What is Ethical Discharge? Turning the Negatives into Positives

Twice life has given me huge negatives. Both times I turned them positive. I had help from medical workers, family, colleagues, friends, and some of the discharge people. But the full recovery, which should be the focus of discharge, was up to me. Full recovery is very hard work. You have to do your best through every grim day—often using only your own powers—to make it happen. What I learned was never to let one day's discouragement distract me from my long-term path.

The first time, in 1993, I had just graduated Stanford law school, was clerking for a federal judge and had just won a fellowship to Harvard. Nice life! Then early one morning, a car hit me as I crossed the street with the walk sign. I hit my head, bled, and went into a coma. I had brain surgery on consecutive days to repair the injuries. Some doctors thought I would either die or live institutionalized, unable to function because of the damages to my brain.

I do not remember any of that; other people saw me through the grimmest parts while I slept. I woke up a week later, and my story begins after that. The only thing I wanted was to be up and out and go home. I wanted to leave the hospital, and then—even more—to exit the in-patient and out-patient rehab units. The goal I set for myself was to go home and to have my old life back again.

The doctors saw it differently. The surgeon was confident, but the others were not. Recovery is incredibly slow. Brain injury is a terrifying occasion. I had to get out of the hospital and out of in-patient rehab. The discharge people had little good news to tell. At the car accident rehab center, the personnel had written books and articles describing how impossible it is for the brain to recover. Their world was full of tests and games. Could I cook? How good was my memory? Could I play computer games? Could I keep my patience? Could I show them all the things they were looking for as proof that I could survive in the real world? Even my mother wondered why it was important to register how many nails I could move into a box in one minute.

Most important to me—would they decide I was fit to go back to work? Many of the personnel thought I should stay in their state, maybe for the rest of my life, receiving therapy. They were good at helping me get rides and other accommodations, as with my brain injury, I was not allowed to drive. But they were not helpful with everything else.

I did not stay in rehab. Wearing a wig to hide the scars and give me hair, I returned to finish the clerkship. I next went to Harvard. Fortunately, a doctor there had seen someone else recover from brain injury. Her knowledge of that story gave me confidence for mine. After that year, I became a law professor.

That sounds pretty good. I have had a lot of success. But I do not want you to think it was an easy path. For five years post-release, I examined my life and often questioned myself. The doctors told me an injured brain could not perceive its life accurately. I read stories saying cancer patients took five years to full recovery. I did too, even while working full time. That is the huge trauma about discharge planning in brain injury: everyone is guessing just how much recovery there will be. As the person in charge of your own discharge, you need to work hard every day to get the best results you possibly can.

Recovery from brain injury may sap self-confidence. First in that Harvard fellowship and then in pre-tenure life, everything I did was about how smart I was—or was not. If I did poorly at something, I might attribute it to brain injury.

The discharge people had emphasized the negative, not the...