Coma
#- 17 000 words
Tend
#- 1 000 words
I do not remember the first six weeks of the coma.
Doctors and nurses and therapists can do little but tend the coma body, try to keep the physical support systems for my brain healthy, try to anticipate with patience but some anxiety, for patients with this sort of haemorragic stroke brain injury about forty-percent die within thirty days, die without waking, die without any recovery then loss, probabilities of surviving declining steeply each day, and even if the patient survives the longer a coma lasts the likely more severe and more dispersed will be the patient's deficits in all ways, in the physical, in the cognitive, and in the psychic. And of course, doctors and nurses and therapists do not know whether this coma might continue forever until braindeath for this is a brain injury and every brain injury is different. My continued survival and hopeful recovery is a daily concern and question to both professionals and my parents and our friends. My survival is no more assured and never certain for all forty-nine days but something my mother will call blessing and my father will not name and my brother will call miracle and I will call luck. I am alive. I am a lucky man. I have no memories of this time. I have recollections of others to the extent I ask, to the extent remembered, and I have the medical transcripts as are explained sometimes by nurses or doctors or therapists. I have no memories that would inform me now or disturb me then from a deep persistent sleep I have fallen into, a sleep that is not sleep, a sleep that may have had dreams but such are quickly consumed by ongoing coma, quickly lost to memory, quickly lost to unchanging rhythm of my sleeping body, even as it never turns and bedsores are a possibility. A major concern these early days is that I have developed pneumonia and have fluid buildup in my lungs and this is a potentially serious source of trouble. I have some qualified but not disputing or deprecating retrospective difficulty in developing much sympathy for myself in these forty-nine days and nights of the coma, for it it is doubtless far more emotionally draining for those who are awake, who care for me, who wait anxiously, who are aware tentatively, who know seriousness of the brainstem injury but know no way to restore my mind and body to life. I simply sleep that is not sleep. I sleep in a way my tending doctors and nurses and therapists can only see from the outside, only watch my brain activity, watch my temperature, watch my heart rate, watch my breathing, even as all these markers of my condition are aided by relevant machines, dosed by appropriate medication, and only know and only care according to uncertain medical expressions of theories they learn and study and can offer only qualified appraisal. For this is a brain injury and every brain injury is different, as my doctors and nurses and therapists tell my parents and tell me later, when it seems I can understand, can remember, can understand the wait, can nurture patience, and in months and years and decades since my injury and my coma and my hospital rehabilitation, this state of knowledge, this diagnostic fidelity is not greatly advanced. I am injured in neural tissue of that organ we believe somehow defines who we truly are and who we will be and who we have been, but there is no simple identity of my person and this neuron or this other neuron but in how indefinite numbers of neurons interact, and further this is the brain working and not the mind. I sleep but this is not sleep as this is not a medically-induced coma which doctors perform to calm rampant injury which threatens the life of a patient, much as cooling the blood can slow metabolic decline, a coma can give the body time to recover and repair itself. I fight to live in dreams and nothing conscious so later approval of personal bravery and determination must be directed to unconscious fortitude, some fortunate kind of desire for life that refuses welcoming quietude of death. I am informed by this person and that person there is a reason I survive, there is a purpose, there is an eventual necessity. I discover that no one knows this reason or purpose or necessity in fact assures the truth of such contention. I might have survived for this reason or for that reason. I cannot judge. I am a happy man but not so judged only in death. I imagine a sort of vestibule to death, I imagine a waiting room, I imagine a judgement room, but this is only later, this is only in trying to write of this time. I am a lucky man. I am tended by various machines, here a ventilator to help me breathe, here an IV that pumps me full of drugs. I remain maybe stable and not critical so I am moved out of the room of two fellow coma patients and given my own room beside the nurses’ station. On days immediately after my injury I am visited, or often rather my parents with me, and examined by many family friends, injustice of this tragedy remarked, each consoling phrase remade and offered again and again.
#
First Person
#- 500 words
I sleep that is not sleep but now must insist this narative follows the esential or the invented or the composite identity of the first-person 'I'. I am recounting these as memories and these are not of some abstract entity I can call 'the patient'. In writing this story of the injury and the coma and the rehabilitation, I now recount from my original and subjective and eventual mental construction of 'I'. There are many and conflicting models of what is this 'I'. There is the philosophical model where there is no thing called self but only the ongoing events as they occur, there is the philosophical model that this self is eternal and necessary and such events by their nature contingent and not affecting this self, there is the buddhist model that insists things arise and persist and perish and demonstrate in this passage through time that events are becoming and not being anything other than what is given, and so we should recognize emptiness of individual things and interelations of all things, there is the model that self is opposed to world and its central condition is that it is a living and separate self of mind and body, there is the model that the self is necessary to coherently unite our thoughts and actions in waking life and dreaming life, and as with those experiential states of the mind and the world, there is no distinction and no duality. There are these and many more models of the self and perhaps the best way to understand this narrative of the coma is as the narrative of self. I use 'I' to try and capture and spur the reader to these questions. I have survived the coma but this does not mean I am any closer to an answer.
#
Forty-Nine Days
#-15 750 words
I am in the coma for forty-nine days.
I am not happy. I am not sad.
I am not any of these things for there is no woken awareness.
I do not remember any of the first five or six weeks while I am completely still, completely unresponsive, completely asleep that is not sleep. When I do remember, when I can later order memories, those moments are fragmentary and have no coherent order. I do not know for certain but believe my life before the coma and since the coma is relatively coherent. Or so I tell myself. I am in the coma for about forty-one days then in the coma-stupor until I wake. There is a difference here between waking life and coma life but I will write both as they intertwine something like reality.
I search now for vivid images through which to transmit something of the very bad but very real dream of the coma, through the days and weeks from that deep sleep that is not sleep to waking my reflective awareness, of which there are only physical and objective descriptions in other sources, from nurses, from my parents, from our friends, and subjective senses are only of the bed and the darkened room and the puzzling and annoying passage of nurses and rare therapists who are doing their best to anticipate, to diagnose, to preventively enact this or that healing gesture. I am annoyed. I do not understand who these people are and where we are. I am not conscious in the coma and later not lucid in the stupor. The scientist and his wife from Hawai’i have given me a little rubber toy like a blue hedgehog, with spines all over its round shape that I clasp and squeeze and bother in my active left hand despite my unconsciousness, and this is simple unending sensory stimulation hoping to wake me. And what the nurses see and where they move in my distorted and uninformed and irrational perspectives, is never more exciting or involving than simply these beige walls and heavy green curtains and those glimpsed floors and this bed.
#
I am in the coma for forty-nine days.
This nurse has red hair and an easy manner, unconcerned that I do not respond. I lie in bed but not asleep, eyes closed then opened to images still and simple yet incomprehensible as a hospital room. I think I think, but that might not be an accurate description of my injured mental processes. I know I feel. On some level I am no more than those autonomic acts of my base or 'reptile' brain of my brainstem, of desires for food or for sex or later to simply leave this comfortable hospital prison. I might have actually been listening that day or another, or perhaps this is only my simulation of that or another abortive conversation that easily becomes nothing but a spontaneous, meaningless soliloquy by this nurse or by that nurse. I am not required to respond. She talks constantly, now about sports, now about the upcoming NHL hockey season.
Are you a hockey fan?
There is no response, but she does not expect one, she is only hopeful and correct in her duties.
What she actually thinks of, is also simulation and more so than those guided by answers of those friends who had attended my bedside, my parents’, for I have only briefly talked to a few nurses who had been there, and this not for their actual words but rather a frame of mind, that had been prevalent then. She talks and talks. Later, in writing this personal history, I research public history through the local city newspapers on microfiche, during those coma weeks when someone would have been talking to me, so topics are likely as there found. 'Sensory Stimulation' such as her patter engages a patient's brain enough to jolt it up, to bring the mind back some degree towards a lucid wakefulness, but the topic does not matter, the words used, the attitude or argument of the nurse, yet this unremembered discussion is evidence of the very simple applicability of language, perhaps forming pictures in the mind of me the patient, perhaps expressing my humanity, my mind in words chosen and subject explored. Words are magical here, useful through practice here, for repetition here, though theory as to why or when it might succeed in stimulating a brain in coma remains rudimentary and only a practical, pragmatic value that serves undefined needs essential to being human, perhaps the urge to talk, to command, to dispute, to be used in any way that might answer that question she asks just as she leaves sad, certain and disappointed that I do not reply. Some research, some few interviews with therapists and nurses, reveals an astounding level of emotional pains the nurses had to endure, but again this is only as I imagine individual responses. For her as for many of the young nurses only recently assigned to the NCCU, this constant talk endows an emotional value to the unresponsive patients otherwise defined and recalled through a catalogue of their injuries, the Stroke, the Industrial Accident, the Car Accident, the Cycling Accident, myself the Brain Injury- an emotional, real dimension that exhausts as much as it is necessary to do her duties. She must care. She is so sad that I and the other two in the shared coma room are so young, in our twenties, very badly hurt, lost in that amorphous dream of coma from which no promises emerge, no indications other than suggestive prognosis as to who shall survive and in what way. She talks and talks.
Are you a hockey fan?
