Extreme Sports… Extreme Living… Extreme Dying

I’ve been thinking a lot about extreme sports and TBI, of late. Just this past week, Nodar Kumaritashvili, a Georgian luger, died on the Whistler track in Vancouver during an Olympic training run. I watched a graphic video of it on CBSnews.com, and it’s pretty wrenching. He lost his sled in a turn, flew off, and went into a pole.

I have heard it said that he was relativley inexperienced. I have also read that he told his father he was terrified of the track. And I’ve read discussion and debates about how lugers and other winter athletes know the risks, but they choose to focus on the goals, the rewards, the prizes that come from winning. If they give into fear or they hesitate, all may be lost.

At the same time, I’ve been reading a bit about Kevin Pearce, the snowboarder who sustained a traumatic brain injury on a halfpipe during a training run. ESPN’s headline seemed to downplay the injury — Pearce hurts head training on halfpipe. Other news told a more sobering story — critical condition… moved to a brain injury hospital in Denver, where he’s making better progress than expected, actually walking and responding.

Only folks who understand the impact of TBI — more than what many folks think of as “just a concussion”… more than “just” a bump on the head — will fully appreciate how much progress Pearce actually is making. Most folks may very well wonder what the big deal is. If Pearce is doing that well, yes, he is making amazing progress. It probably helps that he’s an athlete.

Over the past holidays, one of my nephews had a fall from about 6 feet up. He landed hard and was addled afterwards. I wasn’t there to see it happen. And everyone else who was there just let it slide. According to my nephew, he’s had about 12 concussions. He’s into extreme sports. He skateboards and is an all-out outdoor enthusiast. He’s a great kid — kind and soft-spoken and quite polite. His mom has done a great job with him, I have to say.

But I worry about him. I wonder about him. He’s fine now, but what about in the future?

I look back on myself at his age — 13 and rarin’ to go. Immortal, as far as I was concerned. Untroubled by hard falls and spills and being knocked silly, every now and then. I played hard and fast, and I didn’t follow instructions about being careful. That was for sissies. Wusses. I had a game to play, a goal to reach, and nothing — no timidity, no fear, no trepidation, no namby-pamby wuss — was going to hold me back.

And I think about the concussion prevention/management legislation that’s been proposed in multiple states — some of it requiring medical clearance before kids who have head injuries are allowed to play agan. I wonder what kind of an impact that’s going to have at all — if it may in fact cause more dangerous cases to go unnoticed. I can tell you from personal experience that when I was a kid,  if I thought I was going to be told to sit out a game I wanted with all my might to play, I either lied through my teeth to convice my coach that I was okay. If, that is, I even realized that I was having problems. A lot of times, I didn’t. Or, if I did, I ignored it and played through.

It’s really, really hard to explain what it’s like to get your bell rung in a game, and not be able to think well enough to protect yourself from further injury. It’s like, you know there’s something up, but you keep going, keep playing, keep pressing on. You don’t want anything to stop you, and sometimes the more your bell is run, the harder you push through.

You should sit down. You should rest. Part of you knows that. But there’s this other part that’s very go-go-go that gets jammed in gear and you can’t disengage. Even when there’s this little voice in the back of your head telling you that you need to take a break… that something’s not right… your coordination is off… you don’t have the same control you did, just a few minutes ago… still, you’re jammed in gear, and like the jammed accelerators in pre-recall cars, accidents can happen as a result. More accidents. Just when you least need them.

It’s a tricky, tricky thing, trying to stay safe when you’re just trying to play and have a good time. The Olympic athletes who sustain injuries (or are killed) during training runs… some folks would consider them foolhardy and blind to do the things they do. But when you’ve been pushing the limits, going faster, farther, higher, for years on end, you sharpen your taste for breaking records, pushing past limits…. and with each successive broken record, the bar is set higher. And higher. And higher.

It’s a wonder anyone survives at all, quite frankly.

But here’s the thing — all those stress hormones pumping through the body, all that adrenaline running in your veins, all the hype and pump and competition… they literally change you. They change your brain, they change your body. Just ask people with PTSD — a super-extreme version of what happens to you over years and years of intense extreme sports experiences. Your brain gets used to the pump. It craves it, actually. And if you’ve been marinating in that hormonal soup long enough — and have gotten plenty of rewards from pushing past your limits — pushing through till you’re breaking through becomes very much a part of your person.

And without it, you’re lost.

Literally. It’s not just some psychological “addiction” to the thrill that’s at work. It’s a fundamental, integral part of who and what you are — a piece of your puzzle that has to be fitted into place, in order for you to feel even remotely human. Someone who is at their best when they are pushing the envelope is going to continue to seek out those situations where they can push through, because they want to be at their best. Especially when they are an athlete — and a world class one at that. We athletes want to be the best we can be. We want to perform well. We need it. We crave it. We must have it. If we can’t get it, then who are we? Just another schmoe sitting in a cubicle, answering phones, or wearing an apron and telling people where they can find the plumbing supplies.

