When Nick Van Wattingen was brought to Bacharach Institute for Rehabilitation three years ago, he thought it was all a dream. But the situation became very real when he realized he had suffered a mild brain injury that landed him in the hospital and diminished some of his physical and mental abilities.
About one in every 125 men use emergency medical services for traumatic brain injuries every year, and the rate is similar for women. Health professionals locally and and nationally are trying to develop better ways to diagnose these injuries, especially moderate ones, and rapidly treat them.
"The brain is the most difficult to identify a problem, because if you don't do a test for that specific area, you'll miss it," said Dr. Marianne Sturr, director of the spinal cord unit and the brain injury unit at Bacharach.
The brain is complex. It is the only organ in the body that controls our every movement, feeling, thought and personality trait - all the things that make individuals uniquely different from each other. Damage to almost any part of the brain can result in minor to severe consequences such as dizziness and memory loss.
The spectrum for brain injuries is large, Sturr said, and can include mild concussions, moderate or temporary brain damage and severe traumatic injuries. Wattingen, now 27, fell into the first category in 2012 when he was injured in an attack.
Wattingen, of Northfield, had just graduated from what was then Richard Stockton College of New Jersey with a degree in criminal justice and plans for a career in law enforcement. He attended a congratulatory party one night for a friend at a bar in Sea Isle City.
But soon, things went south for Wattingen and his friends.
"There was a big fight at one of the bars and we decided to head home at that point," he said. "A couple guys followed us and attacked us from behind. I took the brunt from the attack. They never found those guys."
Wattingen was airlifted to AtlantiCare's trauma center in Atlantic City on the same night that his girlfriend's mother, Kathy Kerstetter, was on duty as head nurse practitioner. He credits her for pushing treatment for a brain injury even after a CAT scan failed to show anything wrong.
"Some people with brain injuries don't lose consciousness and nothing appears on CAT or MRI scans," Sturr said. "You could know who and where you are, but that doesn't mean you don't have brain injury."
One of the most difficult things in the matter of diagnosing a brain injury, especially ones that do not appear obvious, is that there is no one test to determine if a person has the injury, Sturr said. It takes a combination of questioning, eyewitness accounts of the accident and multiple medical tests to make a diagnosis.
Diagnosing a severe traumatic brain injury is sometimes easier because the patient might exhibit common symptoms such as major visual, auditory and comprehension impairment, Sturr said, as well as visible damage to the head.
Researchers are trying to find new, more accurate ways to diagnose a brain injury.
Hennepin County Medical Center in Minnesota announced earlier this month it would work with the University of Minnesota on a national study to improve classifications of brain injuries using eye tracking, blood-based biomarkers, imaging and cognitive measures.
Scientists are also looking at the impact of repetitive brain injuries, such as the ones some athletes experience. Brandi Chastain, former professional soccer player, recently announced that she would donate her brain for such research upon her death.
After a few weeks of hospitalization at AtlantiCare, Wattingen became an in-patient at Bacharach where Sturr oversaw his treatment plan. He needed rehabilitation in walking, balance and coordination as well as speech.
"I couldn't say what I wanted to say," he said. "My mouth couldn't catch up with my thoughts."
Wattingen worked with Sturr and a team of professionals at Bacharach to rehabilitate the areas of his brain that were temporarily damaged from the fight. Three years later, he considers himself 100 percent recovered.
Only small things remain different, and Wattingen may be the only one who notices them. He still says his speech is not as fast as his thoughts and he has lost some of his natural ability to quickly pick up new sports or physical activities. For someone with even a mild brain injury, these things are common.
"Anyone that had lack of attention and awareness, who needed hospitalization, can't go right back to remembering things. There are some residual effects," Sturr said. "Some connections in between cells are damaged, which create deficits people didn't have before, and they learn to compensate for it."
Wattingen went back to school and is currently studying at Stockton University for a degree in survey engineering. He just started a new job in Monmouth County and plans to move a little north with his longtime girlfriend, Erin Kerstetter.
Not everyone is as lucky as he, something that Wattingen keeps in mind when he makes visits to Bacharach to catch up with his doctors and the people who helped him overcome his injury.
"I wouldn't say it was a good experience," he said. "I wouldn't recommend it to someone. But all in all, it was a positive thing, not in classic sense of a positive experience, but I made it positive. I made the best out of a bad situation."