She is a hockey fan. She talks of today's newspaper article about a star player, at this time on her favorite, local team, a team only one year removed from having won the league championship. She moves pillows away from the body, for it is time to turn me so I do not get bedsores. She calls another nurse for aid and together they turn the body. I have not been shaved this morning, as many mornings I need not be, and my hair is growing long, but personal grooming acts are no longer required except weekly. I may have looked like a homeless man sleeping outdoors, with no spectrum of bruises, cuts, broken skin, broken bones, in fact generally peaceably and untouched, but the hospital gown and machine attendants remind anyone of the intense injury I have suffered. This nurse talks more about her hopes for the upcoming hockey season, referring to a television sports show she occasionally watches for backup information and analysis. The argument she promotes, or maybe borrows, is that the Flames can win 'the Cup', the Stanley Cup of the NHL Championship- admittedly yet a season past of many uncertain changes, it is too early to know how such alterations will play out, she is not a bettor in any case but they are only a season away from being Champions, they have the needed talent but do they have the desire? She suggests ideas, asks my opinion and seems willing to enter into a discussion on this trivia. I remain mute and frustrate yet another opportunity to contest in that arbitrary reality, that other world where it is only everything surrounding games, particularly this national game, of that time, of those local and rival teams just a few hundred kilometres north of this city, yes we have been so fortunate in the current level of skill seen often on their visits, but this often means that our team is locked in the same division and must often contest early in the playoffs, rather than of their championships yes she is sad about that, and are not winners and losers, teams and players ways to escape from drudgery and usual alienation from work, are more than finally games, do you see how there can be pleasures of the moment, do you see not everything is a matter of life and death?
Are you a hockey fan?
She checks numbers on the machines, aligning tubes that care for me so they are not tangled or likely to be bent inoperative, finishes her duties and briefly checks my still face. The ceiling is built of sound tiles. The floor is pale linoleum with random flecks of brown, on beige ground.
There has been no change.
There is no indication how much longer, or if forever as death, this coma will last.
The ceiling is built of sound tiles. The floor is pale linoleum with random flecks of brown, on beige ground.
#
I am in the coma for forty-nine days.
Of others who visit my first days of coma, friends of mine or my father or mother, or some combination, some overlap, or all of us, there is one man who speaks sincerely of my father as his 'guru' and comes every morning before work at a computer lab at University, to read Sports news to my mute body, to discuss opinions expressed and offer his own, ask for mine, to agree or disagree. These abortive conversations, these banal assertions and repetitive chronicles as is essential of any Sports news, these details which are only sweeter in transience and uniqueness, but contained in a terrain rigidly separated from serious concerns of Life, are for this man a spontaneous gesture, a repetition every morning he visits my entire coma. Games, always games, that invented world perhaps without true tragedy but offering camaraderie in all our misfortunes expected, a world to which emotional investment must be as unconsciously appealed, fanaticism acted out, certain, winning or losing but always a momentarily intense release of a week of work stress. Sports are physical expressions of the human body, as much an art as dance, as ballet, as acting, but unique each time, improvised from a catalog of possibilities limited partly by our finite bodies and minds, partly according to the rules of the game, and of course partly by situation and effects of the natural world, of wind, of gravity, of oceans or mountains. No one can know how any game will progress or end, not even in statistical evaluation, in history, for games are not inevitable narratives, games are not played on paper. For myself and Vasu this is the unspoken beauty of games, this is that infinite source of sports’ fascination, this is how it involves watchers with the promise of its action, that rare discovery of a gesture newly invented or more perfectly expressed. Games play with the clock and thereby anxiety of time, or games without clocks that each time finds its own, unique, irreproducible pace, games on pitches and fields of grass and dirt, on hills of snow and surfaces of ice, on courts indoor or outdoors of specific dimensions, on surfaces of clay, grass, planks or parquet wood, concrete or asphalt, lined in play and out, played with balls of many shapes, resistance, substance, weights and or polygonal forms like hockey pucks or cricket balls, each game with its specific goal to which we strive alone or in groups, each of us in rigidly demarked purpose to do only one or two things supremely well- to kick a ball, to throw a ball, to hit a ball, to catch a ball- and such plays often only for a few seconds and then only once or twice a game or a play as most clearly seen in Baseball or American Rules Football, or multipurpose, where all have almost equal responsibility or possibility, and such play is perhaps constant, as in Ice Hockey or Soccer. Sports or Games is what men often banter about, joyfully returning to childhood loyalties with zest and occasional sincerity or mature mocking, and in this case because respective fields of interest- books, arts and films for me, computers and geology for Vasu- are alien and difficult and maybe impenetrable to each other. Games are, then as now, replacing religion as the opiate of the people, a pleasure often addictive, sports engaged in massive temples of their stadiums, immense crowds in person or through television, every Saturday night or Sunday morning, every weekend or once in every four years, and everyone is finally emotionally democratic whether you are owner or spectator. If you avoid religion or politics and concentrate instead on ephemera of sports, it is possible to share some simple companionship with virtually any other man…
I did then do now and probably always will engage everyone met first on that mythic and playful terrain any Sports levels for us, a gift I do not even recognize as a skill, for such has always been a useful personal quality, and never one that required much thought or planning, listening or sympathy.
On the other hand, neither participant in this hypothetical conversation will gain any sense of real interaction, any sense of personal values, for in some way those truths of religious and political contents may be woven throughout everything we say and everything we do. In this insistent ground of Sports trivia, it is more the care conveyed, less matters the actual topic…
I am sad, for in some cases such as this, the rules of conversation allow a deeper level of care as witness Vasu’s constant visits.
Vasu, his shortened last name that he is known by to his guru's family, or 'Kris', as KristianswamI Vasudevan may be shortened to avoid possible racism, is the youngest son of a Tamil family in Madras, a city in southern India. Once a shy undergraduate student of my father, in the late sixties, he came to respect my father as any elder relative and asks his advice, his wisdom, in personal as well as professional matters in a way that at first confuses my father, until one day I had suggested this was a sincerely manufactured familial expectation, and how advice is indeed being sought and honored as if he were truly a father or an uncle, not merely as a dispassionate mentor but as a revered guru. My father is at first uncomfortably surprised, but this insight helped him understand and act according to expectations rather than be puzzled by appeals to advice in living. My father had assumed that Vasu was an adult who made all his decisions independently, as he himself had, though in time he saw and in honor returned something like familial love. By now Vasu is comfortably familiar with North American life, and had for many years searched for something he can do to repay his guru.
Vasu reads out in gentle, slow seriousness, football scores and game synopsis and analysis in his soft voice, as though he does not, in fact, wish to wake me. Vasu's fine dark hands holds the newspaper up, a corner tilted slightly down so he may regard the body as well, brown eyes behind metal-rimmed glasses, high on his narrow bridge. None of Vasu's calm features betray that this is the fifth, the fifteenth, the twentieth, the thirty-eighth day he has offers this ritual to his guru's son...
There's an article about that player, starts here- shall I read it out? Vasu asks.
I do not answer.
Vasu reads aloud the article, slowly, distinctly, occasionally even the listing of statistics of games, teams, or players, then the various awards or accomplishments of the same, then the rendered quote offered by this local team's coach about the same, a few brief but earnest clichés from local players about importance of this defensive linebacker or that quarterback or this receiver...
Sounds like they should trade for him, eh?
I do not answer.
Vasu may be fondly reliving memories of his own life, his guru’s life, and my life from when I first meet him as an eagerly intelligent six year-old. There are many, many people who care for me, perhaps originally through caring for my parents, sometimes to myself later, some even within the matrix of an extended family of invented relationships not by blood but friendship. Of those friends I had myself developed there were many lost through the past few years, or lost through my disappearance to live that last, awkward, solitary year in Montreal. I had no longer High School friends, I had no longer University undergraduate friends, and I had not even contact with the girlfriend I had lived with for two years, and I had no contacts and no more recent girlfriends. I had withdrawn so thoroughly that it is only family friends and their children, the Clarke Boys, that came to visit me during my first weeks of coma. My father had once explained that it is not all the young students he saw at the University, who made him feel old, but it is those whom he had been young with. Vasu would be one such example. Vasu had not known the game of Canadian Football when he came here, but now it is a common thread of interest with me.
Sensory Stimulation, of all he might desire to help me, is all Vasu can offer, lonely one-sided conversations about Sports, of which no recognition of efficacy may then reward or even now note, for I do not remember any of what he truly spoke.
#
I am in the coma for forty-nine days.
Lucy Worthy, a cousin on my father’s side, a maternity nurse at another hospital but here today to tend me, declines Vasu's offer of help and starts her morning ritual of care, and she is yet another person from whom no one had asked for her care, another gift, and another whose help cannot then be apparently rewarded, nor later recalled, but this does not mean her help is unneeded. She removes my hospital gown, sponged me down, her gentle touch joining her talking as Sensory Stimulation, asks Vasu what he will do this day, the next, the next again when they meet over my coma body. She is a brown-haired whitewoman, neither tall nor short, a mother, and cheeks as if flushed with sudden wakefulness under pale blue eyes, though she has been awake for at least the hour it takes to drive here. She talks, smiling, some mornings, about how I entertain her children- three girls and a boy- and shows Vasu the get-well cards they have drawn a previous day, or a few days past, a week past.
#
I am in the coma for forty-nine days.
If asked to nominate an unexpected windfall, a ‘silver lining’ to dark clouds of my injury, I will suggest how my father then began each morning with a phone call from his elder sister, my Aunt Alice. While my mother and her sisters are in quite regular contact- while ‘family home’ to me means Grandpa and Grandma’s house on the beach in Waimea, on the island of Kauai- this contact is less common with my father and his sisters. Mother and her sisters kept their families informed in pleasures of regular phone calls. For my father more conversation would pass each morning in those new long distance calls than any week, or indeed month, before my injury. I never do ask my father details of what is discussed- this would again summon painful recall, as with any memories of those waiting weeks. My father does not know, does not guess, why Aunt Alice called him, or that my mother had phoned her first. I do not now, never before, ever want to cause pain for my mother, though my father seems reconciled to rueful acceptance of whatever thoughtless depiction his son the writer might feel compelled to write- and should it be most usually true that a family is finished when a writer is born into it, as (Updike? Roth?) says, I would be the determined exception. I will much later decide that when one is self-aware and subconsciously manipulative of emotional reality (which is perhaps symptomatic if not defining artistic skill and sense of the world) one suspects all others as suffering similar awkward gifts. I suspect this is how, despite truthful declarations of love, my father and his sisters can so easily come to arguing and anger, often on shared recollections from their childhood decades past. In fact, in many ways, it is probably through the example of his sisters- and his mother then suffering Parkinson's Disease- that my father had conceived of women being emotional and complex and dramatic and so calmness of my mother was a radical counter-example. My father was on Scholarship doing his Masters at Cal Tech when he met Mother, who was attending another college in Pasadena, and the story of their meeting I always find the most romantic, they could never have met anywhere else but at the midpoint from Hawai’i and Southern Ontario, for my father waa a lucky man. His relationships with his sisters was never extreme enough to be described as estranged, but never as close as Mother and her sisters.
