Bob Woodruff’s Continuing Struggle with Traumatic Brain Injury

USA Today

February 25, 2008 – One year after Bob Woodruff spoke about his brain concussion on an ABC documentary, he is busy flying around the world on assignments and continuing to draw attention to the signature injury of the war in Iraq: traumatic brain injury.

His recovery seems miraculous, considering how the shrapnel from a roadside bomb had ripped into his skull on Jan. 29, 2006. Woodruff, 46, is back at work at ABC news, although he does not have his previous job as a news anchor — at least not yet.

“I don’t know if I could do that,” he says. “I think it’s possible. But one thing that I know for sure is that I’m going to remain as a journalist because I have always loved journalism.”

Woodruff now works with a team to produce more in-depth assignments. He can better cope with longer projects because his traumatic brain injury (TBI) caused a language disorder that makes it hard for him to come up with words. And for a journalist, nothing could be more frustrating.

Woodruff continues to improve and often speaks with ease and confidence. But he still occasionally runs into a roadblock in his brain.

In a recent interview at his office, Woodruff described how reading and writing have helped his brain improve. After he got out of the hospital he was not willing to just sit at home, he said, “watching sports on TV all day long with a — what do you call the thing that controls the TV?” He couldn’t come up with the term remote control.

Woodruff has a disorder called aphasia. It happens when a stroke or TBI affects the language side of the brain, usually the left side. The National Aphasia Association estimates that 1 million people in the USA have it.

In particular, Woodruff has expressive aphasia, which means that he can understand a word but cannot always say it. Fortunately, he does not have receptive aphasia, which occurs when someone cannot make sense of the words that they see or hear.

Those, like Woodruff, who have expressive aphasia may have different types of problems. In some cases, a person may only have trouble coming up with a specific word during a conversation; others may speak in choppy and incomplete sentences; and still others may use the wrong words, says Steven Flanagan, associate professor of rehabilitation medicine at Mount Sinai School of Medicine in New York.

Woodruff says that sometimes he cannot come up with a word that he had used often before his injury. When he woke up in the hospital, he couldn’t name any states. “I couldn’t even remember the word for a hamburger or an egg sandwich,” he says.

When he came home from the hospital with his wife and four children, they used flash cards and word games to help him snap back. It has been most difficult for him to recall nouns. He can easily say the names of his immediate family, but he says it’s harder to recall more distant family members.

And at first, an incorrect word would sometimes slip out when he was speaking. Once when his now-7-year-old twin daughters were in the car, he told them to put on strappers, instead of seat belts, his wife, Lee Woodruff, recalled in a phone interview.

He had to figure out how to access words in his brain. “In the very early days, he’d say ‘I feel one thousand dollars better today,’ ” Lee says. He had intended to say “one thousand percent,” but he would mix up dollars and measurements and miles and inches. “All of those things must be housed in some retrieval area, like a filing system,” she says.

People with expressive aphasia not only have different verbal problems, but they also rely on different techniques to retrieve words. Some can sing songs even when they have trouble saying words, says Flanagan, whose patients include Woodruff.

Woodruff says reading and writing have most helped him recover. Not long after he came home from the hospital, he and Lee started writing their book, In an Instant, recently out in paperback. “I would write things and give it to Lee, and she would write things and run it by me. We would edit each other. It improved me every single day, faster and faster, as weeks and months went by.”

Woodruff even started taking Chinese classes because he had lived in Beijing before he became a journalist. He wanted to see if that could strengthen his English.

“I started taking lessons a couple days a week for a few months, but I’ve run out of time to keep studying,” he says.

Woodruff says it’s much harder to remember a word if he only hears it. “When you tell me a word, even though I know what it means, I can’t really see the vision of it in my head,” he says. He needs to see words in writing.

Even if Woodruff works hard to read and memorize a word, it doesn’t mean that it will always come to his mind when he needs it. People with expressive aphasia may find that words can slip away, especially if they are too tired or nervous, or don’t use a word very often, Flanagan says.

“There are definitely moments when you can hear him stumbling for a word, but he’s become adept at substituting or going around it,” Lee says.

After his injury, some experts feared Woodruff’s career was over. But the brain remains a mystery. “With each new discovery, more questions are raised than are answered,” says Flanagan. At least the brain is “plastic,” which means it has the capacity to change over time. “So after an injury, it adapts by making new connections,” he says.

A year ago, Woodruff says he started working by reporting on the telephone. Last month, he flew to the Sudan to work on a project. Several days after he returned to New York, he took off to research another story in Brazil. He doesn’t know if he will go back to being an anchor, but for now he’s happy to produce in-depth stories.

Even if Woodruff is frustrated when he occasionally can’t find a word, his family and friends are elated by his recovery. “I’m amazed,” says his brother David Woodruff. “Every time I talk to him, I hear improvement. And it’s still going on, two years later.”

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