought a sense of normality – if that is possible. There was ‘normal’ conversation happening, with Pádraig right bang in the middle.

The really amazing thing was that the lads had travelled more than 12 hours yesterday to make it to Hamburg and to visit Pádraig. Tomorrow morning, bright and early, they will make their way back to Dublin, and it will take them around the same time again before they hit the home ground. An early morning bus trip to Bremen, a tram from the bus stop to the airport, a Ryanair flight to Dublin, and another bus or two before eventually getting back home. There’e a lot of friendship here, a great and brilliant connection.

It’s strange to say and to feel this, but I think it is exactly because of this close bond, this friendship, that we almost did not talk about Pádraig tonight when I went out with them for a meal. Pádraig should have been there and we all knew it. It’s like when you don’t talk about the most important thing that is going on, the person that you are most concerned about, because everybody knows. No need to talk about it. He was so present. So present.

Last night, Pádraig got a bit of oxygen, the first time for a long time. For some reason he had vomited a bit and his oxygen levels had gone down temporarily. But only for a very short time, and most likely because something had slightly blocked the cannula in his trachea. We heard about it when we asked because we noticed the oxygen running when we arrived today.

Life, days are never ‘normal’, there is always worry about something. Real worry.

Here is the solution to the little quiz: the correct distribution of the 7 billion people across the Americas, Europe, Africa, and Asia is:

The percentage points are the results of this survey carried out by Der Spiegel amongst people living in Germany. (The results are kind of average and similar in other developed, Western nations.) It demonstrates that most people in the Western world overestimate the number of people living in Africa, and they underestimate the number of people living in Asia – where more people live today than in all of the other continents combined. (You can find out more about Hans Rosling and the test on Gapminder.)

Today’s German Music Tip
Maxim, Einsam sind wir alle. The first song by Maxim during his concert at the “Docks” in Hamburg last week during the Reeperbahnfestival, recorded by the NDR. Here is a bit of the lyrics: My head is heavy, but I don’t mind, I’m carrying it around anyways, … It would be nice to stand straight again, or at least not so worn down,… No reason to ask how I’m doing, I think it’s probably ok. (You’ll also find Maxim on Soundcloud.)

Schwer ist mein Kopf, aber was soll’s,
Ich trag ihn mit mir rum,
Auch wenn er manchmal etwas runterhängt
Und gerade ziemlich brummt.
Irgendwie krieg ich ihn schon gestemmt,
So leicht kipp ich nicht um.
Es wäre nur schön, mal wieder gerade zu stehen
Oder wenigstens nicht ganz so krum.

Ist nicht nötig, dass du fragst,
Mir ist eh nicht wirklich klar,
Wie’s mir geht:
Ich denke, es ist schon ok!

What’s hot
The lads
What’s cold
Talk about the obvious
The German word/phrase/verse of the day
Hand auf’s Herz!

The boys are back in town. It’s great to see them again, and I’m sure Pádraig was really happy to see them and to hear their voices. We caught up on loads of things, heard how everyone was, and got an update on the Dreamboat. (Can’t wait for it!)

When we were leaving the hospital and we got talking, we stumbled upon some essential questions, touching the heart and soul of what it means to be German.

Have you ever wondered what this is?

The first questions is one many visitors have asked before – and I don’t think I ever gave them a proper answer. What they were wondering was why on earth had the engineers who built the Schön-Klinik decided to put down those concrete ‘stones’, paving that is not really paving because you would probably break you ankle if you tried to walk on it. – Tonight, I will lift the vail of mystery: the mysterious structure is called “Uferstein”. Here is what one major supplier has to say about “Ufersteine”:

“Ufersteine werden in Randzonen von stehenden oder fließenden Gewässern zur Vermeidung von Ausschwemmungen oder Ausuferungen eingesetzt. Auch der Einbau in Anböschungen und stärker belasteten Verkehrsflächen, z. B. Feuerwehreinfahrten, ist üblich.”

Oh – you don’t speak German? Don’t worry. I don’t really understand myself what this means either. And I still don’t understand why they don’t just use “Rasengittersteine”. Wouldn’t you agree?

The second question was really touching the core of what it means to be German.

To really appreciate this you must know the following (source: http://www.tagesschau.de/inland/fleisch104.html):

“Vier ganze Rinder, vier Schafe, zwölf Gänse, 37 Enten, 46 Schweine, 46 Puten und 945 Hühner – im Laufe seines Lebens verzehrt ein Deutscher laut “Fleischatlas 2013″ durchschnittlich 1097 Tiere.”

Oh, you don’t speak German? But this time, you must have guessed what the above says!? The quote is from the German ‘meat atlas’ and it says that, on average, each German eats per year 1,097 animals. Would you believe it!? Four entire cattle, four sheep, 12 geese, 37 ducks, 46 pigs (that is almost an entire pig a week!!!), 46 turkeys, and an unbelievable, incredible 945 chicken! It’s almost three animals a day, 3 in 1 (one) day!!!

