THIS PROGRAM IS MADE BY MPT TO SERVE ALL OF OUR DIVERSE COMMUNITIES AND IS MADE POSSIBLE BY THE GENEROUS SUPPORT OF OUR MEMBERS.

THANK YOU.

LIVE FROM MARYLAND PUBLIC TELEVISION, THIS IS "DIRECT CONNECTION" WITH JEFF SALKIN.

*] [*] >> Jeff: FROM MARYLAND PUBLIC TELEVISION THIS IS "DIRECT CONNECTION" WITH JEFF SALKIN.

>> Jeff: GOOD EVENING AND WELCOME TO YOUR "DIRECT CONNECTION".

WE BEGIN TONIGHT WITH NEWS FROM THE UNIVERSE.

JAMES MPT.ORG/DONATE SPACE TELESCOPE HAS BEEN LOOKING WAY OUT THERE FOR ABOUT THREE YEARS NOW.

JOINING US FROM THE SPACE TELESCOPE SCIENCE INSTITUTE TO ANSWER YOUR QUESTIONS IS KELLY LEPO, Dr. LEPO THANK YOU FOR BEING HERE.

>> THANKS FOR HAVING ME.

>> PEOPLE THAT ARE WATCHING ARE FAMILIAR WITH THE HUBBLE.

THE MPT.ORG/DONATE HOW ARE THEY DIFFERENT?

>> THE HUBBLE TELESCOPE ORBITS AROUND THE EARTH.

THE MPT.ORG/DONATE TELESCOPE IS A MILLION MILES AWAY FROM THE EARTH PAST THE MOON AT L2, THE SECOND POINT AND THAT ALLOWS IT TO HAVE A COLD, VERY STABLE ENVIRONMENT.

BUT IT STILL FOLLOWS THE EARTH AROUND SO IT COMPLETES AN ORBIT IN ONE YEAR.

>> Jeff: WE HAVE PRETTY PICTURES FROM THE MPT.ORG/DONATE TELESCOPE IN TODAY AND THIS IS LABELED THE COSMIC TORNADO.

>> I DON'T THINK I NAMED THIS ONE.

>> Jeff: WHAT DO WE HAVE?

I KNOW ON THE LEFT IT IS AN OLDER IMAGE ON THE RIGHT IS THE NEW IMAGE?

>> ON THE LEFT IS FROM THE SPITZER SPACE TELL COPE AN INFRARED TELL COPE LIKE MPT.ORG/DONATE WE ARE SEEING AT THE END OF THE SHOCKED GAS FROM THIS STAR IS A BACKGROUND GALAXY YOU CAN SEE THE SPIRAL ARMS.

IT HAPPENS TO BE A CHANCE ALIGNMENT.

>> Jeff: I HAVE TROUBLE UNDERSTANDING THE DISTANCES.

HOW BIG IS THIS THING?

>> THIS THING IT'S A COUPLE LIGHT YEARS-LONG.

IT'S ABOUT 1.5 LIGHT YEARS FROM THE STAR.

SO MAYBE WE'RE SEEING A LIGHTYEAR WORTH OF STUFF HERE.

THE BACKGROUND GALAXY IS SOMETHING LIKE 100 MILLION LIGHTYEARS AWAY.

MUCH, MUCH FARTHER.

>> Jeff: WHAT IS THE ARGUMENT, THE PURPOSE FOR INFRARED IMAGING AS OPPOSED TO THE VISIBLE LIGHT THAT YOU AND I SEE?

>> EVERY TIME YOU LOOK AT SPACE, YOU GET DIFFERENT INFORMATION.

SO FOR INFRARED LIGHT, WEBB CAN SEE THROUGH DUST WHICH BLOCKS OUR VIEW WITH INVISIBLE LIGHT AND ALLOWS US TO SEE COLD GLOWING THINGS.

IF YOU'VE DONE A HOME INSPECTION WITH THE CAMERA IT'S THE SAME TYPE OF LIGHT.

>> Jeff: WE HAVE A LOT OF PRETTY AND COOL IMAGES TO LOOK AT.

AND THE NEXT ONE DOESN'T LIVE UP TO THAT DESCRIPTION.