I am leery of ever suffering any version of such estrangement from my sibling, though my brother laughs away this fear and I realize this will never happen between us. He is my big brother, he is always there, he loves me, this is now, not then, this is an exaggeration of those relations between our father and our aunts. I would later suggest that, as my father grew quickly independent a child, as he became a successful student and later scientist, secure in his ability to deal with those usual problems of life- not only having a younger son who harbored desires to be some kind of artist and would not accept advice from his father unless prefaced by ‘Alice says…’- there never is need of his elder sister aiding him...
She can help him now, in precise, carefully asking and offering only within his demands overt and unspoken all those emotions of his reveal, prove her worth as emotional balm, demonstrating the privilege of family members, to console, to support, to assume a place in an emotional inner circle, all aid she can offer as a sister’s gift of love. Will this event somehow infiltrate her own writing, this is a question far too specific to be entertained now, will her particular removed but present experience, as sister, as aunt, be useful in any artistic way, this good material, I think of this only now so many years later, a narcissistic musing against my version that may seem too cold, too intellectual. Details are contingent, but it is out of details I would render my injury and coma and rehab but is there a story here, is this or that detail relevant, can I not rearrange or alter focus of this or that detail, is the interpretation that this is as factual as I remember, rather than an invented narrative, the only aspect that saves it from being a sadistic story with a generally happy outcome which relies more on assumptions of living perspective than artistically convincing foreshadowing or dramatic arc or verbal structure…
I am sad.
As the coma passes, as rehabilitation passed then somewhat ordinary life returns, these long distant calls became less frequent, finally ceased, and ordinary relations with familiar lack of communications resumed...
This is a return to infrequent contact, an indication of progress, an assumption that by now I am past my immediate injury and all anyone can do is wait.
#
I am in the coma for forty-nine days.
This count my father gives me, for the last few days show radical improvement, as noted in the coma diary. Forty-nine days I will never regain, forty-nine days of sleep that is not sleep, forty-nine days of dreams I do not recall, and then those memories of the times I am active, in a coma-stupor, are of a very bad dream. I do not recall any dreams so persistently bad from which I do not eventually wake up. I am terrified and confused and persecuted. This is my world. Ending the count of days is not entirely arbitrary, or no more so than waking any morning and claiming to leave that ordinary madness of dreaming behind, because some disorientation and confusion persists even when I seem aware.
When I wake I do not appreciate the severity of my injury. I do not realize how rapidly I recover each waking. I am later impatient to walk again but refuse to simply applaud my given survival and waking and tense mind. At the moment I am not pleased. I am silent. I am planning my escape.
One day I am nowhere near lucid.
One day I am awake and eager.
I see the universe but do not understand my world. On reflection later in the rehabilitation and the years since, the universe is that shared reality built out of the perspectives of many minds, that we call objective, that we might mistakenly say is more real, but it is never the entire world, which takes that given sense and endows it with meaning, with value, with the subjective real. On reflection years later I learn this. I learn after reading psychology and philosophy of the coma that according to therapeutic neurology, this inability to connect even the simplest universal qualities, the causality, the movement, later the varied devices that support me is known as ‘psychic blindness’. I see but I do not see.
I am silent. I am planning my escape.
I am not aware of anyone ever recounting this particular experience of coma and this is all I try to do here. Or so I tell myself. These are not the various exteernal and objective perspectives, the coma as seen philosophical, theoretical or medical, but my memories, my senses, my internal and first-person observation. I would like such to unify with those other ways of recounting the coma, and so flatter my sensitivity and insight, but I also want to be truthful. I have not read anything that will help me understand. I might not understand anything written to help me understand.
One day I am lost in sleep even though I struggle to walk away.
One day I finally understand my injury.
I understand my world.
My father tells me I am asleep immobile, for the first six of the seven weeks and of this I should have no memories. I am in the coma. I come to the coma-stupor in the last week and of this I have vivid recollection even if not lucid or clear thoughts or senses. I read the coma diary more than once, and it generally abides by this distinction, but then I read the medical papers and discover I had some awareness and movement in about the fifth week as some of my memories fit this earlier time. I am confused. I seem to have become awake, though not lucid, though there is only brief explication of actions, though around my unvoiced and private desires to escape and my certainty of suffering persecution.
#
I am in the coma for forty-nine days.
I am entered in the NCCU at 2: 24 AM Thursday 2 August 1990, and this time is probably immediately recorded as soon as they have me transferred from rolling bed to that more permanent resting place surrounded by the necessary machines. I see myself and I look longer and bigger laid out flat and wreathed in tubes from the IV sources, the breathing tube, the waste tube, the blue or green hospital bed linen below and above tightly distressed wrinkles but unmarked with stains of blood or other fluids. I imagine the routine of NCCU nurses tending me according to doctor’s orders, but in trauma I see all this in the codified actions of a TV program or of movies or even of daytime TV- where actual healthcare is only background to emotional adventures- I see this only in imagination and not with the same conviction of watching my injury.
I am not there. I am silent. I am planning my escape.
I cannot later divide this and that memory according to the medical papers, perhaps my memory is fading, perhaps it is never that sharp, perhaps it is simplest to allow that, as sleep has no apparent duration paralell within experience and without times, neither does the coma. It is only when I come out that time is measured again in sunset and sunrise, in clock and calendar, in seasons and weather. I have forty-nine nights and days of something like sleep.
After the adrenaline rush of my rescue by the paramedics, then the rush of trauma care now comes the long wait of any brain injury- it is a brain injury and every brain injury is different- when the basic whole of my brain now sustains me in a sort of stability, but no one can know exactly all that is injured. Medical guesses are educated ignorance for each brain as each brain injury is different. No one will know or diagnose much until I begin to revive from wherever the coma mind goes.
Everyone must wait.
I am not there. I am silent. I am planning my escape.
I see the others waiting but I do not see what they see.
I will later have some sense of this waiting years later, when a friend’s mother suffers a stroke and brief coma and unasked I come to the same hospital ward that evening. This is twelve years after my coma and the NCCU has been repainted, resurfaced, and what had been brown and beige and tan and yellow, is now pastel blues and pale blue and green, and muted flat-screen TVs are mounted in the quiet room and near the nurses station. I come to the quiet room and give my friend a welcomed embrace, and then she introduces me to her family and offers me as proof that stroke and coma need not be fatal. Her mother is in a coma for a few days. Her family and she wait in shifts for her to wake, and I feel superfluous after briefly meeting them, I wonder if my presence would become rather that disheartening positive result should their mother and wife and sister not survive as well. I will try to offer an idea to aspire to, but every brain injury is different. I look at their tired huddle, their murmured comfort, their shared touches, and feel suddenly my presence could be wrong, for I do not know this family well but only the daughter. I wonder if strangers waited over my coma. I see her family resemblance, I see blotchy faces after tears, I see blank confusion at the sudden and complete change of this stroke, I see or think I see something like resentment that I should be well and whole and the mother not and perhaps never again. I let her daughter my friend eagerly draw out details of my coma, certain that my survival is what they can pray for her mother. I feel embarrassed. I see their agony. I wait only for a few hours. I will not impose on their anxious waiting, their fear, their grief, their doubts.
I imagine this gathering is no less than would have been the case for my injury.
I will ask after her mother every time I see this friend and she seems to recover well.
I will think of how wide the range of possibilities can result from such injury. I will learn that to others I am injured, how I will need help for the rest of my life, when all I want to say is that I am well, I live well, I do not need their pity, that, truly, my brain injury is not so severe. Or so I tell myself. I do not like to think of myself as severely disabled. Of course then, during my coma, no one can know this and only I could comfort them.
Everyone must wait.
I am not there. I am silent. I am planning my escape.
I see the others waiting but I do not see what they see.
#
I am in the coma for forty-nine days.
I have vivid impressions in recollections of the coma-stupor, as I then become active, as I try to escape, as I pull out tubes, as I clamber over bedside railings and I try to walk away. I would then immediately fall, for my feet do not do as I wish and is it my right or my left foot that refuses any weight, at the moment I seem unable to tell which is which.
I can remember intense but boring detail in only a limited palette, in only the hospital muted brown and beige and yellow, and then those companion artifacts, mecahnical sculptures constructed in gray brushed metal or dull chrome, whose meaning will later seem so obvious in purpose that I will wonder how they can have ever seemed so unfathomable, so frightening, so mysterious- but such they are during this period of stupor. An upright thin metal tree, without leaves or roots, serves to suspend this or that intravenous source in a translucent plastic bag deflating as fluid empties, from leafless metal branches and supported as the whole on splayed casters not much different than wheels of a shopping cart. I only fear this for no sensible reason. I fearfully brush away all those tubes serving me. I must free myself from as if a fly in a spider’s web. I push tubes and trees away frantically, angry to the extent my motivations ever have any true emotional quality, to the extent these acts are more than automatic refusal of my person being violated without consent.
I am terrified and confused and persecuted. I am silent. I am planning my escape.
I see this place clearly- someone has put my glasses on me- but I do not understand.
I see the universe but do not understand my world.
