2 or 3 Things I Know About a Brain Injury

I’m driving south into Athens, Georgia, on a cloudless Friday morning in September, 1985, when I have to stop. An oversized pickup truck, the wide kind with tool lockers built into either side of the bed, and extra wheels, is blocked from entering a convenience store parking lot by another truck. I’m in no hurry, and wait while they wave and negotiate. I reach up to adjust my rearview mirror. The grill of a truck fills it, getting closer—I turn the steering wheel left a quarter-turn and put my foot on the gas, there’s a squeal of brakes then a crash and glass flying everywhere.

The next second stretches out. I’m airborne. I notice how quiet it is. I think, “I can’t believe this is happening to me,” then, “This son-of-a-bitch is ruining my car,” and am amused to think it about the piece of junk I’m driving. Then I crash into the truck ahead. I’m too stunned to put on my brakes and I guess the guy ahead is too, we roll one hundred and fifty feet according to the police report. That’s a lot of force to go through me. All I hear is the tire tread coming up off the blacktop. Then we stop.

I take a deep breath. No pain in my chest, shoulders, or back, when I breathe deeply. Good. I wiggle my fingers and toes, flex my arms and legs. No numbness. Everything moves without pain. I’m okay.

Unbelievable.

And if I’m not injured, then everything else—wrecked car, late for an appointment, marriage, mortgage, my life as father, husband, professional (I’m a Physician Assistant in medicine and psychiatry), and any leaks that life can spring in a crisis—can be dealt with. At thirty-five I’m mentally very tough. I can deal.

I can’t know, as I undo my seat belt, open the car door, and swing my legs out, all the freaky shit my brain will put me through over the next twenty years. No bones are fractured, but I am. I won’t have “me” to help me through what comes next.

I stand up and fall down in the road, stand up and fall down again. That doesn’t make sense. I crawl around the car up onto the curb. This time I can’t get up at all, so I sit there hugging my knees and looking around as though this is the most normal thing in the world.

People come up and speak to me. I’m as tired as if I haven’t slept in two days. Everything seems far away, and grey, as though I’m looking through a screen.

The cops come. They take me to the hospital and I get a ride home from there. My wife and daughters—Kate, eleven, and Zoe, six—look somber when they see me home early, wearing a soft collar. I reassure them that after a good night’s sleep I’ll be fine.

Four days later, I’ve slept a lot and feel no better. About 11 am I feel tired and lie down on the bedroom floor. My face is numb. The grain patterns on the wooden door start swirling, the ceiling fan blades tick back and forth.

This isn’t good. My first thought is that I’m bleeding inside my head from the impact, and it’s taken this long to accumulate enough blood to put pressure on nerves along the optic tracts from my eyeballs to the back of my brain, causing visual problems, or on my spinal cord, where motor and sensory nerves going to my face emerge, causing numbness. I feel my pulse: slow and steady, as usual. So far there’s not enough bleeding to push the brain down and cut off breathing and heartbeat. I need a brain scan, maybe surgery—have to go to Atlanta for that.

I’m pleased to notice how calm I am. I pick up the phone to ask my neighbor for a ride, explain the situation briefly, tell him if I’m not outside in ten minutes to come in after me, because I might black out. I call my friend Hector, the neurologist. Come in right away, his nurse says. On the drive over I keep talking to make sure I’m still breathing and make sense.

After the history, exam, and CT scan, Hector gives me the lowdown. “The good news is you don’t have any bleeding. You had a brain injury, okay? So just expect all kinds of weird symptoms.”

That’s a huge relief, and basically I stop listening, because what I hear is, Everything is okay.

“When that truck ran into you, your head went back fast with the impact. Your brain is soft, like Jell-O. There’s a delay in how it moves inside your head. It got compressed against the back of your skull, then when you hit the truck ahead of you and your head went forward, your brain hit into the front of your skull. At the same time, your brainstem got stretched and twisted, because you turned the steering wheel and went up and came down on an angle. So you have all these places where basically, your brain hit into bone, and it got bruised, okay? Now all these nerves are irritated, they’re very irritated, and they’re firing on their own, and you have all these odd symptoms. But it’s not dangerous. And as time passes, it’ll all get better. It takes, usually, about twelve to eighteen months for things to settle down. Whatever you’ve recovered at that point, that’s pretty much it. And you have to accept it.”

I plan to be the exception, back to normal in a couple of weeks.

Then Hector gives me the best advice anybody ever gave, and I pass it along.

“Look—this just happened. There’s nothing you can do to make it better. You just have to give it time. Meanwhile, do whatever you want. You want to go to work, fine, go to work. Understand that you could, you know, mess up. Your brain’s not working right. So any time you need to stop, go home and take a nap, that’s okay, just do it. You can do whatever you want,” he says. “It just can’t matter to you how it comes out.”

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