Life in a MOMENT
MANOJ PATEL
On a hot summer morning
at 8:31am on June 24th, about a decade ago, I was given a choice… be a victim or choose “What’s been handed to me” the so called message”. This is the beginning of a new chapter of my life. The choice so it seems simple now, as simple as the choice between chocolate or vanilla.
I am in the hospital emergency room, anxious and agitated at the same time. My neck cushioned on each side and head strapped such that I can only see the ceiling lights glaring straight back at me. And that smell…the hospital smell, forever imprinted in my RAM forever. My chest, my hips and my legs thoroughly strapped. I can’t feel the left side of my body. The only body parts I can move are my eye lids and the tips of my fingers. People all around buzzing away like worker bees, accompanied by noises of machines that clicks and beeps and chirps and carts rolling and more people voices. The collage of that aggravates my nerves that makes me feel the pain deep down but can’t figure out where. I can barely keep my eyes open. I’ve never felt like this… I don’t understand but I don’t have the energy to try to make sense of it. I disappear into a fog many times.
My last clear memory before waking up in that hospital was sitting in heavy morning traffic at a freeway overpass with cars all around me. Everyone waiting for the light to turn green so to speed away into our routines of life we all have taken it so robotically serious. I have been conversing with my passenger, whom I have just picked up about 5 minutes ago on our way to a conference. He is a brilliant scientist with a wit of Einstein but the charisma of debonair middle eastern gent.
From what I now know what happened is, while waiting at that traffic light, I was the fourth car behind in the left most lane going straight. A 17-year-old, with no driver’s license, rear-ended my car at 47 miles per hour. No skid marks on the road…meaning no break streak marks were left behind, indicating he had not seen anything in front of him. Drugs, alcohol, texting… I’ll never know as his records were sealed as he was underage. I am told I was out for a few moments but did call 911 and talked with the paramedics as well as the police, which came to my rescue within minutes of the call.
However, I have no recollection of that at all to this day. I was transported to the hospital ER in an ambulance in a wake state of which I have no memory of as well. In the hospital the paramedics and the police asked me the routine questions and all five individuals who attended me at the accident site could not believe I was still alive after witnessing the state of my full size four door car. The trunk of the car was smashed to where my rear seats were supposed to have been. The rear seats of the car were uprooted and pushing the fronts seats forward. My car had metal reinforced bumper and full metal frame to withheld a rollover and side impact. The only thing that saved my life was the full size tire fully inflated, screwed tight at the bottom inside of the trunk. That tire withheld the impact.
IV’s running fluid and pain medications, MRI’s, Xray’s, etc etc etc for three hours straight. I was released after 6 more hours with aches and pains. I was prescribed 7 medications, mostly pain killers and muscle relaxers and two to make me sleep. But that not only didn’t make me sleep but affected me where I felt like I was between a wake stare and a sleep state.
Unfortunately, that was just the beginning of a new chapter. I kept on insisting that there was something wrong that I could not explain. My colleagues tell me to snap out. I have memory loss. Can’t finish full sentences. I just felt different. After a few calls, I was given an appointment to see another specialist. I had requested another MRI and a cat-scan. Since the attending doctor at the hospital had released me with no physical injury, I had to fight to see a neurologist. To sort it all out took another day and half. After three visits in two days and hours of paper work, I had another MRI. More X-rays, and a Cat-Scan. The next day, my cell phone rings and I was summoned to see the neurologist immediately. At the medical center, I saw the fear in the eyes of the radiologist. And here I thought they were trained professionals to hide those sentiments. While waiting for the neurologist, my questions persisted.
My agitation was obvious and the MA as well as the PA joined in the observation room which was fairly large. The largeness of the room had this ire feeling with all the equipment occupying the space while still large blocks of empty space cornered only with the beige colored walls. While the silence of the room from the outside world had this chill that sends this shiver along my spine, the memory of the hospital kept creeping into the vision of my eyes that were either fooling with me or was it real? I still could not tell. The fog was heavy and the mind could not keep up with the brain in battle with my body. After long 30 minutes or so, the neurologist with the assistance of a trauma expert progressed with their explanation.