It’s not that the athletes (and other high-performers) of the world can’t deal with regular life. We just operate at a different level. And to get to that level, you need an element of risk to sharpen the senses. You need a bit of an edge. And if you don’t have it… can’t get it… then it’s not just your performance that suffers. It’s your very self, your very core, your very interior person, that suffers, as well.

It’s not just thrills we seek. It’s not just mindless risk that we’re addicted to. Those of us who are peak performers — whether athletes or stock brokers or CEOs or award-winning writers, scientists… whatevers — need a little extra something to stay on top. We needed it to get there, and we continue to need it to stay there. To do anything less than push past our personal best, is to fail to be the persons we are. Some of us turn to drugs. Some of us turn to foolhardy decisions. Some of us turn to adultery with easily recognized flings. Some of us bungee jump. But the need and the drive is the same — seeking the edge, so we can find ourselves. So we can be ourselves. So we can be more of who we have become over time, over years of progressively more advanced tests, and progressively higher risks.

Deathwish? No.

Lifewish – yes.

Now, I know my psychotherapist friends would argue this point with me. BUt you know what, none of them are — or ever have been — athletes. They are not particularly active, to begin with. Understanding what would cause someone to lie down on a small sled and hurtle downhill at 95 mph with just a helmet to protect them… or what would induce someone to snowboard high in the air and do flips and twists… well, that takes a certain kind of experience. Physical experience. Physically extreme experience. Now, I’ve never been attracted to extreme sports that involved fast speeds and heights (my balance has never been good enough for me to go there), but I do know what it’s like to push myself as hard as I could go for 3.2 miles… or around a track 8 times… or down the final stretch of an 800 meter race… or down a runway with a javelin in my hand. I do know what it’s like to practice in all kinds of weather and push through, no matter what. I also know what it’s like to lay it all on the line, time and time again… to reap the rewards of success… and to suck up the dregs of failure and start all over again — next time working all the harder.

It’s not about some psychological death wish. It’s not about having no sense of imminent danger. It’s not about any conscious thought process, other than focus on the end-goal, the prize, the medal, the reward. On some level, it’s not even a mental process at all. It’s a physical, spiritual, metaphysical process to which the mind must be subservient. And as such, there will always — for some of us — be an element of terrible risk… risk of immediate death or eventual debilitation.

And until people figure out how to get that “high” (that insulting slight of a term for what is a complex process) from a safe and secure place, there will always be mortal danger for the best of the best. We don’t just like that pump; we need it. We must have that rush that gets you thinking better, cogitating more clearly, and feeling like you’re alive again. Until people acknowledge this as a valid human need and figure out how to help us get it without putting our necks on the line, the only way to get that will be through more risk, chancier actions, and increasingly dire danger.

After all, if you can’t live fully without that biochemical pump, and you can’t stand how you feel without it, the prospect of being hurt — or dying — while marinating in that soup of fully alert humanity, probably seems worth the risk.

The force of habit

I didn’t want to exercise, when I got up this morning.

But I did it anyway.

I was feeling “gunked up” and sluggish and I have a lot to do. I didn’t want to spend the first half hour of my day riding the bike and lifting my 5 lb weights.

But I did it anyway.

And I’m glad I did.

I would like to say that I was able to follow through with my morning routine because I realize it is good for me, and I look forward to doing it every single day. But that would be untrue. Fact of the matter is, I’ve built this routine into my daily schedule so completely, that to veer from it or deviate in any way causes me intense anxiety. Its not so much high-minded intentions and enlightenment that gets me on the bike and stretching and lifting weights, first thing. Its the sheer force of  a strictly enforced habit.

A friend of mine tells me it takes six weeks for a habit to form. Well, I’ve been at this morning routine for nearly six months, and its so ingrained in me that doing something different is not a prospect I relish. I have a tendency to intense anxiety and nervousness — and I use that to my benefit, by creating positive, constructive structures which cause me intense anxiety if I deviate from them.

If you can’t get rid of your neuroses, you might as well put them to work for you. That’s what I did this morning. And I’m glad I did.

‘Cause now I feel a whole lot better. My sinuses have cleared, my body feels more awake, and I’m mentally much clearer.

Clear is good. I have a lot to get done today. It’s Sunday, and part of me feels like I should be taking it easy, as I had such a rough and long week, last week. But if I work this right and play my cards right, I can actually settle into what I’m doing and take it easy while I’m doing it.

Easy does it, say friends of mine. After hearing them say this for 20 years, it’s starting to sink in.

