At this point, for the first time in two days, it finally occurred to me that there was something going on besides sore muscles from being “shaken up” in a car accident. It was not supposed to take me fifteen minutes to be able to figure out that I’d been wearing my shoes on the wrong feet all day, right? And yet I still didn’t understand that there was anything really wrong—how could there be? I just couldn’t “get” it. On the surface everything was in order.
I called the family doctor, and he said that I should go to the emergency room and get checked out—the standard response.
I thought about going to the hospital right away, instead of to the insurance claims office, but I was unable to make a decision about what I should do.
“This is weird!” I thought. “Just pick one.” But I couldn’t. After ten minutes of sitting in my chair waiting for a plan to come to me, nothing happened. In the end, without thought, I managed to focus on getting the car sorted out first. It was the fear of being without transport to get around in my busy life that finally made the decision for me.
I drove to the address that I’d written down. The navigation was unaccountably hard for me. My sense of time became distorted as I began to focus on minute details of the environment around me: the color of a sign, the smell of the car, smudges on the windshield, the wind blowing leaves across the road. By the time I arrived I had a terrible headache. I was looking, and feeling, distinctly disheveled after two days of managing almost nothing. I had not shaved, or changed my clothes. I sat in the car for twenty minutes, staring off into space, then went into the office and talked to the receptionist—a large, unpleasant woman who looked as though she had had to calm down irate insurance claimants all day.
“Hi,” I said. “My name is Elliott. I spoke to someone this morning about my car.”
“Okay,” she said. “Why are you here? Do you have an appointment?”
“I’m not sure,” I said slowly, hesitating between words. “One of the people you insure ran into me. I was told I have to come in right away.”
“If you don’t have an appointment [ . . . ]” I was having a lot of trouble processing her words. I couldn’t follow her.
“I’m sorry,” I said, “could you speak more slowly? I don’t understand what you are saying.”
She spoke more loudly, as though I were hard of hearing, which, because of the phonosensitivity I was experiencing from the concussion, was painful. But she did not speak more slowly. Because she was now annoyed, her consonants became increasingly percussive, which felt like small hammers rapping against my skull. I was even less well able to follow her than I was before.
The receptionist scowled at me. “Just a minute,” she said, and walked back and spoke to another woman whom I took to be the handler-of-difficult-customers person in the office. The second woman looked something up on the computer and then came over to me.
“Mr. Elliott, you have an appointment on Friday,” she said in a painfully loud voice. I winced and tried to make sense of what she was saying to me. Friday? I said to myself. Friday . . . I didn’t know what that meant. I had no sense of the flow of time through the days of the week. I could see the word “Friday” in front of my eyes, but nothing else came to mind.
“Is it possible you could have someone look at my car if I was willing to wait for a spot?” I asked. “It’s right outside.”
“Our office [ . . . ]” she said loudly, glaring at me. I tried to follow, but I couldn’t make out what this woman was saying, either.
“I’m . . . sorry . . . what . . . ?” I said hesitantly. I was having trouble forming my words, and was slurring them slightly.
She interrupted me in an even louder voice, speaking even more rapidly: “OUR OFFICE [ . . . ]” Her face was determined, and angry. I covered my ears with my hands, closing my eyes.
Once I covered my ears, she stopped altogether, clearly offended. “I am going to have to ask you to leave the premises right now,” she demanded.
What was happening to me? I couldn’t get it. It was like I was in the Twilight Zone.
I didn’t know how to explain to her. I was certain we could have worked it out if she just spoke more softly, and slowly enough that I could follow. But it was obvious that she thought I was a troublemaker.
I was incapable of explaining that I had brain damage from the accident two days prior because I myself had no concept of what was wrong. And it never occurred to the office workers that my difficulties might be stemming from the accident.
I later found that it was important to smile and fake it at times such as this—to nod and pretend that I understood, say “yes” often, and then try to work it out on my own later.
I gave up and left the office.
This was the first of many such situations in which people took offense at my manner as I struggled to navigate social situations, and got angry at me.
I drove home, and then rested through the evening, night, and next day, mostly staring at the wall, sitting in my Eames chair.
By Thursday I was feeling more normal, and taught my class downtown at DePaul. Because I couldn’t read more than a line or two, I lectured extemporaneously from memory—while sitting at the desk in front of the class. By the end of the lecture I was in the soup again, unable to stand or walk. One of my students drove me home.
Once back in my house, I tried to sleep, but I found that if I closed my eyes, or turned off the light, I got seasick from disorientation. In the end I fell asleep with my eyes open and the light on, staring at a spot on the wall.
