When Brian Krinke became aware of his hospital surroundings, five days after he was struck by a car and sustained a traumatic brain injury, his first thought was not about what had happened to him. Instead, he began thinking about what he needed to do to prepare for his Monday class session.
Brian, an esteemed classical musician and Juilliard School graduate, is a violinist and piano virtuoso as well as a Professor of Music at Colorado Mesa University. He is a composer, conductor, concertmaster, and sought-after guest artist on the classical music festival circuit.
He grew up in a home filled with music, with a mother who was a pianist and organist and four older siblings who played instruments. His friends were music students, and his daughters are following in his footsteps into a conservatory.
“Music has been my life and my identity forever," Brian says. “It’s also my livelihood.”
On the Friday before Thanksgiving break in 2020, Brian was crossing the street to enter the campus music building when he was hit by a car.
Luckily, much of Brian’s physical functioning, speech and cognition were spared. He was discharged from the hospital and sent home. Once home, he soon discovered his injury had left him unable to read.
“It was blatantly obvious that I couldn’t read,” he says. “I couldn’t look ahead and was reading only one letter at a time.”
Even more upsetting, Brian discovered he could no longer read sheet music. His family and worker’s compensation case manager knew he needed help and worked together to get him admitted to Craig for brain injury rehabilitation.
“I didn’t want to be limited by my accident,” he says. “I needed to be able to do all the things I did before.”
At Craig, Brian was diagnosed with alexia, a disturbance in one's ability to read written language due to a neurological impairment, and musical alexia. Music sight-reading is the process of interpreting both pitch and rhythm from written symbols. Musical alexia is the impairment of interpreting one or both of those symbols.
Brian’s care team went to work, designing a therapy program that would help Brian regain the skills he needed to return to his employment and passion.
The donor-funded neurologic music therapy program was central to his therapy. Annamarie Engelhard, Craig’s neurologic music therapist, worked closely with Brian’s speech therapist, occupational therapist and physical therapist to incorporate aspects of music rehabilitation into each respective treatment.
Individual neurologic music therapy sessions allowed Brian to continue rehabilitating the injured parts of his brain and learn new strategies to help him return to music. Some of the tools implemented in the neurologic music therapy program included technology for enlarging, coloring, and spatially-editing sheet music and using a digital display so that Brian could read and play.
Brian was also introduced to Hayley Medina, an occupational therapist in Craig’s Community Reintegration program. The program, with support from Craig Foundation donors, works to return patients to employment, school, volunteering or other meaningful activity following their injuries.
“Brian’s main goal was returning to his role as a professor," Hayley says. “He loves his students and being able to share his passion and talents through his work role was always a top priority. He is also very active in his local orchestra, the Grand Junction Symphony, and being able to return to performing was a major motivator for him.”
Hayley met with Brian frequently to understand the different tasks he did at work and to discuss his workplace priorities.
“She wanted to know what I did before, what skills I needed for every aspect of my job and what was most important to me,” he says.
To assess his organizational skills and showcase his progress, Brian’s team tasked him with organizing and performing a concert while an inpatient. Brian performed seven pieces on violin and piano, including a work that he had finished composing during his time at Craig.
Hear Brian perform “Etude Velocity,” the piece he finished composing while at Craig:
In coordination with his doctors and care team, Hayley assessed barriers, established accommodations and created a return-to-work plan that would ease him back to employment.
“Some things she put the brakes on and pulled me back when I thought I could do too much,” Brian says. “But she knew that the idea was for me to go back successfully, and not get in too deep too soon.”
Brian was discharged from inpatient therapy in February and returned home to Grand Junction where he continued outpatient therapy via telehealth technology for several months.
Hayley worked with Brian’s supervisor, the HR department and his worker’s compensation case manager to implement the return-to-work plan, and in April, he returned to conduct the orchestra for half of the rehearsal.
“It was great to be back and the kids were very sweet,” he says. “But in the end, I was very tired. I guess Hayley knew what she was talking about!”
By the following fall, Brian was back to work full-time and has fully returned to his performing duties. In addition to his teaching, composing and conducting, he is traveling the country to perform, with concerts scheduled in Arizona, Minnesota and New York City in the coming months.
According to Hayley, returning to work after an injury brings family stability, enjoyment, happiness and overall sense of purpose. “Work is such an important piece of our individual lives; many times it is a piece of our identity. Helping our patients return to that role is a goal we strive for.”
Brian says he does not know what would have happened to him if he had not come to Craig.
“My team took my goals seriously and pulled out all the stops to make sure I had the skills and ability to get there.”
October is National Disability Employment Awareness Month, recognizing the important role people with disabilities play in a diverse and inclusive American workforce. This year’s National Disability Employment Awareness Month (#NDEAM) theme is “Disability: Part of the Equity Equation.”