THIS LOOKS LIKE A SERIES OF DOTS.

BUT I KNOW IT'S IMPORTANT.

>> IT'S COOL, I PROMISE.

ONE OF THE WEIRD THINGS THAT WE SAW WHEN WE ARE TAKING DEEP FIELD WE'RE STARING AT OTHERWISE DARK PATCHES OF SKY AND WE'RE GOING TO SEE AS FAR BACK IN SPACE AND AS FAR BACK IN TIME AS WE CAN.

AND WE SAW RED DOTS.

IF WE LOOK AT THEM WE CAN TELL THEY ARE FROM THE EARLY UNIVERSE LIKE 600 MILLION YEARS AFTER THE BIG BANG.

AND WE KNOW THERE'S ACTUALLY A SUPER MASSIVE BLACK HOLE AT THE CENTER OF THESE LITTLE RED DOTS.

SO THIS TELLS US A LITTLE BIT ABOUT HOW BLACK HOLES FORMED IN THE EARLY UNIVERSE.

WE CAN ACTUALLY SEE THAT THERE'S TWO WAYS THAT YOU CAN FORM A BLACK HOLE.

ONE IS TO COLLAPSE A STAR FIRST AND HAVE IT PULL IN GAS AND GET BIGGER.

AND THE OTHER WAY IS TO COLLAPSE THE GAS INTO A BLACK HOLE.

WITH THE STAR FIRST SCENARIO IT'S HARD TO MAKE THE BLACK HOLE GET BIG ENOUGH IN THAT 600 MILLION YEARS THAT YOU HAVE.

SO IT'S POINTING TOWARDS THE LIKE REFORMING THEM DIRECTLY IN THE EARLY UNIVERSE.

>> Jeff: A VIEWER WANTS TO KNOW ARE THERE COLORS IN SPACE AS THERE ARE IN THE IMAGES?

TO WHAT DEGREE IF WE CAN ZIP OVER AND TAKE A LOOK WOULD IT LOOK LIKE THAT?

>> PROBABLY NOT.

WE HAVE A BIG TELESCOPE AND CAN STARE AT THEM FOR A LONGTIME AND THESE ARE ALL INFRARED IMAGES THE TYPE OF OUR LIGHTS OUR EYES CANNOT SEE.

WE TAKE THE SHORTEST WAVELENGTH AND ASSIGN THAT BLUE AND THE LONGEST RED.

AND IN THE MIDDLE IS GREEN.

IT'S SORT OF LIKE HOW OUR EYES WORK WHEN WE PICK THE COLORS.

BUT WE'RE SHIFTING THAT OVER TO SEE INFRARED LIGHT.

>> Jeff: NEXT IS MORE DUST.

THERE IS A LOT OF DUST.

>> THERE IS A LOT OF DUST.

SPACE IS FULL OF DUST.

AND DUST, LIKE TINY PARTICLES OF SAND AND SOOT.

>> Jeff: BUT THEY ARE NOT A PERMANENT FEATURE LIKE THE DUST IS STARDUST AND IS IT ON ITS WAY TO CONGEALING AND BECOMING SOMETHING ELSE?

>> SO THAT'S WHAT PLANETS FORM OUT OF IS THIS STARDUST.

WHAT WE'RE LOOKING AT HERE WE'RE ACTUALLY LOOKING AT THE GAS AND DUST BETWEEN STARS.

AND WHAT WE'RE SEEING IS THERE WAS A SUPER NOVA THAT WENTZ OFF 350 YEARS AGO, AND THAT SENT OUT A FLASH OF LIGHT.

AND THIS LIGHT IS NOW HITTING THE SURROUNDING GAS AND DUST.

IT HEATS IT UP A LITTLE BIT AND THAT GLOWS IN THE INFRARED LIGHT THAT WESTBOUND CAN SEE AND SENDING IT BACK TO US LIGHT ECHO.

AND WE CAN SEE THE STRUCTURE IT REMINDS ME OF THE INSIDE OF A KROY SANT.

SO WE'RE SEEING THE STRUCTURE OF SPACE BETWEEN THE STARS.

