Yesterday was a difficult day.

I woke from a dream of obtaining work. That thought fell away like a collapsing mirage and I was left facing fact. Today dawned grey and wet, the sky echoing with drumbeats of thunder. After waking, I lay still and listened to the endless beat and slosh of rain and found myself enumerating brain injury impacts. As best I understand them the impacts are these.

Self Awareness

One of the difficulties associated with brain injury is that the victim has an impaired capacity to gain awareness of her own injured state. The damaged brain is responsible for processing information about the world; because of the brain injury that information may be distorted or incomplete. The same brain also bears responsibility for processing information about the self and for situating the self within the context of external phenomena. With brain injury the ability to maintain self awareness  is compromised.

Because of this, the victim does not perceive the nature and extent of their own injury. If I suffer a wound to some other part of my body, a cut finger for example, I can observe the flow of blood, examine the cut, take steps to staunch the bleeding, apply compression, affix a bandage. But this sequence of remediation depends upon first gaining an awareness of the injury.

With a brain injury there may be no observable outward signs. That is one issue. The victim may lack understanding of the signs that do make themselves present. That is a second issue. The victim may misinterpret the signs that she does observe. That is the third issue. The victim’s capacity to perceive their own brain injury may be damaged. The signs are there but they are simply not seen. That is the fourth issue. The victim’s ability to present the extent and nature of their brain injury to a third party may be impaired. That is the fifth issue. Even where the victim gains an awareness of her problem she may be reluctant to communicate the problem to others. If you realize that you are in some way mentally deficient there may be great reluctance to communicate that fact to the world; I have had to confront this issue in writing this blog and, to be honest, I remain undecided on the appropriate degree of disclosure. It may be a big error to communicate these issues; it may significantly impair my ability to locate work; there may be other unforeseen blow back. That is the sixth issue. And when the nature of the problem is finally communicated to a third party there is no foretelling what the reaction of that third party may be. My experience is that people shy away, contact breaks off, isolation ensues. This social isolation is the seventh issue. It makes recognition and recovery from brain injury much more difficult.

All of these factors serve to compromise self-awareness, make it harder to gain self-perspective. Without that self-perspective it may be difficult to re-mediate the problem or to seek help. My own experience of seeking help was that I had great difficulty in communicating the nature of my brain injury. After visiting the Doctor I would realize that I should have communicated X. I should have communicated Y. I should have communicated Z. But I forgot to do so.

I was extremely fortunate to have an established prior association with a clinical psychologist. I reached out to her in distress. She did not turn me away but was generous in extending her assistance. I owe her a tremendous debt that I doubt I shall ever be able to fully repay.

Brain Injury and Time Discrimination

I have come to realize that my relationship with time is off in some respects. I examine my calendar and realize that events which I thought occurred last week actually transpired 3 weeks ago. That I have been waiting over 3 months for some administrative notice that should have arrived in a week.. Or I sit down to perform some task at eight am and then realize I am hungry and that it is now six in the evening and I have devoted my full attention to a single task more or less without interruption.

Bias Toward the Past

I have this sense of being anchored in the past in some way. For a period after the accident I would have extremely vivid flashbacks and memories of events in my past. These would erupt suddenly, without warning. An example: I was seated at my desk engaged in a task and with no warning or change of context, a mental image of a roadway came into mind. This was followed by a vision of a rushed downhill descent into a rural village with great trees lining each side of the road in shadow. I had no idea why this set of thoughts presented themselves to me. The vision was extremely vivid, as if there were something remarkable about that afternoon. But there was nothing at all remarkable about this memory apart from its droll mundanity and its sudden, unbidden, eruption.

A week passed before I realized that the memory was from a bicycle trip I had taken in my early teens. I had left my residence in Québec and cycled 50 or 60 miles through flat farming country until I passed into Ontario and reached the shores of the St Lawrence. From the river I had turned north toward the town of Alexandria. The memory sequence was of me riding the overpass that climbed over highway 417 and the subsequent swift descent into the small town on the other side of the highway. Why this particular event popped into mind with such clarity is unknown to me. What I do know is that there were many other similar episodes.

Difficulty With the Future

In March / April of this year I underwent a crisis. In attempting to resolve the crisis, understand it, make sense of it, I spent long hours lying awake at night trying to gain perspective on my situation. From these attempts I realized that I was fairly effective at “back-casting,” that I could examine events in the past and make sense of them, but when I directed my attention to the present I drew a blank. It was extremely difficult for me to gain a fix on my present day situation. It was impossible to obtain a sense of the future. I do not yet fully understand what I am trying to present here but I have the nascent realization that I have some difficulty in working with time. One of the arguments in favour of the blog is that it forces me to confront time, it forces me to consider the future in a limited and manageable way.

Preference For the Concrete

I appear to have a bias toward the actual, the physical, toward concrete phenomena. I will engage in minor tasks and perform them repetitively to the exclusion of all other activity. One day I went and polished all of my shoes and spent the full day on this. At a later date I spent a day waterproofing all my winter footwear. The next day was spent in waterproofing jackets. When I face a difficulty I will retreat to the kitchen and prepare food, frequently going overboard on quantities. I become heavily invested in the act of food preparation with little regard for practical limits on consumption or storage.

I have frequently found myself staring absent mindedly at space with no real set of thoughts. I am just there in a vacuous sort of state and have no sense of how long I have been occupied in this manner. This is one of the factors that drove me to text, perhaps the primary factor. Creating text provides for a chain of thought, mandates a sequence of thoughts, requires the next thought to complete the sequence, finish the sentence, while at the same time generating cues for the start of the next phrase, the next paragraph.

Since the accident I have done an enormous amount of note taking. Some of it is gibberish. Some of it is highly repetitive (I have been surprised to go back and review my notes and discover that I have made entries days apart from each other that are almost verbatim. It is as if an idea has become lodged in my mind such that I commit it to paper again without being aware of having done so previously).

I believe I have become much more proficient at writing text. A year ago it took me a month to complete a five page letter to the insurance company. This year a well polished two page letter only takes three days. This blog is an attempt to see if I can gain further improvement through making consistent daily entries.

Lack of Anxiety

When I attempt to take stock of my situation I arrive at an intellectual appraisal that suggests I should be deeply concerned. But I have no such concerns. I have no sense of fear for my situation. I am running through my small retirement savings and am facing a financial catastrophe yet I have no anxiety, or worry, over this fact. I find this difficult to understand.