MOORHEAD, Minn. -- When a pickup rear-ended Linda Beauchene's car at a Bismarck intersection in 1995, she knew she'd been hurt, but it was years before the extent of her injuries became clear.
Plagued by headaches, she would sleep 10 to 14 hours and wake up feeling tired.
Doctors could provide no answers, and she became increasingly desolate, unable to understand why someone who had graduated from college with honors suddenly could no longer keep a job.
"I was used to succeeding at life," said Beauchene, a former librarian who now lives in Moorhead.
She describes the years following the accident as one long, continuous decline.
In 2001, six and a half years after the crash, Beauchene was tested by a doctor who was able to provide her with some answers.
"He said very calmly and quietly: 'You have a permanent, mild brain injury," ' Beauchene said, recalling the moment.
The revelation was a turning point for Beauchene, who had long suspected she had suffered a brain injury.
"I found out it's quite common to fall through the cracks. I had a lot to catch up on, and he was willing to help," she said, referring to Dr. Rodney Swenson, the Fargo neuropsychologist who provided the diagnosis.
Swenson said many people have faced struggles similar to Beauchene's.
"Studies show missed diagnosis is common in mild traumatic brain injury," he said. "That's not because people are bad at diagnosing it; it's more that some symptoms can develop after you leave the emergency room."
While every brain injury is different and requires its own path of treatment, Swenson said some generalities hold true.
"When talking with families, I use an analogy," he said, adding that in Beauchene's case the example is particularly ironic.
"I tell them their brain is like a huge library full of knowledge and facts that they've stored over the years.
"In mild traumatic brain injury," he said, "your library is intact; it doesn't affect your intelligence. What is injured is the librarian who operates the library, that person that has to meet customers, go in the back and retrieve books."
He said people with mild traumatic brain injury struggle with things others give little thought to, such as mentally making future plans while physically occupied with a task.
"What was automatic is now effortful, and they're frustrated," he said.
Reason for hope
Preventing brain injury is something everyone should be mindful of, according to Swenson, a big believer in protective gear.
"Side airbags are wonderful, and wearing your seat belt is a great idea," he said. "You want to do anything you can to reduce the biomechanical forces your brain might be subjected to."
If there is an upside to mild traumatic brain injury, it may be the fact that people often make a full recovery.
Estimates put the recovery rate for uncomplicated cases at 85 percent or better, according to Swenson, who said that simply knowing they have a brain injury can be a major step forward for patients.
"It gives them some kind of understanding that, 'Hey, I'm not crazy,' " he said, adding that a diagnosis can set a patient on the road to improvement via a process he outlines as the three A's - Awareness, Acceptance and Adaptation.
"A lot of times, these are people who are victims of an accident, so they're kind of angry about it," he said. "There's a big psychological part of this, where you have to accept what's going on and deal with it."
Beauchene, who is now on disability, has devoted hundreds of hours to things like relearning how to write.
"I've worked really hard to get back my language skills, but it took an amazing amount of effort," she said.
It is still a challenge to keep her emotions in check, a common issue among those with traumatic brain injury.
Beauchene credits her dog, Duffy, with having helped her through the worst parts.
Duffy died in 2005, and Beauchene wears a heart-shaped pendant to remember her by.
"I don't know if I would have made it without that dog," said Beauchene, who has turned traumatic brain injury awareness into a mission.
One of her main messages is that things can improve.
They have for her.
"It's kind of a long, sad story with a happy ending," Beauchene said.
Dave Olson is a reporter at The Forum of Fargo-Moorhead, which is owned by Forum Communications Co.