The Concussion Crisis

by Linda Carroll

  More troubling to Radke was the loss of his long-term memory. He couldn’t remember his favorite color, his favorite food, his favorite movie, his favorite football team. He remembered that Nova was his wife, but couldn’t recall the past he shared with her. He remembered his parents’ names, but not his childhood.

  Without memories of his past, he’d lost any sense of who he was. “Sometimes,” he said, “I feel like I’m just a body.”

  • • •

  Feeling lost and empty, Radke searched desperately for clues that could help him understand who he’d been before the blast. The neurologist at Walter Reed had told Radke that his memories hadn’t been completely erased, only locked away: “The filing cabinet is there. What’s impaired is your ability to open it.”

  Radke found a key to some of those locked-away memories in his hometown. Visiting his parents while on a brief leave, he stopped by the baseball field where he’d played Little League as a boy. As he looked out across the expanse of lush green grass, images of long-past games and old teammates started flashing in his brain, like still photos. He couldn’t convert those mental snapshots into a flowing narrative, but at least it was something.

  He drove back to the small brick house that had been his parents’ home for nearly half a century, hoping that the familiar surroundings might spark more flashes of memory. But even when his mom and dad tried to reminisce with him, he couldn’t remember anything before Iraq—not his childhood, not his school years, not even the day he met Nova. Trying to help things along, his mother dug out a stack of family photo albums. As he thumbed through the stiff pages, he saw himself wearing his father’s Army jacket while playing dress-up with his big sister, blowing out birthday candles, running the football in a high school game. He’d stare at a series of photos chronicling an event in his life and then try to connect the static images. But he never managed to fill in the voids between the snapshots.

  Radke’s luck wasn’t much better on a trip back to Arizona with Nova, even though that was where they’d built their life together. They had met late one night a few years earlier and had immediately connected, sharing their most intimate thoughts and dreams. Right from the start they were finishing each other’s sentences. It felt as if they had known each other all their lives. Nova would say later that it was the first time she felt she could breathe. Within a year, they were married.

  Nova was now hoping that the sights, sounds, and scents flooding her heart with warm memories would spark the same for Brian. But he couldn’t remember what was important about any of the places and things that meant so much to her. She rented movies they’d enjoyed together, but none resonated with him. She took him to his favorite restaurants, but he didn’t order any of the foods she knew he’d loved. She would start to reminiscence about one of their shared memories, hoping he’d chime in and finish the story, but he would only stare back blankly.

  It was as if a complete stranger had taken over her husband’s body, one who sometimes bizarrely spoke in a southern drawl that Brian had never used before the blast. Worse yet, the man beside her was a stranger even to himself.

  Nova had heard the divorce statistics—that fully three-quarters of marriages involving a brain-injured spouse fail—and now she could understand firsthand why. But she wasn’t ready to give up. She was sure the old Brian was locked away somewhere in that brain, and if she kept searching, she would find him and rescue him. Only a year had passed since he’d awoken from the coma—she just needed to be persistent.

  Brian wasn’t as confident, and he was scared that Nova might lose patience and leave before he could figure out who he was. He kept poring over old photos, trying to use them to reconstruct his life story. It would be another two years before his mental snapshots started to connect like the film frames of a movie.

  In the meantime, memories trickled back only as disconnected fragments. For Brian, it was like having a handful of pieces from a huge jigsaw puzzle—there weren’t enough of them yet to get even a glimpse of the whole man. When new memories did show up, it was with no pattern or predictability. Sometimes he’d have a flash when he was concentrating hard on an exercise during cognitive therapy. Sometimes a memory would resurface when he wasn’t even looking for it.

  That could happen during something as mundane as eating dinner at home with his wife. One evening, while he was still chewing on a forkful of taco salad, he suddenly stopped, looked down at the tomatoes and onions on his plate, and exclaimed, “Are you trying to kill me? You know I don’t eat this stuff!” Then he flung his plate across the room. Nova was taken aback. While it was true that Brian had hated tomatoes and onions before the blast, he’d been gobbling them down with gusto ever since then. Before Nova could respond, he pointed an accusing finger at her and said, “I have a brain injury and you’re just trying to use that to change me into what you want me to be.” She shook her head emphatically and replied, “No-no-no-no, I was just feeding them to you because they’re healthy and good for you. I don’t know, I figured maybe you like them now.”

  Nova didn’t understand why tonight that particular memory suddenly surged back. For months, she had been watching Brian eat all sorts of things he’d previously hated and turn away from foods he’d formerly loved. She had recently taken him to a steakhouse so he could enjoy his favorite cut of beef, only to watch in disbelief as he ordered chicken.

  Brian’s recollection that he hated tomatoes and onions was a turning point. In the months that followed, he started to remember which foods he loved. Of far more significance to him were the bits and pieces of his past that also started to flow back. He could now recall how it was that he’d wound up in Iraq: he had decided in the wake of the 9/11 attacks to join the Arizona National Guard and hoped to parlay the Military Police training he would receive into a career in law enforcement. He remembered that before enlisting he’d coached football and baseball at his old high school. The pieces of the jigsaw puzzle were starting to fall into place.