About time 😉

Anyway, this morning I realized I’ve run out of my pre-printed daily tracking forms, and I had to go back to writing things out by hand on scrap paper on my clipboard. In a way, I like this better. I’ve recently realized that the more stressed I am, the worse my handwriting is, so I can use that as a measure of how tweaked I am over things. Since being tweaked over things sets in motion a whole bunch of complications that set me off-track — I start to load up all sorts of extra activities on myself that do not need to be done — I’ve realized that I can gauge how well or how poorly I am doing, in general — and how well or how poorly I am likely to do through the course of the coming day  — by my handwriting.

Having a pre-printed form with lines on it that keeps me neat and tidy is actually a short-cut that keeps me from having to really focus in on my handwriting. It’s also a little bit of a crutch for me, as it structures my day for me and tells me what I’m supposed to do — and when. I’ve been very much in need of that kind of structure, for the past decades, and I’ve suffered with out it. Stuff just didn’t get done. It just didn’t. Important stuff. Stuff that I’m now paying the consequences of not finishing. And a lot of stuff got started and commitments got made that had no business ending up on my plate. Not having that structure, not having a consistent way to go about things, was — well — in some cases small-scale catastrophic.

But in the past couple of years, since I realized what havoc mTBI has played in my life, I have done a really focused and intensive job of ordering my life in a much more constructive way. I’ve created routines for myself specifically to strengthen and support the parts of me that need help. I’ve taken myself to task for lots of things that I messed up for no good reason, and I’ve taken steps to remedy them. I’ve really stepped up in many, many aspects of my life that used to either languish or fall by the wayside. And I’ve made tremendous strides in the past 18 months — largely because I suddenly realized that I had problems, and those problems needed to be solved.

Now I find myself not only able to follow through with the required activities I set for myself each day, but I’m also better able to manage the optional ones.  I’m also better at distinguishing which ones matter and which ones are wishful. I am better and not packing my plate full of things that “must” be done, and I’m better at deciding which ones are energy drains and not contributing to my overall progress.

It’s been a long time coming, but it’s finally starting to come together. And a key part of all of this has been the force of habit. Identifying what I’m going to do, and doing it religiously, each and every day without fail. The things that are important to me — like exercising — I do every single day. Without fail. At the same time, each and every day. Without fail. And it’s the daily aspect of it that I think really makes a difference.

Now, a lot of people say that you don’t have to exercise every single day, in order to get benefits. Well, I tried that, and in my case, if I don’t do my exercises each and every day, I end up forgetting about them, doing other things, and not doing them even once a week. Trust me – I’ve tried to do the “half-way” fitness routine, and it doesn’t work. So, I broke the cardinal rule of fitness and I do my workout every single morning.

No, I do not give myself time to “rest” between daily workouts. I do not give my body time to “catch up”. But I also don’t push myself really hard every single day that I exercise. Some days, I’ll put a little more into bike ride, pushing myself to work up a sweat. Or I’ll focus on more weights with my lifting, so I feel a little sore the next day. But I don’t give myself time off, because by this time exercise has become like any other daily activity — like eating a meal or sleeping. It’s just part of my daily routine. It’s just part of my life.

Force of habit to the rescue.

And now that I’ve got the exercise thing down — which still takes discipline and determination, some days, like today — I can extend that into other areas of my life. I’ve been giving a lot of thought to what I want my life to be like, on down the line, and I’ve been giving a lot of thought to what parts of my life now are contributing to making that a reality later. I’ve come to the realization that my neurological and physiological issues may never go away and I’m going to have to factor them in at every turn, but I’ve also proven to myself that I am capable of positive change, and if I follow certain steps and do so consistently, I can — and will — make the kinds of changes I need in my life.

I may not be able to get back the years and the money and the relationships which fell prey to my injury, but I can work towards building something new for myself which is a reflection of what capabilities I have, and what my character truly is.

Ultimately, for me, the real power of the force of habit is about it relieving me of the need to think through every single action I take. Developing good habits frees up valuable time and energy I would otherwise be spending considering the pros and cons of what I’m doing, getting my head around the reasons why I’m doing them, and convincing myself they’re worthwhile. Developing rock-solid habits around good activities and behaviors enables me to focus on the important stuff — the actual doing of the activities, not the constant thinking about them. Developing positive habits frees me from analysis paralysis, and it acts as a kind of artificial executive function that keeps things running smoothly, even as the thinking parts of me are noodling about how to go about things.

Set-in-stone habits take care of the What and Why, so I can focus on the How.

And that’s a good thing.

So, that being said, it’s time to come up with some more habits. It’s time to create some more structure around what I absolutely positively need to do, in order to get where I’m going. This morning I created my daily planning list without the benefit of a pre-printed form. And my day is progressing really well anyway.

Good, good, good… and more good.

The difference between concussion and mild traumatic brain injury

Follow these links for more writing (and thinking) about concussion vs. traumatic brain injury, including the reasons why I believe concussion and brain injury are two separate parts of an ongoing process. I also believe we should stop calling the whole process “concussion” and refer to it as Concussive Brain Injury, or CBI.