I will later think of this akin subtitled or dubbed foreign movie, one in which the images are clear and obvious, and then subtitles a scroll of misunderstandings rather than translations, of of dubbed words never matching movements of lips, of some malicious misinformation, of something like screeching laughter emerging from no source and according to no joking fractured logic. I will later wonder how I could have misconceived so radically. I feel wonderfully stupid. I will later find the mistakes of almost comic nature, but at the time there is nothing at all humorous.
I am terrified.
I am terrified and confused and persecuted. I am silent. I am planning my escape.
A bedside railing is raised to protect the patient from unwise exertions towards climbing off the raised bed and trying to walk way, but somehow these railings become rather sinister bars to restrain my senseless escape from this place, this place I want to leave, this place where I understand nothing but fear everything, that only in retrospect will be known as a hospital. I have to escape. I come somewhat towards lucid perception of this place, at the least enough as required for desperate escape, this place with complete fluorescent illumination but still somehow dark, lighting more familiar as that of offices rather than homes or other apartments that I must have seen before, this place that must be a hospital, for I have seen hospitals before, even if mostly from dramatic television, but in my stupor these accessible indicators are disregarded and this place is only some place I would rather not be. I am afraid. I venture to escape. My right foot is pulled inward such that only the back of my feet, the knuckles of my toes, can meet the linoleum and only in pain that shoots up the leg. I am angry. I feel I feel. I think I think. Obvious and correct understandings- that this is hospital and I am patient- do not then come to me, in fact I do not know if it is the first or the last perception, I do not recall even entertaining this possibility, as that would be something too rational and apt and not nearly confusing enough to describe my state of body and mind. I have to leave. I feel intensity of fear that I do not recall ever before the coma or since the coma.
I am terrified.
I am terrified and confused and persecuted. I am silent. I am planning my escape.
I look around but the vivid persistence of this place does not signal that it is therefore real and persists whether or not I want it to. I have to leave. I fear I have risen in a very bad dream that refuses to end, to even show plot of interest, or characters desired, a terrifying dream without logic- even later, considering these events as if images of film, subtitled with endless permutations of paranoia- a terrifying dream that cannot be described in my words for an essential memory is the long and boring and tiring time that requires some sense of elongated rhythm not merely in sight or other senses but also in the pace of my thoughts and words that come silent against the trachea. I do not want to bore readers, I will satisfy my sense of truth by mentioning only one similar event or experience that it is said war is prolonged periods of tense languor and boredom and helplessness, punctuated by moments of sheer terror. This is valid description of the terrifying bad dream of my coma. I do not know where my mind is at that time, cannot in retrospect find it years to now, and that it is just there in that injured brain, that bed, that ward, that hospital and so on, is probably all we need to agree with, for like dreaming or recalling or intending, no matter how wild and distant, intense and meaningful or opaque and boring, we know that the brain has not physically migrated to wherever is dreamed. Connecting moments of awareness with the diary dates reveals that those useless and boring and unending sleeps seemed long because they were long. I am out not hours but days. I am bored and tired and restless because I have slept and I do not move for days after the immobile weeks of the sleeping coma.
I am terrified and confused and persecuted. I am silent. I am planning my escape.
I think of the nurses I have during this bad dream, who only frustrate my desires to escape as I reach towards them with a pathetic drooling attempt at a smile as my only way to ask for help. I am placed in a wheelchair, freed of many tubes, and then launch equally pathetic and restrained lunges towards the few women visitors, who will surely help me escape. Or so I tell myself. I do not recognize this as hospital much as I do not even think this is real. I do not follow the patterns of movement, the logic of a hospital, the routine and then the unique gestures of care. As ever there is no blurring or shivering or fearful distortion of my senses- my sight in particular- but simply constant disconnection from sense to logic. I see clearly- unaware even that one eye is covered in a patch so there is no double vision- but the entire visual sense has that unreality and illogic that camouflages any inconsistencies which would surely contrast with my world view.
I see clearly in one literal sense, but how much of what we see can only be acknowledged according to comprehension, how much of what we see must be taught, and now more than just those untutored, natural play with an infant for whom we must recognize that everything seen is often even literally for the first time. All fact is interpretation, it is said, so perhaps all sight is those initial impressions, those sense-data, uneducated absolute sensation that is more frightening than seductive for me, but these sights are not somehow objective, viewed from somewhere other than through my eyes, sensed in my body, no the teachings of the philosopher Merleau-Ponty have here direct relevance. I am embedded and surrounded and interpenetrated if not intertwined, by the various technology of this NCCU ward, by this practical application of theoretical science, by this medical adumbration of theories of neurology. I am lost, I am afraid, I am never able to think clearly of where I am or how I got here or what I see. I need only find someone who will help me escape. Or so I tell myself.
I see my body clearly but I do not see what I see. It is a waking dream.
I am terrified and confused and persecuted. I am silent. I am planning my escape.
The ceiling is built of sound tiles. The floor is pale linoleum with random flecks of brown, on beige ground.
I do not understand these images of the NCCU, the motions of the nurses caring for me, though my vision is clear- one eye already covered by a patch as there is a difference of forty-five degrees vertical focus from one to the other. I am not in pain, not that I can immediately sense, that I experience rationally, that I remember. For this is the coma from subjective senses, from what I can remember, from what I learn of, from what I can flow together. I have recall of images true or false, or dream-like and beyond that distinction. I am silent. I am planning my escape. NCCU nurses do not refer back to the injury that has brought me here but rather talk about innocuous events, about movies or politics or weather or music and so on, switching sometimes to sports in their hope that the young male patient will care enough about that to wake.
What anyone might say to another riding an elevator.
#
I am in the coma for forty-nine days.
I have no memories of this first two weeks of the coma, nothing that would disturb me from a deep persistent sleep I have fallen into- a sleep that may have had dreams but are quickly consumed by ongoing, unchanging rhythm of the sleeping body. A major concern these early days is that I have developed pneumonia and have fluid buildup in my lungs- a potential source of trouble. I have some retrospective difficulty developing much sympathy for myself in these days of the coma- it is far more emotionally draining for those who are awake, who waited, who are aware, who knew seriousness of the injury but knew no way to restore me to life. I simply sleep that is not sleep. If I run, if I fight, it is in dreams and nothing conscious, so approval of personal bravery and determination must be directed to some unconscious fortitude, some fortunate kind of desire for life that refuses welcoming quietude of death. I was born and raised and desire to live. I am a lucky man. I am tended by various machines- ventilator to help me breath, IV that pumped me full of drugs. I remained stable and not critical so is moved out of the room of two fellow coma patients, given my own room beside the nurses’ station. On days immediately after my injury I am visited, or often rather my parents with me, and examined by many family friends, injustice of this tragedy remarked, each consoling phrase remade and offered again and again.
#
I am in the coma for forty-nine days.
For my mother there are far less intellectual hurdles to overcome, as she would admit later, as my father would relay with a mixture of mute awe and his accompanying protective tendency, she has direct recourse to letting her emotions surface. Simply, when the urge came, she wept. When ministrations of those skilled in dealing with my coma endangered me she became angry in her abrupt way, then as quickly came back to her faith, her belief she would not help them by making a scene, that it is not something fully understood, that, after all, it is a Brain Injury. I do not like even in words to imagine my mother in such distress. There is a brief note in the coma diary that when the trachea is first removed- an attempt to wean me off the 100% concentrated oxygen that I breathed. I failed to breath and suffered momentary death. My mother noted in the diary that a 'Dr W... explains himself.’ This is only the first major alteration that is practiced, trying to restore my normal reflexes of breathing and getting me down to 23% room oxygen. When an application is successful, well planned, and useful, my mother left ward and hospital with flickering hope, but never completely left me, only rested, slept, waited with a little less anxiety. She met the mother of another young man, just then rising from his coma, a woman who suggested keeping a coma diary for future reference, for eventual reading by me. This diary is my mother’s only concession to the possible severity of injury, something she can do while professionals took care of me- my memory might be damaged, my curiosity might be aroused, might want to know exactly what happened while in the coma, though I do not know if she ever expected I would write it out and use her notes. I read it now, each reference to my improving control and consistent bodily functions, the brief reference to a tracheostomy given so that I can more easily be medicated, and this helps me understand timetable of the coma.
This first section, about two weeks long, I am asleep in coma proper, immobile, unconscious, aided by several necessary machines, completely reliant on care.
The next five weeks I am in coma 'stupor', no longer supported by so many machines, sometimes violently active, sometimes restrained in bed, not very lucid, unable to tell private dream from shared wakefulness, prey to basic emotional and physical urges, desires, intentions multiple and forever thwarted- do I admit there are no words to describe these memories, do I abdicate that claimed role of any artist, any writer, to somehow, somewhat communicate pale suggestion of these experiences, do I find these words, do I talk of the fears that coursed through what fragmentary flashes I have, do I elevate inchoate sensations to the status of the whole of reality?
These are questions I ask years later. At the time it is simply a bad dream...
#
I am in the coma for forty-nine days.
I come to understand my waking environment, not yet as a hospital but only a very bad dream- detailed, vivid and inescapable nightmare. I am terrified and confused and persecuted. This is a bad dream that sometimes only puzzles, rather than disturbs me, that sometimes terrifies in how much it is so impossible to understand- there are often people I know, deep sleepiness, long rests that are pointless and dreamless despite which I remain tired all the time and then sleeps that always return me to this bad dream. There is no escape from this bed, no response of aid by my friends, no matter how often and in how many ways I plead for their help. There is disturbing tri-partite architecture of this hospital and two banks of elevators- one always crowded, open to the public, for ambulatory patients, visitors and staff- the other inaccessible to the public, reserved, designed larger, carrying hospital service materials, laundry, machines, meals, wheelchairs of patients, hospital beds such as I arrived in. From my bed, out the window, I see the 'Mini-Manhattan' of downtown Calgary towers suggestive of New York and I wonder how I have gotten there, why I am there, then assume it will come to me later, and worry instead about expense of care. While I have the trachea medications are directly introduced to my stomach with diet of liquid IV (Intravenous) food. There is a plate in my throat, above the trachea, over which another tube sucks away saliva I cannot automatically swallow, that I will otherwise choke on, but most irritatingly also takes away what voice I have. There is an ongoing theme to what I try to say, it is always the same: ‘help me someone please’. Sometimes I try more specific requests such as 'please take this tube out’. I find better and more direct ways to communicate in expressive gestures, for example picking at my diaper to alert nurses of need to urinate, for I am soon off the catheter, able to hold my penis and void by myself, polite and private. NCCU nurses consider this a big step. I apologize.