  While relieved to see improvements in his long-term memory, Brian was discouraged by the continuing problems with his short-term memory. No matter how well he remembered his past, he would never be able to function independently without the ability to create and store new memories. Sometimes the fallout from these deficits was simply tedious and vexing, with Brian repeating the same task over and over again because he’d lost track of what he’d been doing. One day, he spent the better part of an hour riding the Walter Reed elevator up and down in search of the orthopedic clinic he’d been to countless times before. On another occasion, officials contacted his case manager after Brian was found wandering aimlessly through the hospital halls and then blamed Nova for failing to care for him properly. He had simply forgotten where he was going.

  Sometimes the consequences of that spotty short-term memory could be much more distressing and dire. When a new psychiatrist prescribed an antidepressant, Brian didn’t remember that he had taken the drug before and it had caused confusion and hallucinations. So he had the prescription filled again. The next night Nova found him out in woods behind Walter Reed, crawling on the ground as if he were on maneuvers back in Iraq; he’d strapped a flashlight to his cane and was carrying it like an M4 rifle.

  As time went on, Brian realized that the enduring problems with his short-term memory might be his most life-altering handicap. He’d pieced together enough of the jigsaw puzzle that he now had a picture, albeit a blurry one, of the man Brian Radke had been before the blast. He could remember how much he’d identified himself as an athlete and as a soldier with dreams of a future as a police officer. Now it was becoming increasingly clear how much the explosion had stolen from him. Without his trigger finger and a dependable memory, his dreams of a career in law enforcement had all but evaporated. He was becoming more and more resigned to the probability that he wasn’t going to have anything like the life he’d planned. The day he finally accepted all the changes as permanent, he told himself, “You’re not the same person you use
d to be, and you never will be.”

  What he couldn’t know was who Brian Radke would become. With his identity and dreams wrenched away from him, it was like going back to the beginning and starting over. “Sometimes,” he told Nova, “I look at it almost like being born again.”

  Brian wasn’t telling Nova anything she didn’t already know. It seemed as if the blast had sent her husband back through time. In an instant, Brian had regressed almost to the point of infancy. When he awoke from his coma, he had become childlike in so many ways. From her perspective, it was almost like raising a baby. She would see him gradually progress over the next few years from a toddler to an adolescent to an adult striving to be the man she married.

  The process seemed painfully slow to Brian. Day after day, he would endure hours of cognitive therapy with barely a sign that it was having an impact. He often didn’t understand the point of the various exercises he was asked to perform. Sometimes the therapist would reel off a list of words and then ask him to repeat them. Sometimes she’d show him a geometric design and then ask him to replicate it from memory with a set of children’s blocks. Each session, she’d give him a newspaper article to read and then minutes later quiz him about it—but he could never recall a single detail.

  Brian didn’t realize at the time that the therapist was trying to help his brain rewire connections obliterated by the blast. The bits of information in his head were like the books in a library; if the card catalog were destroyed, it would be impossible to locate a specific book. The therapy was designed to reconstruct the card catalog in Brian’s brain. When the therapist would give him a list of animals, for example, she’d tell him to think about which ones were pets, which ones were wild, and which ones were farm animals. Now when he’d try to remember the words on the list, he’d first think about pets that could have been on it.

  Although Brian could see small improvements in his short-term memory, he still felt like a schoolboy destined to repeat first grade for the rest of his life. It didn’t matter how adept he became at recalling lists of words if he couldn’t remember the contents of a newspaper article he’d read minutes before. That frustration was further magnified as the improvements became smaller and smaller. Some mornings he could barely drag himself out of bed. Discouraged and depressed, he thought, “Well, maybe this is the best I’m going to get. Maybe this is me now. And I’ll just have to deal with it.”

  Through it all, Nova kept encouraging him to stick with his therapy, to keep fighting like the Brian she married. “You’re going to get back to a hundred percent,” she’d say reassuringly. One day he just wheeled around and snapped, “Your husband died in Iraq.” As Nova stood there in stunned silence, he hammered home his point by announcing that he now considered the day of the blast to be his real date of birth.

  Despite his frustration, Brian slogged on, attending his therapy sessions no matter how futile they seemed. Then he had a breakthrough: he’d had to read his assigned newspaper article in the noisy, bustling lobby, and this time, despite all the distractions, he remembered every detail when his therapist quizzed him later.

  In October 2008, three years to the month since the blast, doctors at Walter Reed decided to send him home to Arizona for good. “You still might see some improvements once you get home,” they said, “but this is probably as good as we can get you.” Brian nodded his assent. “It’s time to go,” he thought. “I’ve got to try and do this on my own.”

  • • •

  Brian arrived home full of hope. Now that he was back among the people and surroundings that made Phoenix so comforting, he assumed everything would fall into place. He and Nova had just bought a house, and they were expecting their first baby in a few months. He still harbored aspirations of salvaging some sort of career in law enforcement; if he couldn’t be a cop on the street, maybe he could find a training position or a desk job. He saw his homecoming as a chance to start over, a chance to build new dreams.

