María Pánfila Garay

Trigger Warning: This story discusses domestic violence.

María Pánfila Garay was a loving mother who enjoyed music and the outdoors. After noticing changes to her personality, thinking, and behavior after years of suffering from domestic violence, her eldest daughter decided to donate her brain to the BU CTE Center for answers after her passing at age 69.

We thank the Garay family for their generous donation and commitment to our research.

Read María’s story below.

María Pánfila Garay was born in El Niño Jesus in Zacatecas, Mexico. “My mother was a beautiful Mexican-immigrant woman who loved her family,” her eldest daughter, María Garay-Serratos, MSW, PhD, said. “She was proud of her heritage and taught her children the importance of self-identity, cultural pride, kindness, and compassion.” 

María enjoyed gardening, reading, traveling, playing the guitar, singing, cooking, and being outdoors. She had seven children who she loved very much.

During her lifetime, María was a victim of domestic violence (DV). Garay-Serratos remembers witnessing the trauma her mother endured, sharing she can’t quantify the number of concussions she suffered because her mother did not receive any formal diagnoses. “Most domestic violence victims do not seek medical care for a variety of reasons, especially immigrant women like my mother,” she said. “However, she sustained numerous [non-concussive hits] and concussions as well as anoxic brain injuries and other injuries from thousands of domestic violence episodes over the span of four decades at the hands of my father.” Over the years, Garay-Serratos saw the impact the abuse had on her mother and would nurse her after each episode. She recognized her mother was suffering from concussions due to the symptoms she reported after many of the episodes, including headaches, vision problems, nausea, and vomiting. She said following each concussion, her mother would sleep in her dark bedroom for hours while she watched her siblings and kept them quiet. When her mother needed to get up to attend to urgent issues, she seemed dazed and showed an inability to focus.

Her recovery from these episodes could take weeks or longer depending on how severe the concussion was. “The most horrific aspect of domestic violence was that she did not have time to recover from any single head trauma injury as the abuse was on-going. Just when she was feeling better, another DV-head trauma episode would take place,” Garay-Serratos said. “This is not like a football field where there are referees and medics to help and intervene. There was simply no recovery period for all the head trauma my courageous mother suffered.”

As time went on, Garay-Serratos remembers her mother’s symptoms worsening, including severe and constant migraines, for which she “would take Anacin like it was candy to alleviate the pain.” She also experienced sensitivity to light and noise, and she developed new symptoms such as agitation and other behavior challenges, vestibular problems, executive function decline, memory loss, crying spells, apathy, paranoia, suicidal thoughts, and others. “As her brain diseases progressed, she could no longer fully take care of herself,” Garay-Serratos said. “The last three years of her life, she could not recognize her children or husband, or enjoy the things she loved to do.”

Her mother was unaware she suffered from any type of brain trauma due to the domestic violence she endured and was therefore not aware of brain donation to help further DV-chronic traumatic encephalopathy (CTE) research. Garay-Serratos recognized the symptoms in her mother and suspected she may have been suffering from CTE since the 1970s.

Upon her passing in 2015, Garay-Serratos donated her mother’s brain to find answers. At the UNITE Brain Bank, director Ann McKee, MD, diagnosed María with stage IV/IV CTE and Alzheimer’s disease.

“I was overwhelmed and devastated to learn the extent of my mother’s brain trauma. I keep hearing what Dr. McKee shared, ‘Alzheimer’s and CTE were both very severe by the time of death, and then compounding that is just this incredible loss of nerve cells and white matter fibers, the likes of which I’ve never seen in CTE or in Alzheimer’s disease… I don’t know how your mother was functioning.’”

“Her findings left me breathless and shattered, but not broken,” Garay-Serratos said. “They emboldened me with my life’s mission.”