The ceiling is built of sound tiles. The floor is pale linoleum with random flecks of brown, on beige ground. I am silent. I am planning my escape.
My mother is pleased I retain such manners as she had taught.
#
I am in the coma for forty-nine days.
I am unable to speak and an anxiety of no communication bothers me- set me free... help me get free... I try forming words around my trachea, these and other combinations, but it is only my wordless struggle that indicates this. I try to escape, I try to climb off my bed, I try to place these thoughts of terror and desire in the minds of visitors, but only by reading my one eye, my desperate, incoherent face can others receive these ideas. I am terrified and confused and persecuted. Voices of friends always tell me they cannot help, that I must be patient, that I am badly injured, that they will help me here, rest, Michael, rest. How can these people be my friends? They will not help me free myself. I am silent. I am planning my escape.
One day I am given a board with magnetized letters on a metal board on which children would play, and so form the words 'help me someone please'. There are only four 'E’s so I make them serve double duty, and design placement so it reads 'help me someone please'. This careful design is assurance my intellect, however dominated now by anger, by fear, by animal urges, remains somewhat that intellect I have grown up with, that intelligence is not lost, that creativity is not lost. My mother notes this hope to any who ask how I am doing.
The ceiling is built of sound tiles. The floor is pale linoleum with random flecks of brown, on beige ground.
The nurses are pleased, but not convinced I have come to lucidity.
#
I am in the coma for forty-nine days.
Ellen comes to visit. I see her pinkish-tan face of a whitewoman rendered in detail, recognizable but so closely defined, so finely perceived, so marked by skin pores and lines of incipient wrinkles, in folds of flesh, in lips, in eyes, under a curly mass of brown hair defined in each strand. I see her as if for the first time with sudden and cruel clarity, with no cosmetic familiarity, no sense of how her intellect or kindness would in time soften her features until I see her reality, forget those universally unattractive qualities we all live with. I will think later of that necessary make-up used under harsh lights of television studios, but I am confused, I had not before thought and do not now think of Ellen as ugly. I see her sit beside my bed, her brown eyes liquid, her expression still, sympathetic and calm, accepting imy confused pain and fear, holding my nervous, twitching, active left hand. She speaks gently. She speaks slowly and clearly. She says I must be patient, that I am fortunate to be alive, that I am severely injured, that she cannot help, that these people here will help, that I am in a hospital, that these people are professionals, that I have many people caring for me, many people hoping for me, that I must be patient, that I am fortunate to be alive. I beg her to help me, help me, help me someone please, help me free myself, trying to speak around the trachea, trying for legible writing on paper she offers, here she watches my left hand’s movement and tries to see what letters and words I make always the same, help me someone please, help me get free. She says she cannot help me free myself. They will help me here. I must be patient. I push her away.
The ceiling is built of sound tiles. The floor is pale linoleum with random flecks of brown, on beige ground.
I am silent. I am planning my escape. I cannot leave.
#
I am in the coma for forty-nine days.
There is a loud crash.
A blonde nurse enters my room and finds me on the floor, now quiet, now immobile, now angry that my escape has been betrayed by this noise. I have decided that silence is necessary to escape. I have angrily pulled out various tubes that violate my body, the nose tube for food, the trachea for breathing, the IV, the leads of electronics I cannot understand then, only knew they are all binding me as surely as fly in a spider web. I am silent. I am planning my escape. I have slowly climbed over railings of my bed, muscles trembling in my tense co-ordination, pausing halfway to hear if others are approaching or even aware of this attempted escape. I have then been trying to stand up and walk away. I fall. I am not hurt. I do not understand my injury. I do not want to be here. I am terrified and confused and persecuted. I do this attempt over and over such that my order of memories is not clear. I remember my silence, I remember my anger, I remember my fearful purpose. I will walk away. I do not even have the ability to stand up, my right leg suddenly refusing to bear any weight, jerking out, never gradual or measured movement despite my careful, slow transfer of weight and so inevitably I fall, my body will not listen to me, my entire right side will react to other sensations my mind would rather pass over, my entire right side is not marked, not visibly injured, why is it numb? Why is it so difficult to move as I wish? Why is it so heavy? My memories are not clear here. I remember lightness or darkness of the room, wondering what time it is, when they will upright me so I may try again, but these new nurses put leg restraints on me so that I cannot try again.
Now you stay like this Michael, just relax and be comfortable, a white nurse says while fluffing a pillow, resting it under my head.
I lie restless in bed, fading in and out of consciousness.
I am silent. I am planning my escape. I cannot leave.
For seven hours... seven days... seven weeks... I rest in bed and my attempts to stand continue, fruitless but entertaining in retrospect, though these attempts to escape are submerged by total, uncomprehending terror. I am terrified and confused and persecuted. I am alone, I am unable to escape, and I am tending by others who seem to be torturers with whom I can plead mercy to no effect. I refuse lucidity, I do not hear or follow any logic for the pain they cause, I do not even know the question- the question is the answer, the answer is pain, and the pain is life. The ceiling is built of sound tiles. The floor is pale linoleum with random flecks of brown, on beige ground. This part of my coma I will come to see in jerky speeded-time of early silent movie comedies- a dark comedy following a young man trying and failing to exit strange dream, strange bed, strange torture cell, strange place where even his own body is rebellious and throws him to the cold linoleum floor, strange dark comedy with the same disturbing logic of a very bad dream from which I am unable to wake, a dark comedy of my life of unavoidable tragedy I know nothing about, of inventive physical comedy, of movement all to the same effect, the same illusory goal, day or night, fast or slow, angry or concentrating, always desperate and slapstick, always so easily forgotten and thus entertaining over and over...
Don't try to get up Michael, brown-haired white nurse says.
This is not amusing to nurses or therapists, who correct these falls, who scold me over and over.
I am silent. I am planning my escape. I cannot leave.
I am forgiven these constant attempts to stand, in the course ripping out as many tubes as I can, as it becomes clear I want nothing other than to walk off the ward. I persist in trying to stand. I mumble meaningless pleas around the trachea. Nurses put my left hand, the moving hand, in a padded mitt, but this does not work to stop me, as I constantly work it free and yank the tubes out anyway, and soon undo leg restraints as well. I try again to escape. I try again to to stand. I offer relentless dismissive apologies to those nurses who have to pick me up and put me in bed and reconnect tubes. Then the trachea is removed. Once the saliva plate and tube are out the fluid drains down my throat, and I feel as if I breathe underwater, I feel I am drowning, I feel gasping and unable to breathe. I am suffocating. I am dying. I am terrified and confused and persecuted and no one seems to care. This difficult passage is necessary to re-establish patterns of breathing alternately with swallowing saliva. Throat valves must relearn this autonomic mechanical ability to avoid liquid falling to my longues, and fighting feared pneumonia as chest congestion increases. IV tubes are put back in and nurses say variations of Don't yank it out Michael, it's only there to help you, and we’ll only put it in again. Eventually I heed these words but have no idea whose voice is finally heard and believed. I never do know. This self-aware action does move me to my own room beside the nurses’ station. I think I have come to a far nicer room in my very bad dream, with curtains here pulled back, with summer sun flooding in, though curiosities such as distant mountains and no sea alert me this is not New York. I am more lucid, I am awake, yet I still lapse into irrational states and express anger at being kept in this very bad dream.
#
I am in the coma for forty-nine days.
On the cabinet by the raised-head of my bed there are drawings from 'Kerri' and from 'Lisa', that I see every time I wake. These images make me wonder what sort of bad dream this is- one with children's drawings in felt, one that says 'get well soon' and both say 'love'. I know only children of Lucy Worthy, the cousin nurse, by these names, and what are they doing in this bad dream? One drawing is simple flock of birds in bright, orange, upside-down W’s flying above house of green siding and red brick. The other drawing is of smiling face, with glasses and unshaven-beard dots, and striped shirt of blue and red, this is their portrait of me, from some months ago, though I do not remember this.
I am silent. I am planning my escape.
There is another pair of papers with drawings by 'Eddy' and 'Jeff'. I do not recognize these names, though later I will learn these are the sons of that English scientist, the boys I had led down to the reservoir two days before the injury.
#
I am in the coma for forty-nine days.
Now in wheelchair, nurses leave me parked within sight, though I am now generally quiet patient and rarely disturb them from doing their charts and other tasks on the unit. It is high-backed wheelchair found by Liz, an Occupational Therapist, in which I can recline but instead tend to lean forward. I am more lucid, aware in watching people go by, and to many women I try smiles or gestures. I become very animated and my mouth tries to form words around IV tubes. I am disappointed that no women stop to speak to me, so I try to get up and follow to wherever they go. To do this I rock back and forth in the high-backed wheelchair, building up necessary momentum to come forward onto my feet, or this is the theory I work on at any rate, though because I am strapped into the chair I can only lurch the wheelchair into imbalance and crash loudly.
