Brain Injury Trauma 

If a brain injury doesn't kill you, the neglect and loneliness that follow just might.

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MARGARET’S BRIDGE
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Margaret Burke was a familiar face in Salt Lake City’s welfare and mental-health state system. People at the Utah Housing Authority [UHA], Valley Mental Health and nonprofit day treatment centers knew her, as did workers at a number of shelters. Burke was physically frail but had a feisty personality and was guarded about her past. She was always dragging bags around, wore a white winter coat twice her size and her trademark knitted beanie cap in the cold or an enormous floppy hat during the heat. UHA senior executive Lana Walton says Burke reminded “me of my nana.” They were both walkers, “who embraced life.”

Born in Wisconsin on Aug. 7, 1948, Burke converted to The Church of Jesus Christ of Latter-day Saints and moved to Utah, where she married her first husband in the late ’70s. That marriage fell apart a decade later, and sister Henningfeld believes that after Burke lost her parental rights to her two daughters in the 1980s, she began a slow decline, mentally and physically.

“Her heartache was her lost relationship with her daughters,” her friend Judy Perry agrees.

“There were moments you would see her by herself,” recalls Naomi Spencer, a worker at Valley Mental Health day-treatment center Pathways, which is slated for closure at the end of this year. “She was lost and alone.”

Toward the end of her life, Burke suffered from severe diabetes—which destroyed her eyesight and her feet—and paranoia and anxiety. In her final months, she needed new eyeglasses and teeth replaced, but never got them. Nevertheless, Burke fought hard to keep her independence. She wanted to start a business and tried unsuccessfully to fund her own newsletter, Margaret’s Bridge. “She wanted to share all the things she was aware about for the disabled with other people who needed them,” BIA’s Valerio says. “She had a huge heart, cared so much for everybody.”

From 2005 until August 2008, Burke lived in a basement apartment on 700 East and 1800 South. Now 71-year-old Perry met Burke in the early 1990s, when Perry worked as a teller in a downtown credit union where Burke deposited her checks. She says Burke was a “pack rat” who couldn’t even throw away an outdated grocery flier or used pizza-box “in case it might trigger a memory.”

Burke felt unsafe in her 700 East apartment, convinced people were entering it when she was gone. On Aug. 25, 2008, she called Cathy Clara at the Independent Living Center, which helps the disabled. She asked Clara to help her find a new home, and then put all of her endless papers and boxes in several storage units.

All she cared about, Clara says, “was having her stuff. The paper was evidence of her life.” It may also have held, at least in Burke’s mind, the clues to one day explain to her estranged daughters why she lost custody.

After Burke moved out of her apartment, the UHA agreed to give her a 180-day extension to find another home. But first, the UHA required that she pay her previous landlord past-due rent of $280, which she couldn’t do. Complications from her diabetes and brain-injury-related memory issues meant she often lost money and checks. She also couldn’t afford the co-pays for her insulin shots and medical visits, so she often went without them.

Her storage units, however, were always paid up.

IN YOUR FACE
Ruiz knows too well how hard it is to process reality with a brain injury. “I can’t just do things,” he says. “I have to think about it.” To cross a room, he thinks about moving his arms, then standing up, then looking to see if there is something he might run into. Only then does he consciously step forward. It is an exhausting process.

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Post-injury mood swings, an inability to recognize the personal space of others, and a new bluntness drove many former friends away. “He would say what he felt and it would hurt people’s feelings,” his mother says.

Another problem was the abrupt way in which Ruiz would behave immaturely. When Ruiz celebrated his 13th birthday at home surrounded by friends, he behaved “very young,” his mother says. “His friends didn’t understand how to be with him.” The following month, most of those same friends stopped coming to his house or answering his calls.

His former best friend, Enrique Connor O’Neill, still struggles with guilt about Ruiz. He walked his friend around Ruiz’s home, pointing out objects to see if he remembered them. But Ruiz endlessly repeated embarrassing questions, such as why he wore cologne, with a bluntness that upset O’Neill.

Additionally, O’Neill felt personally responsible for Ruiz, but adds, “when it was time for me to step up to the plate, I ran away screaming.”

Along with disappearing friends, relatives drifted away. That’s all too common, BIA’s Valerio says. “They look at you and physically, once the scars have healed, you’re the same person. They think “Why can’t you put it behind you and stop using it as an excuse to not be able to work or remember?”

Ruiz started West Jordan Middle School in August 2003, a period of his teenage life that his mother calls “the meanest years.” Post-accident, Ruiz was determined to return. “He missed his friends,” his father says. He went back at the start of eighth grade, his head shaved, the scars across his scalp painfully visible. None of his old friends would hang out with him. When he saw people laughing at him, he thought they liked him. He would go over, and they would laugh more and walk away. “That would kill him,” his mother says.

“I WANT THE BRAIN I USED TO HAVE”
A few weeks after Ruiz had returned to school, a “kid tried to punk him for his sunglasses,” O’Neill says. Ruiz needed the sunglasses because light distracted him too much, and when he refused to give the glasses up, the kid punched him.

Brooke Gonzalez says initially, the school was sympathetic to Ruiz’s needs, but soon got tired of her weekly visits to complain about the bullying—or, as a school report described them, “slight altercations.” Those altercations, Gonzalez and Ruiz recall, included a youth throwing a Pepsi bottle at his head, but what hurt Ruiz more than the bottle was that former friends stood by, watching instead of protecting. Even the classroom wasn’t safe for him. While sitting at his desk, a classmate slammed the back of his head with a textbook so hard that Ruiz had to go to the hospital. It was as if his peers wanted to see if his brain injury was real.

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“They kept testing me,” he says. “I didn’t know what to do.”

Ruiz took several classes at West Jordan Middle School, while also being bussed for two classes of woodshop to South Valley, a school for handicapped students, in 2006. Ruiz’s parents hoped being with teens more disabled than he was would improve his self-esteem. “He taught others,” his mother says. “He did wonderfully there.”

When Ruiz started Copper Hills High School in 2007, he insisted on two classes a day at the school. Copper Hills, Brooke Gonzalez says, was more sympathetic to her son’s needs. While there was still bullying, it was mostly verbal abuse, such as calling him “a retard,” she says.

He continued attending woodshop at South Valley but, after several months, asked his parents, “Am I like them? Am I mentally retarded?”

In October 2007, while his peers attended school football games and dances, a friendless, rejected Ruiz plunged into depression. He cut himself repeatedly. One night, he made multiple slight cuts on one wrist and stabbed himself in the other. He went crying to his mother and showed her the wounds. “I need help,” he told her. He spent a month in a psychiatric unit.

In October 2008, Ruiz tried to kill himself again after the break-up of a four-year relationship with a neighborhood girl. “She was the one person who was a real good friend back there,” his father says. The loss of her support, Ruiz says, “was the most painful thing I ever had.”

When his family moved to Sandy, a suburb he found cold and unfriendly, “I didn’t know what to do with my life anymore. I had no friends, no one to turn to.”

Before his suicide attempt, he looked at pre-accident photos of himself. “I want the brain I used to have,” he told his mother. “I want to be like I was before.”

He stole three bottles of NyQuil from a gas station, drank them and swallowed a handful of pills. His mother, hearing his labored breathing, forced him awake.

“Just leave me, Mom,” he said. “I want to die.”

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