The Preparation and Presentation of a Traumatic Brain Injury Case

By Gary Gober

I have long maintained that the trial of a significant TBI case (and I think every TBI is significant) is as much a spiritual undertaking as it is a purely forensic one.

A traumatic brain injury that results in permanent memory loss, personality change or destruction of the ability to earn a living amounts to the amputation of the soul.  Insurance defense attorneys often wrap their minimization of a brain injury by saying, “So what? She survived, didn’t she?”  But as the great trial lawyer Moe Levine observed years ago, “If all life amounts to is survival, who needs it?”  It is the ability to enjoy companionship, to savor tender moments and cherish precious memories that make life worth living.

All trial advocacy is story-telling. The victim of a brain injury that is caused by someone else’s carelessness is coming before the bar of justice and saying, “I have been deprived of my ability to think, my memories and my earning power.  I ask for compensation.”  Achieving justice for that person is my job and my calling as a lawyer who tries cases.

Allow me to simplify.  In trying a TBI case I employ three paradigms.  One is the INJURY paradigm.  I have got to prove that my client has more likely than not suffered a brain injury.

This requires testimony from experts.  Neurologists will testify to the anatomy of the brain and will show the jury what happens when the brain’s message carriers, called axons, are sheared and torn by the force of a blow or trauma to the head. Modern neuroimaging techniques can show graphically where such shearing has taken place.  Neuropsychologists will tell about the cognitive testing they employ to illustrate the loss of cognitive function as a result of a TBI. A neuropsychiatrist may testify as to the depression resulting from a TBI and the loss of function it entails, depression so deep and dark as to be completely disabling in some cases.

The second paradigm I utilize is the PERSUASION paradigm.  Once the nature and existence of the TBI has been established by vocal, visual and graphic medical proof, I must show the effect such an injury has had on the life of the victim.  The single most powerful aspect of this paradigm is, I believe, the testimony of before and after lay witnesses, not just experts. Who are the people who know the injured person best?  It is here that family, friends, neighbors, co-workers, and supervisors are vitally and decisively important.  They knew the victim before, they see her now, and they can explain the difference they have perceived.  They have no axe to grind, they are simply there to tell what they have observed.  Properly developed, this testimony can be of immeasurable persuasive value in determining the compensation to be awarded the brain injury victim.

Finally, there is what I call the POWER paradigm. It brings the case down to its final ultimate resolution. It’s what the story is ultimately about:  the value of living a human life.

It is here that the advocate must call forth from the depths of his being those thoughts and values that make life more than just “surviving”.  The Bible teaches that we are made “a little lower than the angels”.  The loss of that special something that makes us human, of memories of life experiences, of the joy of smelling the roses, of loving and being loved, of the obliteration of memory and identity, the sense that “I’m not me anymore”.  These harms and losses are what provide the basis for justice, for adequate compensation for the catastrophic  effects of traumatic brain injury.

I will be speaking on this subject at the annual convention of the American Association for Justice in Montreal, Canada this July.  If you would like a copy of my remarks, please email me at gary (@) goberlaw (dot) com, and I will send you a copy.

Traumatic Brain Injury, An Insidious Stalker

For the last half century the subject of traumatic brain injury (TBI) has been one that has evoked controversy and sometimes heated debate. Today with the benefits of thousands of case studies in the literature and the development of diagnostic tools such as diffusion tensor imaging, neuro-imaging and advanced MRI machines, a consensus is emerging regarding the characteristics and nature of TBI.

It is now recognized that TBI is A PROCESS, NOT AN EVENT

Some injuries involving  the brain may take weeks or even months to manifest themselves. Every brain contains billions of filament-like  structures called axons..  Encased in a white fatty substance called myelin, these axons comprise the part of the brain known as white matter.   They conduct impulses of information across pathways called synapses and are the highways that carry messages from the brain to the body.  When a brain sustains trauma these axons may be twisted and torn and their ability to convey information through the brain is compromised and even destroyed.  This is known as axonal shearing. Sheared axons can emit toxic chemicals that have a corrosive effect on other  nearby or adjacent axons causing them to cease functioning normally and resulting in a cascade of pathology with more and more affected axons  diminishing and destroying healthy brain functioning.  Thus it may take up to several months before this spreading malfunction manifests itself in disabilities such as loss of mental cognition, behavioral changes and problems with memory and mood such  as depression.

Therefore when  a person sustains a head injury in a collision  or in a fall we should not jump to conclusions too quickly about the presence, duration and seriousness of the trauma to the brain.

TBI is an insidious stalker.  Once it occurs it can develop and spread in the brain over time beyond the date of the initial trauma.

Close observation and proper continued treatment  and testing: these are the watchwords in fighting this stealthy enemy we call TBI.  Keep visiting this website for more information in future blogs to be posted periodically.

Effects of Traumatic Brain Injury

If you, a family member or a friend have not had your life touched by a traumatic brain injury (TBI) they probably will be. Over a million Americans sustain a TBI every year. These injuries range in consequence from disruptive to catastrophic. The three categories of TBI are usually grouped as “mild, moderate or severe”. But don’t be misled by facile categorizations: even a so-called “mild” TBI can profoundly alter a person’s life, affecting mood, memory, cognition and decision-making ability. Many TBI’S–perhaps 57% of them–fail to be diagnosed in the Emergency Room.

TBI IS PERHAPS THE HOTTEST HEALTH TOPIC IN AMERICA TODAY. The prevalence of concussion among high school, college and professional football players as well as brain injuries from roadside explosions in Iraq and Afghanistan among returning soldiers has produced wide-spread awareness of this phenomenon among the public.

Our self-identity, our sense of who we are is wrapped up in our brains. A TBI can destroy that self-awareness. That’s why TBI has been referred to as “the amputation of the soul”.

Keep visiting my website at to learn more about this important health challenge and how it can affect you. I’ll be talking a lot about it in the blogs I will post in the days to come.