>> Jeff: I PREFER THE CONTRACT SANTS WITH.

>> WE'RE ALTERNATING BETWEEN PICTURES AND DOTS.

WHAT ARE THESE DOTS, EXOPLANETS.

>> ORBITING AROUND THE STAR CALLED HR7899, THE STAR IS AT THE CENTER.

WE CAN'T SEE IT BECAUSE WE HAVE A DISK THAT IS BLOCKING OUR VIEW.

BUT WE'VE MARKED IT WITH THE STAR FOR CONVENIENCE.

AND THESE DOTS ARE PLANETS ORBITING AROUND THAT STAR.

AND WHAT WE CAN SEE WITH LOOKING THROUGH WEBB'S INFRARED VISION THERE ARE CARBON DIOXIDE CO2.

AND THAT TELLS US HOW THE PLANETS FORMED.

WE ACTUALLY THINK THEY FORMED LIKE JUPITER OR SATURN THERE IS A ROCK PULLING IN GAS.

AND THE POINTS THAT YOU ARE SEEING THERE ARE ACTUALLY JUST TINY DOTS OF LIGHT THAT GET BLURRED OUT BY THE TELESCOPE.

>> Jeff: IT WASN'T THAT LONG AGO WE WEREN'T SURE THERE WERE PLANETS OUT THERE.

>> 1993, THE FIRST EXOPLANET IS DISCOVERED.

>> Jeff: AND THEY ARE ALL OVER THE PLACE.

>> THERE IS ONE STAR FOR EVERY PLANET FOR EVERY CAR.

>> Jeff: SAME RATIO.

>> IN THE MILKY WAY GALAXY.

>> Jeff: INCREASING THE CHANCE ONE ARE FAVORABLE FOR LIFE.

>> THERE ARE SO MANY PLANETS OUT THERE, RIGHT?

>> Jeff: WE'VE TALKED ABOUT BLACK HOLES.

THIS IS NOT A PICTURE OF A BLACK HOLE BUT AN ARTIST CONCEPT OF A BLACK HOLE BUT THE BLOCK HOLE WE BELIEVE TO BE AT THE CENTER OF THE MILKY WAY.

>> IF YOU HAVE SEEN THE MOVIE INTERSTELLAR THIS IS BASED ON REAL DATA WHAT WE THINK BLACK HOLES LOOK LIKE.

SPACE IS FULL OF DUST OUR GALAXY IS FULL OF DUST AND WE TOOK WEBB TO THE CENTER OF OUR GALAXY TO STARE AT OUR BLACK HOLE, SAGITTARIUS A STAR AND IT WAS GETTING BRIGHTER AND DIMMER.

AND WE THINK THIS IS LIKE SOLAR FLAIRS THAT WE'RE SEEING MAGNETIC FIELDS RECONNECTING IN THE DISK OF GAS AND DUST.

>> Jeff: VIEWERS IF YOU HAVE A QUESTION ABOUT THE UNIVERSE, THE GALAXIES, SEND US AN E-MAIL TO LIVE QUESTIONS AT MPT.ORG.

THE PROBLEM AS I IMAGINE, IN MY LIMITED CAPACITY THE MILKY WAY OR ANY GALAXY IT'S ALMOST FLAT AND WE'RE ON THE FRINGE OF IT TRYING TO SEE THE MIDDLE.

LIKE A FRISBEE BUT WE ARE LOOKING THROUGH THE OTHER STUFF.

HOW COULD YOU EVER MEASURE ANYTHING?

SY.

IT'S REALLY HARD, ACTUALLY.

AND THE FAR SIDE OF THE MILKY WAY WE CANNOT SEE IT THERE'S TOO MUCH IN THE WAY.

WE CAN SEE THE 26,000 LIGHTYEARS TO THE CENTER OF THE GALAXY WITH INFRARED LIGHT.

>> Jeff: BACK TO PICTURES.

AND THIS COMES FROM THE OLDER OF THE TELESCOPES, THE HUBBLE.

THIS IS THE OFFICIAL 25TH ANNIVERSARY IMAGE.

WHAT ARE WE SEEING?