I’ve been reading up on University at Buffalo’s work with concussion rehabilitation, using regulated exercise to deal with post-concussive syndrome (or post-concussion syndrome).

I have to say, it’s probably the most exciting news I’ve come across in a while. With all the talk about the NFL’s new post-concussion guidelines (which may or may not make a difference), and the increasing awareness about head injuries, expecially mild traumatic brain injuries (MTBI), it gets a little depressing, thinking about all the people who are getting hit in the head and suffering for years as a result.

A lot of folks are talking about it being an epidemic, that concussions are no joking matter, and lots of people are getting on the helmet bandwagon (especially since Natasha Richardson died from a brain injury while skiing). Prevention is great. But concussion is all but unavoidable in sports — especially student athletics. It happens. All the time. Yet nobody seems to have come up with a reliable way of addressing it when it does happen. Aside from bed rest and taking it easy, suggests for howto deal with concussions/brain injury are few and far between.

We know concussions happen. We know head injuries are common. We know they can have serious long-term consequences. You can try to prevent them, but you can’t be successful 100% of the time. And if you do have a head injury, you have to be sidelined from your life/sport, with no guarantee that the “treatment” will actually work.

I was starting to get seriously depressed.

Then, suddenly, I was looking around the other day and I found that the University at Buffalo has been working with regulated exercise to treat — even heal — the after-effects of concussion. Post-concussive syndrome is, according to the definitions of Willer and Leddy (at UB),  “persistent symptoms of concussion past the period when the individual should have recovered (3 weeks)”. According to them, post-concussive syndrome “qualifies as mTBI.”

This is interesting. I have heard a lot of people say that concussion is an mTBI, and the two are interchangeable. I am not a doctor, and I don’t have medical training, so I can’t throw my hat in the ring on that debate. But it is interesting to me, that people distinguish between the two.

At the UB web page on concussion research, there are some interesting papers, and they do talk about the difference between concussion and mild TBI.

Here’s what they have to say in the paper Retest Reliability in Adolescents of a Computerized Neuropsychological Battery used to Assess Recovery from Concussion (bold is mine)

A recent review … of concussion and post concussion  syndrome provided a model for distinguishing concussion from mild traumatic brain injury (mTBI) and post concussion syndrome (PCS). The model uses the most commonly accepted definition of mTBI and the one proposed by the American Congress of Rehabilitation Medicine and the Centers for Disease Control: loss of consciousness for no more than 30 minutes or amnesia as a result of a mechanical force to the head, and a Glasgow Coma Score (GCS) of 13 to 15 …. The model also uses the most commonly accepted definition of concussion as established by the American Academy of Neurology (AAN): a trauma induced alteration of mental status that may or may not involve loss of consciousness …. Although not explicitly stated in the AAN definition, concussion is generally viewed as a transient state from which the individual will recover fully in a relatively short period of time …. In contrast, mTBI is viewed as a permanent alteration of brain function even though the individual with mTBI may appear asymptomatic. Post concussion syndrome was defined in the Willer and Leddy … model as persistent symptoms of concussion past the period when the individual should have recovered (3 weeks) and therefore qualifies as mTBI. Neuropsychological testing is often used to describe the impairment associated with mTBI and PCS and have done so with relative success ….

So, basically,

  • mTBI = a loss of consciousness for no more than 30 minutes or amnesia as a result of a mechanical force to the head, and a Glasgow Coma Score (GCS) of 13 to 15
  • Concussion = a trauma induced alteration of mental status that may or may not involve loss of consciousness; it’s a transient state from which the individual will recover fully in a relatively short period of time
  • Post concussion syndrome (PCS) = persistent symptoms of concussion past the period when the individual should have recovered (3 weeks)
  • PCS, due to its enduring nature, qualifies as mTBI

(Note: I think someone needs to fill in the gap about how PCS satisfies the criteria for mTBI,  if they require that there be some loss of consciousness or amnesia involved. How lasting effects qualifies based on these criteria puzzles me. But for the purposes of this discussion, I’ll let this slide.)

I find this really compelling information, and it helps me make more sense of the whole “concussion thing”. I know I’ve sustained a bunch of concussions in the course of my life, and I also know that I have been diagnosed with “Late effect of intracranial injury.” But I could never really distinguish between the mTBI vs. concussion. I actually thought — and had been told — that they’re the same thing.

But that never made much sense to me, because when I look around at me, and I read that “An estimated ten percent of all athletes participating in contact sports suffer a concussion each season” And that’s just athletes. Plenty of people fall down, too, or are in car accidents. I’m not entirely sure what to make of it. Apparently, hundreds of thousands of people sustain concussions each year, yet the general population doesn’t appear to be completely crippled by TBI (though some people I know would debate that 😉 ) How is it possible, that so many people are sustaining concussions, especially in their youth and/or in sports, yet we’re not all running around impaired?