Back to the original question from the lads. They wanted to know why a German sausage or “Bratwurst” could not be sold like a ‘hot dog’. Not sure whether you are as surprised as I was when they asked that question? I mean, come on, even the thought of comparing a ‘hot dog’ with a German Bratwurst… I mean, if you allow that comparison, where will it all end? Next time they’ll probably question why we use “Ufersteine” instead of straight forward asphalt!

Now seriously, what they were wondering was: why is the bread roll so short and the Bratwurst so long? – In my mind I was thinking (though I didn’t tell them) that they should be grateful to get a long bratwurst and not a short hot dog. Here in Germany, the customer is still king. What I told them instead was that they could, if they were on their own, and since the bread roll was wider than the sausage, that they could double up the sausage to fill the entire bread roll; and, if they were with someone else, they could break the Bratwurst into two pieces and each eat half of the Bratwurst together with half of the bread roll, dividing it into upper and lower halfs. The only problem in such cases that I have encountered is the discussion about who will get the upper and who will get the lower half of the bread roll. (The top is crispier than the bottom.)

If you managed to read through all of the above you probably think that I have finally lost my mind. – Rest assured, I haven’t. Yet:)

Another day of action, really, in the hospital today. The dentist was back to check Pádraig’s tooth guard and teeth, and decided that while both showed some degree of damage, it was not bad enough to require his intervention. Pádraig was also visited by surgeons who fixed the nails of both of his big toes which had caused him small local on/off infections for weeks if not months by now. A nurse proposed to get a hairdresser in (she meant to say a  ‘barber’) to cut Pádraig’s hair in order to make it easier to ‘wash’ it with their chemical ‘shower cap’-like hair-cleaning method. – I think we’ll cut it ourselves and then try out the head-bath we got to wash his hair.

It was great to see so many good things all happening over the past two days, some of the issues that were dealt with in the space of just two days were issues about which we had asked questions for months. It’s like as if someone had flipped a switch and the magic started to happen… Just shows you that you need keep asking questions.

We’ll keep the questions going. No question is ever a stupid question – whether it’s about personal hygiene, German sausages, or ‘Ufersteine’. Wouldn’t you agree?

You know that I have been looking for people to join me in Wacken, this tiny village in the North of Germany, between Hamburg and Tating, that, every year, is home to the world’s largest heavy metal open air concert. Today, Pat and I visited a house, not too far away from Wacken, that has been bringing its tenants to Wacken, wheelchairs and all, for many years now.

The promoters give them free tickets and they get close up to the stage. Heavy Metallers help to carry the chairs across the mud, if necessary. They bring persons with very severe ABI, even in a state of extreme minimal consciousness. The manager of the house told us that one of their clients who had never even moved before, lifted his head, opened his eyes, and smiled – for the first time ever. Heavy Metal therapy.

When we met them, we met a group of people, between 16 and 50, sitting around in a circle, kicking a giant ball towards each other. A lovely labrador running towards us to great us as we came through the door. Really funky music playing in the background. Some people sitting on one side of the room, but still right bang in the middle of life, resting, sleeping, just being them, in really comfortable chairs.

It’s an image I’ll never forget.

They had serious fun and those who, because of their condition, could not actively take part in the fun, felt the energy, life happening, in this large yet almost homely feeling room.

Most of the people were what I so often have heard being called by the professionals ‘hopeless cases’. Yet, they were as active as they could be, they engaged as much as they could engage, and there was a level of interaction going on that was truly inspiring.

One of the people was a German lady who had had an accident in the USA. When her doctors proposed to switch off her food supply, her family rescued her and brought her to Germany. After a few months, here carers noticed that she really likes horror movies. (Yes, I was thinking something similar to what is probably just going through your mind.) They decided to buy a gadget (something like one that takes an EEG, but better and more mobile) which allowed them (=researchers at a nearby university) to identify the currents in her brain that show that she wants to change the channel on her TV. The last problem they have to resolve now is to translate that signal into one that the remote control for her telly understands. Should be a piece of cake.

The place I am talking about is a small, 39 bed home in a village you’d hardly find on a map, set up by a man who came across a place for people with acquired brain injury (ABI) that was about to close down because the man running it couldn’t do his job anymore. So he took heart and decided to do what he had never done before: he took over the home and expanded it to what it is today. Pat and I went to see it this morning and were truly impressed.

This is the closest place we’ve seen to what we imagine An Saol to be.

Today, we met people with very severe ABI. Nobody, nobody looked at them as ‘hopeless cases’, not worth the investment. To the contrary, all of them had a life they seemed to enjoy and waiting for W:O:A 2015!

Pádraig went back eating today almost as good as he had before the injury on his left arm. The swelling there continues going down, and the dark and yellow patches are also disappearing. He’s got over it and we’re moving on. Another memory. We had a meeting with his doctor today who will start using new medication and build that up over the coming three weeks or so to see whether it’ll have an effect on Pádraig.

We asked again about bringing him out, downstairs, for a walk. There doesn’t seem to be a way. On the positive side: there is always the roof garden! And the sun is still shining in Hamburg!