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In 2011, I suffered a severe traumatic brain injury (TBI) in an accident. I experienced a bilateral subdural hematoma — blood in the brain. My doctor, who had over 20 years of experience and had treated upwards of 10,000 TBIs, said after reviewing my medical case that 60% of those with a similar injury do not survive. 

I lived, but the impact was great. As a result of my injury, I not only lost my sense of smell but I also became a psychological disaster. I was in and out of the emergency room for a couple months with excruciating head pain, but I always left agitated by the waiting. I don’t remember that. I had trouble walking, talking, sleeping, eating and socializing. I have no memory of that either. 

All told, about six months of my life are missing from December 2011 to June 2012.

But it didn’t end there. Over the next few years my personality and behavior became increasingly cold. Once a social musician and gamer who enjoyed the company of those in my life, I became increasingly isolated and much less social. I stopped playing music and going out. 

I had multiple mini-breakdowns, chronic headaches, sensitivity to light and sound, and increasingly frequent mood swings from manic to depressive. I constantly felt overwhelmed. I also did not understand what was happening and therefore lacked the ability to articulate any of it. My pre-existing mental health issues, which were already quite extensive, were severely exacerbated by my TBI.

And then in September 2016, it all came to a head. A severe mental health crisis led to my arrest in my own home. It was the same old story as far as mental health issues and the police were concerned. Rather than helping me to receive treatment for my mental health challenges, I was sentenced to a Virginia Department of Corrections (VDOC) prison.

My story is not unusual. According to the Centers for Disease Control and Prevention (CDC), between 25% and 87% of prisoners in the United States have suffered from a head injury or TBI prior to their incarceration. A lack of proper awareness and screening techniques, however, have prevented an accurate count. 

TBIs in the criminal justice system are arguably a public health crisis. There are many medical and psychological reports on the subject. But I don’t need those because I have my own story. And I know how prison can make it worse.

Prison is loud. Doors are slammed 24/7. Shrill whistles blare. PA systems are misused. Staff are disrespectful. For 19 hours a day, the din of 50 to 80 people, who all feel the need to yell, buzzes in the background. With my chronic headaches and sensitivity to sound, it’s miserable. I live in a constant state of pain, inflicted by the whims of others. 

This holds particularly true for the two bright lights that are on for 18 hours a day. I no longer leave my cell for very long. I’m out only long enough to make a phone call or for the very limited outside time we’re provided.

I had trouble with social interactions before I was arrested. Here, it’s almost impossible — not for a lack of effort, but because I cannot understand what is going on. I already tend to miss nuances and cues, but it’s much worse in prison where these nuances and cues are muddled and obfuscated. Picture Sheldon from “Big Bang Theory,” but less intelligent and not as well scripted, in a prison environment. 

I am constantly overwhelmed and cannot remember a time in my life when I felt so out of place.

I’m afraid to talk to people beyond the help I am often asked to provide with writing and legal aid. I’m always anxious. Sometimes I just want to scream — make everyone stop doing what they’re doing just so my mind and emotions can catch up and make sense of everything. 

I should be in a low-security prison for people with mental health issues. Instead, I have been in four pods and seven cells, and I have had 11 cellmates in three years. I have endured at least eight concussive blows since I was arrested, and two of those rendered me unconscious. Still, I have not received any medical care.

My doctor’s recommendation for a full evaluation has been ignored. I have filed a civil suit which is now pending. All I can do in the meanwhile is endure the pain and document as much as possible before I am overwhelmed to the point of rash action. 

Something must be done before more of those suffering from TBI get trapped in the system. Something needs to be done to get those of us already trapped in here back out in the world. 

Disclaimer: The views in this article are those of the author. Prison Journalism Project has verified the writer’s identity and basic facts such as the names of institutions mentioned.

David Annarelli is a father, musician, activist and writer. He is incarcerated in Virginia.