>> WHAT WE'RE SEEING HERE IS A CLUSTER OF STARS ABOUT 3,000 STARS AND THEY ARE YOUNG LIKE A MILLION YEARS OLD OR SOMETHING.

AND THEY ARE ERODING AWAIT NEBULA THAT THEY FORMED IN.

THE REMNANTS THAT NEBULA ARE ON THE LEFT.

AND YOU CAN SEE LITTLE PILLARS AND ALL OF THE PILLARS ARE POINTING BACK TOWARDS THE CLUSTER.

BECAUSE YOU HAVE A DENSE CLUMP OF GAS AND THAT IS SHADING THE NEBULA BEHIND IT FROM THE ULTRAVIOLET LIGHT AND THE WINDS FROM THE STAR.

>> Jeff: VIEWER QUESTION: IF OUR SOLAR SYSTEM WAS THE SIZE OF A GRAIN OF SAND, VERY SMALL, BY PHONE SHUTS DOWN HOW LARGE WOULD THE REST OF THE UN VOTERS BE?

DO WE KNOW THE RELATIONSHIP BETWEEN OUR BACKYARD AND EVERYTHING ELSE?

>> YEAH.

SO, GOSH.

>> Jeff: DO WE KNOW HOW BIG IT IS?

EACH GALAXY IS A COUPLE HUNDRED BILLION STARS HOW MANY GALAXIES?

>> AS FAR AS WE KNOW THE UNIVERSE IS INFINITE AND THE UNIVERSE GOES ON FOREVER.

THERE IS A LIMIT TO HOW FAR WE CAN SEE AND THAT IS THE AGE OF THE UNIVERSE TIMES THE SPEED OF LIGHT.

SO WE WERE CUTOFF BY THINGS THAT ARE 14 BILLION LIGHT YEARS TRAVEL TIME THAT IS 80 MILLION LIGHT YEARS IF YOU COUNT THE EXPANSION OF THE UNIVERSE AS WELL.

>> Jeff: LET'S SKIP AHEAD TO IMAGE 8 IF WE CAN.

WE HAVE A COUPLE MORE PRETTY PICTURES HERE.

THIS IS A COMBINATION OF HUBBLE IMAGING AND WEBB IMAGING OF A SPIRAL GALAXY NICKNAMED THE SPANISH DANCER.

MY QUESTION FOR YOU YOU CAN EXPLAIN WHAT IT IS.

I SEE IT IN TWO DIMENSIONS AND I'M WONDERING IF IT IS IN THREE.

IS THIS A CORKSCREW AS OPPOSED TO THE FRISBEE?

>> IT'S A FRISBEE BUT IT HAS LIKE A SPIRAL STRUCTURE ON IT LIKE OUR GALAXY.

AND SO WE'RE SEEING IT FACE ON SO IT LOOKS TWO DIMENSIONAL.

SO WHAT WE SEE IS ON THE TOP LEFT, IS THE HUBBLE VIEW.

AND YOU CAN SEE THE DUST IN THE GALAXY IS IS DARK BROWN AND BLUE STARS YOUNG, HOT BLUE STARS IN THE CENTER WE HAVE THE OLDER STARS.

IN THE INFRARED WEBB VIEW WHAT WE'RE SEEING IS THE DARK DUST INVISIBLE LIGHT IS GLOWING IN INFRARED LIGHT AND YOU SEE THIS WHOLE NETWORK OF BUBBLES AND FILL MEANTS CAUSED BY STARS THAT ARE FORMING AND EXPLODING AND IT'S VERY DYNAMIC PLACE.

>> Jeff: HOW DO YOU AND YOUR COLLEAGUES AT THE HUBBLE, THE SPACE TELESCOPE SCIENCE INSTITUTE DECIDE WHAT TO PRIORITIZE?

YOU MUST GET GREAT RESEARCH ITEMS FROM ALL OVER THE WORLD?

>> WE USE DUAL ANONYMOUS PEER REVIEW.

SCIENTISTS SUBMIT A PROPOSAL I WANT TO OBSERVE THIS GALAXY OR THIS STAR FOR THIS REASON.

