I clearly wasn’t getting anywhere, and both my head and my back were killing me, but I had a little bit of good luck—it wasn’t far to Tacoma General Hospital. The doctors took x-rays and did CT scans and found a baseball-size bruise on my kidney. I would have blood in my urine for the next few days, they said, but they released me that night. They figured I had a profound concussion. Little did they know how profound.
Angela had followed me to the hospital, and of course her date was long gone by then. She vowed never to see him again. I gave her a ride home even though the doctors had advised me not to drive. All the way there, I couldn’t believe the light show of shapes and colors before my eyes. It was all I could do to stay in my lane.
When I got back to my house I couldn’t sleep. I lay awake reliving the incident over and over, but in my mind I killed them every time. In one scenario I had a box cutter from work in my pocket and slit their throats; in another, the cops showed up and shot them dead. It was totally unlike me to have violent thoughts but I’d never been so profoundly physically and mentally violated in my life.
I was angry with myself for not figuring out what was going on from the beginning. My intuition had told me something was off twice that night—when I noticed how seedy the location was and when I caught the bartender staring at my wallet—but I completely ignored the signs.
The next day I woke to more incredible visual phenomena. When I used the sink and took a shower that morning, I saw lines emanating out perpendicularly from the flow of the water. The lines extended beyond the basin and the tub and I quickly stepped back for a moment, since some of the lines were heading toward me. At first I was startled, and worried for myself, but it was so beautiful that I just stood in my slippers and stared. I also felt some vertigo as I tried to walk around in the midst of the light show. Despite how upsetting and disorienting it was, I forced myself to clean up, get dressed, and return to the bar to ask, yet again, for help in learning the identities of my attackers. They stonewalled me, just like they had the night before, and it made me feel victimized all over again.
But I trusted that I would recover. I had no idea that I’d left the old Jason behind, lying in a heap on that sidewalk.
Chapter Four
Gray Matter
IN MY MIND, I’d play back the attack beginning with the last happy moments when I was whole, before the painful impact with its flash of light, the impossibly low piano note, and then the blackness. I watched myself crumple to the ground. In the days after the attack, I continued to relive the mugging over and over again. I obsessed over every detail, trying to remember exactly where I was struck and how many times. Soon I began to see it as though I were watching from outside myself.
I began researching traumatic brain injuries (often referred to as TBIs) online. Soon the brutal narrative of that night, still on a replay loop in my obsessive mind, was overlaid with new information at every critical point. A new, richer story emerged as I began to come to grips with the reality of what had happened.
As I exited the bar, just before the mugging, my healthy three-pound brain was floating in a bath of cerebrospinal fluid, moving ever so slightly with each step I took. Inside my brain, some of my one hundred billion neurons were busy talking to one another thanks to an information network that’s more complex than any computer’s on earth. Electrochemical signals were flying through my brain, some at speeds of more than two hundred miles per hour, across a web of nerve fibers that if stretched out would measure about one hundred thousand miles. The nerve fibers responsible for sending out all these transmissions are called axons, and they look like long, thin tails on the ends of neurons. A protective coating called myelin encases the axons and helps keep the communications flowing at top speed.
Thanks to all this brain activity, I was able to instantaneously interpret and navigate the world around me as I left the bar—accurately calculating the height of the steps I walked down so I wouldn’t trip, pulling my leather jacket tighter around me in response to the cool night air, and, of course, replaying my rocking Bon Jovi performance in my mind. Believe me, there was nothing extraordinary about what was going on inside my brain. It’s just what average brains do on a daily basis.
The first punch hit the back of the right side of my head, but that initial impact, or what brain experts call the coup, was only the beginning of the problem. My brain was likely propelled by that force to the other side of my head—the contrecoup.
During the mugging, my brain likely had at least two points of impact for each blow, but that’s not the only damage that occurred. Brains, I have since learned, are not hard and rubbery, as I once thought, but rather the consistency of tofu or Jell-O, and my fragile brain was slammed violently into a number of sharp, bony ridges protruding from the interior of my skull, causing it even more harm. In addition, there were injuries right down to the cellular level.
