Toronto Star, TORONTO >>
Kim Johnson was driving on the wide roads of Mississauga with her 14-year-old daughter when a sports car coming from the opposite direction drove over the median, hit her Honda Civic, and spun it off the road and into a nearby parking lot.

At first she was aware of only the obvious physical injuries, including whiplash and a cervical spine disk herniation. (Her daughter suffered mild bruising from the seat belt.) But it wasn’t long before she realized her injuries were more extensive.

Johnson, 48, returned to work as an insurance adjuster just two days after the crash.
But she had returned too soon. Johnson sat down with her manager to discuss a file that she had read and reviewed just two hours prior. Her boss was waiting for the answer to a question she’d asked, and with Johnson seemingly at a loss, he told her to take a minute.

Johnson recalls saying, “’No, I really don’t remember what I read two hours ago.’ That was my first realization that I was having some cognitive problems.”

Those problems are evident now, as she pushes a trolley through the aisles of a Mississauga supermarket, and recounts the events of 2005.

Scanning the rows of vegetables, Johnson passes the potatoes three times before she spots them. She sometimes forgets what she is looking for, and loses focus. After going to the opposite end of the supermarket, she returns to the vegetable section for the third time – this time, to get beans. “That’s what I’m like shopping everywhere,” she says, laughing.

Johnson’s brain injury was diagnosed as mild, but it affects every aspect of her day. She gets lost using roads in her own neighbourhood. She tires from a few minutes of chores. And she has lost her bankcard and other valuables on countless occasions.

She is one of more than 400,000 Ontarians currently living with the effects of an acquired brain injury, according to the Ontario Alliance for Action on Brain Injury.

Afflicting more than 50,000 Canadians every year, traumatic brain injuries have become known among health care professionals as the “invisible epidemic.”

That’s because there are more brain injuries per year than there are cases of breast cancer, HIV/AIDS and Multiple Sclerosis combined. But the other illnesses are far better known thanks to years of publicity and campaigns like the bike ride for cancer that took place last weekend.
The horrors of brain injuries came to light last March, however, when actress Natasha Richardson died only hours after hitting her head on a ski slope.

Dr. Donna Ouchterlony, the Director of the Head Injury Clinic at St. Michael’s Hospital, feels Richardson would have taken her head injury more seriously – and possibly sought treatment earlier – if she had been aware of how prevalent, and deadly, brain injuries can be.

“Everybody is contributing to breast cancer. And it’s such a small percentage [of patients]. But people are absolutely irrational about it. I was telling that to a female lawyer…she says ‘Yeah, breast cancer, that’s what terrifies me.’ And I said, ‘Think about it. Would you rather lose your ability to think, or your breast?’”

Dr. Ouchterlony started what became Ontario’s first neuro-rehabilitation clinic at Bridgepoint Health (formerly Riverdale Hospital) in 1972. It began as a stroke recovery unit, but expanded due to the rising number of head injury victims.

And yet, almost 40 years later, Dr. Ouchterlony still struggles with a lack of resources.
Cutting edge medical equipment that helps diagnose brain injuries is available in other parts of the world – but not in Toronto. “It’s crazy,” she says. “I’m a doctor but I have to spend time fundraising when we should be spending the time with patients. And I’m not the only doctor to have to have to do this. Far from it.”

Government cuts to funding have forced her clinic to close beds and let go of valuable staff, even as wait times get longer.

The bulk of the medical treatment and rehabilitation given to car accident survivors like Johnson is provided by their automobile insurers. The amount allocated to all but those in the most serious condition (known as “catastrophic”), is currently capped at $100,000.

The Financial Commission of Ontario, the body that oversees the insurance industry, recently published a review in which it advised the government to reduce that cap to $25,000.

Dr. Ouchterlony is bracing herself for the coming weeks, to see whether Finance Minister Dwight Duncan does indeed implement that recommendation, which came in response to insurers’ complaints that they are losing money to rising medical costs.

Seeing patients who depend on accident benefits for essential rehabilitation, Dr. Ouchterlony says such a cut would be “disastrous.”

What’s more, it would widen the gap between the level of care offered to patients of various income levels. Wealthier patients can top up their insurance beyond standard levels of coverage, which is not an option for those who can’t afford pricey premiums.

Back at the supermarket, Kim is describing the kinds of coping mechanisms she’s developed to compensate for her impaired memory, such as writing up lists and double and triple-checking written documents. When she’s out, friends do a “Kimmy Sweep,” making sure she has her bag, keys and money.
Still, Johnson depends on accident benefits for a host of therapies that help her recover, and reduce pain. And if the new cap on benefits were in place today, she would have already exceeded the limit.
“I’d be screwed,” she says. “I am still getting treatment, four years later, which I need now, and will continue to need.”

Minister Duncan is expected to announce the changes he’ll make to auto insurance legislation in mid-July.