AND THEN A PANEL OF THEIR PEERS LOOKS AT THE PROPOSAL, THEIR NAME IS NOT ON THE TOP SO THEY ARE LOOKING AT THE SCIENCE AND THE BEST IDEAS WIN.

>> Jeff: HOW LONG DOES IT TAKE FROM THAT PROCESS TO LET'S POINT THE TELESCOPE OVER THERE AND THEN GETTING DATA BACK AND ANALYZING IT.

IT IS NOT LIKE TOMORROW?

>> NO.

IT'S NOT.

IT DEPENDS SO GENERALLY WE WORK ON YEAR CYCLES.

YOU WILL APPLY FOR A COUPLE MONTHS IN ADVANCE AND GET TIME SOMETIME DURING THAT YEAR ON THE TELESCOPE.

IT'S SOMETHING EXCITING IS HAPPENING YOU CAN PETITION THE DIRECTOR OF THE INSTITUTE TO POINT THE TELESCOPE THERE.

AND YOU CAN GET IT WILL IN A COUPLE DAYS.

>> Jeff: IT DOESN'T MOVE THAT FAST.

>> THERE IS A SCHEDULE YOU HAVE TO KEEP, BUT, YEAH.

>> Jeff: LOOKING FORWARD.

WHAT IS THE MOST INTRIGUING THING THAT YOU JUST CAN'T WAIT FOR THE DATA TO COME IN?

>> SOMETIME IN THE 2040S WE ARE WORKING TOWARDS DEFINING THE SCIENCE OF THE HABITABLE WORLD'S OBSERVATORY TO TAKE AN IMAGE LIKE AN EARTH LIKE PLANET AROUND A SUN LIKE STAR.

HOW SIMILAR ARE THE PLANETS TO OUR OWN?

WE HAVE TO WAIT TO SEE BUT THERE WILL BE COOL SCIENCE THAT COMES OUT.

>> Jeff: HOW MUCH FUN DO YOU HAVE GOING TO WORK?

>> I HAVE THE BEST JOB IN THE WORLD, I TALK ABOUT SPACE ALL DAY.

>> Jeff: AND YOU DO LECTURES AND STUFF.

>> THE SPACE TELESCOPE SCIENCE INSTITUTE HAS A YouTube ACCOUNT AND WE'RE DOING PUBLIC LECTURES OF COUPLE MONTHS.

>> Jeff: KELLY LEPO DELIGHTFUL HAVING YOU HERE.

WE'LL DO IT AGAIN.

STILL TO COME TONIGHT HOW DOCTORS ARE IMPROVING THE OUTLOOK FOR PATIENTS WITH TRAUMATIC BRAIN INJURIES.

WE WILL BE RIGHT BACK.

>> Jeff: AND JOINING US TO TALK ABOUT YOUR HEALTH IS Dr. EUGENIO ROCKSMITH A UROLOGIST AT THE UNIVERSITY OF REHABILITATION AT THE UNIVERSITY MARYLAND SCHOOL OF MEDICINE IT'S GOOD TO HAVE YOU BACK AT MPT.

>> THANK YOU.

>> Jeff: OUR FOCUS IS THE TRAUMATIC BRAIN INJURIES WHAT ARE THE MOST COMMON CAUSES.

>> WE HAVE A HOSPITAL AND DEAL PRIMARILY WITH TBI'S, TRAUMATIC BRAIN INJURIES FROM CAR ACCIDENTS, OFTENTIMES FALLS, ELDERLY PATIENTS WHO HAVE FALLS AND VIOLENT CRIMES, IN BALTIMORE CITY.

>> Jeff: WHAT ARE THE TRENDS IN TERMS OF RESEARCH AND TREATMENT THAT YOU'VE SEEN OVER YOUR CAREER?

>> I WOULD SAY WITH THE EXPLOSION OF COMPUTERS AND COMPUTER SCIENCE AND THE INTERNET, WE SEE A LOT OF COGNITIVE REHABILITATION TRENDS IN DEALING WITH PATIENTS WHO HAVE COGNITIVE ISSUES WHO HAVE PROBLEMS WITH PERFORMING THEIR ACTIVITIES OF DAILY LIVING AND WE CAN SIMULATE ENVIRONMENTS WHICH THEY ARE GOING TO BE IN WHEN THEY GET BACK HOME OR TO WHENEVER THEY ARE GOING AFTER THEY FINISH REHAB AND THEY CAN PRACTICE THROUGH REPETITION.