Scientists now know that when the brain ricochets inside the skull, it can stretch or even tear the myelin sheaths that protect axons. It’s the same mechanism that causes whiplash in a car accident. In an accident, the head jerks forward and then back, overstretching or tearing the muscles and ligaments in the neck. I suffered a kind of brain whiplash, overstretching the delicate structures inside my head, an injury that can kill neurons or damage them so badly they are no longer able to communicate.
Despite the shock of what had happened and of my new perceptions, I was filled with intense curiosity and began researching on the Internet other cases of concussions and TBI. I immersed myself in the stories of what happened to other people in my situation. I wasn’t sure why I now had such an aptitude for research. And for the first time, my interests didn’t lie in thrills or the rush of my social life. Was this some temporary side effect of the beating I took? Unfortunately, I didn’t have the money for the medical testing necessary to get more answers. This isolation also had another layer: I was now afraid to leave the house.
What I learned from my personal research painted a stunning picture of what happened to my brain the night I was attacked. I knew it was tragic, but it was also fascinating at every turn. In some ways, it was like passing a terrible accident on the road. I was afraid to look and at the same time unable to turn away.
I was seeing the most bizarre things. When I extended my hand and then withdrew it, it was like watching a slow-motion film. I saw an image on the television of light glistening on a lake, and it was as though the light points also emanated from the screen—they grew larger than the actual image. I was obsessed with every shape in my house, from the rectangles of the windows to the curvature of a spoon. The house itself seemed to fall away as a whole and become just a collection of shapes. The sudden importance of geometry—whether in the environment or in my visions—felt at once invasive and awe-inspiring.
I realized there must have been some misfiring going on because there were physical symptoms. It began a day or so after the mugging: I was lying in bed, and my right foot started to vibrate. It felt like someone had laid a violin or a small guitar on top of my foot and started strumming it. The vibrations went over the top of my foot like waves of different tones; I could feel the change in frequency in my skin and deep in my muscles. It was almost as though I could hear the notes the imaginary instrument was playing because the depths and vibrations varied as though they were music, like the way it feels at a very loud live music event, only much deeper in my musculature. It continued for longer than any song; it was more like an entire symphony. Several weeks later, I became so worried about this that I left the safety of my house and went to the doctor. I was sent for a magnetic resonance imaging (MRI) scan one Friday, and the neurologist who ordered the test told me my symptoms might be due to multiple sclerosis, Parkinson’s disease, or Lou Gehrig’s disease, among other disorders, and he’d have the results on Monday. I spent the weekend frantic that something would show up to confirm I had one of these devastating illnesses.
On Monday, a nurse from the doctor’s offic
e phoned and said the MRI showed no evidence of any of these diseases. She said it was likely that the twitches and tremors, which had also started to affect my arms and my legs and even my tongue, were a result of the concussion I’d suffered during the mugging. She couldn’t say how long they might last, but she did say they could stop at any time and were not considered dangerous. The condition was called benign fasciculation syndrome, a fancy name for involuntary muscle tics. These twitches can happen in any skeletal muscle in the body and are sometimes visible through the skin. I sat one day watching the waves of them ebb and flow through the back of my hand. Though they are often found in otherwise healthy people, they can interfere with the quality of life. Magnesium deficiency is a common cause of involuntary muscle twitches, but my level was apparently normal.
I felt so strange with my visual impressions and physical tremors that all I wanted to do was retreat to my home. I felt compelled to sit alone just pondering things, stuck in the puzzlement of what I was becoming. It was a strange fate to have mobility of body but not of mind—my mind, while opening up whole new worlds to me, was like an anchor keeping me still and thinking for the first time in my life.
