Mike O'Connor's life was in a funk.
The Canton man was once a social butterfly. He enjoyed going to bars and meeting new people.
Then he suffered a traumatic brain injury.
O'Connor was walking out of a Baltimore bar in 2010 when he was sucker-punched. With his hands in his pockets, he could not brace himself. When his head hit the concrete, it split open.
O'Connor could no longer remember old friends and past events. Memory problems left him unable to work. Feelings of inadequacy overwhelmed him. He felt sorry for himself. He became a recluse.
Those who work with patients who suffer traumatic injuries say O'Connor's experience is not unusual.
Trauma from car accidents, falls, and sports and work injuries accounts for 41 million emergency room visits and 2 million hospital admissions a year, according to the National Trauma Institute. Trauma costs the U.S. economy more than $671 billion annually in health care costs and lost productivity.
After enduring often long hospital stays and rehabilitation programs to recover physically, trauma patients return to lives very different from those they lived before their injuries.
Many find it hard to cope.
"People have expectations that they will bounce right back and be like they were before," said Dr. Marcie Feinman, a trauma, surgical critical care and emergency care surgeon at Sinai Hospital. "And that doesn't always happen."
Feinman and the staff at Sinai counsel patients and families before they leave the hospital on what to expect once they get home. But she said the reality can still come as a surprise.
The Maryland Shock Trauma Center started the Trauma Survivors Network in 2009 to help patients return to regular life. The program offers support groups, educational sessions, private online forums and counseling to help trauma patients deal with life years after they suffer their injuries.
"We save their lives physically, but there is more to healing the person than just healing the body," said Frannie Grissom, a trauma nurse who is the group's coordinator. "There are real effects of trauma — anxiety, depression. All of these things need healing."
Network volunteers have visited 735 patients and family members at Shock Trauma since the group began keeping track in 2013. Nearly 900 patients and family members have attended survivor support groups, and nearly 400 have attended family resource and support sessions.
O'Connor's injury was compounded in 2014, when he suffered a seizure and fell again, this time in his basement. Much of the progress he had made in the past four years was wiped away. He fell deeper into self-doubt and hopelessness.
His fiancee — now his wife — heard about the trauma survivors group and encouraged him to try it out.
O'Connor, 37, was reluctant to attend the first meeting. But when he got to the lecture hall and heard a doctor talking about traumatic brain injuries, he knew he'd made the right decision.
"I felt like he was talking to me personally, because everything was resonating with me," he said.
O'Connor also felt an instant connection when heard other patients talk about their experiences.
He had been used to working, and supporting himself — he got his first job when he was 12 — and now felt like a burden on his family. Listening to the others, he learned the feeling was common.
Others, like him, worried about medical bills. And others, like him, sometimes looked in the mirror and wondered who was looking back at them.
O'Connor left that first meeting "grinning ear to ear" and "feeling like it was Christmas morning."
Most members of the group were injured in car crashes; there are also victims of violence, sports injuries and falls.
Some patients attend meetings for only a short stretch; others stay involved for years. Some talk openly about what they're going through. Others prefer to say little.
O'Connor can no longer remember parts of his life. But he says he has come to accept that he is not the person he was before the assault, and that the incident and his injuries should not define his life.
He has learned coping skills from the survivors network that help him when he hits emotional bumps. He keeps a journal to record his feelings and a jar filled with slips of paper bearing inspirational messages that he can pull out and read when he's having a rough day.
He said he wishes he had known about the network earlier.
"There was a lot of depression and self-loathing I probably could have avoided," O'Connor said. "Going there, you realize you're not alone. I am not happy other people are injured, but I am happy to know we are not alone and we're there for each other."
Grissom says talking to the families of trauma patients is just as important as helping the patients. While they don't have the physical injuries, she says, family members go through their own emotional changes. Many miss work to care for their injured loved ones and grapple with the recognition that the victim is not the same person they were.
"It is the family in the background trying to piece together a new life with or without the person in the same place they used to be," Grissom said. "They are postponing and delaying and oftentimes totally ignoring their own grief process."
Sinai starts conversations with families in the intensive-care unit well before the patient has recovered, Feinman said. They may have a social worker and palliative care specialist as part of the conversation.
The Morning Sun
Liz Roberts, 63, was skiing down an unmarked trail in Utah in 2014 when she went off a bridge. She fell 30 feet to a road below and suffered multiple injuries.
The part-time ski instructor spent weeks at a Utah hospital before she was transferred to Shock Trauma.
She joined the survivors network shortly afterward. The greatest benefit, she says, was finding people who are going through similar experiences. She finds fulfillment in telling her story to other victims, in hopes that it will help with their recovery.
When she misses meetings, she feels regret.
"If I am tired that day and can't go, I get a little sad because I have met amazing people that I won't get to see," she said.