By Friday I felt that I had lost control, and thought I had better go to the emergency room after all. But this was easier said than done. I had always been a natural multitasker: able to get my kids out the door and into the car, work on an AI problem in the back of my mind, consider the best route to our destination, make a mental note to call a friend, and so on, all running in parallel. Now I found that I could only do one thing at a time. If I had even the slightest thought about any other subject at all—for example, about where I was going, or what I was going to do there, or even simply did I have my wallet?—everything else just stopped dead: my body stopped moving, my balance systems began to fail, and my internal organization of keys, glasses, doors, coats, and shoulder bags disappeared into the ether.
DO YOU KNOW YOUR NAME?
On my way to the emergency room I drove along a thoroughfare I had traveled daily for eighteen years. But nothing was familiar to me, and none of the landmarks in the visual scene carried any meaning. I was not delusional. I could have described, for example, the middle school that my daughter attended, and identified it by name. But the description would have been purely intellectual in nature. There was nothing about my visual apprehension of the actual school building that would lead me to believe I had ever seen it before. There would be no visceral sense it inspired, no history, and I could not use it in the visual-spatial scene for navigation because it had no “place information” attached to it. In a Capgras-like twist (a delusion in which family members seem to have been supplanted by look-alikes), it was as though all the buildings had been replaced by others that looked the same, but were part of a foreign landscape that was not my home.
With difficulty I managed to get myself admitted to the emergency room, but I have only patchy memories from the seven hours I spent at the hospital. The intake nurses asked me questions, but I couldn’t make sense of them. Later, in a scene reminiscent of a late-night horror movie I was rolled around in a wheelchair, overcome with nausea from the motion, and the spinning of the visual scene in front of my eyes, as I went through batteries of tests. The orderly who was pushing me kept banging my foot into things; it hurt, but I couldn’t figure out how to ask him not to do that anymore. I had specifically rehearsed three things that I wanted to make sure the doctor knew when I finally got to talk to him, but I couldn’t retrieve even one of them sufficiently to be abl
e to form the necessary words.
The doctor asked me, “Do you know what your name is?” I could see, in my mind’s eye, the words “Dr. Clark Elliott” in black type against a white rectangular background, mixed case, in Times New Roman font. However, as soon as I started to speak the answer, the words disappeared. But the vocalization had only just started. Without the words before my eyes, my motor system failed, and I could not speak them. At this point I also found myself unable even to decide whether the answer was “yes” I knew what my name was—after all I could see it in front of my eyes—or “no” I was unable to perform what is known as the speech act of saying my name in response to the question.
In the end I just sputtered.
I was so frustrated that my eyes filled with tears. I felt that the doctor assumed I was just an idiot. I felt like I was faking it somehow, in a perverse scheme to emphasize my troubles. But I was not an idiot. I knew exactly what was going on (sort of, in one way). I just couldn’t communicate it. I wanted to have the doctor understand my symptoms, and wanted to be an active participant in treatment, but was completely shut out of the process.
Much later, when they were ready to discharge me, the doctor simply said, “Everything looks fine.” I asked him, “What’s the problem? I don’t feel right.” He said, “You have a concussion, and it’s a bad one.” I remember seeing the words “severe concussion” written on a form.
The doctor told me I could go home, then left. They gave me some papers, which turned out to be instructions telling me to have someone wake me up several times at night, but I didn’t read them until months later. I didn’t know what they were, I was living by myself, and besides, by this time I had found that I couldn’t read. They gave me some pills, but I didn’t know what to do with them. (I discovered the bottle of Vicodin in a drawer, unopened, a year later.)
It would have been extremely helpful to have some explanation given, carefully, of what a concussion was. That is, something such as, “You have permanent brain damage and it is going to take some time for your brain to rewire itself to work around the trouble so that you can start to function more normally. In the meantime—for months—you might expect to have a lot of trouble getting through the day.” But no such explanation was given, and I was simply given my clothes and released. It took me several hours to make the one-mile drive home.
By the next morning my arm was quite sore. By Sunday it was swollen to twice its size. The hospital staff had forgotten to take the catheter out of my arm before releasing me. It would have been easy for me just to take the tape off and pull the catheter needle out, which any reasonable person would have done. But I couldn’t make sense of it: my arm hurt . . . it was swollen . . . I had been in the hospital. . . . For some reason there was tape and a plastic connector, with a big needle sticking in my arm. I couldn’t figure out how to get the tape off. The best I could manage was to drive back to the hospital emergency room one-handed and bang on the glass door with my good arm.
It was after midnight, so the overnight guard sent me in to the nurses’ desk. The nurse there laughed when she saw my arm, and others of the night staff, standing around the nurses’ station, looked over our way, and started laughing too, at my expense. I was the big joke that night—too goofy to realize I had a needle sticking in my arm. I felt both helpless and ashamed to be such a dope with my swollen arm. My sense of isolation was growing.