I continued to obsess over the accident and what might have happened if things had gone differently. What if Angela hadn’t needed a ride that night? What if I’d said no to going out? Why did we choose that particular place at that particular time on that particular night? What if my Alaska crew of guy friends had been with me to bail me out? For the first time in my life, I tried to do the math on the statistical likelihood of a specific event occurring. I don’t even know how I realized it had to do with math or probability, but I did. Other things in life suddenly had math behind them as well—I found myself counting my steps as I crossed the living room or went up the stairs to my house. I started thinking about the infinitesimally small chance that I had even been born, given all the millions of circumstances that had had to be aligned, from the Big Bang to the migrations and marriages of my thousands of ancestors. I now wanted to know how everything worked. I had deep questions about the mysteries of the universe and my place in it, and the feeling was a bit euphoric.
What was most peculiar to me about some of these thoughts was how fresh they felt. I sensed they weren’t inspired by old memories of teachings I’d forgotten; they resonated from somewhere deeper than that.
As wondrous as my new abilities seemed to be, the drawbacks that accompanied them were plentiful. Many brain-injury victims change for the worse, not the better, and I was already showing signs of some of the negative effects. I had no idea at the time how common brain injuries were, but I soon discovered that I was just one of an estimated 1.7 million Americans annually who suffered TBIs. I was shocked to learn that about fifty thousand people died each year from brain injuries, and as many as ninety thousand developed some sort of lifelong disability. In fact, according to the Centers for Disease Control (CDC), traumatic brain injury is the leading cause of death and permanent disability for Americans under forty-five.
I continued combing through the frightening statistics and found that survivors can experience a wide range of negative changes—mood swings, emotional imbalances, cognitive impairment, anger issues, poor concentration, and the deterioration of social skills. To their friends and families, they can come across as completely different people. The bad news didn’t stop there. I also found that survivors are at increased risk of developing substance abuse, depression, phobias, psychotic disorders, and posttraumatic stress disorder (PTSD). The odds of any or all of these happening to me were enormous. I was already starting to notice some of the more common cognitive consequences of TBI: impaired judgment and difficulty with decision-making.
I noticed that I now didn’t want to be around other people, but at the same time, I wished I had just one trusted person near me who could tell me exactly what to do—from what to eat for breakfast to how to handle the consequences of my injuries. I couldn’t come to a decision about anything—even which shirt to wear when I got dressed in the morning. I worried about people not wanting to be around me if I began to exhibit an inability to relate. It’s not always easy to tell if someone’s had a brain injury; TBI survivors tend to look normal. But people with brain injuries can miss important social cues, like when a conversation is over or when someone is growing annoyed or uncomfortable.
I worried I was becoming another Phineas Gage, the railroad worker whose story I came across in my reading. On September 13, 1848, Gage was leading a group of men working for the Rutland and Burlington Railroad near Cavendish, Vermont. Gage was compacting blasting charges with a large iron rod when the powder exploded and propelled the rod through his head. It was an inch and a quarter thick and more than a yard in length. It pierced the side of his skull behind his left eye and then continued through, exiting out of the top of his head.
Gage miraculously recovered from the horrible wound and lived, but his personality transformed dramatically. In 1868, one of his doctors, John Martyn Harlow, wrote that the man who had previously been even-tempered, energetic, and well regarded by his peers was now “fitful, irreverent, indulging at times in the grossest profanity (which was not previously his custom).” Quite simply, wrote Harlow, he was “no longer Gage.”
Reading about Phineas Gage made me worry. I walked over to the mirror and stared for a long time. I knew I’d become a different person, just like he had. And yet, parts of me were still the same. In the weeks after the mugging, I’d begun to lose weight and looked extremely tired, yes, but when I looked at my eyes, they were the same color and shape. How could they look the same when I was seeing so many new things?