Making the distinction between a concussion that is transient, and a concussion that turns into an mTBI makes all the sense in the world to me. It makes it possible distinguish between someone who’s experiencing short-term issues, and someone who needs to deal with a broader-spectrum and deeper set of challenges. And in doing so, it de-stigmatizes concussion (at least in my mind), by steering clear of the “concussion = brain injury = brain damage” concept, which could be quite debilitating to a youth who has hit their head while playing a sport they love.

There are tons of potential ramifications and implications from being able to state that concussion is not necessarily an enduring brain injury. I may write more about this later, but it requires more thought.

The other very hopeful piece of this is that, by saying concussion is not always followed by brain injury, you’re opening a window to addressing concussions promptly so they do not turn into mild traumatic brain injuries. This, to me, is key. It not only makes sense of the two different kinds of injuries, but it also establishes that it may in fact be possible to treat the concussion to prevent it from becoming a more serious, long-term injury — the “gift” that keeps on giving. And by understanding concussion and brain injury this way, you also up the ante and really infuse the topic of prompt treatment with urgency. If acting promptly to address concussion makes it possible to avoid a lasting brain injury, then it’s in everyone’s best interest to become familiar with and properly trained in the recognition and treatment of concussion.

In this case, if mTBI is only present if concussion symptoms persist, and there’s no guarantee that concussion will result in a lasting brain injury, then prompt recognition and action may save the day.

Now, I’m still noodling over the idea that subconcussive impacts can seriously affect the brain over the long term, which Malcom Gladwell talked about in his article “Offensive Play“. But I am still hopeful. Because while subconcussive impacts may affect the brain, it could be that the damage takes place when no action is taken to address the injuries when they happen. Again, I’m not a doctor or a qualified medical professional, but it seems to me that if actively treating concussion helps with the really obvious issues — as the University at Buffalo has shown it does (albeit on a fairly limited scale) — then it might just help repair lesser damage done.

It might. I only wish I had the medical and scientific background and credentials to be able to speak as an expert on this. But apparently expertise is no guarantee of being able to help out, when it comes to TBI. The vast majority of experts haven’t had the wherewithall to state definitively what can actually be done about brain injuries, let alone recommend specific action that works, and there are thousands upon thousands, if not millions, of people suffering, day in and day out (along with their loved ones and co-workers) with the after-effects of concussion and mild traumatic brain injury.

So, somebody’s got to take the lead in finding a solution… Or at the very least think about finding one. The folks in Buffalo are up to wonderful work, and I can only hope that more folks have the gumption to take their lead and do something about this wretched hidden epidemic of ours.

Now, I’m off to address my own issues of the day.

Concussion information

Here’s some concussion info:

Concussion Overview

The term concussion describes an injury to the brain resulting from an impact to the head. By definition, a concussion is not a life-threatening injury, but it can cause both short-term and long-term problems. A concussion results from a closed-head type of injury and does not include injuries in which there is bleeding under the skull or into the brain. Another type of brain injury must be present if bleeding is visible on a CT scan (CAT scan) of the brain.

  • A mild concussion may involve no loss of consciousness (feeling “dazed”) or a very brief loss of consciousness (being “knocked out”).
  • A severe concussion may involve prolonged loss of consciousness with a delayed return to normal.

Concussion Causes

A concussion can be caused by any significant blunt force trauma to the head such as a fall, a car accident, or being struck on the head with an object.

Concussion Symptoms

  • Loss of consciousness after any trauma to the head
  • Confusion
  • Headache
  • Nausea or vomiting
  • Blurred vision
  • Loss of short-term memory (you may not remember the actual injury and the events some time before or after the impact)
  • Perseverating (repeating the same thing over and over, despite being told the answer each time, for example, “Was I in an accident?”)

When to Seek Medical Care

Call the doctor about any of the following situations. The doctor will recommend home care, set up an appointment to see the patient, or send the patient to a hospital’s emergency department.

Go to an emergency department by ambulance in the following situations. For people with less severe injuries not requiring ambulance transport, a car may be taken to the hospital.

  • Severe head trauma, i.e., a fall from more than the height of the person or a hard fall onto a hard surface or object with resulting bleeding or laceration.
  • Any child that loses consciousness as the result of a head injury.
  • Prolonged loss of consciousness (longer than two minutes)
  • Any delayed loss of consciousness (for example, the injured person is knocked out only momentarily, then is awake and talking, then loses consciousness again)
  • Vomiting more than once
  • Confusion that does not go away quickly
  • Extreme drowsiness, weakness, or inability to walk
  • Severe headache
  • Loss of memory of the event (amnesia)
  • Perseverating (saying the same thing over and over)
  • Someone who takes warfarin (Coumadin) for a medical problem suffers and suffers a significant blow to the head.
  • If the person fails to regain consciousness after two minutes, or the injury is very severe even if two minutes have not passed, DO NOT move the person. Prevent movement of the neck, which may cause spinal injuries. If the person needs to vomit, carefully roll the person onto his or her side without turning the head. Call 911 immediately for help.

