In the name of the son, a family pleads for the forgotten ones
Paul Heinrichs
April 29, 2007

A father's tender gesture, a stroke of his son's brow, goes unacknowledged. The head lolls, the brain's relearned ability to control swallowing the only observable activity.

The life-force that used to brim in James Macready-Bryan today leaps out only from photos on the hospital room walls. Footballing days, cricketing moments, family events, hanging out with the boys at the beach, the girls at a party … James "packed a lot in" to his first 20 years.

But the young man from the Carey Grammar community, who was to become an arts/law student, lies stricken with a catastrophic brain injury in Royal Melbourne Hospital's Gardenview House, the result of a street assault.

He is not the only one — young men are increasingly at risk of the devastating consequences of street violence. The neurosurgeon who helped save James' life, Professor Andrew Kaye, knows the extent of emotional trauma the young man's family is going through.

" It's like seeing your son or daughter die every day," he says. "This is every parent's worst nightmare." His only good news is that, as the blackboard proclaims, "James is back without his 'trache' " — he's improved to the point where he can breathe without a tracheotomy tube.

But for his father, Andrew Macready-Bryan, nothing is more important now than receiving some form of communication from James — something that would give hope of a potentially meaningful recovery. It is not there yet. James' eyes are open but they track aimlessly around the room. He drifts between sleep and a form of limited consciousness. Even slight recovery could take years, if there's recovery at all.

But his plight has stirred a determination to improve the care and funding arrangements for young people with such devastating acquired brain injuries.

The assault on James, which took place in the city on his 20th birthday last October 13, left him in the worst category of victim — one with a non-compensable injury.

If he had suffered his injury in a car accident or at work, statutory schemes like the TAC's would have ensured lifetime quality care. But because he is not under those umbrellas, just where and how he will be looked after cannot yet be determined. " It just seems to us that the whole notion of funding based on cause rather than effect is all upside down," says Mr Macready-Bryan.

James will be at Gardenview for up to two years, and is on the waiting list for a State Government program — the only one in Australia — specifically targeted at the slow-to-recover category.

The good news in the coming state budget is that the program is being expanded from $5.6 million annually, helping 130 people a year, to $9.7 million — an extra $12.3 million over three years to reduce the waiting list. " This funding will provide assessments, case management and treatment for approximately 300 Victorians with acquired brain injury (ABI) each year," says Community Services Minister Gavin Jennings.

" People with an ABI often require services that aren't readily available in the disability system, and this investment will help meet the needs of those people. 'Slow To Recover' is the only service available to people who cannot seek compensation and prioritises people under 50."

The Bracks Government last year said it would explore options for an insurance scheme for catastrophic injuries — an idea a key lobby group, the Young People in Nursing Homes Alliance, believes the Federal Government should put in place.

" We are still looking at how such a scheme would work and examining various options," Mr Jennings says. James Macready-Bryan's family and its well-connected friends have begun a foundation that is raising money — and community consciousness — about the gaps in the system.

Australia's systems of disability care were mostly developed to care for people who had a disability from birth or required care when they were elderly. But the numbers of people surviving catastrophic injuries has placed pressure on the system.

Australia has 6700 people under 50 years old recovering from catastrophic injuries who are living in aged-care nursing homes because there is nowhere else for them.

Professor Kaye is the patron of the Macready-Bryan Foundation and believes there needs to be "a scoping study" of the extent and resourcing needs of patients such as James.

" We need to develop a coherent system of looking after these patients," he says. "At the moment, it is a hotchpotch run by well-meaning people doing their best. These are the most vulnerable people in our community, and in the end we will be judged by how we look after the most vulnerable people in our society."

Federal Treasurer Peter Costello used to sit next to Andrew Macready Bryan in year 11 at Carey, and their sons were schoolmates. Mr Costello came to the foundation's first fund-raiser, a cricket match last month, and made a moving speech.

But words are not enough. Professor Kaye hopes that Mr Costello will act to create a social insurance scheme — a safety net to help James Macready-Bryan and all the others like him.




Source: © 2007 The Age