THEY CAN PRACTICE DIFFERENT ACTIVITIES AND THAT TYPE OF ENVIRONMENT.

>> Jeff: HOW MUCH IMPROVEMENT SHOULD SOMEBODY EXPECT?

I'M SURE IT'S IMPROVED FROM WHAT IT USED TO BE S THERE UNFORTUNATELY A CEILING?

>> USUALLY I TELL PATIENTS THAT THEY HAVE ABOUT FIVE YEARS TO MAKE THE GREATEST AMOUNT OF RECOVERY DURING THEIR PROCESS DURING THE RECOVERY PROCESS BUT IT DOESN'T MEAN THAT RECOVERY STOPS IN FIVE YEARS IT MEANS IT WILL SLOW DOWN SIGNIFICANTLY.

PATIENTS WILL MAKE THE GREATEST AMOUNT OF RECOVERY IN THE FIRST SIX MONTHS.

AND BY THAT POINT, THE MAJORITY SWELLING IN THE BRAIN CAUSED BY THE INJURY AFFECTED, MOST OF THE SWELLING HAS DISSIPATED.

SO WHAT YOU ARE LEFT WITH IS DYSFUNCTION OR DAMAGE TO THE BRAIN CELLS.

SO THAT'S WHEN YOU KNOW EXACTLY WHAT THE SEVERITY OF THE BRAIN INJURY IS.

AND THROUGH REPETITIVE PTOT AND SPEECH THERAPY PATIENTS WILL CONTINUE TO GET BETTER.

THEY MAY PLATEAU AT TIMES AND TAKE OFF AND START GETTING BETTER AND PLATEAUING AGAIN.

SOMETIMES THEY MAY DECLINE WITH AN INFECTION OR THEY DON'T SLEEP WELL AT NIGHT.

THE TREND IS STEADILY UPWARDS IN TERMS OF RECOVERY.

>> Jeff: WHAT KINDS OF TREATMENT MODALITIES DO YOU HAVE AT YOUR DISPOSAL?

PHYSICAL THERAPY, OCCUPATIONAL SPEECH?

>> WE HAVE THOSE AND WE HAVE ONE AREA OF REHAB THAT I ENJOY IS RECREATION THERAPY WHERE A THERAPIST WHO DOES TRAINING, LEARNS HOW TO USE WHAT IS IN THE ENVIRONMENT TO KIND OF PRACTICE WHAT PATIENTS LEARN IN PT, OT AND SPEECH THERAPY.

THEY TAKE PATIENTS INTO GROCERY STORES AND GO UP AND DOWN THE AISLE AND PICK DIFFERENT PRODUCTS ON A LIST AND PUT THEM IN THE CART.

AND THAT INCORPORATES ALL OF THE DIFFERENT ACTIVITIES THAT THE PATIENTS PRACTICE EVERYDAY IN THE REHAB HOSPITAL.

>> Jeff: FROM THE STANDPOINT OF THE PATIENTS AT THE REHAB HOSPITAL THEY ARE DOING A LOT OF WORK AND IT SOUNDS LIKE THEY CAN SEE IMPROVEMENT OVER TIME.

THE INITIAL SIX MONTHS AND OUT TO FIVE YEARS AND BEYOND.

WHAT ARE THEIR BIGGEST CHALLENGES?

>> PROBABLY THEIR BIGGEST CHALLENGE IS NOT TO GIVE UP.

AND WE TEACH THEM THAT THE MORE EFFORT YOU PUT INTO YOUR RECOVERY AND WE TEACH THIS TO THEIR FAMILIES THE MORE EFFORT THEY PUT INTO THE RECOVERY AND THE MORE THE FAMILY SUPPORTS THEM THE BETTER THE LONG-TERM OUTCOME IS GOING TO BE.