Fortunately, I had something that Gage did not: access to advanced medical knowledge and high-tech brain-imaging tools. I’d had that one MRI scan for my fasciculations, which to my surprise had come back normal. I have since learned that it’s not that unusual for an MRI to miss the type of damage associated with mild traumatic brain injury. MRIs do provide more detailed three-dimensional images of the brain than CT scans, which are typically used to detect skull fractures and life-threatening bleeding in the brain. But MRIs aren’t sensitive enough to pick up damage at the microscopic or cellular level. Nowadays, there are more effective brain-imaging scans available, such as functional MRI (fMRI), which measures brain activity by showing detailed images of blood flow throughout the brain. This type of test probably could have detected changes in the way my brain functioned. Unfortunately, fMRI wasn’t widely used at the time. I couldn’t afford additional testing anyway, and I’d never heard of anything more advanced than a regular MRI, so I didn’t pursue further studies.
Even the doctors responsible for my care at the time didn’t recommend any other testing. In the medical community, there are agreed-upon protocols for severe brain injuries—say a bullet wound that leaves a gaping hole. But when it comes to treating closed-head, less traumatic injuries, like mine, there is a bit of a gray area. Despite the fact that my MRI was read as normal, my new impressions of the world persisted, and they were as astonishing as they were disturbing.
In the mugging, I had received three direct punches to the back and sides of my skull and at least one very hard kick to the back of it. My skull wasn’t fractured, probably owing to bone being one of the strongest materials found in nature.
Bone is, ounce for ounce, stronger than steel. Even though the eight bones that make up the human skull average only about a quarter of an inch in thickness, some parts of the skull are estimated to be able to withstand a force of twelve hundred to fourteen hundred pounds. Research shows that Olympic and professional boxers are capable of delivering blows that top one thousand pounds of force per square inch. Lucky for me, the guys who assaulted me were likely delivering only about sixty to eighty-five pounds of force per square inch, which is the average for a human punch. The kicks to my head were probably about three and a half times stronger, but still within the ability of my skull to withstand them. But that doesn’t mean that
nothing devastating happened inside my head.
The mugging did physical damage to my brain, but it also did psychological damage, a result of being the victim of a violent crime. I was warned I might experience some posttraumatic stress disorder symptoms related to this, and as I read about it, I really began to recognize the feelings I was having. I was becoming afraid to leave my home and afraid to be around people. I couldn’t explain it beyond the fact that people, even my friends, made me feel uncomfortable and suspicious.
From what I understand, it’s completely normal to feel anxious, jumpy, or frightened for some time after something traumatic happens. But when those feelings don’t go away or when they start interfering with everyday life, then it may be PTSD. To understand this better, I needed to look at what had been happening inside my body while I was being attacked.
As I walked out of the bar on the night of the mugging, my body was in a state of homeostasis, or internal equilibrium. But when I was attacked, a part of my brain called the hypothalamus sent out an SOS message, triggering my body’s natural fight-or-flight stress response. A cascade of hormones, including adrenaline and cortisol, flooded into my bloodstream, causing my heart to beat faster and my breathing to quicken. My muscles tensed up so they were ready for action. And my liver started breaking down glycogen (a form of sugar) and converting it into glucose so I’d have the energy to either fight back or run for my life (that’s why they call it the fight-or-flight response). I tried to fight back—remember, I bit that one guy on the thigh! Sometime after the mugging was over, this chemical surge subsided, and my body returned to its state of homeostasis.
The problem is that in some people, when a traumatic event occurs, the body’s stress response system gets out of whack and gets stuck on high alert. Little things, like a door slamming or a telephone ringing, can trigger the fight-or-flight response. It’s like you feel like you’re still under attack even though you’re in the comfort of your own living room. That’s PTSD, and it comes with a laundry list of unpleasant symptoms, including flashbacks, insomnia, nightmares, being easily startled, and more. I found myself exhibiting some of the most classic PTSD symptoms: reliving the mugging over and over, avoiding situations that reminded me of the event, and feeling both numb and overstimulated at the same time.
Struck by Genius: How a Brain Injury Made Me a Mathematical Marvel Page 4
