Understanding TBIs at Work: A Personal Story

At the end of my first ever week of work, right at the start of my career, I was a passenger in a car that collided with a double decker bus in central London. Unconscious, I was airlifted to the Royal London Hospital, where I came to (nb: in a very groggy way – it’s not like you see on TV) later that night.

I was lucky to survive. In fact, I later found out that the police and fire service (the car had been on fire) had prepared the scene according to their protocols for potential fatalities. My only clear thought upon regaining consciousness, amidst the blur, was “I’m back”: of course, I have felt a deep and emotional gratitude for that moment ever since.

Amongst my injuries were breaks in the biggest and smallest bones in the body: the femur, and inner ear. The former, coming as it did with months on crutches, gained me much sympathy, as did having had such a near-death experience.

But much more profound and debilitating was something much more difficult for anybody who wasn’t spending a lot of time with me to notice: a significant traumatic brain injury.

As I’m based in the US, let’s check in with the Mirriam-Webster definition of a Traumatic Brain Injury or “TBI” - an acquired brain injury caused by external force (such as a blow to the head sustained in a motor vehicle accident or fall or shrapnel or a bullet entering through the skull).

TBIs, per the definition, can have many causes. From some further research, it seems that (sadly – preventably?) a large proportion are suffered by either small children or older adults, through falls. Indeed, research reveals something of a silent epidemic: 80,000 people in the US experience the onset of long-term disability following a severe brain injury annually.

TBIs are also perfectly intersectional – anybody can fall or have a car accident – and per my case TBIs can affect people of all ages, too.

Given the complex nature of our brains, and the infinite variety too of TBIs, symptoms can of course vary. Those in my case involved, firstly, severe mental fatigue (and no, it’s not the same as just being a bit tired after a busy day – you literally can’t think!). It also involved executive function and memory issues, particularly with short-term recall, which I found myself struggling with for the first time in my life and desperately making notes of everything anybody said to me in order to compensate. Combined with these came significant sensory sensitivities for the first time, particularly to bright lights, which I gathered is another common experience of those who have suffered TBIs. Though these have all abated somewhat in the many years that have passed, I still find myself being very selective in restaurants about where I sit and which direction I face.

One final facet of the TBI experience - again, one very personal in its detail, but I suspect very common in its fact – was significant anxiety. This came in many forms, and included anxiety around my work performance as, with a damaged brain, I slowly began to try to rebuild my career.

Why, then, does all this matter to businesses?

Well, firstly, there are support obligations that businesses have under equality legislation such as the Americans with Disabilities Act or the UK Equalities Act: TBIs count as disabilities under each, and therefore employers are obliged to make reasonable accommodations/adjustments where requested.

But – and I hope here that spelling out my experiences above suggest this - there’s more to it, too.

My brain, like everybody’s, was and is unique. After the TBI, I found it needed to work differently from before – and certainly, very differently from colleagues, when it came to things like how I managed my energy, engaged in meetings, where I worked from a sensory perspective, and so on. But at the time I’d never even heard of the word ‘neurodivergent’ – even though TBIs typically are considered under this umbrella – and certainly I was ill-equipped to self-advocate for these hidden but profound needs.

What I needed in reality wasn’t just adjustments, much as the initial negotiation of a custom work schedule was critical. It was – and still is – ongoing and consistent empathy and curiosity into my ways of working, and how they might be different from (but not better or worse than) somebody else’s with very different mental information processing from mine.

This, really, is the key principle of where TBIs and neurodiversity more broadly matter to businesses and what they can do about it. And it’s about going beyond reactive, individual adjustments to create teams and cultures where all our differences and preferences are welcomed and included, so that both individual and collective output can be maximized.

So as a manager, HR person or colleague. be aware of how common TBIs like mine are, even though you can’t see them. Be aware of how debilitating they can be too, and how much they can change someone’s operating system. And be aware that without curiosity, openness, empathy and flexibility, people like me will never be able to reach our potential.

Years after my car accident, I started Uptimize to help foster this approach in business as a whole, and happily I get to build a company that works internally on these principles as a result.

But individual employees at your company don’t have that luxury. By paying more attention to flexibility in how we work, in all its facets, you can contribute to everybody’s success.