Billy Norris is wearing a Superman T-shirt, and he knows even Superman has a hidden weakness.
"Kryptonite," Norris said. "See, I remember that."
He can talk about the terrible car wreck in 1992 that left him in a coma for three months, about the long rehabilitation to learn how to walk and even talk again. What he can't remember is asking the same question four times in the span of about 20 minutes, and apparently forgetting the answer each time.
He looks fine, but the accident apparently affected his short-term memory, which was aggravated by a recent seizure that landed him back in Walton West Transitional Living Center, where he does memory exercises to help him improve.
Norris and other patients with seemingly hidden deficits are being highlighted by Walton Rehabilitation Health System in its 2nd Annual Brain Injury Awareness Walk on Saturday.
Awareness of traumatic brain injury got a temporary boost earlier this year from U.S. Rep. Gabrielle Giffords, who is recovering from a gunshot wound to the head.
"It did for a little bit, but then it kind of died off unfortunately, like everything else," said Jennifer Litchfield, clinical program director for Walton West. People just don't know how prevalent the injuries are -- there were about 2,000, ranging from mild to severe, in 2009 in Richmond and Columbia counties alone, she said. The Centers for Disease Control and Prevention estimates that 1.7 million occur in the U.S. each year.
The effects in mild traumatic brain injury can be subtle, from memory problems to difficulty organizing to an inability to perform routine, everyday tasks. In fact, Walton West is seeing an increasing number of patients who were discharged from the hospital before the families realized there was a problem, Litchfield said.
"Things that they were able to kind of cover up in the hospital, or things that really didn't come up because they had constant care, they see once they go home," she said. "So we are seeing a lot more of that. You see that on the mild side because they're able to cope when they are in a controlled setting like a hospital."
At Walton West, which is essentially a five-bedroom house, they can relearn to cope, Litchfield said.
"It's just everyday tasks," she said. "We run the household like you would normally do, and then we also have groups where we would teach those compensatory strategies. We're constantly going over the importance of lists, the different memory strategies."
Increasingly, particularly among younger patients, they are turning to technology for help.
"Especially the younger kids, they don't want to use notepads," Litchfield said. "They'd rather bust out their cellphones or their iPads or whatever it is they are using because that is what their friends are using. So they don't feel any different; they don't look any different when they are taking out their iPad to put something in."
The key is to make it productive for them, she said.
"We just teach them to use it in a more effective and efficient manner rather than just jumping on there, downloading ring tones and playing games," Litchfield said.
A couple of times a month, she said, she will get a call from a parole officer or social worker about someone with a brain injury whose behavior has run afoul of the law, and Walton West is not really equipped to help them. In fact, few places are.
"The funding is just not there," Litchfield said.
Patients with traumatic brain injury often don't appear to have anything wrong with them.
"That's the thing with brain injury, is you can't really see it," she said.
Norris realizes that he doesn't appear to have a problem.
"Not until you talk to me for a while," he said.
But people often assume that because there is a problem the patient is limited mentally, which is not the case, Litchfield said.
"It's not their intelligence; it might be their short-term memory or their ability to organize their thoughts and hold a free-flowing conversation," she said. "It's not necessarily their knowledge base. It's trying to get people to understand that, that's difficult."
Using the computer to play memory games and working on other tasks is helping, Norris said.
"I've got good days and bad days," he said. "It's been good since I've been here. This is a good place."