Act I opens with lyrical footage of Lake Tahoe, where we first meet Jay Waller, who introduces himself in voice-over as a TBI survivor. I will always have a brain injury; a brain injury doesn’t go away. Jay states that he is participating in a marathon 22-mile paddle to help raise awareness about TBI, and that the Tahoe paddle is a metaphor for the struggles TBI survivors face everyday. The beautiful scene of the lake paddle recurs throughout the film, providing a backdrop for essential facts about traumatic brain injury.
After the opening title, Jay begins to tell the harrowing story of his road-rage beating. Jay’s sister recounts the call from an emergency room nurse in the middle of the night: Get on the next plane and we’ll try to keep him alive until you get here. Jay was in a coma for 32 days. When he was released from the hospital, his impairment was not obvious to many, but his friends and family realized he wasn’t the same Jay. His first testing revealed his IQ was at 7th grade level. Changes to Jay’s behavior included his “disinhibition” or lack of discretion that got him into trouble as he struggled to recover.
An African-American Marine in his twenties, Jason Poole was ten days away from the end of his third tour of duty in Iraq when an improvised explosive device (IED) injured him severely and left him with TBI. He was in a coma for two months, lost an eye, and had to undergo massive cranial-facial reconstruction. Jason describes his first anguished look in the mirror post-injury—the moment becomes a poignant metaphor for the changes confronting all four characters. We see footage of Jason before reconstructive surgery struggling to put a sentence together, as well as his jocular and easy interaction with his twin sister and younger brother. Jason’s spirit and humor make him inspiring and charismatic.
Over images of headlights on a rural road, Kristen’s parents describe getting “the phone call that every parent dreads” from a hospital chaplain. A lovely young woman with a bright smile and big blue eyes, Kristen Collins explains that she has no memory of the truck that ploughed into the motorcycle on which she was riding, or the first weeks after she emerged from a coma. Her realization that she was impaired came gradually, with great resistance and a lot of anger. Her parents express the anguish they experienced when some of Kristen’s doctors recommended they begin looking into nursing homes for their daughter.
Ian McFarland’s aunt and grandparents recount how Ian’s family was en route to a wedding when the car they were traveling in veered, flipped over and went off a bridge. Ian’s parents were killed immediately. His younger brother and sister emerged with slight injuries, while Ian suffered a traumatic brain injury that left him impaired and in a wheelchair. Ian’s Aunt Melissa describes how she packed up everything she owned and abandoned her life in Oklahoma to care for Ian and his siblings. She took that brave step at a time when nobody—including Ian’s physicians— knew whether the little boy could possibly make it.
In Act II, our characters journey on the daunting but rewarding road of rehabilitation. Truly, it takes a village to heal a TBI survivor: we meet support circles, including family members, friends, physicians and therapists. As they share our characters’ back-stories, we sense the magnitude of their losses and the emotional rollercoaster of living with, and caring for, TBI. Jason was a ladies’ man and the life of the party. After his injury, he and his fiancée separated, another painful loss he had to endure. Jay’s impairment was overlooked and misdiagnosed for years, until he sought cognitive therapy and faced that his dream of becoming a physician was over. Kristen expresses the frustration of losing her independence and feeling like a prisoner when her fragile health and changed personality require constant supervision. Ian is learning to walk, talk and feed himself. But to maximize his chances for recovery, he needs intensive speech, physical and occupational therapy. His medical insurance coverage will max out within the first month of the year. Ian’s community of San Diego surfers, as well as volunteer psychologists and therapists, come forward to help.
For our protagonists, “going the distance” involves acceptance of an impaired self as well as learning to adapt to the changed person they have become. Although their stories are unique, the dilemmas they face are universal and profoundly human, impacting that part of ourselves that informs who we are and governs our personality, thoughts, feelings and perceptions. An injury to the brain is an injury to the essential self, which is why one of the film’s therapists explains that TBI survivors “have to reinvent who they are.”
As Kristen, Jay, Jason and Ian struggle with their disabilities, we witness how the medical and social safety nets are stretched thin: insurance companies are unwilling to pay for adequate treatment and TBI patients face stigma and ignorance from the general public and families struggle with “caregiver burnout”— there are simply not enough caregivers, resources or facilities to treat or even diagnose TBI. The system is in crisis.
In Act III, the film’s protagonists continue to struggle with TBI, but have begun new lives. Jason is still receiving rehabilitation therapy at the V. A. Polytrauma Rehabilitation Center in Palo Alto, California. He volunteers at a children’s center and has a new love, Angela. They share funny and touching boy-meets-girl anecdotes. Angela talks about the special needs of partners of TBI survivors, and Jason navigates his disability and relationship with equal measures of charm, sympathy and humor. Fifteen years after his accident, Jay is on the road to achieving his new dream: in 2008, he began a Ph.D. program in physical therapy and plans to specialize in brain-injured patients. Kristen applies and gets accepted to nursing school where she struggles to keep up while choosing not to disclose her disability due to its stigma. Ian’s circle of support would like him to be mainstreamed in elementary school, but it’s unclear how his special needs will be met long term. His Aunt Melissa struggles with the burdens of parenting three children, one significantly disabled. Ian’s support team helps him return to the San Diego surf his father had introduced him to as a toddler. His love of the ocean becomes a key factor in his healing.
While honestly portraying the serious ongoing challenges of living with TBI, Going the Distance concludes on a hopeful and inspirational note, as we witness Jason marrying Angela; Jay receiving his doctorate in physical therapy and beginning a professional practice; Kristen graduating from nursing school and passing her R.N. exam; and, in the closing scene, Ian McFarland talking about, and surfing with his new friend and surfing partner, Ricochet, the surfing Golden Retriever. The Lake Tahoe paddlers, including Jay Waller, complete the 22-mile paddle exhausted but happy, and the metaphoric portrait of heroic struggle powered by hope, courage and love is also complete.
Facing the estimated 320,000 TBI survivors returning from the Iraq and Afghanistan wars surviving injuries that had been fatal in the past, combined with the 1.5 million annual civilian TBI injuries, most TBI experts and medical professionals argue that the U.S. is facing a “TBI crisis.” The number of people afflicted far exceeds the resources, medical facilities and trained professionals focused on brain injury. Countless TBI survivors who are as yet undetected will exacerbate the crisis in the years to come, while war-related TBI screening continues to lag.
In addition to To Iraq and Back, the ABC News documentary on the Bob Woodruff story, and the Woodruff-reported TBI stories on ABC News, the recent death of actress Natasha Richardson from a traumatic brain injury suffered in a skiing accident and recent reports on football-related TBI have all raised public awareness of the gravity of this condition. But additional broadcast-quality media resources on TBI are needed—especially one that addresses both civilian and military TBI survivors, and can be used for education and outreach by the organizations that are focused on the care and treatment of TBI survivors. The existing media resources on TBI are limited to productions that are mostly devoid of hope and inspiration. There is a great need for a compelling, realistic but inspiring broadcast documentary that tells a variety of survivor stories while exploring the key medical and social issues raised by the Silent TBI Epidemic. Going the Distance will be educational, inspirational and empowering for a broad television audience. It will be especially powerful and important for all those involved with survivors of TBI.