My once-vibrant husband died of ALS, and my  complicated grief is deep

The Washingtomn Post

Democracy dies in Darkness

By Maya Vijayaraghavan

October 27, 2019

On Jan. 1, my husband asked me whether he would die that year. I said no. It happened to be my birthday, and I wanted to feel jubilant despite the tragic turn of events in our life.

I thought Rahul might have another year, that he might beat the odds of dying this year. In other words, his hazard ratio was favorable compared with someone else in his situation. He liked talking about something related, hazard scores — a composite score of one’s genetic risk for a particular outcome such as diagnosis of a disease. It was his thing as a neuroscientist-physician. He developed one for Alzheimer’s disease, and was on his way to developing one for amyotrophic lateral sclerosis (ALS), the disease he had been studying even before he got sick with it. In reality, he had declined significantly since his diagnosis of ALS two years prior.

First, he lost his speech, then his mobility, and very quickly breathing became a struggle. But any talk of decline came with an acceptance that his life was imminently finite, and neither of us were willing to accept that outcome. But Rahul did die, six months after that conversation.

I remember some of our last conversations, when things were very difficult. His forewarning that this existence with him teetering at the brink of life and death was much easier than the life I would lead as a widow, raising two young children.

I think neither of us really understood that the emptiness I’d feel would be soulcrushing.

That I would cry all the time. That I would miss him so much. That I would become a ghost of my former self. That this thing they call complicated grief, in which healing doesn’t occur as it’s supposed to, and which supposedly happens only after a year, is something that I feel now. That I would think constantly about the time when my husband was first diagnosed and he got into a fight with our then-3-year-old (now 5) about how he could not carry him because he did not have the strength to and not because he did not want to. That I would have nothing to say to my youngest (now 3) when he is confused that if “appa passed away” then who is his “daddy.” That I knew how much Rahul wanted to once again carry them both on his shoulders, hug and kiss them, and never let them go.

That I would think painfully of how we would never again work side-by-side, across our dining table both immersed in our science. And that with a sideward glance at his frozen body I would see him looking at me; a look that was timeless and enough to convey that he loved me forever. No matter that he could no longer hold me or say it in words.

It does not help the grieving process that I am a highly functional person. In fact, I find it a betrayal of my inner broken self. What I really should be is a mess of a person heaped up on the floor, with no distinction between detritus and self. Instead, I wake up every morning at 6 after having slept minimally the night before, get dressed, make my children lunches, drop them off at school, pick them up and be their everything; review for my internal medicine recertification board exam (no matter that it takes me a whole day to get through subject matter that I would, in my previous life, been able to complete in a half-hour); try to write scientific papers with my research team; complete the endless tasks of informing every single government body about my husband’s death; tackle rodent problem in my backyard; and yet feel completely disconnected from this world.

Program to Prevent Suicide by Veterans Earns Bipartisan Support

The New York Times

Published Sept. 20, 2019 Updated Sept. 24, 2019

PHOENIX — Gloribel Ramos sunk slightly under the weight of her 32-pound body armor and gingerly gripped a plastic facsimile of an M4 rifle as she prepared to watch a video of a roadside bomb detonated in Iraq, all so she could better understand the experience of war and its impact on people who have fought in one.

Along with about three dozen other people gathered here, she had joined an effort to stem veteran suicide, one heavily reliant on civilians in the community willing to take the time to learn the warning signs rather than depend only on the Department of Veterans Affairs, which has for years failed on its own to turn the tide of veteran suicides.

The program, called Be Connected, represents a rare — and quiet — spot of bipartisan cooperation between congressional Democrats, who are highly critical of so much of the president’s policy, and the Trump administration, which has moved aggressively to try to turn around the intransigent veteran suicide rate.

“We are working well with them,” said Representative Mark Takano, Democrat of California and the chairman of the Committee On Veterans’ Affairs, referring to the department. He specifically cited the Be Connected program, which focuses on reaching veterans at risk for suicide, whether they live on a Native American reservation at the bottom of the Grand Canyon or in this bustling city.

Veterans died by suicide at roughly one and a half times the rate of the rest of the American population in 2017, according to data released Friday by the Department of Veterans Affairs. More than 6,000 veterans took their own lives each year between 2008 and 2017, and roughly 20 a day since 2014, according to the statistics.

There has been increasing awareness that suicidal veterans often are best reached through members of their own community, and not the federal government. Some of those veterans who may need help do not seek Department of Veterans Affairs services, and some suicides stem from issues not related to military service at all.

In March, President Trump issued an executive order to reduce the suicide rate by assigning other federal agencies — like the Agriculture Department in rural areas — to get involved, and enlisted local governments, veterans groups and social service organizations to pitch in.

The approach is a shift for an agency that for years attacked the problem alone, and it has impressed even the Democratic chairman of the House Committee on Veteran Affairs, who has been relentlessly critical of the department, especially over the issue of veteran suicide.

