The crash happened somewhere on the map. The next seven days are the same everywhere.

Every crash on this desk starts the same way: a jolt, a second of silence, and then the adrenaline. People step out of the car on the shoulder of 270 or in the turn lane on Manchester, check the other driver, take photos, trade cards, and tell each other they are fine. Some of them are. Many are not yet, and do not know it. This page is the week that follows, written for the whole metro because the week does not care which county you were in.

Hour one: the adrenaline hour

Adrenaline is a painkiller. It is also a liar. In the first hour most people report feeling shaky, keyed up, and otherwise all right. That is a normal stress response and it is exactly why scene reports are unreliable. If you hit your head on the window, the headrest, or the wheel, say so out loud to someone, even if it feels like nothing. If there was any loss of consciousness, any vomiting, or any confusion about where you are, that is the emergency room. The bright line is at the bottom of this page and on every page of this desk.

Take your photos. Write down the time. Keep whatever the responding officer hands you. None of that is medical, but all of it becomes part of a clear history when a clinician asks what happened.

The first night

The first night is usually quiet, which is the problem. People go home, eat, sit on the couch, and stiffen. The body's inflammatory response to strained ligaments and muscle ramps over hours, not minutes. Whiplash, the common name for a neck sprain or strain caused by a rapid back-and-forth motion of the head, is the textbook example: the injury happens in a fraction of a second and announces itself the next morning.

If you feel a growing headache, nausea, or a strange sensitivity to the TV light that night, do not sleep it off and hope. Concussion symptoms in adults can include headache, dizziness, light and noise sensitivity, trouble concentrating, and irritability, and the CDC notes they can appear days after the injury. The difference between a concussion question and an emergency is spelled out in the bright line below; read it once tonight.

Day two: the morning the neck reports

This is the morning in the photograph above. The ice pack comes out of the freezer. Turning the head to back out of the driveway hurts. Looking down at a phone hurts. Some people notice a headache that starts at the base of the skull and wraps forward. Some notice the low back instead, especially after a side impact or a hit with the seat reclined.

Day two is when most readers of this desk start searching. Good. The instruction is simple: call the nearest of the three offices and identify the visit as a crash exam. Hazelwood, (314) 627-1411, for the north. Tesson Ferry, (314) 530-5480, for the south. O'Fallon, (636) 280-0990, for St. Charles County and the far west. All three close from 12 to 2, so call in the morning or after two.

Day three: the fog

If there is a concussion in the picture, day three is often when it shows. A shift at work feels harder than it should. Reading a screen for ten minutes is tiring. A conversation in a noisy room is overwhelming. People describe it as fog. It is not weakness and it is not imagination; it is a brain that took a load and is asking for time and a plan.

Missouri Injury Clinic publishes a dedicated TBI and concussion rehab lane alongside its auto injury lane, which means the head can be evaluated behind the same doors as the neck. The tools it names, oculomotor rehabilitation, neurofeedback, vagus nerve stimulation, and the rest, are listed on the concussion guide. You do not need to diagnose yourself before you call. You need to mention the fog.

Days four and five: the bargaining days

By midweek, most people have decided one of two things. Either they are a little better and therefore fine, or they are a little worse and therefore scared. Both groups postpone. The first group postpones because improvement feels like proof; the second postpones because an exam makes it real.

Here is the editorial position of this desk, stated plainly: a little better on day four is information, not a verdict. A sprain that is improving still deserves findings and a plan so the next three weeks go right. And a little worse on day four is precisely the reason the exam exists. Either way the appointment is the same phone call.

Days six and seven: the record starts, or the gap does

If you have been examined by the end of the week, you now have a dated history, findings, a diagnosis if the findings support one, and a written plan. That record exists so that the next clinician works from facts, not memory. If a claim is ever part of your story, the dated record from the first exam is what everyone will ask for. That is a byproduct of care done on time, not the reason for it.

If you have not been examined, the gap starts here, and a record that begins after a long gap has to explain the gap forever. Go anyway. A later exam is still a real exam, and being honest about the timeline is part of the record. This desk would rather you call on day twelve than not at all.

What the week is not

The week after a crash is not a legal process and this desk is not a law office. Missouri Injury Clinic is a chiropractic injury clinic run by Joseph L. Hollingsworth, DC. Nothing here is legal advice, and nothing here puts a number on anyone's injury. If you already have an attorney, bring their contact so records can be sent where they need to go. If you do not, you do not need one to get examined.