WORD MAPS GONE AWRY
By this time, because the experiences were so odd—and, in a macabre way, fascinating to me as an AI scientist—I had taken to capturing the most salient details on scraps of paper around the house, and in short text files on my computer, stuffed into random directories. It was ironic that I could not read, but as long as I did not go back over my work, or think about what I was saying, I could write after a fashion, consistent with my odd, fractured brain state. Trying to read would leave me in pain, and wear me out within a few minutes. By contrast, if I just let my fingers produce the sentences directly from the images in my head, I could write for twenty minutes or more at a time. The key was to not see the words.
This turned out to be a general theme in my life as a concussive: my creativity was actually enhanced—both by my need to invent novel solutions to tricky problems that now continually arose in everyday life, and also, in a perverse way, by damage to the perceptual filters that most of us use to block out much of the detail in the world around us. For someone like me whose filters weren’t working, those observed details could sometimes lead to creative ways of seeing solutions that others might miss.*
To outsiders it looked, on the surface, as though my life were continuing as it had prior to the crash. Because of my recent divorce, I had purchased a burned-out house in a neighborhood close to where my children lived, and, making use of my experience as a former boat builder and carpenter, I was rebuilding it. After the crash, I made my teaching at the university a critical priority, second only to being a father. My young children were with me a little less than half of the time, and the rest of the time I lived alone. As I was able, I continued to manage the subcontractors who were often in and out of my house.
My personality was such that I tended to keep quiet about my struggles and see if I could work them out on my own. My mother often joked that the first words out of my mouth as a toddler were, “Do it myself! Do it myself!”
But I couldn’t hide everything.
One of the problems that started to arise, and that ultimately I had to be quite vigilant about, was that while writing I would use inappropriate words in odd places. At times this was so peculiar that I feared appearing mentally ill to others in my professional life. My notes and e-mail messages from the time show that I frequently had begun incorrectly substituting words in my writing that sounded similar, or, sometimes, that were conceptually similar. For example: over-serving/(instead of) observing, way/weigh, right/write, imagine/manage, say/said, feeling/meaning, phone perception/phone reception. Sometimes I would get phrases wrong, such as “yet to be reader”/“yet to be written,” and “wrapped tightly under practice”/“wrapped tightly under plastic.”
I believe that many of these errors had to do with my inability to do two things at once, and would happen when my mind strayed momentarily to an ancillary thought. In one example, while composing an e-mail response, I noted that I was thinking of a “file” where text about a tenure meeting was stored. The “f” from file caused “meeting” to become “feeting,” which was subconsciously corrected to “feeling,” thus producing the phrase “tenure feeling” in place of “tenure meeting.”
I had different difficulties with spoken English.
According to my brother’s observations, which he made during a rare visit a year after the crash, I would “talk . . . like . . . this . . . ,” with my eyes staring out of focus, and my head tracing slow arcs through the space around me, as though I were trying to will the words to come to visual consciousness, or trying to locate them in the space around me, searching for them in slow motion.
WHY ARE YOU HERE?
Several weeks after the crash I was feeling so debilitated and confused that I again called the family doctor, and again was told to go to the emergency room.
I was understandably reluctant to return to the hospital, but I was getting desperate. I couldn’t make sense of what was happening to me. By this time a whole potpourri of strange things had been occurring. I would get stuck in a chair, unable to get up for an hour at a time. I could go up stairways, but I could not go down them. I couldn’t understand jokes that people told. I couldn’t follow announcers on the radio. I often had to sleep with my eyes open. I had serious balance problems. Shopping was almost impossible. I couldn’t take the train, or manage an elevator. I couldn’t listen to anyone on the phone for more than a minute or two before nausea began to set in.
The emergency room was busy. After waiting forty minutes, I was taken inside and told to take my clo
thes off, put on a gown, and lie down on a bed. This took me a long time. The geometry of my clothing was difficult for me to “see,” and consequently my hands were moving in slow motion, and awkwardly.
A harried emergency room nurse came in to talk to me.
“Why did you come here?” she asked.
“I don’t know why I came,” I said honestly. “I don’t know what’s wrong.”
She looked at me suspiciously. “How can we help you, if you won’t tell me why you are here?”
She was right, but I didn’t know what to do. So I didn’t say anything.
“Dr. Elliott, have you been taking drugs? Did you take something? Have you been drinking?”
I shook my head, but didn’t say anything.
She left, and sometime later, a doctor came in. Presumably he had looked me up, and seen that I had been diagnosed recently with a concussion. He had a clipboard with him.
“Are you in pain?” he asked.
“Yes,” I said. “A lot of pain.” This was true. Whenever I had had to think about anything the pain in my head and in the neck muscles under my skull was intense. “Strange things have been happening to me.”
“Do you have nausea?” he asked.
“Yes,” I said. “If I try to read, or think about much of anything at all, I have to work hard to keep from throwing up.”
“Okay,” he said, and wrote something on the clipboard without any explanation. Then he left. I lay on the bed and stared at the cloth curtain that separated me from the next bed.
The Ghost in My Brain Page 4