If you are unsure of the severity of the injury, take the person to the emergency department immediately.

Should an injured person be allowed to fall asleep? Many mistakenly believe it is important to keep people, especially children, awake after they have been struck on the head. Children are often more emotionally upset than they are physically injured after a minor fall. They will cry and appear distressed, but as the parent rushes them to the hospital, children may begin to calm down. Because they have expended a lot of physical and emotional energy crying, they will often want to fall asleep.

  • You do not need to keep the child awake. In many cases it may be helpful to the emergency doctor to be able to awaken the child who is now more calm and rested and will behave normally. This gives the doctor a better assessment of the severity of the head injury.
  • If, however, a child who was initially normal after a head injury cannot be awakened, or is extremely difficult to awaken, then the child may have a more serious head injury and should be evaluated by a doctor.

Read more…

All or nothing – for real

I have been looking at my notes from the past days, seeing what I’ve gotten accomplished, and what I haven’t.

There is a whole hell of a lot I have not gotten accomplished, that I have been promising myself I would. Some of the things I have not done are serious. They are job-related. Survival-related. Pay-related.

I cannot NOT do them. But that’s what I’ve been doing.

Not.

I’ve also been thinking about how long it took me to realize that my fall in 2004 had affected me the way it had. Some call it “denial.” Some call it a “cognitive blind spot.” I call it “not sinking in because I have so many other things to think about.” Things like stray distractions that come across my path that for some strange reason I cannot resist following. Like a mynah bird. Magpie me.

The really freaky thing is, I ‘got’ that my concussions as a kid had affected me tremendously, when I was young. The discipline problems. The meltdowns. The outbursts. The getting kicked out of class because I was too much of a handful and nobody knew what else to do with me. I also ‘got’ that the concussions of my childhood had affected my development and made it difficult for me to really function as a regular adult throughout most of my life. Certainly, I did a great impression on the surface, keeping a job (well, a series of jobs) and getting married and settling down and doing important things.

But nobody on the outside ever saw what went on inside. And very few people ever knew what living with me was really like.

The fact that my spouse has stood by me all these years is nothing short of a miracle.

Anyway, the reason I bring up my cluelessness about the impact of my fall in 2004, is that it’s the same kind of obliviousness that I now sense, around my work and the things I have let slide. It’s like I’ve been in this haze, this wandering-about fog, where my brain is busy thinking about everything except what it’s supposed to think about. And that happily distracted piece of me is quite content to not give much thought to my work.

But I must change this. Because focused attention is what helps restore my everyday function, one task at a time. I hate that I have to approach just about everything I do like some rehabilitation exercise, but I do. I just do. I have to make extra effort to get things started, and I have to make extra effort to stay on track, and I have to make extra effort to finish what I start.

I don’t like it. I hate it, in fact. But that’s how it is. That’s how it is with me.

So, I’ll make the extra effort.

And yes, I’ve decided to drop my shrink, once and for all, because they keep encouraging me to not work so hard, not be so hard on myself, not expect too much of myself.

That’s no way to recover. I need to recover, and not give up. I need to treat each and every day like a chance to recover some part of me I’ve lost — or am in danger of losing, if I don’t pay extra attention. I just can’t end up like the football players and other professional athletes who end up demented and/or dead long before their time, because they had no idea what they were doing to their brains, and they never found out what they could do to fix them — or probably ever realized that they needed to fix anything.

Enough of the blind spots. Enough of the denial. Enough of letting things slide and acting like that’s okay. I have to keep sharp. I don’t want to fade away. I don’t want to end up demented and dazed, because I was too dazed and/or lazy to put in the extra effort to keep my brain healthy and engaged.

I need to be healthy. I need to be engaged. Like the nuns in the Nun Study in “Aging With Grace” I need to keep disciplined and focused and not give in to my lazy streak… the streak in me and my broken brain that loves to wander around and follow whatever little distraction comes along. My brilliant mind knows better than to do that all the live-long day.

I must do better. Each and every day is an occupational therapy opportunity. I need to get back what I’ve lost – and make sure I don’t lose what I’ve worked so hard to get.

Crossing the river(s) when the bridge is washed out

I’ve been thinking a lot about how my brain developed over the course of my life, wondering if/how my early mtbi’s affected me.

I have to say, it’s a bit confounding. It’s hard to see where the differences between me and everybody else are just regular personality differences, and which ones could be related to my falls and accidents and the assault when I was eight. I’ve actually remembered more incidents, over the past few months, most notably an incident when I was in daycare as (I believe) a 4-year-old.

