a knock on the nobbin

January 23, 2008 12:21 AM

What did doctors know about the brain in 1945? How would you describe brain injuries at that time?

So I'm working on a story about a 5 year old British kid (based on a family member's true story) who was hit by a car in 1945. This resulted in a hole in his skull. Up until his late twenties, this hole was not covered over by anything other than skin and hair.

So when he was first hit, what kind of brain injuries did he likely suffer? How would doctors in England have described those injuries and his prognosis (keeping in mind that he was five)?

I have no medical knowledge at all and want to give the doctor a bit more to say than just "He's got some brain damage".

posted by stray to health (9 comments total)

The 1946 British film "A Matter of Life and Death" centres on a brain injury and subsequent life saving operation (amongst other things), you could try stealing a bit from that perhaps? It's an excellent film regardless, so you won't be losing out by watching.
posted by biffa at 1:18 AM on January 23

Dunno whether you were planning to put this in, but the wide boy / boxing term for 'head' you're looking for is 'noggin' not 'nobbin'.
posted by beniamino at 2:22 AM on January 23

The book Possessing Genius, about the story of Einstein's brain after his death, is an interesting read that (indirectly) demonstrates the evolution of neuroscience. In a similar timeframe to your story...
posted by misterbrandt at 7:46 AM on January 23

The prognosis would depend where in his head the hole was, and what part of the brain was damaged, but in 1945, they would not have known much about how a specific brain injury would affect cognition or motor skills -- today the brain is intricately mapped and we know which parts of the brain control which parts of the body and the senses.

A lot was learned about the brain after 1945 by studying the cognitive effects of head injuries suffered by soldiers during World War II.

One of the leaders in this research was Hans Lukas Teuber at MIT. Worth Googling and reading books by/about, if you want to know how brain research progressed during the postwar period.
posted by beagle at 8:00 AM on January 23

A lot of brain research at that time came out of the Montreal Neurological Institute which opened in 1934 and was founded by Dr. Wilder Penfield. He pretty much mapped all the sensory and motor sections of the brain as we know them today and came of with the "montreal procedure" which through the prodding of sections of the brain could determine where seizures were originating in a patient and cure them through removal of the tissue in question.
posted by furtive at 9:32 AM on January 23

Though nowadays most professionals say that dyslexia, ADHD, and other learning disabilities are genetically-based and can be inherited, when I was a kid in the 1970s, it was widely believed that when kids (none of whom wore helmets) fell off of bikes, skates, trees, and playground equipment (none of which had padding underneath) and got hit on the head, they either lost a few IQ points or gained a case of dyslexia or sometimes a combination of the two. Similar problems were said to have been caused when kids ate (then lead-containing) paint chips. When I was in special ed during the elementary grades, sooner or later, I heard stories of this kind about my classmates: "he fell off the monkey bars", or "she was a forceps delivery". If that hypothesis of Learning Disabilities is true, theoretically, it should have been possible for some kid to fall off the monkey bars and end up as a math whiz, but I never heard of that happening. I ended up doubting the belief that there was such a thing as a Learning Disability, but absolutely sure that there was a Luck Disability.
If you're looking for a book about what doctors/psychologists observed about brain injuries from that time, I have some suggestions: Theories of Personality by Calvin S. Hall and Gardener Lindzey c. 1954 describes some common behaviors and problems affecting brain injured patients in hospitals during & immediately after WWII, and cites a book called "After-effects of brain injuries in war". New York Grune and Stratton, 1942, by Goldstein, K.
posted by bunky at 3:12 PM on January 23

I just saw The Lobotomist on PBS about Walter Freeman, the guy who popularized the lobotomy by shoving ice picks through people's ocular cavities. The doctor who pioneered the surgery won a Nobel prize in 1949 for a procedure that is now widely banned. The PBS show explained a lot about what was understood about the brain in the 1940s.
posted by Frank Grimes at 5:14 PM on January 23

Symptoms which may be experienced by those with actual physical brain injuries and/or a case of ADHD combined with Learning Disabilities include problems with spatial perception (estimating distances, telling "left" from "right"); sense of "time" may be impaired, as well as short-term and/or sometimes long-term memory, face recognition, and more, including but not limited to partial amnesia (when it happens to real people it is a bit less thorough than when it happens to Gilligan after a coconut falls on his head). All these can be pretty frustrating. And then add "low frustration tolerance" to the list.
posted by bunky at 8:12 PM on January 23

One way would be to scour 1945-era copies of medical journals such as the Lancet, the British Medical Journal, the New England Journal of Medicine (for a start). I would think you would be able to find a similar case from roughly the right time described in one of those journals, which would give you a huge amount of information. You can find such ancient copies of journals in good academic libraries.
posted by beniamino at 5:56 AM on January 24