Reflections On Brain Injury and Spirituality

by Paula Friedmann

As a nurse who works primarily with people whose brain function has been compromised by birth defects or injury, I have learned much from my patients about what makes us human and what defines us as spiritual beings. Many of my patients have had very limited cognitive abilities, far less than it would take to grasp the concept of God or understand the particulars of any religion. Yet I have come to see them as richly spiritual.

In thinking about what makes them so I see some common threads. One is the ability to find humor. Another is their deep appreciation of music. These characteristics are not necessarily supported by neurological science, at least to the extent of my knowledge. What I say here is based on my observations alone. As I approach my retirement for nursing in a few months, I welcome the opportunity to explore some of the rewards of my career.


One of my first patients was a young man in his thirties who was badly brain damaged in a motor vehicle accident. He was unable to speak and totally dependent for his physical needs. He was only able to move his left leg. His ability to think in the way we understand thought was severely limited. But his most consistent form of interaction was to wait until I was busy at his bedside and then reach across with his left leg and kick me lightly on the behind. Then he would grin.

What is so spiritual about this, you might ask. I think an essential feature of our God-given humanity is our ability to laugh at ourselves. In it we acknowledge our limitations and rest in the awareness that we need not take ourselves too seriously. In surrendering our need to be all and know all we make room for One who IS All. You might say my patient was laughing at my expense. But, whether he knew it or not, he was reminding me to laugh at myself.


One of the unfortunate results of brain injury is that frequently language is lost, or in the case of young children, may never develop. This aphasia may be expressive or receptive, or both.

Another of my patients is a seven-year-old whom I have cared for since she was one year old. While she has developed physically, her mental development and vocalizations are those of an infant. But she is acutely sensitive to the language of music. Hearing just the first few notes of a song she especially likes makes her giddy with excitement. Often she will look at me as if to say, "this is our common ground... I know you love this,too."

Music is often described as the universal language. If we see language as a cognitive function, then I believe music transcends language. It is a perfect form of spiritual expression for those who have limited cognitive function. And seeing this reminds us "normal" people not to value thinking too highly.

My brain-injured patients have taught my not to over-think my spirituality. Humor and music delight us all, whatever our abilities. For me that delight is a gift from God. I am grateful for the teaching of my patients and hope that I can carry it forward in whatever I do.