I don’t remember much — just climbing up some stairs when some of the older kids encouraged me to come play… then running and jumping a lot… and then lying on the ground, looking up at an older kid looking down at me… and one of the other kids running downstairs to tell the lady who watched us all that something was wrong… the lady coming at me, looming over me, checking me over… yelling at the big kids… lots and lots of yelling. I’m not sure if my parents ever found out that something happened, but I remember trying to get upstairs a few more times, but the lady who ran the place wouldn’t let me, which really made me mad! It was fun playing with the big kids. I didn’t want to be stuck downstairs with the “little peepies”. I wanted to run around and play with the big kids.

I think that I may have been kept downstairs because I was small for my age. A couple of my younger siblings were actually bigger than me, till I was about 12 years old and I started to grow. I was a little kid, so I think the lady who kept me probably told me to stay downstairs so I would be safe.

Clearly, that didn’t work. If memory serves — and there’s the distinct possibility that it doesn’t. At least, in this case. I was reading a book, lately, about how the brain doesn’t always store the information it’s exposed to. It’s not like a tape recorder or digicam. It doesn’t just take in everything it’s shown. And sometimes it “records” things that never happened. So, I could be wrong about this — yet more fiction about my life…

But I’ve felt for a long, long time that something bad happened to me when I was little — in day care — and I always had this faint memory lurking in the back of my mind. It’s always just been there, I just never paid any attention to it. But then, the other week, all of a sudden, I got this big Wham! of a hit of the sequence of events. Like all of a sudden, they “clicked” with me, and I could see it all happening in front of me, like it was yesterday.

Hmmmm…

I also remember falling down the stairs more than once when I was a kid — one time in particular, I went down and slid the whole way down the carpeted stairs, banging my head on them, one at a time. Similar to my fall in 2004, which anniversary is coming up soon, but when I was little, I hit just about all the stairs on my way down. I can still remember the feeling of my head bouncing off the stairs — bang-bang-bang-bang-bang-bang-bang-bang-bang-bang — and the dull fog that enveloped me when I got to the bottom.

Man, oh, man…

Well, anyway, I know that I have a long history of head traumas — plenty of them subconcussive, as I was a very rambunctious kid with a lot of energy but not quite as much balance… I was always biting off more than I could chew, energy and coordination-wise. So, I fell down a lot, hit my head a lot, ran into things a lot. I got banged up, bounced back up, and got back in the game. I was game. Totally. Always up for more. Just try and hold me back…

Sometimes, people were able to, like the lady who watched me when I was little. But most of the time, they weren’t.

I showed them. I could do it. I’d be up and at ’em in no time. Sure! I could do it!

Now, I’m dealing with the after-effects of my (sub)concussive childhood. And I’m wondering if the impacts over the years had a lot to do with how my brain developed. I have to say, although I have some complaints (who doesn’t, tho?) I’m pretty pleased with how flexible my thinking is, and how well I can perform, by and large. I tested very high in my neuropsych evaluation – high 90’s, percentile-wise. In my moments of self-satisfaction, I imagine I’m a genius or a savant of some kind. (Ha – yeah, right – when I figure out how to keep my study clean and get stuff done when I’m supposed to and make it to the train on time, then I’ll qualify). I have to say, though, I don’t have that many of those kinds of self-satisfied, self-congratulatory moments (I should be so lucky), so I try to savor the ones I have.

But anyway, back to the washed out bridge thing. I’ve heard head injury described as a shearing of fragile connections in the brain — the fine connectors get disconnected, sheared, frayed, and generally disrupted. Kind of like the frayed strings in my sweatpants when I was a kid and I wore my sweats to shreds. And the routes that normally connect the different parts of the brain end up having to re-route to find other ways to connect. And that’s where the fatigue comes from. And the constant restlessness. And the agitation. The brain has to work all the harder to do basic, regular stuff. It can do it, it just takes more effort. The ways that are usually used, the pathways that everybody else seems to have intact, don’t quite work the same for us.

So, we mtbi survivors have to find other ways to get down the neural pathways of our lives. We have to find other routes, when the highways and byways of our brains are washed out by the storms that take us by surprise. The traffic of our brains doesn’t stop — not as long as there is life in us. It just keeps coming and coming and going and going, and when it comes to a place in the road where a bridge used to be, or a paved portion is mising from a huge-ass virtual sinkhole that opened up under it, or there’s a huge fallen tree getting in the way, we — the traffic in our brains — have to find a different way of getting where we need to go.

And I think about all the times when I was a kid, feeling like I was so far behind, just struggling to keep up with what was going on around me, hassling and hassling and hassling over every little detail… all the while seeming to be fine, because I learned pretty early on to be stoic and not let on when I was having trouble — and anyway, I was a tough little kid who didn’t take shit from anyone — and I think about my brain and how hard it was working to put two and two together…

Man, I have to hand it to myself for not going crazy. Granted, I was a strange kid who went off on horrible tantrums, beat up on my siblings, and had all sorts of weird habits, like rubbing through the satin edge of my blanket because the feel of the satin between my fingers was the only thing that would calm me down enough at night to get to sleep… I won’t go into the hiding in dark corners and talking to myself for hours on end and tearing out clumps of my hair — that’s a tale for another time. But all that disturbance aside, I actually came out okay. And nobody I know seems to have noticed there was something really amiss with me.