  That optimism didn’t last long. He had placed too much faith in the power of home and underestimated the pull of what he’d left behind at Walter Reed. There, he could lean on a ready support group of soldiers who, like him, had been wounded in the war. Back in Phoenix, despite being surrounded by family and friends, he felt more isolated and alone than ever. No one understood his frustration and anger.

  With each passing day, Brian’s mood darkened. His pending medical discharge from the Army left him adrift, without direction. He reached out to friends in law enforcement, but no one had any job leads. He reached out to the Phoenix Veterans Affairs Medical Center, but it seemed too much like a hospital and not enough like a community. Instead of being comforted by the warm anchor of home, he felt more disconnected than ever. Nova saw Brian losing his bearings, his confidence, his self-esteem. To her, he seemed like “a tumbleweed blowing around the desert.”

  Here he was, just thirty-four years old with no prospect of a job and no idea what he was good for now that his brain was broken and his body damaged. Within weeks, Brian was so depressed that sometimes he felt the only solution would be to take his own life. His despair was so deep that it couldn’t be salved even by the imminent arrival of his first child. While Nova was all aglow throughout the pregnancy, Brian became increasingly distant and unresponsive. Although he knew intellectually that the baby was on the way, he never emotionally connected his wife’s burgeoning belly with his own approaching fatherhood.

  That all changed the instant he heard Nema cry for the first time in the delivery room, on Christmas Day of 2008. It was as if life flowed back through him again. From that moment on, Brian would tell everyone that his infant daughter saved his life.

  Nema’s impact on Brian is clear to everyone attending her first birthday party. Family and friends watch as Brian hovers over his daughter, trying to coach her to blow out the single candle on her cake. When Nema is turned loose on the living room carpet, Brian eases himself down on the floor despite the excruciating pain he still feels, then starts rolling around with her like a little kid. As she rips open her birthday gifts, Dad proudly snaps photo after photo. Watching all of this, Nova can’t help shaking her head in wonder. “I think our little girl is what brought him out of it,” she marvels. “I do believe she is what he’s living for.”

  To Nova, it’s as if Brian were a wilting plant and Nema the water that brought it back to life. Nova can see new branches shooting out from her plant as Brian reaches for things that for a long time seemed beyond his grasp. He’s begun talking hopefully about doing volunteer work and going back to coaching high school baseball. As much as Nova is heartened by this recent progress, her hopes are tempered by all that’s gone before.

  “For so long I thought that, with all the doctors and the love and his strength, we were going to get him back to a hundred percent,” she says wistfully. “I knew that we couldn’t get his finger to grow back, but I really thought that somehow, some way, we could get my Brian back. Now I’ve just got to accept that’s never going to happen.”

  Brian, too, mourns the loss of his former self. He remembers a time when he was so much more easygoing, when he and Nova rarely said an angry word to each other. Now even little things can set him off. In a flash, he’ll go from talking calmly to screaming obscenities at his wife. Though he later regrets these outbursts, he hasn’t figured out a way to keep them from happening. Sometimes, in the middle of a fight, he gets so befuddled and scared that he’ll yell at Nova, “How am I supposed to trust you if I can’t trust my own mind?”

  Making matters worse, Brian still can’t connect with the man Nova first fell in love with. “I guess you could say I used to be a hopeless romantic and now I’m just not very loving,” he says glumly. “I care and I feel all the stuff I’m supposed to, but I just don’t show her. I don’t do the little things. A lot of times I forget; it just slips my mind.”

  Nova still loves her husband, but she misses the man she married. “They say women pick the strongest men to protect them and to
procreate with, and I know that’s true for me because most people couldn’t survive what he survived,” Nova says. “He was my knight in shining armor. It’s like he got knocked off his horse and he held on to the tail and he pulled himself back up and now he’s riding right along with me again. I glance over at him and he looks the same, but it’s just somebody different.” She pauses for a second to wipe away the tears. “I love him because in so many ways he’s still the same,” she says sadly, “but there’s so much that’s different.”

  II

  The last thing Chari Abb remembers from the cold winter night that forever changed her life is steering onto the quiet country road that should have taken her home.

  Everything else she learned from the police report: how a drunk driver swerved into her lane just after she made the turn, how there wasn’t time to notice the other car before it struck hers, and how the force of the head-on collision crushed both vehicles beyond recognition.

  The loud bang from the crash caught the attention of a bartender at a nearby restaurant and he raced out to investigate. He found the two cars in a tangled heap, steam rising into the frigid air, fluids streaming onto the asphalt of the deserted road. As he peered into each vehicle, he shuddered at what he saw. Between the mangled metal and the pooling blood, he couldn’t imagine how either driver could have survived. Blood covered Abb’s head and face; a crumpled steering wheel pinned the drunk driver against his seat. The bartender determined he could do nothing for them and raced back inside to dial 911.