The first time I do this I manage to tilt the wheelchair backwards and crash and summon nurses with some anxiety. I am not hurt. I lie on my back, viewing a ceiling of sound tiles, and wait to be righted. NCCU nurses scold me and I accept this concern with patience, then dismiss it as irrelevant before second thought. I look down the hall, not at any particular patient or therapist or nurse or visitor, but at architectural structure of the hospital. I have always been fascinated by architecture and this interest sustains me through worry and boredom. I am not hurt. The pillow behind my head protects me from any possible further injuries sudden rocking escape attempts contact could bring.
Now you stay like this Michael, just relax and be comfortable, another red-haired nurse says.
I look at her. I am not intellectually aware, emotionally accepting, of my injury and continue to act as if any coordination to stand and walk away is undamaged.
Don't try and get up Michael, another white nurse says.
I look at her. I am silent. I am planning my escape.
The ceiling is built of sound tiles. The floor is pale linoleum with random flecks of brown, on beige ground.
My wheelchair is backed against the hallway wall so I will not crash again. After some more rocking back and forth in place, I manage to tilt the wheelchair now forward onto the floor in another crash. This summons severalnurses with some anxiety. I am not hurt. I look closely at random brown flecks on beige linoleum, searching for a pattern that is too minute for my surveillance, or is not there anyway, and feel blood rushing to my head, but this is not an anxious experience. I wonder how I managed to get in this position. The waking memory of a world of cause and effect is unknown orridiculous, never persisting in the suvjective realm of this very bad dream. I am silent. I am planning my escape.
I am angry, but even half-conscious, able to see if not understand, there is no calm rest for my racing urge to organize those perceptions, to manufacture consent, to render spurious logic, and as in any dream, what is most horrific is that I am alone, that I can no more share this pursuit of sense with friends or others. I am terrified and confused and persecuted.
I am alone in my intractable dream. I am silent. I am planning my escape.
I must escape this bad dream by myself, all familiar friends and unfamiliar nurses white and black and asian counsel patience, tell me to wait. The ceiling is built of sound tiles. The floor is pale linoleum with random flecks of brown, on beige ground, and I search for a pattern that is too minute for my surveillance, or is not there anyway.
Pain is the answer, I decide. I will wake if I cause myself great enough pain, if I can shock myself to waking from fear and agony, and such radical options seem somehow better than remaining in this dream. I am terrified and confused and persecuted. I am not thinking clearly. I wait impatiently for this chance to arise. I am frustrated, I am defeated, I am frustrated by my early attempts. I clearly cannot hurt myself to cause enough pain because my treacherous body refuses to follow my attempts through, forever pausing, forever ceasing, forever when reflex overcomes intent. I decide I need some tools, some devices, some actions that will induce required waking pain. I try, I try, and I try again and again to simply stop breathing. I am now without the trachea, without the saliva block, and common air is swallowed with saliva. I swallow huge gulps of air then consciously hold back breathing, hold back, hold back, hold back, then terrible and rebellious self-preserving animal urges insistently force me to gulp air again, again, again, but this attempt will be forgotten or disregarded, so I try this again, again, and again.
#
I am in the coma for forty-nine days.
I am placed on a board-stretcher and rolled down the hall.
I am no longer laced with any tubes, so there is nothing to hinder this nurse's movements, there is nothing to say, nothing to listen to, and I am at first unaccountably afraid, but this process becomes familiar and fright dissipates each time repeated. I see only sound tiles of the ceiling roll quickly by, with cool hallway air moving gentle breeze under the sheet, but I am immobile, I am languid, I am relaxed, and I do not struggle to escape this board even though I am now without restraints. Though I do not know what is happening I am now calm and curious, I am questioning no questions, I am fearing no fears, I am making no commands or pleas, I am aware and use none of these multitude ways to use words. It is important to be quiet. I am sad. I do not know where this is in my bad dream, why I am here, or where I am heading, but this ignorance is finally of no consequence, though whether it means I now trust these others who guide my body, or that I am simply too tired or drugged to dispute, I never bother myself to discover. The male nurse who pushes me is at least a familiar face. Only vaguely, a pleasant dream within this bad dream, I recall an experience similar to this giving pleasure. I come to a yellow-painted room that is warm and humid, with familiar smell of soap and shampoo over prevalence of hospital disinfectant, with short tub of gray enamel, steeply sloped down from the end my head is aligned to, too small to ever drown in unless I were somehow entered inverted. Hot water comes pulsing in two jets on each side of the tub about halfway down, thick splashing in cords of water, white with bubbles and thrust of air. The white male nurse checks water temperature, adjusts taps, patiently waits for the tub to fill halfway, rolls the stretcher into position over the water, lowers one side and then I am shifted off the stretcher, oriented, and as I do not protest in act or words, slid into pleasantly warm water. I begin to enjoy this experience, though unfamiliarity of the room continues to disturb me. I look around as the nurse soaps, sponges, and rinse my arms then legs then torso, which is flexible and comfortable in each move as if without rigidity of bones inside. He is pleasantly singing a chorus, or this is perhaps inside myself. Then he wants to wash my right shoulder, and there is sudden, intense struggle, as it feels as if he is breaking my arm by bending it backwards. I am terrified and confused and persecuted. Pain is great and violent and sudden and I have no sense of why, but I do not cry out. I ask no questions, I make no pleas, but automatically resisting I splash water violently with my left hand, somewhere between swimming away and climbing away. I bend my right arm against the nurse, so strongly he must use both arms to force it down into now turbulent water. No technique distracts him from washing me. Pain becomes very great but this does not wake me. I do not understand why this man wants to hurt me. Finally, satisfied in this final torture of being washed, the bath ends, and I am transferred back onto the stretcher, toweled off and covered with new sheets before being transferred back to my room, sheet billowing as air flutters across my now relaxed body. At this point memories are not clear. I remember trips to the bath but never away, as I am then tired, sleepy if not asleep, after this curious exertion. I have always forgotten this experience by the time it is repeated in weeks that follow.
#
I am in the coma for forty-nine days.
I am in a new room, the Physiotherapy mat-room.
I am silent. I am planning my escape.
I see this is a good time to hurt myself, if unable to otherwise wake. The room is four metres-square in yellow and white, designed for Physiotherapists to work on patients here near the NCCU, lit by large windows out to summer sky I remember as always an intense, cloudless blue. The ceiling is built of sound tiles. The floor is pale linoleum with random flecks of brown, on beige ground. The wall tiles end at the doorway. An upright mirror in the wall niche reflects young slim man in blue hospital gown, fabric black patch over one eye, an image of myself I do not at first recognize and when I do it is with the same confusion as throughout my experience of the coma. This man is not me. Beside this niche is a poster from some Physiotherapy conference, advertising funding from levels of government, with abstract figures dancing after a leader in a pale blue sky under rays of a cartoon sun, a simple graphic that endlessly captures my fascination. This talks of 'the science of movement' in English and ‘la science de mouvement’ in French.
I wonder at this bilingualism in my very bad dream.
Liz places my wheelchair in the doorway.
Liz talks to Lara.
I look out into the hall. I am silent. I am planning my escape. Here thisrecurrent image comes of myself standing and falling and waking up, for I have illogically argued with myself, that as it is that great fear wakes a sleeper from a dream, as in falling from a great height, so I should maneuver into such position and deliberately act in a way to cause this to wake me. This illogic comes to me early, in the middle, and late in this coma-stupor. I decide that I should fall through this window here out over suburban streets, over unheard highway, over golden prairie, as an excellent way to wake me, and my reasoning to wound myself seems entirely sound. I will hurt myself then I will wake. I wonder how often this thinking truly happens, for I remember being told to back up and sit down, even guided firmly away to the mat, as I tremble from this final effort, as I struggle to take one stride and fall through the window, to hurt myself, to cause great pain and so wake, for pain, pain is the answer. I do not know if they can fear my desire to stumble into the window, of hurting myself, of falling through, or just want me to take a rest.
I will learn later that this is the eleventh floor of the hospital.
#
I am in the coma for forty-nine days.
Other times I come to this Physiotherapy mat-room and sudden dream-orders took over. I am silent. I am planning my escape. I want to leave, just leave, I have no idea where to- elsewhere, somewhere, anywhere else- I wish to prove to others I do not need help. I will not ask for aid. It is important to be quiet. I struggle with the wheelchair and reach for the near doorjamb, pull very hard, causing the wheelchair, with its brakes on, to tilt onto its back with another crash. Liz and Lara express surprise that I am strong enough to upset the wheelchair, but to their solicitous concerns I simply watch ceiling sound tiles and wait to be righted.
The ceiling is built of sound tiles. The floor is pale linoleum with random flecks of brown, on beige ground.
I am not hurt. I am silent. I am planning my escape. I am disappointed I cannot leave.
#
I am in the coma for forty-nine days.
I am not alert, aware, and politely shy with social control.
I express my needs hungrily, constantly, without socialization, manners, rules of interaction- the need most obvious is sex drive of healthy young man. I attempt to capture passing women, whether nurses, patients, therapists or visitors. I want to stop them to talk- get to know them, to touch them, to seduce them, to have sex with them, to do all these things every new woman who passes by. I sense or only imagine powerful scents, of perfumes, of soap, of female bodies so desired through all my senses, from sight to touch, shape to texture, voice to smile, I want to touch so I grasp towards and they elude too constantly my trapped urges. I know if she is the right woman she will help me escape. There is no doubt I am straight for no men ever start my interests. There is much doubt that women would be more than ultimately or finally only sex. To my immediate sexual ends, with trachea removed and voice back, I can now add florid compliments and bold proclamations of her attractiveness in summoning, without any trouble, all that familiar and essential articulate vocabulary of desires. I once briefly detain one female visitor, surprised that I act rational and awake enough, polite, friendly and coherent even as I speak slowly, slurring, in some sort of accent. I remember her now a slim redhead, seeming tall to me in a wheelchair. She escapes with promises to return and continue this conversation...
The ceiling is built of sound tiles. The floor is pale linoleum with random flecks of brown, on beige ground.