I have sustained a traumatic brain injury (TBI) more specifically I suffered a diffuse axonal injury or (DAI). The term refers to a brain injury that produces brain lesions in bundles of white matter across several brain areas. These type injuries that result from rapid acceleration and deceleration of the brain. This process causes what’s known as a shearing injury, as brain tissue slides over itself, creating tracts of lesions in the brain’s white matter.
Furthermore, to my fate, the cat-scans had shown a severe bilateral hippocampal atrophy. Hippocampal atrophy is a form of brain
damage that impacts both memory and special navigation, also another symptom of DAI.
The brain has been subjected to shearing forces, usually from severe rotational acceleration which is quite common in car accidents. Just imagine a roller coaster, where you are in a controlled environment, with the ups and downs combined with the side to side accelerated movements. Now imagine what happens during a high-speed car crash, with the sudden and extreme change in velocity upon impact, your body abruptly stops, but your brain continues to move and sometimes even rotate within the skull. (Remember, my car was in a dead stop position. I was not moving. I had an opposite effect of a moving car crash). Our brain is not meant to do that. In an accident like mine, it even bangs back and forth against your skull, which it is also not meant to do either. The force of my head slamming into the seat head rest, didn’t help matters as the brain is meant to exist in a safe space, protected by the skull and cushioned by several thin membranes called meninges and cerebrospinal fluid. The skull and the fluids are brain’s friend. The brain is never intended to touch the skull, let alone bang against it. The shearing forces of a severe head injury, tear and stretch neurons and their fibers called axons throughout the brain like electrical wires. Axons are insulated by a protective coating or buffer called the myelin sheath. Damage to the myelin sheath can significantly slow the speed at which information travels from neuron to neuron. More important, it even licks and shots the communication pathways. Imagine a conduit with several electrical wires passing through it and the insulation torn off in various areas touching each other are various spots in the conduit. In a TBI and DAI, the injury occurs throughout the brain unlike a very specific location in event of a shooting or a direct blow to the head at one point.
Our brains work with the neurons communicating, but when you have a damaged communication pathway, the links are broken. With this condition, no Neurologist can predict the outcome of the injury. Their guesses are objective at best to their subjective analysis. They are not going to tell you that you have damage to your motor skills, or speech cognition, where processing speech is a challenge for the brain. They won’t know what brain functions will be effected, let alone how well or if you will ever recover from the damage to the brain. Will your memory will be impaired, your spatial skills, your motor skills or even your emotions are all in total judgement of the doctor’s pure guess, as there are no definitive results when it comes to TBI and DAI. Hence the unsaid words are… the diagnosis that is often left to the patient, while the patient has not been told so.
After TBI you are a different person in many ways. How you think, especially how you feel. How you express yourself, how you respond, interact, are all are in an infinite space of your “being”. All of these dimensions are affected, on top of that your ability to understand yourself has taken such a hit, you’re not really in a position to know exactly how you changed and no one, no one can tell you what to expect.
I received occupational therapy, cognitive therapy, physical therapy. My closest friends, have noticeably pulled away from me and told me in ways that my mind could not process and comprehend. You’re just not the same anymore! My family cannot understand the new me. I was no longer myself. How was I different? They couldn’t see me; hell, I couldn’t even see myself. Head injury makes you feel confused and anxious and frustrated, and sometimes all at the same time. When your doctors tell you they don’t know what you should expect, your friends and family tell you that you’re different, it certainly magnifies all that confusion, anxiety and frustration. Your processing ability takes a turn that is not recognizable by you. You think you know, only to find out that was not what was “it”.
As a result, for 7 ½ months I was basically a vegetable. The next few months was in a fog. Anxious, disoriented not sure what I would do next. Every morning a new day was in front of me with a new set circumstances and new challenges. My body had certain muscle memory it was working from, but my brain was not recognizing the signals. It went from a conversation to a screaming match between my brain and my body. I was fighting an internal civil war.