Since learning of her mother’s CTE diagnosis, Garay-Serratos has become an expert and advocate in the field of domestic violence and CTE research. She advocates for more DV and head trauma-impacted brains to be donated to further the research and says she decided to donate her mother’s brain “to sound the alarms about this pandemic so that we can start a new brain scientific field (or encourage the current brain science field) to focus on domestic violence and head trauma.”

Garay-Serratos works every day to make sure victims, survivors, and thrivers of domestic violence find answers and says “the call for DV-brain donation is an urgent one.”

She shared that there is no public education about this pandemic and “no brain bank in the world is stating that they are strategically and intentionally encouraging DV victims, survivors, and thrivers to donate their brains to advance the science for DV-head trauma and DV-CTE.”

“Unlike retired NFL players, veterans, and individuals in contact sports, there is minimal to no education about DV-head trauma and DV-CTE in the world,” she said. “Hence, most domestic violence victims, survivors, and thrivers are unaware that some of the symptoms they are experiencing might be from DV- traumatic brain injury (TBI), DV-CTE or other brain trauma from DV. The same can be said for the system of care established to assist them. In essence, they are in the dark like my mother was wondering what is happening to them. Tragically, they are not seeking or receiving health care.”

She says domestic violence-related head trauma has been recognized in the scientific literature since the late 1980s, but “at a global level, this pandemic is being ignored. Catastrophically, millions of individuals, globally, are unable to fully participate in daily living like work, school, caring for children, and family life due to DV-head trauma. I was left alone to make sense of what was happening to my family. I worry I too have DV-CTE. I am hopeful that we can reverse this trajectory together by answering the call to action.”

Garay-Serratos has shared her mother’s story and expressed the importance of furthering research in several ways. One of these is through the 2023 documentary by Sydney Scotia titled This Hits Home, in which she is the protagonist, associate producer, and DV-TBI/CTE expert.

She has also created a non-profit connected to the film, the Pánfila Domestic Violence HOPE Foundation, which she named after her mother. She describes the mission as “a call to action to address DV-CTE and DV-head trauma” and shared a few of the foundation’s goals:

• Publicly speaking about the DV-head trauma and DV-CTE public health crisis and what we can do to address it
• Reaching out to brain banks to encourage them to focus on the DV-CTE population and encourage brain donation among them to understand disease progression, develop treatments, and identify biomarkers
• Providing DV-head trauma and DV-CTE trainings/workshops to first responders and other providers within the system of care advocating for the DV population
• Writing to publish in professional publications to encourage research about DV-head trauma and DV-CTE

As she works to share her mother’s story and bring attention to domestic violence and head trauma research, Garay-Serratos is thankful for the support she receives from her family, including her husband, and her brother, Gumaro. “Their presence, compassion, insight, and overall support have been my light when I only saw darkness,” she said. “They have helped me maintain my hope and faith.”

When Garay-Serratos thinks of her mother she remembers her as “resilient, courageous, tenacious, strong, determined, faithful, and full of hope for a better life.”

She is currently focused on writing a book about her own DV-head trauma journey, which she says will focus on how she has “maintained hope throughout the process to advocate for the world to address it.”

“My DV-head trauma journey, although difficult and challenging, has served to make movement forward,” she said. “I was not able to save my mother or father, but I fight every day to save other DV-head trauma and potentially DV-CTE impacted individuals.”

María’s diagnosis was made by Dr. Ann McKee at the BU CTE Center. If you would like to support the BU CTE Center’s research and help give more families life-changing diagnoses, you can donate here.

If you or a loved one are interested in brain donation, please view our Frequently Asked Questions (FAQs) and brain donation brochures for more information.

You can visit our Resources page to find resources for anyone struggling with suspected CTE symptoms. If you or a loved one are a victim of domestic violence, please call the National Domestic Violence Hotline at 1(800) 799-SAFE [7233].

This story was written by Amanda V. Cabral at the BU CTE Center. If you are interested in having a donor story written for your loved one, please reach out to her at avcabral@bu.edu.