#
I am in the coma for forty-nine days.
I am again in the Physiotherapy mat-room in this continuing bad dream, illusions or memories now proceeding in no particular order, as They, the Physiotherapists, flex and stretch my limbs, testing automatic responses, tension, firmness and flexibility, gauging how nerves in my brainstem that are here reacting- they do this many days in order that I do not become set, that certain muscles do not bunch up, shorten, and others extend. I am naturally curling into a fetal position but closure to that shape is denied by these others working my body, by the bed, the resting now becoming active even if unconscious. I try to fall, to hurt myself as required to escape, but animal self-defense reactions remain in place and nurses or- now, Physiotherapists- will not let me hurt myself awake.
I am not hurt. I am disappointed I cannot leave.
#
I am in the coma for forty-nine days.
Nikki, a favorite nurse, enters. I am not lucid, I believe this is all a dream and am not concerned about staring at her. I do not touch myself in pleasure. I watch, caress her with my eyes, each time renewing acquaintance with her form, her grace, her sensual body- I drink in her beauty as if I have never seen a woman before, whereas in fact I am mentally stripping her, each new profile revealing more sites of my famished desire, each curve, each point and surface momentarily describing her body under her clean white uniform. I believe whatever conversations or pronouncements I make are only to myself, yet I do not talk. Nikki is shapely- much more curved than model-thin- she looks soft and hard in all the right places. Neither tiny nor giant she has paleness of porcelain doll. She strains her uniform in some places, for best effect. She has a pretty face, brown hair, brown eyes, a bud of small lips with pink flushing cheeks, not bony nor dramatically posed as if a model- in fact not in body or face any visual ideal I might have previously pursued. I am unsure if it is sexual desire more than simple friendship that powers this first, desperate encounter with a woman who surely has some reality outside my bad dream, for she resembles no fantasy figures, no selective memories, no girlfriends, no woman I have met or will meet someday. I am silent. She straightens my pillows, continues to hum an unknown song, and walks towards the door. I must say something to her. My voice does not have any volume control, so it comes out a shout-
You would look much better naked!
This is a good sign- that my desires, my healthy physical and usual psychological desires are coming back. Nikki flushes red as she walks from my room, embarrassed ‘beet-red’ but smiling into a young white woman’s room, Cheryl, another NCCU patient, a ‘quad’- quadriplegic, who will relate this story to me months later. Cheryl is further awake, she has not suffered a coma since the car accident she survived, and in her judgment she has identified me as a constant sexual obsessive, this she portrays in humor of gestures and smiles during that brief period we shared the H-7 ward at BVC. Cheryl will tell me that though she can no longer walk, she can feel everything ‘down there’. When my interest is briefly distracted she brings it back by mentioning that her boyfriend was so large he made her feel like the first time, every time. I have no comeback for this.
The ceiling is built of sound tiles. The floor is pale linoleum with random flecks of brown, on beige ground.
And there, then, as here and now, I am constantly disconcerted that another would have an outside perspective of my uninhibited actions, my hunger for only one thing from any women, desires so open, where I remember nothing. I am able now to think of this as only anyone’s common frustration, that we, none of us, can ever have an objective perception of ourselves. We are always subjects and our portrayals of our character are never guaranteed in accuracy, transparency and truth of our intentions. I am sad.
I cannot leave.
#
I am in the coma for forty-nine days.
A nurse washes me in bed one morning as I wake and my half-hard penis responds with an automatic erection. I ask if she is married, I ask if she has a boyfriend, I ask where I am, what is happening, who she is, why I am here. I remember no answers. I may have only asked these questions in my mind. Details are deleted, when I am told of this incident, for as with Nikki the border between waking, shared reality and privacy of dreams is not clear and even in recall there is some suspicion it is only long and intense in fantasy, where it had been brief, where it had possibly occurred previously when unaware. I remember a nurse stroking my erection as she washes it, gently one side then the other, the shaft, that centimetre of dense nerves just beneath that spongy flesh of the tip. I do not remember which nurse or any characteristics of her voice or her appearance. She is a nurse. She looks at my aroused flesh, not surprised, herself probably professionally unaffected.
The ceiling is built of sound tiles. The floor is pale linoleum with random flecks of brown, on beige ground. I talk and talk. I tell her that, contrary to visual display, I cannot feel her doing this. This is not an entire truth but what pleasure there is seems peculiarly impersonal, seems likely frustrating, unlikely to continue to anything else, to continued stroking, to oral sex, unlikely to be continued to ejaculation even if I find mad courage to ask. I become fully hard, firm, aching, unresolved, urgent. I look away. I look back to see her regard it with perhaps only professional curiosity and wonder what is interesting, for of size I am well within range of normal, and in all other ways unremarkable, and what in recall can seem erotic fantasy is not so defined at the time...
What happened this morning? Liz the OT will later ask, standing at bedside, while she and this nurse discus my care, my senses recovering, my physical reaction that is usual for a young man’s body. I may have had such display before, while I am sleeping in my coma, of course, and nothing new to my various caregivers. I answer in a hesitant, slow voice.
She took care of me, I look towards the nurse. I heard about that! the two laugh.
This is also a good sign, my sensations are coming back.
#
I am in the coma for forty-nine days.
OK, Michael, Lara the Physiotherapist says, now this is what we're going to do.
I wish to be somewhere else in this bad dream but I am frequently returned to the Physiotherapy mat-room. This frustrates me. I am terrified and confused and persecuted. I wish to have more control over my dream. Here, as anywhere in my bad dream, the physical environment does not explain itself, the psychological environment is narrowed down to immediate impulses, which remain stubbornly, deliberately, entirely denying signs of my physical health. I am injured, voices often say, Rest Michael, voices echo in my fleeting consciousness but I do not listen. I do not before, do not then respond to that obvious disability that slams me down with each step. All I know is that I must leave, that I must go somewhere- anywhere- else. I will walk away. I try to stand, I fall, I wait, I sit on the mat, I try to stand again, and I fall again. In my dream my perceptions are microscopically detailed, so brightly lit against unremembered sleep, so finely etched it is as if I felt the smoothness and roughness with my eye. At least the environment is by this time becoming familiar, as we move from the physio mat-room to the dark hall. Shelves are still of same dark veneer, view still same unrecognizable south view over a field, a highway, neighborhoods to towers of downtown. I focus on my immediate surroundings in this endless bad dream. I see again an image in the mirror beside the doorway but do not recognize it as myself, of an unshaven man in hospital gown with patch over one eye, wavering, stumbling, moving in awkward steps despite all his futile efforts towards fluid grace. To the left of this doorway a poster reads 'Physiotherapy: key to independence'. This poster has bands of small dots, red then orange then yellow as they radiate, on a black ground, as if a minimal graphic of an explosion or a nova. I feel Lara beside me, trying to move my right arm back. She is speaking softly and calmly but I do not listen.
Liz is helping as well. I ask if she is married.
By agreement, they stop and consult each other.
I would rather not be here, I decide, I will walk away.
I have trouble even standing up.
My right toes are curled inward, foot tensely pointed down and still refusing to bear any weight, with each glancing, momentary weight drawing quick response, always shifting weight to the other foot faster than, and without consulting seemingly rational thoughts. I jerk to the right but Liz supports me now, I do not fall, and so I begin to walk, more a hobble than walk, as I swing my right foot forward then balance on its point while rushing a step with my left foot, which moves normally. It is a slow, painful progression, evidence of how much I want to leave this room, this place, in silent determination. It is important to be quiet. For years I will believe that I am compelled by Lara to walk this distance, forced in pain to, but in fact this is all my own instigation, in fact the two women press me down to sit on the mat. I will stand up, they will press me down, I will stand up, I will disregard their solicitous words and offered help, I will do this the next time, the next again, repeating this until it is clear I will follow only my own agenda. I will walk away. I will prove that I do not need their help. I hobble silently forth, if there are words of argument against this intent I will not hear them. I do not need their help, I will walk, I will leave, where is unknown, anywhere else, somewhere else where I will recover all I lack Now that I had Before, the co-ordination, the communication, the complete freedom to run or dance as any desires encourage...
OK Michael, now slowly, slowly, Lara says, giving up trying to dissuade me.
The NCCU hallway is darker and there is nothing like the posters to focus on. Tiles covering the lower part of walls rise to eye-level. Corners of floor and wall are cut off with a slope of these sandy-brown tiles, with grouting white and clean. A red fire extinguisher and folded tubes with a brass nozzle beside it, is behind a glass door in a yellow metal panel. Metal fixtures, chrome hooks of various uses, some holding back curtains, plastic file holders with cards and clip-boards, jut out from walls below chest height. Nameplates I do not read are beside each doorway, faces that pass by I do not investigate, and everyone is no one. I stare blankly ahead, I see myself but of course I do not see what if anything I see. I am agitated and nervous. I see something, I see nothing, and I see but do not see. There is only simple hallway emptiness, emotional if not actual darkness, and glimpse of an occasional nurse tending another room. Other patients in the NCCU are out of sight, in wheelchairs or beds with groups of familiar yet fearful machines tending them, restrained by belts and served by many translucent tubes, looped from body to one of those chrome trees. Lara tells me I walk well, just not to rush, to be patient, to realize the severity of my injury, to understand how I need not do everything right at this moment, to accept this recovery as a process that might take years, to believe in tomorrow and the next day coming to my life, to be alive is always a gift. I do not hear her, I hear her, it makes no difference. I will walk away, I will escape, I do not need their help, and I say nothing. It is important to be quiet, it is important to devise some stealthy manner, it is important they cannot sense my intentions, that I do not betray my ultimate goals, that I wait for that moment they are distracted that will allow me to escape. Liz and Lara give no inkling of knowing my strategy, my goal, though it seems loud enough in my thoughts. I will walk away, I hear shouting in my head, I will walk away. My movement is not so jerky when she and Liz aid rather than stop me, and this seems encouragement for my escape. I am going to escape, so I come as near upright as my right foot allows, then my left foot goes forward and I start an awkward hobble down the hall, but of course this is no escape. I am furiously disappointed in my body that refuses the mind’s commands to escape. I lean to the right on Liz, use Lara for balancing on the left, and each careful step is painful in silence. I sweat and tremble and breathe harshly but will not stop to rest, will not allow their patient guidance to sit here, to stop, and to rest for just a second or two. I am convinced they are holding me back, so venture another move I name a ‘step’. After three of these 'steps' I adjust to lean less on Liz and gasp out a polite exclamation of pain.