Soon after, visits to the neurologists were part of the new robotic routine. Visits to neuro-psych were the ones I looked forward to most. As that was the only place I felt they understood me. After about a month of visits various issues arised and one of them, took me aback. In one of the visits to the neurologist after the medical doctor had prescribed anti-depressants and two other pain medications for pain due to my cervical, where my C3 was compressing to C4 and sending shooting pains to my left hand all the way to the tip on my fingers, I was told if I had someone to take care of things. Obviously my first question was… what things? The explanation was simple. There is good chance that I can get a brain aneurism with a small blow to the head or just normal activity can cause the brain to react in ways that may be detrimental. As I researched more into the matter the evidence of that appeared.
Then by chance, a friend of a friend who had some connection with the Neuro-Quant facility in Houston, came to my rescue. I got first hand evidence of the superior benefits of Hyper Baric Chamber treatments. As I started with the HBC treatments, my body finally found the fuel it needed to stop the inner civil war it was fighting. The agitation went away but other issues persisted. The most important the brain can do is feel at ease and hyperbaric gave it that.
12 sessions of acupuncture made a profound and lasting impact on the nerve pain in my left arm. With the suggestion of my Neuro-psyche, I started school again, but it turned out too much, too soon. I couldn’t think, I couldn’t adequately process spoken information. I couldn’t remember information from just 30 minutes ago. I would confuse various conversations between people. Mix-up conversations between people within a day. My physical being was the same, but my mental and emotional state was in outer space. However, the new me persisted and continued, albeit a slower pace. It was like listening to someone speaking half in a language I knew and half in a language I didn’t know which only made me more frustrated and anxious. I look physically whole and because traumatic brain injuries are often invisible to others, people said things like wow you’re so lucky you could have broken your neck or lost a limb. I was truly frustrated by their well-intentioned comments, also hated them for it. These comments started to affect my personality.
The way of being, we never think it will ever change. We take them for granted. TBI and DAI, changes us into a new being we are not familiar with. That cycle continues until we accept we are not our former selves. We are a new being that no one, and I repeat, no one will ever understand while they will continue to treat us like our former selves. I was an imposter in my own body. I had to relearn being “me”. I still am making my new self.
Now after all this years, the effects are still there, however the Picasso has new colors and form unknown to us. Sitting for longer periods is a bear. My tail bone pushes the spine upwards which makes my C3 and C4 to impact, resulting in crushing the nerves between them. That sends the wrong signal to the brain. The brain acts as it is supposed to. This indignation of feeling that something is pulling inside my left arm from the tips of my fingers upwards towards my Glenohumeral joint, (ball and socket of the should joint). The worst of the is effect is the pulling of the tendons from the Glenohumeral joint to behind the left ear going upwards to the brain moving forward to the forehead. Sleeping has taken a whole different meaning now… 4 straight hours and it felt like heaven. Waking up with no feeling on the arm became the new normal.
Motion is lotion for the body and my body now needs that lotion every waking hour. My body turning into a pretzel numerous times a day, is now a normal sight for people around me. Learning and accepting the new normal is becoming easy and every new challenge that comes forth is now accepted with open arms.
How many people in the world today have an opportunity to re-wire their brains with them in control in some sort of way.
How many people today have an opportunity to try out new habits, the good and the not-so-good habits. Haha those are the fun one’s. Play a little, be defiant. Be silly. Be stupid. Have fun with life.
How many people today have an opportunity to influence their character, train themselves to be something they never would have been in their former selves. That is the opportunity that lies ahead. Every day my memory of the yesterday fades faster, new memory is planted in to the “hard-drive” of my brain that now I feel I have some control over.
Note from the author:
This article was written as suggested by my neuro-psyche, a mind-body treatment to help alleviate stress and as an ongoing mental fitness exercise.
Technical and medical information contained in this article have been attained from various sources online and off. Various medical literatures and online sources have been used for the descriptions. If any depictions’ or content is familiar, is purely unintentional.
This article was written as a personal experience and not to be used or referenced for medical advice. Personal use is granted for the benefit of any individual.