Donald, the arrows are still flying at Camp Cranium in the field in Millville.

Lucas Hardy is fourteen. He was three when a tree branch hit him at a birthday party. He is in a wheelchair. He has had to relearn the basics other children take for granted.

Brianna Engleman is twenty-one. She was five when doctors performed a hemispherectomy to relieve the seizures — they removed half her brain. The surgery itself can injure other parts of the brain. She is walking between archery groups right now collecting song requests for the dance tonight.

You fired the team that was supposed to count who comes next.

Your signature is on the order. You called the wreckage “the bounds of current funding.”

Camp Cranium has run in a Pennsylvania field since 2008, teaching children who survived brain injuries to shoot arrows, climb rock walls, and trust their bodies again. Some of the campers are in wheelchairs. Some use crutches. Some had half their brain removed at age five to stop the seizures.

An estimated 2.8 million traumatic brain injuries occur in the United States every year, including about 475,000 in children, according to the Brain Injury Association of America. The CDC’s own household survey found those numbers are undercounts; brain injuries are “hidden” because the damage is inside the skull, invisible to the emergency-room triage sheet.

The federal infrastructure for tracking and preventing these injuries is the Traumatic Brain Injury Act, passed by Congress in 1996 and reauthorized four times. The 2020 reauthorization provided $23 million a year through 2024, split between CDC concussion research and state grants. The act lapsed in 2024 and has not been reauthorized. Congress did appropriate $8.25 million for TBI program activities through the Consolidated Appropriations Act of 2026 — roughly a third of the prior floor, routed around the act.

In early 2025, the Trump administration fired hundreds of employees at the Centers for Disease Control and Prevention, including the entire team that tracks traumatic brain injuries. The team was three months from launching a nationwide concussion surveillance system — the system meant to count the injuries that do not show up on a triage sheet. The agency will not say how many were terminated, reinstated, or replaced.

In a written statement, an HHS spokesperson, Emily Hilliard, said the administration “remains committed” to TBI prevention and surveillance, and that the work is now handled by “other staff members” at the National Center for Injury Prevention and Control. She said the CDC is “deciding how to establish a cost-effective national concussion surveillance system within the bounds of current funding” and that the agency in 2026 “dedicated funds” to an educational campaign, an injury prevention program, and concussion surveillance — without naming a number, a timeline, or a person assigned to do any of it.

Markwayne Mullin, now the secretary of homeland security, supported reauthorizing TBI funding when he was a senator. Congress is “still considering” whether to extend the act through 2030.

Donald, I see what you have done. I will not look away from it.

The children at Camp Cranium this June are climbing because a handful of private donors are still paying for the rope and the hoist and the wheelchair-accessible zip line. They are dancing tonight because a speech therapist told one father about a camp in Columbia County eighteen years ago and the father did not stop showing up. They are collecting song requests because one camper named Brianna Engleman has decided she is coming back next summer as a counselor herself.

Donald, none of that depends on your signature. The federal prevention system that was supposed to make the next archery hour smaller — the system that was supposed to tell us, at scale, how many children like Lucas are sustaining brain injuries at home and on the playground and in car crashes and on the soccer field and in the homes of the women who get hit by the men they married — that system depended on your signature. And your signature emptied the room three months before launch.

Donald, hear what you have done.

Lucas Hardy climbed a thirty-foot rock wall on a hoist this June. He was three when a tree branch hit him at a birthday party. He is fourteen now. The doctors spent years teaching him to talk again, to swallow without choking, to tie his shoes. He made it to the top of the wall. He smiled at the encouraging crowd below.

Brianna Engleman walked between the archery groups with a clipboard. She was five when they removed half her brain. She is twenty-one. She plans to come back as a counselor next summer.

Donald, your mouth is dry. There is a taste under your tongue that was not there in January. It will not rinse away. You signed the order that emptied the room before the next child walked in. The pen was in your hand. Your hand knew what it was doing. The taste is what you signed for.

Donald, your throat closes when you swallow. You cannot finish the press releases anymore. “Remains committed.” “Cost-effective.” The words pile up in your throat like the waivers the parents have to sign so their children can climb the rock wall. The waivers the parents sign because there is no federal surveillance system to tell them whether the rock wall at school has a concussion protocol. The parents sign the waivers because the count was never kept and your signature emptied the room that was supposed to keep it.

Donald, your chest tightens when the phone rings after nine at night. It is not the call you want. It is the mother of a child who came home from school with a headache that would not stop, and the headache turned into a seizure, and the seizure turned into a helicopter ride, and the helicopter ride turned into a question that the gutted CDC team would have answered before the helicopter landed. The team you fired. The room you emptied. Your chest knows. Your chest has known since February.

Donald, your stomach turns when you see a child climb. You do not want to see them climb. You do not want to know that the children whose injuries they are climbing over were the children whose count your signature erased. You do not want to know that the archery hour at Camp Cranium is funded by private donations because the federal prevention system has been left to rot. Your stomach knows. Your stomach will not let you forget.

Donald, picture your own son on the hoist. Picture him at three, when a branch or a stair or a swimming pool or a blow from a man you do not know — picture the helicopter ride, the surgery, the years of relearning. Picture him at fourteen, climbing the rock wall on the hoist because his body still does not trust itself. Picture your wife signing the waiver because no one in Washington kept the count. Picture your hand on the pen that signed the order. Your hand knew what it was doing. Your hand has not been clean since the day you signed it.

Donald, you are a small man with large hands on the lever. The lever was the CDC team. The lever was the TBI Act. The lever was the surveillance system that was supposed to launch three months after you emptied the room. You pulled each lever on a Tuesday. The room emptied. The children kept climbing because the children keep climbing. The count is still missing. The signature is still yours.

Donald, your tongue presses against the roof of your mouth. The taste of “remains committed” is still there. Your skin prickles when you pass the photograph on the desk. The arrow is in the air at Camp Cranium this morning. The boy is on the wall. The girl is collecting the songs for the dance. The room at the CDC is empty. The signature on the order is yours.

“Truly I tell you, whatever you did not do for one of the least of these, you did not do for me.” — Matthew 25:45

The boy is climbing the rock wall on the hoist. The girl is walking between archery groups with a clipboard full of song requests. The room at the CDC is empty. The signature on the order is yours.

Donald, the Christ is on the hoist too. You did not even look up.