AND INVOLVED IN THAT IS THE FACT THAT SOMETIMES PATIENTS WILL BECOME A LITTLE DEPRESSED OR BECOME ANXIOUS THEY WILL HAVE PROBLEMS SLEEPING AND IT WILL AFFECT THE LONG-TERM RECOVERY.

PATIENTS WILL GO HOME WITH SWALLOWING DIFFICULTIES SO THEY CANNOT EAT ALL THE FOODS THEY ENJOY AND IT CAN LEAD TO DEPRESSION DOWN THE ROAD.

>> Jeff: YOU MENTIONED SLEEPING A COUPLE TIMES IS IT COMMON AND MORE OF AN INPATIENT THING?

OR WHEN SOMEBODY IS BACK HOME IT CAN REMAIN?

>> NO, IT CONTINUES.

IT'S ESPECIALLY PROBLEMATIC IN THE HOSPITAL BECAUSE PATIENTS HAVE THEIR BRAIN INJURY WITH REVERSAL OF THE DAY-NIGHT SLEEP CYCLE.

BECAUSE THE HOSPITALS ARE LOUD.

THERE ARE LIGHTS ON ALL THE TIME AND PATIENTS TEND TO STAY UP DURING THE EVENING OR DURING THE NIGHTTIME AND SLEEP DURING THE DAY.

IT'S DIFFICULT FOR US TO BALANCE THAT WITH THEM BEING ABLE TO DO THEIR THERAPY.

SO THAT IS SOMETHING WE'RE ALWAYS FOCUSED ON TREATING IN TERMS OF GIVING THEM MEDICATION TO HELP THEM SLEEP BETTER AT NIGHT.

>> Jeff: THE MENTAL HEALTH SIDE OF IT, ESPECIALLY A TRAUMATIC SITUATION YOU WERE WALKING AROUND FINE ONE DAY AND NOW YOU'VE GOT A SERIOUS SITUATION.

HOW DO YOU HELP PEOPLE THROUGH THAT?

>> I TYPICALLY WILL REFER THEM TO AN OUTPATIENT NEUROPSYCHOLOGIST.

A PSYCHOLOGIST WHO SPECIALIZES IN BRAIN BEHAVIOR RELATIONSHIPS.

AND THESE PSYCHOLOGISTS WILL HAVE FREQUENT COUNSELING SESSIONS WITH BRAIN INJURY PATIENTS HELPING THEM TO ADAPT TO THEIR NEW BODIES AND TO THEIR NEW DISABILITIES.

>> Jeff: IN YOUNGER PATIENTS, IN CHILDREN, ADOLESCENTS, DO THEY SEE TRAUMATIC BRAIN INJURIES AND DO THEY COME FROM DIFFERENT CAUSES?

>> I WOULD SAY THAT TYPICALLY THERE'S A BI MOD DAHL MEANING THERE ARE TWO PEAKS.

ONE IN PEOPLE MUCH YOUNGER CHILDREN, ADOLESCENTS AND YOUNG ADULTS.

AND THEN OLDER PATIENTS WHO ARE IN THEIR 60s, 70s OR 80s.

THE YOUNGER ADULTS HAVE MORE FREQUENT CAR ACCIDENTS.

TRAUMATIC INJURIES RELATED TO SPORTS.

AND THE OLDER PATIENTS TEND TO HAVE MORE TRAUMATIC INJURIES RELATED TO FALLS.

THE TYPE OF INJURY THE PATHOLOGY IN THE BRAIN IS DIFFERENT BETWEEN THE TWO GROUPS.

>> Jeff: YOU THINK ABOUT SPORTS YOU THINK ABOUT SOMEBODY HAS A CONCUSSION, THE SOCCER FIELD, THE FOOTBALL FIELD DOES THAT RISE TO THE LEVEL OF TRAUMATIC BRAIN INJURY.

>> IT DEFINITELY DOES.

THERE IS A SPECTRUM RANGING FROM MILD TRAUMATIC BRAIN INJURY OR CONCUSSION, MTBI, ALL THE WAY UP TO PROFOUND, SEVERE TBI.