The program, called Be Connected, is based on one that worked with Arizona National Guard members who were dying by suicide at increasingly high rates over the last decade, and supported by a 2015 law designed to improve veteran’s mental health. It is operated by the Arizona Coalition for Military Families, a statewide public-private partnership that includes the Arizona governors office, the Arizona Department of Veterans Services, the federal veterans department and other partners. It is funded by a combination of federal, state, foundation and corporate sources.

There were roughly a dozen National Guard deaths in 2010 in Arizona; that fell to zero a year after the program began, said Thomas Winkel, director of the Arizona Coalition for Military Families, the backbone of the consortium.

The philosophy, he said, is to intervene on “the myriad issues that service members and their families struggle with” before they “lead to crisis.” Two years ago, the veterans department became an official partner in the consortium, which has since received 10,000 calls.

Members of the Arizona National Guard in Phoenix last year. There were roughly a dozen National Guard deaths in 2010 in Arizona; that fell to zero a year after the program began.

By identifying veterans who have the kinds of struggles that often lead to suicide, the program can connect them with the services they need while they still can be helped, like therapy, health care or a pet sitter to take care of their animals as they seek substance abuse treatment.

 “It’s not just about health issues,” said Wanda Wright, the director of the Arizona Department of Veterans’ Services. “It’s about all the determinants in your life that are barriers to services.”

The person to identify them comes from the community, like Ms. Ramos. They could be a doctor or nurse, or a civilian “navigator” such as a homeowner who spent the last few days chatting with his house painter, one who might happen to be a deeply troubled veteran. Those who sign up for navigator training might work for a state social service agency or a health care provider. But they might be just a family member of a veteran, or anyone else interested in helping veterans.

Sporty teens with concussions are three times more likely to be depressed

Brisbane Times

By Stuart Layt

September 2, 2019

Medical researchers are calling for an urgent investigation into whether there is a link between concussions suffered by teenagers playing sports and depression they develop later in life.

In a perspective paper published in the Medical Journal of Australia, the researchers said a review of relevant cases found adolescents with a history of concussions were up to 3.3 times more likely to experience depression in their lifetime than their uninjured counterparts.

Australian researchers are warning there needs to be an investigation into the link between teenage concussions sustained playing sport and the onset of depression. But the researchers, led by Amanda Clacy of the University of the Sunshine Coast, said the data did not give enough information to make a definitive link.

“A longitudinal understanding of the neurobiological mechanisms associated with concussion recovery in adolescents is urgently needed,” Dr Clacy and her colleagues wrote.

“The same structures in the frontal cortices and hippocampus that are known to undergo rapid development throughout adolescence are also implicated following concussion and in young people experiencing depression and suicidal behaviours.”

The most recent data from the Australian Bureau of Statistics show young Australians are now more likely to take their own life than to die in a car crash, with suicide accounting for more than one-third of deaths (36 per cent) among Australians aged 15 to 24.

The matter was complicated, the team said, because there was significant evidence showing playing a team sport was beneficial to young people, both for physical health and social development. “Given the overlap in the regions of the brain significantly associated with depression and concussion and those most sensitive during development, two main concerns are raised,” the researchers wrote.

“First, whether these developmental neurophysiological changes render adolescents more susceptible to emotional disturbances following concussion; and second, what can be done to make these mechanisms more resilient to adverse and ongoing consequences of concussion.” In particular the team identified a contradiction in how teens were advised to recover from a concussion.

Current orthodoxy stresses the need to temporarily withdraw from usual activities, including school, work, physical activity and training, and screen time. But the researchers said this could exacerbate feelings of social isolation and lead to the onset of depression. They said the physical cost-benefit of playing sports where concussion was a possibility needed to be explored more thoroughly.

“An improved understanding of the neurological and developmental benefits ofphysical activity for the treatment of mood disorders in adolescents would offer the opportunity to concurrently promote neurological development and recovery, while also mitigating many of the known risks of depression and suicidality,

A Melbourne-based start-up is using high-tech mouthguards to give doctors objective data to help diagnose and rehabilitate athletes from brain injury. HitIQ is monitoring players at four AFL and four NRL clubs to collect data which, if proven to be reliable, may help explain what separates a heavy hit from a. potentially damaging one.

The research is being led by University of Newcastle neuroscientist Dr Andrew Gardner, a leading authority on concussion in sport.