OK Michael, now slowly, slowly, Lara says.
How far do you want to walk? Liz asks.
I pass the Physiotherapy posters, glossy paper printed in vibrant, new, pure colours. A number of intriguing shapes populate the lower third of the ‘key to independence’ poster but I do not stop to wonder what it means. I look ahead down the NCCU hall. I see myself but this is not what I see, when I return to research, when I discover how I had mistaken the distances and size of halls, when I had seen the world larger than it is, broader, taller, from the perspective of a wheelchair patient, and so I realize this is why my childhood world is larger in memory than when revisited. I had seen the world from a much lower perspective, and that emotional memory is retained and so even had I grown up there, the world would have always seemed larger. I will note this later, but at the time I am violently committed to walking, so I find a rhythm of motion and though each step is an ungainly process I move faster. I lean a little less on Liz. Each hobble, each 'step' does not alter my right foot being so extended, if I have not had Lara to guide and Liz to lean on I might have gone in circles, I might have not moved at all. Sudden pain is very great on each quick rest swinging the good leg forward, more so pain in that I do not understand it, but I do not wake, my face remains rigid and calm, and no words, no cries of pain, come from me. I concentrate on the floor two metres ahead. In awkward movements, in grotesque hobbling, in desperation, in mindless anger refusing to listen to pain, I walk faster. I throw my right side forward- not a smooth stride but a stabbing- again balance weight on the point of my right foot, and follow quickly with the left stride that is no longer because of the time I refuse of the pain. I have gone about ten metres when there is a short pause, and for a moment it seems the wheelchair might be called for- but I feverishly renew this ungainly dance to a music only I hear...
How far do you want to walk? Lara asks again.
Do you want to rest? Liz offers.
I wake from a trance, gaze about my s surroundings as if newly discovered, sandy-brown tiles, beige walls, brown highlights of wood, black plastic, aluminum chrome, green sheets, yellow curtains, and then look down. I look at random brown flecks on beige linoleum, searching for a pattern that is too minute for my surveillance, or is not there anyway. The ceiling is built of sound tiles. The nearest target I focus on is the nursing station twenty-five metres away. I pursue this goal with renewed intensity, hobbling roughly along the hall, as Lara and Liz remain silent and supportive. I have for many years the idea I was compelled by these others to walk this distance, but it is in fact my desire, my angry insistence that I walk, and when I later will use them as research sources they will laugh in correcting me. As if after this long hiatus, and now directed to the physical movement and not whatever writing or arts project, I am still convinced I must do everything right now. Both women, then, are surprised that I have this drive and energy to do all this now, this desperate moving, this angry hobbling, for this imagined escape from my disability, which only now do I begin to understand is impossible, is not violently described by each step, is not heard, is not dismissed, and is no more than if they knew in professional awareness can admire. Each metre is about three hobble-steps and so in seventy-five approximate repetitions of this injured choreography I am finally beside the nurses’ station...
I correct my posture and speak slowly, distinctly, as slurring allows.
I think I need my wheelchair, please.
Liz holds me upright while Lara returns to the Physiotherapy mat-room, and pushes the wheelchair to me, and both women share pleased smiles. With an exhausted sigh but an alert gaze, gingerly, tired but ready to walk again, I sit down. I am happy.
#
Coherent General Propositions
#-1 250 words
I recount here the theoretical perspective.
I am not a neurologist.
Theory is a «coherent group of general propositions used as principles of explanation for a class of phenomena», (2001- Random House Webster’s Unabridged Dictionary, Second Edition).
Theory is a term often wrongly used as dismissive, a common error which tentative and qualified certainty of most scientists does little to dispel, as evidence for the truth value is extreme. Theory is never proven, but only the inference that most ‘elegantly’ fits with all previous theory. Elegance is the quality of applying the Principle of Economy- that the simplest logical system that renders the evidence is nearest to the truth. I have faith in this method. I am impressed that argument and experiment can lead to logic previously unknown. Theory may be replaced, even when elevated to axiom, if another theory offers a more elegant incorporation of all previous theory and perhaps new or previously ignored evidence.
No one claims to know details of how the human mind comes out of 1.4 kg of soft, liquid tissue of brain, but there are theories through many years of investigation of physiology. We call this Neurology, the convictions elaborated that rely on certain core philosophical axioms such as validity of evolutionary theory as a guide to our human bodies. Brains of many mammals all follow the same development, suggesting the right patterns were reproduced, but as always those are only material evidence and not the process. Through our evolutionary heritage as only described and inferred by bones of ancestors over millions of years the primate braincase swells to our modern size of brain. As the unearthing of homo florensis suggests, not only the increased size of brain viewed as necessary to create tools that appear to lead to modern Homo sapiens, but also increases in connections, density, enfolding of tissue, and unfortunately soft tissue such as the cerebellum does not usually fossilize. Those prehistoric eons have left no evidence of recognizable effects of this, as only relatively recently, a few tens of thousands of years past through art and technology did we learn to draw pictures on cave walls, to create simple tools for cutting carcasses in absence of tearing teeth, to care for our dead by burying appropriate tools for afterlife hunts, then even more recently we humans learned to write. When someone argues that we cannot be descended from apes (actually the inference of natural selection is that we and apes have shared ancestry) because there are still apes, this is premature as it seems humans are in the process of eliminating them faster than any other causes of extinction, and this in thousands of years, not over millions of years. And in this tentative, contingent, conception of the brain- even closely watched by fMRI- there are only more discoveries of how complex and unknown are those aspects of the brain expressed in action.
Human brains are entirely neural tissue, a simple swelling in size and complexity of a vertebrate spinal cord. Its cells are known as neurons and a normal, healthy, human brain is composed of about two hundred-thousand cells of which as many as a trillion interconnections web them together. Each neuron, as each brain, is best seen as the result of millions of years of evolution- a theory that each and every positive mutation serves to further survivall of that living system, plant or animal, and thus its propagation until all descendants manifests that mutation. Brains may be described as machines but are rather more biological results from the original judgment that special neural cells were a useful mutation for bacterium such as E. coli. Pathways of special receptors communicated and responded to the environment in ways that were useful. Neurons are how these receptors developed, from the simplest segmented worm to the tubular architecture of all vertebrates, grouping, swelling, to create- many millions of years later- the brain that is reading this sentence. Theory of Evolution is the best inference several hundred years of biological science has come up with to explain this process of accumulated adaptations to our environment- which we are eagerly hurrying to despoil for all other forms of life, and perhaps to our form of life as well.
Brains are composed of neural tissue, cells composed of connecting branches- ‘dendrites’- of the hundred millions of a brain capable of a trillion pathways to receptors- ‘axons’- that receive input from all our senses, or generate those invisible, indefinite, endless effects of consciousness. Communication from senses to cells, cells to cells, in continuous spontaneous and automatic incidence that we humans use to understand and live within the world. We call this perhaps ‘sensing’, ‘thinking’, or ‘acting’, or ‘reacting’, in physical descriptions of minute electrical stimulus and emission and capture of resident chemical markers called ‘neurotransmitters’.
Research can be conducted on primate brains- monkeys- and paralleled with similar structures of human brains. Research is not extensive on human brains. Areas of the brain are labeled, through working on people who have suffered some localized brain injuries. Sensory areas. Motor areas. Integrative areas. Here hippocampus, here cerebellum, this ‘Broca’s area’ which when damaged results in inability to create grammatical language, that ‘Wernicke’s area’ which when damaged is unable to comprehend language, forth temporal lobe, back occipital lobe, there olfactory bulb: in our confident medical understanding each have specific functions. Healthy brains are also mapped by ‘positron emission tomography’ (seeing where glucose, as biological, brain-tissue energy, goes).
It is through decades of research we have learned these areas control these parts of body, on the opposite side; these areas hold abilities of memory, here short-term, here long-term; this area here seems to act as linking tissues, from right to left, left to right hemispheres; we talk of hemisphere-specific skills, of right-brain language skills, of left-brain spatial skills and then weight these according to predisposition by sex- the damage to language areas might be why this work seems more imagistic than plot; these nerve tissues allow one or the other hemisphere to act, to dominate, to express itself in language or instead in artistic images; this area- which might be most bruised- guides ‘gross-motor functions’, such as raising an arm, taking a step; these areas, this visual cortex- yes, from the coma he might emerge blind- these areas for sounds- he might emerge functionally deaf; neural tissue, brain tissue, are the same- ‘synapses’ we call them- here stimulus translates by electrical and chemical means across this neural gap…
It is not simply the force of insult- the brain bruising against wall of my cranium- that expresses injury, rather it is what came next in those minutes and hours and days: release of ‘free radicals’- ‘charged oxygen molecules- released by brain cells in response to injury, causing damage by disrupting cellular DNA and enzymes and altering plasma membrane permeability...’. Perhaps Doc could have explained it, but he had moved out to Vancouver and died years ago. I skim a current text recommended by a professor of Neuropsychology, and he suggest I return when I have read it, but I find it far too technical and never do complete it. I do not read many texts that might help me understand Neurology beyond this brief sketch offered.
I am alive. I am a lucky man.
#