Trey's House's unique low-budget outpost for brain-injured residents pursues its own recovery

The Center for Disease Control and Prevention estimates 1.7 million Americans sustain TBIs annually. The causes are myriad: from brain tumors to car accidents to steep falls to improvised explosive device blasts overseas. The Center of Excellence for Medical Multimedia writes that TBI may be the "signature wound" of modern military conflict.

Michael Mason, author of Head Cases: Stories of Brain Injury and Its Aftermath, calls the problem of TBI "truly a health care crisis," one that may not dwarf post-traumatic stress disorder in occurrence but that blows PTSD away in the sheer costs of rehabilitation. The Family Caregiver Alliance estimates the lifetime cost of rehabilitating someone who survives a severe TBI can reach $4 million. Mason is skeptical of describing a clubhouse like Trey's as "therapy," however. He describes the wide variety of clinicians — including speech language pathologists, occupational therapists, recreational therapists, neurologists, neuropsychologists, behavioral therapists, psychiatrists and internal medicine doctors — that are required for recovery. TBI follows a disease process that heralds a lifetime of struggle requiring lifestyle changes akin to diabetics altering their eating and exercise regimens.

Mason said that TBI remains a vastly underfunded yet growing medical problem. Signature nonprofits such as Susan G. Komen simply do not exist for TBI. The American Heart Association — with needs roughly comparable to those of the nation's brain injury victims — receives hundreds of millions of dollars of aid annually, while the Brain Injury Association of America had a total revenue of only $1,892,198 in 2010. "It's a very serious legislative problem," Mason said. "I don't know that brain injury is being adequately funded in any state in America right now."

Because of dramatic changes to speech, character, and work performance — and the fact that TBI has only recently begun to be better understood by the scientific community — it's perhaps unsurprising that TBI survivors often find themselves ostracized by family and friends. "If the brain is its own universe, then we've only just landed on the moon," said Mason. "There is still a tremendous amount of research that must be done on the brain and how it heals." Trey's approach, he says, offers "a more serious, more organized version of the support group." It is, in effect, "a supplement" to therapy, but not a replacement for it.

Though TBI survivors have access to Department of Assistive and Rehabilitative Services benefits (for the purpose of recovery in accident and emergency room rehab), few options remain outside of general support groups, said George Yesian, president of the Brain Injury Association of Texas, before adding that Trey's House is the only TBI clubhouse available in San Antonio and likely the only one in Texas. Simply put, challenges to the effectiveness of its approach aside, beyond Trey's, there are just not many accessible options for TBI survivors locally. And that makes Trey's struggle all the more difficult to watch.

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