Up at 0300 and unable to return to sleep. Today, I face a 20 mile hike to attend a Concussion Research Group meeting. The distance is not a problem. I have attended three or four of these meetings to date. The problem derives from the fact the weather is expected to deteriorate. The days of spring warmth and sunshine have come to an end. In their place the forecast is for snow, ice, and freezing rain.
The freezing rain makes for significant difficulty in walking. On backwoods winter trails, freezing rain is less of a problem. The packed snow soaks the rain up like a sponge and footing is not much altered. On city pavements, the ice wax of frozen rain renders the sidewalks impassable. Another danger comes from the adjacent speeding hulks of metal. These also have much less traction. They are more likely to enter skids, or to leave the roadway and threaten the safety of adjacent pedestrians when they do so.
When I learned of this change in forecast last night, I changed my plans. I would depart at 0600 and reach the destination before the freezing rain hits. A 0600 departure called for a 0500 wake-up. Instead, I woke spontaneously at 0300, unable to return to sleep. And to me, this is the greater problem.
I have managed to force myself back into dealing with the TAQ submissions. This is found difficult for two reasons.
Cognitive Intensity and Fatigue Onset
The first has to do with the cognitive intensity of the associated tasks. When I am doing no more than futzing around the house performing clean-up chores, I can go seven hours before the onset of fatigue. When I return to the cognition intensive document, I experience the onset of fatigue at the four hour mark. The timing of this fatigue is like clockwork.
Yesterday, I was up at 0600, felt fresh and ready to go, and plunged back into the work. At the onset of fatigue, I checked the clock. It was 1000, exactly 4 hours from the start of the difficult routine. I took a forced nap, woke spontaneously at noon, spent an hour on brunch, and then started in again. The Accident Log contains the following entry from yesterday:
It is now 1726 and I am agains experiencintg fatigue abd the desire to nap.
Once again, almost exactly 4 hours from the start time. I went for a second nap of an hours duration, then made dinner and, from 2000 on, spent time on other minor chores. At midnight I was again fatigued and able to get to sleep with no problem, intending to sleep through the night until the 0500 alarm. Instead, I am up and wide awake at 0300.
I can easily see how this fatigue / nap cycle drives me into a 24 hour sleep / wake cycle composed of four hour work units interspersed with periods of rest ranging from one to 3 hours in duration. This is the pattern I have experienced on each of the previous major document creation attempts.
Emotional Reaction
The second problem derives from the nature of the material I seek to document. During the past years, my Ontario doctors have repeatedly advised of my mistreatment at the hands of the Québec medical profession. My son has made similar observations. I heard what they were saying, understood it on some intellectual level, but failed to completely comprehend what was meant, or understand the full implications. I have this unfortunate ability to be a complete bozo and not fully realize it.
The submission process requires that I provide a summary overview. I am experiencing considerable emotional difficulty as the process of “writing it out” results in the forced review of this recent past history. I am made to confront a great deal of unwelcome fact. What appears to be happening is that this confrontation triggers an emotional response of either considerable anger, or aversion, or a degree of shock. Without the good fortune of having an established prior relationship with a health professional, someone who had obtained knowledge of me from before the injury, then I would have been forced into being reliant on the negligent diagnostics of the Québec medical profession. I would never have been alerted to the true nature of my injury. I would have suffered a decline, been unable to identify or understand the source of that decline, and entered a downward economic spiral that would have likely ended with me living on the street, homeless.
My research into mTBI indicates that this is a common trajectory. There also exists strong evidence that mTBI results in an increased incidence of suicide. And I have had my brushes with that.
I am writing this text while in a calm and neutral emotional state. If today is like other days, I expect that once I am on the hike, I will experience a surge of anger toward those persons ignorant, or dismissive, of the effects of brain trauma. I will also experience a strong will to fight on behalf of all of those persons who sustain this form of injury and are miss-treated or ignored by a medical establishment that does not care for humanity, or the suffering that their professional ignorance and inaction exacerbates.