>> Jeff: WHAT ARE THE STRATEGIES FOR YOUNG PEOPLE FOR PARENTS FOR OLDER FOLKS TO AVOID BEING IN THIS SITUATION?

>> FOR PARENTS I WOULD SAY THE MOST IMPORTANT THING THEY CAN DO TO PROTECT THEIR KIDS IS OF COURSE WHENEVER THEY ARE INVOLVED IN ANY CONTACT SPORT TO WEAR A PELL MUTT.

HELMET.

SKIING WEAR A HELMET.

BIKE RIDING WEAR A HELMET.

JUST THIS WEEKEND I WAS IN WASHINGTON D.C.

RIDING AROUND AND I THOUGHT I FEEL SO UNCOMFORTABLE IF I DIDN'T HAVE A HELMET.

>> Jeff: AS A CYCLIST?

>> EXACTLY.

FOR OLDER PATIENTS IT'S IMPORTANT THAT THEY ESPECIALLY IF THEY HAVE ANY TYPE OF MOBILITY ISSUES VERY IMPORTANT THEY HAVE SUPERVISION AT HOME.

THAT THEY USE ANY TYPE OF ADAPTIVE EQUIPMENT LIKE A WALKER OR CANE.

AND A LOT OF TIMES THEY DON'T WANT TO USE IT.

THEY FEEL LIKE I'M FINE.

MY MOTHER HAS MOBILITY ISSUES AND I FIND SHE DOESN'T WANT TO USE THE CANE AND SHE HAS FALLEN SEVERAL TIMES.

YOU HAVE TO BE ON THEM TO CONTINUE TO USE THE ADAPTIVE EQUIPMENT TO PREVENT THEM FROM FALLING.

>> Jeff: HOW DO YOU MEASURE THE BRAIN INJURY?

SOMEBODY COMES IN, AND UNFORTUNATELY THEY ARE COMING IN FROM SHOCK TRAUMA, IS THERE A WAY, I GUESS THERE'S IMAGING, BUT IT'S NOT LIKE A BLOOD TEST WHERE YOU HAVE A SCORE FROM 1-100.

>> THERE ARE BLOOD TESTS IN THE EARLY INFANCY OF USE, THERE ARE A LOT OF RESEARCH PROTOCOLS ESPECIALLY DOWNTOWN AT THE UNIVERSITY OF MARYLAND SHOCK TRAUMA HOSPITAL THERE ARE BLOOD TESTS BEING RESEARCHED TO DETERMINE WHETHER OR NOT THEY WILL BE HELPFUL IN TRYING TO DETERMINE HOW SEVERE THE BRAIN INJURY IS.

AND THEN THOSE BLOOD TESTS CAN BE REPEATED OVER TIME AS THE PATIENT GETS BETTER.

AND SO WE DON'T HAVE A BLOOD TEST LIKE CARDIAC ENZYMES WHEN SOMEBODY HAS A HEART ATTACK WE CAN'T CHECK THEIR -- WE CAN CHECK THE ENZYMES AND KNOW HOW SEVERE THE HEART ATTACK IS.

THAT'S COMING FOR BRAIN INJURY.

>> Jeff: QUICK QUESTION IS THERE ROLE FOR MEDICATION HERE?

>> BIG ROLE.

AND THAT'S SOMETHING THAT I REALLY ENJOY WORKING WITH THE PATIENTS ESPECIALLY IN TERMS OF PATIENTS WHO HAVE BEHAVIORAL ISSUES I USE A LOT OF MEDICATIONS TO HELP CALM THEM DOWN, SO THAT THEY CAN BENEFIT FROM THE THERAPY AND ALSO SO THAT THEY CAN REMAIN FOCUSED.

>> Jeff: Dr. EUGENIO ROCKSMITH THANK YOU FOR YOUR TIME.

>> THANK YOU.

>> Jeff: AND THANK YOU FOR WATCHING "DIRECT CONNECTION" WE'RE BACK FRIDAY WITH "STATE CIRCLE" AND THE LATEST ON MARYLAND POLITICS.

NOW, FOR ALL OF US AT MPT THANKS AGAIN FOR WATCHING AND HAVE A GOOD NIGHT.

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