  1. Just one season of playing football—even without a concussion—can cause brain damage
  2. Startups fighting a 'bulletproof' mentality in men's health
  3. 'His personality changed': Michael Hutchence's sister on his traumatic brain injury
  4. Toddler suffers 'catastrophic brain injury' in alleged beating
  5. Cyclist, 70, left with head and spinal injuries after being hit by car
  6. 'Choked to the point of brain damage': Ice scourge fuels domestic violence
  7. Mass Murderer Possible undiagnosed brain damage
  8. Savage attack in Melbourne's north leaves tourist with bleeding to the brain, broken jaw
  9. Link between concussion and brain damage to ensure AFL debate rages
  10. Sports commentator Billy J Smith dies after a fall
  11. Surgeon killer could be first to get10-year term under one-punch laws
  12. Liam Neeson's nephew Ronan Sexton dies, years after serious fall
  13. Toddler burnt with lighter and hit every day in lead-up to her death, court told
  14. Patron filmed unconscious, held around neck as guard evicts him from hotel
  15. FA Cup set to introduce concussion substitute trial this season
  16. Teen fighting for life after Healesville car park brawl
  17. Police discover critically injured man at Logan Village address
  18. 'Don't ask me for compassion': Angry Anderson has not forgiven his son's killer
  19. Brain Injuries Remain Undiagnosed in Thousands of Soldiers
  20. Man dies in hospital after falling to punch in Fortitude Valley
  21. Maradona to be discharged within days, says doctor
  22. Cricket bat bashing victim fights for life after Ballajura pub brawl
  23. Diego Maradona, World Cup-winning football superstar, set to undergo brain surgery
  24. 'Country footy is way behind': The missing concussion discussion in local level Aussie Rules
  25. Autistic girls going undiagnosed due to ‘camouflaging’ behaviour, study says
  26. Lisa Montgomery to be first female federal inmate executed in 67 years
  27. Man dies after being shoved to the ground in New York mask altercatio
  28. Thomas had a rare brain cancer and no good options. Then he joined a clinical trial
  29. Nearly One-Third of Covid Patients in Study Had Altered Mental State
  30. Shaun Smith supportive of daughter Amy, signed by AFLW club North Melbourne
  31. Texas residents warned of tap water tainted with brain-eating microbe
  32. 'It's been a big day for me': Smith wants change after $1.4m concussion payout
  33. Damage Assessment
  34. What are CTE and concussion and how do they affect athletes?
  35. Danny Frawley was suffering from chronic brain disease when he died
  36. Elon Musk unveils brain computer implanted in pigs
  37. Portland truck driver apparently kicked unconscious as unrest continues
  38. Treatment for aggressive brain cancer shows promise in early trial
  39. Four-year-old injured after motorbike crashes through barriers at Sydney race
  40. 'Dangerous behaviour': Horror crash in sprint to finish leaves rider fighting for life
  41. Father charged with murder over death of six-month-old baby Beau
  42. Sickening Michael Chee Kam concussion overshadows gritty Eels win
  43. We asked veterans to respond to The Post’s reporting on Clint Lorance and his platoon. Here’s what they said.
  44. Doctors find brain issues linked to Covid-19 patients – study
  45. Widow of heart surgeon killed in one-punch attack sues Melbourne hospital
  46. Crowdfunding raises £30,000 for veteran's brain tumour surgery
  47. Boy in critical condition after fall at Sydney primary school
  48. 'I began to wonder if I would be better off ending my life': The invisible war wounds
  49. VA unlawfully turned away vulnerable veterans for decades, study says, with 400,000 more at risk
  50. Brain wiring could be behind learning difficulties, say experts
  51. Concussion: there's no knockout answer
  52. CTE discovered in Polly Farmer's brain in AFL-first
  53. Six-week-old baby nearly killed in ice-fuelled attack, court told
  54. Former hard man Ron Gibbs' chilling admission as head knocks take toll
  55. An Olympic Hockey Hero, a Violent Crime and the Specter of Brain Trauma
  56. Traumatic brain injury is a signature wound of the wars in Iraq and Afghanistan. But the military still has no objective way of diagnosing it in the field.
  57. More than 100 US troops suffered traumatic brain suffered traumatic brain in Iran strike,to report
  58. Man, 28, fighting for life nearly two weeks after Southbank attack
  59. NRL pledges initial $250,000 for landmark concussion study
  60. Veterans criticize Trump's downplaying of US troops' brain injuries
  61. Trump should apologize for minimizing troops’ injuries, VFW says.
  62. Fifty US troops left with brain injuries after Iranian rocket attack
  63. Can heading a football lead to dementia? The evidence is growing
  64. Mobile phones cause tumours, Italian court rules, in defiance of evidence
  65. Scientists create decoder to turn brain activity into speech
  66. Woman reportedly wakes up from coma after 27 years
  67. Enraged Qld dad who killed toddler jailed
  68. 'We thought it would be wonderful - we didn't know what was to come'
  69. 'We thought it would be wonderful - we didn't know what was to come'
  70. Graham must wake up to dangers of concussion
  71. Footballers focus on concussion, but there are many other risk factors
  72. Ex-AFL player sues club after retiring because of concussion
  73. When will we stop butting heads over sporting concussion?
  74. Why people with brain implants are afraid of automatic doors
  75. Christchurch mosque shooting victim, 4, suffering brain damage
  76. Link between concussion and brain damage to ensure AFL debate rages

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