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Rethinking 'Mild'
BAKED PINEAPPLE SALMON
Ingredients
• 1 can pineapple slices, drained, reserving 1/4 cup of juice
For a long time, doctors categorized traumatic brain injuries (TBIs) as mild, moderate, or severe, and the classification focused on the acute phase, around the time of the injury. They’d look at things like how long someone was unconscious or how long they experienced memory loss. That was basically it. And while it might have seemed straightforward, it completely ignored the long- term consequences of the injury. For lawyers, this old system was a nightmare. Imagine having a client who was labeled as having a “mild” brain injury. On paper, that sounds like no big deal. Defense attorneys could easily say, “It’s mild. How bad could it really be?” And suddenly, you’re trying to tell a story about someone whose life has been forever altered, starting off already on the back foot. It’s like the system was stacked against people who were actually suffering. But now, things are changing. This year, the National Institute of Neurological Disorders and Stroke proposed a new framework called CBIM. CBIM stands for Clinical, Biomarkers, Imaging, and Modifiers. Instead of relying on just a few acute indicators, this system takes a more comprehensive look at the injury. It combines traditional clinical assessments with blood-based biomarkers, imaging results, and individual patient modifiers like age, medical history, or other factors affecting recovery. The goal is to provide more personalized, accurate care for each patient. Moving beyond the broad “mild, moderate, severe” labels allows doctors to capture the true complexity of brain injuries, rather than oversimplifying them and leaving lingering symptoms undiagnosed or untreated. This is a huge step forward because TBIs are more serious and more prevalent than many people realize. For anyone suffering a brain injury, this new system represents hope for better care, understanding, and outcomes. And for those of us working in litigation, it’s equally transformative. We no longer have to fight against a classification system that trivializes lifelong consequences. CBIM gives us the tools to show the real impact these injuries have on people’s lives, ensuring that the severity of a TBI isn’t underestimated just because it looked “mild” in the immediate aftermath. A New System Is Revolutionizing Brain Injury Care
• 2 1/2 lbs side of salmon • Salt and pepper, to taste • 1/2 cup sweet chili sauce • 1/4 cup unsalted butter, melted • 4 tbsp hoisin sauce • 3 garlic cloves, minced • 2 tbsp fresh lemon juice • 2 tbsp fresh cilantro, chopped • Lime slices
Directions
1. Preheat oven to 375 F. 2. Line a baking sheet with aluminum foil. 3. Place pineapple slices on baking sheet. 4. Season both sides of the salmon with salt and pepper and lay over pineapple. 5. In a small bowl, whisk together chili sauce, melted butter, hoisin sauce, garlic cloves, lemon, and pineapple juice. Pour over salmon. 6. Bake for 15 minutes or until cooked through. 7. Garnish with cilantro and serve with lime slices.
Inspired by ChefJar.com
LAUGH LAWS
It’s a small change in terminology but a huge leap in understanding and advocacy for anyone affected by brain injuries.
–Case Barnett
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