DISABILITY, NOT DEATH, IS THE ISSUE IN LIGHTNING INJURY

摘要

Effort in the past has concentrated on preventing lightning fatalities. However, disability from lightning-strike injuries is a far greater problem. While lightning has been exceeded only by flash floods as a storm killer in the United States for the last thirty years, it causes fatal injury to only about 9-10% of those it strikes. While death is devastating, adjustment occurs and families take up life again. Far more pervasive changes to the family may occur if the survivor is disabled. Survivors tend to be young, otherwise healthy, productive working people often with families to support. After injury, many survivors are unable to return to work or to resume their previous lives and social roles. This necessitates many changes in the family structure, economic level, social structures, interpersonal relationships and dreams and plans for their future. There is an intense personal cost as well as a societal cost after survival. The primary areas of disability involve neurocognitive functioning. This manifests itself as deficits in short-term memory, processing of new information, cognitive ability, personality changes with consequent relationship disturbances, easy fatigability, and decreased work capacity. Chronic pain syndromes, sleep difficulties, dizziness, and severe headaches are also often reported. Those who attempt to return to work often find they are unable to carry out their former functions and after a few weeks, when co-workers get weary of 'covering' for them, they either are put on disability benefits (if they are lucky) or are fired. Some are found alternative duties with consequent changes in work satisfaction and fulfillment. The social aspects of injured lives demand dramatic re-orientation. Survivors often find themselves isolated because friends, family and physicians do not recognize their disability or feel they are 'faking'. The role of the physician who often holds the key not only to treatment but to obtaining social security benefits or the results of litigation is particularly critical and is a highly responsible role.