So, what do you do?
I specialise in physical medicine and rehabilitation (PM&R or physiatry), a young specialty with only about 10,000 practitioners in the US. We treat people of all ages with disabling conditions such as arthritis, brain injuries, chronic pain, congenital conditions, muscle and nerve conditions.
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You鈥檝e just written a book about concussion. Why?
Films and other media depict concussion as a brief jolt to the head. Victims who don鈥檛 die 鈥渟ee stars鈥�, but they quickly recover. These portrayals convey the message that concussion is a trivial matter without lasting consequences. But that is far from the truth 鈥� concussion is an injury to the brain.
What kind of impacts can cause problems?
It could be a fall or a sports injury. But it doesn鈥檛 have to be a blow to the head: a combination of acceleration-deceleration and rotational forces can cause a concussion. Some parts of the brain are very susceptible to stretching by these forces. So, for example, in a high-speed motor vehicle crash, a seat-belted person may sustain a concussion without any direct impact to the head.
Can concussion have long-term effects?
Some people develop a chronic condition called post-concussive syndrome, especially if they don鈥檛 receive education and targeted treatments. Typical symptoms include headaches, depression and memory problems. Early diagnosis and treatment of associated conditions such as post-traumatic stress disorder and insomnia lead to the best outcomes, along with non-opioid treatment of pain and individualised exercise programmes. Repetitive concussions are associated with more problems, including neurodegenerative conditions.
鈥淔ilms depict concussion as a brief jolt to the head without lasting consequences. But that is far from the truth鈥�
Is brain injury more serious in children than in adults?
Our brains are not fully developed until our mid to late-20s, and there is some evidence that brain injuries in young people may set them up for health problems later in life. In my opinion, children should not be subjected to repeat concussions and we should find safer ways for them to get exercise. However, this is a complicated area of investigation that has not yet produced definitive answers. I hope people will read my book so they can draw their own conclusions.
What鈥檚 the most interesting thing you are working on right now?
The neuroscience of consciousness and neurotheology 鈥� the study of the brain and religion 鈥� are areas of research that excite me.
Were you good at science at school?
I preferred biology and physics, possibly because my chemistry teacher joked about having to repeat explanations so the girls would understand.
If you could have a conversation with any scientist, living or dead, who would it be?
Sabina Strich, a pioneer in the study of brain injury, who died in 2015. She studied the microscopic damage that I explain in my book. I鈥檇 like to talk with her about the distinction between the mind and brain, and her life in Munich and later in England, after her family fled the Nazis.
Do you have an unexpected hobby, and if so, please will you tell us about it?
A beautiful and challenging jigsaw puzzle offers a distraction from the world and life鈥檚 stresses. I also play the piano.
What鈥檚 the best thing you鈥檝e read or seen in the past 12 months?
Greta Thunberg is mobilising the rest of us to pay attention to climate science. She exemplifies the kind of activism that is necessary now.
OK, one last thing: tell us something that will blow our minds.
The human brain鈥檚 current configuration may only be about 40,000 years old. That greater capacity for thinking and creating has had helpful and harmful results. I鈥檝e always been an optimist, but unless we figure out how to manage the darker side of our psyches, we will destroy the planet.
