By forgotten victims, I am referring to adult siblings of brain-injured individuals. Although chronologically adults, there is still a need and desire for a parental bond, attention, and time. Unfortunately there is a lack of focus on this group on the part of health care providers. With younger children it is fairly easy to see the psychological impact of a brain-injured sibling. They may act out at home or in school (i.e., physically or verbally abusive with peers and authority figures), seemingly overnight develop academic difficulties, withdraw and avoid social interaction. With adult siblings, the dynamics are less obvious.

The issues that will be discussed arise from my experiences and conversations with my siblings. I was 25 when my brain injury occurred. At the time, my brother was 29 and my sister 23. Although my brother lived locally, he was busy with his own career and personal life. My sister and brother-in-law were living in Boston. She was attending business school and my brother-in-law was attending dental school. We never discussed her feelings or experiences over my situation, however several incidents arouse.

It has been reported by family members my sister felt terrible that she could not be more involved when I was very sick. With the demands of business school, she could not drop everything and get on the next plane. Talk about bad timing, the same day of my sister's graduation, I was scheduled for a tendon release on my left ankle. This procedure would enable me to walk again. My parents flew up for the graduation, but took the next plane back to New York to see me. I had minimal speech ability. However, I remember saying to my sister "I feel terrible, you deserve all the attention."

Several months ago, I sat down with my brother for an hour interview. After giving him the topic, I said "just start talking". His response was "I do not know where to begin. There was so many thoughts and emotions". Here Is what he came up with.

1. I was so angry at the medical staff and held them responsible

2. I was angry at what could have been with your career

3. I was upset for our parents. Life should have been easy for them. They were distraught and had to shoulder a huge burden

4. I wanted to take of some of the burden off our parents. I made sure to visit you almost every day. I would tell them to take some time for themselves

5. I did not talk to our parents about any of my personal problems. I felt the could not cope with any more

6. I have the utmost admiration for you. I don't think I could have put the pieces of my life back together the way you did

7. I felt guilty when I think about my problems. In comparison to you, them seem so trivial

8. I was scared. What would happen to you? 9. I was sad thinking about what we cold no longer do together

My message to health care providers. DO NOT ignore this group. They are affected and have their own set of issues to deal with!

Kathy D. Greenberg, Ph.D.