This Review was reprinted from the Journal of the American Medical Association, December 8, 1999, Vol 282, No 22

Every hour of every day, people around the world fall victim to life altering accidents. On July 11, 1988, Claudia Osborn, a successful physician and respected medical school faculty member, became one of those statistics. Osborn’s life took a dramatic shift after a bicycle accident left her with a severe head injury.

Over My Head is the powerful story of a warrior, battling her disability and motivated by a profound desire to beat the odds, restore her cognitive abilities and ultimately return to practicing medicine. She was able to put her life back on track with the help of the physical medicine and rehabilitation team.

Osborn’s gripping account begins first with her incessant denial of an impaired ability and the depression and frustration that follow when she attempts to return to her career and social life. With virtually no short-term memory and devoid of many cognitive skills, Osborn is forced to take notes on practically every occurrence in her life; her memory becomes a few shorthand notes scribbled on a pad.

After months of treatment by physiatry and allied rehabilitation specialists at the Head Trauma Program of New York University’s Rusk Institute, Osborn learns the magnitude of her injury and slowly overcomes the severe depression that accompanies her neurologic transformation. With the support of her family and friends new and old, she forges ahead despite very slow and painstaking progress. Osborn comes to grip with her reality and with much diligence learns to appreciate her newfound life and future.

Physicians who read this book will develop a supreme appreciation for the long and difficult journey patients with head injuries must make to become rehabilitated.

Lucidly described are some of the practical compensatory strategies used by patients with head injuries to surmount the challenge of their injury. Forced to resort to an index card memory, Osborn develops an elaborate system of reminders, cues and alarms to get through the day. Precise notes about how to cook or where to drive lie strewn across her house and taped to appliances. After a move to New York City, one note reads, "Today is Tuesday, March 14, 1989. YOU HAVE MOVED. You live at 69^th and 2^nd. Turn right for the bathroom. There are no lights. If it’s morning, get up."

The system is certainly not foolproof, and Osborn shares several other frustrating and, at times, comical stories that will entertain the reader.

Dr. Osborn currently is associate professor of internal medicine at Michigan State University. With ongoing involvement in the rehabilitation process, she continues to make great strides.

Often a physician can forget or overlook the difficult physical and psychological struggle that accompanies severe head injury. Claudia Osborn’s poignant account can help physicians of all specialties vicariously appreciate the intricacies and challenges of brain injury. Well written and easy to understand, this volume will appeal to a diverse audience. The brief glossary enhances the reader’s comprehension of technical terminology used.

Osborn’s rehabilitation was more than physical. It had tremendous psychological significance, which shaped her attitude and focus. In a speech made upon completion of the Head Trauma Program Osborn closes with the touching words, "If I could return home knowing I could again contribute, that I would be a whole person able to give to others and be an equal partner in every relationship, it would be the greatest gift I could give myself and to those who love me." This statement echoes the philosophy of the rehabilitation team that aided her in her journey to recovery.

Over My Head is an inspirational account of one person’s unrelenting and courageous pursuit to cope with life following severe traumatic injury. It is also a book about the bonds of friendship and the powerful emotional and physical lengths that family and friends travel in caring for a loved one with a disability. Moments of humor, sorrow, pain and frustration flood the pages and help the reader to develop an appreciation for the challenges confronting patients with brain injuries.

Over My Head is a valuable book for those facing a severe brain injury, for rehabilitation specialists, or simply for those interested in a powerful story of strength and courage.

Mark Allen Young, MD
Maryland Rehabilitation Center
The Sinai Hospital of Baltimore

Joseph M. Powers, BA, RHY
Temple University
Philadelphia, PA

Over My Head: A Doctor’s Own Story of Head Injury from the Inside Look Out, by Claudia L. Osborn, 239 pp. $21.95, ISBN 0-83625419-8, Kansas City, Andrews McMeel Publishing, 1999.