Of course they didn’t. I learned a long time ago, to hide what goes in with me. In fact, it wasn’t until I realized I was several hundred thousand dollars poorer than I’d been three years before, and I couldn’t explain to myself exactly why or how or when that had happened, that I noticed there was something amiss with me.

Crazy.

Anyway, something must have worked, because here I am, relatively normal, as far as anyone else can tell, testing well, for the most part, in my evaluations, and able to hold down a job and advance my career. Maybe I’m just fooling myself and I’m in for a rude awakening, when I find out that I’m not nearly as competent as everyone else seems to think I am. Maybe I’ll crash and burn. Maybe I’ll self-destruct. I don’t plan to, and I don’t think I will, but you never know.

All I know is, all these years, whether because I’ve kept busy or just kept moving, I’ve been able to re-route my brain around lots of obstacles, and find other ways of getting where I need to go. I may have had all those falls and all those injuries, but if anyone is a testament to neuroplasticity, I am. I’m serious. All the crap that’s gone down in my life, and miraculously my brain has managed to adapt, grow, change, and not show up horribly deformed on my MRI or register more than slight abnormalities on my EEG. For all I’ve been through, for all the crap that’s been done to me, and the wrecks I’ve survived, I’m doing okay.

Even if the bridge is washed out in places, there’s plenty of territory to discover while I’m bushwhacking my way through the underbrush. And if I’ve learned anything from this life, it’s that if you just keep going and use your good sense and you don’t go out of your way to do genuinely stupid stuff, you can find your way back to a beaten path of some kind. It might not be the road you left, and it might not be the road you were looking for. But sometimes a detour is the best thing for us.

Just keep going.

Remembering how good it feels to move

Changing the cat’s litter box, last night, on a whim, I hoisted the 20-lb bag of litter and did 10 overhead presses, just for the feel of it. Pressing against the weight felt good, in a way I remembered from my youth. In high school, I was a thrower in track and field, and lifting heavy weights overhead was a regular part of our training.

To this day, I still have pretty well-developed upper body strength. It’s diminshed, over the past five years or so, since my fall down the stairs and my “decision” to quit going to the gym. But I still walk with a thrower’s posture — poised for action, and leading with my shoulders.

It feels good to move. I had forgotten that, over my years of post MTBI inactivity. I became intensely uncomfortable in public places, and I became almost agorophobic in ways. I also became a lot more sedentary, just sitting for hours, literally doing nothing. Strange, how that goes.

But in the past several months, since I started getting on the exercise bike and riding, I’ve rediscovered how good it feels to move. Just to exercise, to engage my muscles in motion. To feel the blood rushing through my veins, the breath quickening in my lungs. And sweat trickling down my torso — a feeling I had all but forgotten.

And when I spontaneously lifted that bag of litter over my head and did 10 quick presses, my muscles warmed with a welcome glow, and part of me remembered — I used to know how to do this. And I used to do it a lot.

It’s true. I did used to do it a lot. In the years before my fall in 2004, I was a regular at the gym, and the “extra” weight I carried was all muscle. My doctor would lecture me, when I got on the scales and they showed I was “over”, but when I rolled up my sleeve and flexed my bicep, they stopped complaining at me being 10 pounds “overweight”.

I haven’t seen that doctor in quite a few years. I’ve moved on. My new doctor has never seen me in peak physical condition, and they don’t know I’m capable of it.

But what nobody probably knows — or would guess from looking at me — is that my body responds extremely well to exercise, especially weight training. Perhaps it was my athletic youth that set the stage. Perhaps it’s just a genetic thing. My dad has always been lithe and athletic, and he’s pretty much kept in shape over the years, as his brothers and friends have all gone to pot. On my mom’s side, my grandfather is also wiry and fit, despite pushing 100 years of age. Now, the women on both sides of my family tend to be heavier, which is where I’ve been leaning. But as a kid, I always took after my dad’s looks and build, so I’m guessing (hoping) that once I get past this lumpish existence, I can restore at least some of that past grandeur. Not all of it, perhaps… no, wait — why not all of it? Why not go even farther? Why not get even more fit? When I was weight training regularly, I consciously held back from my workouts, not wanting to bulk up so much that I’d have to work like the dickens to maintain it over time. I know for a fact, I could have gotten even more fit, back then. Why not do it now?

Why not indeed?

Well, anyway, first things first — I need to ease into this, so I don’t injure myself right out of the gate. I’ll need to use lighter weights from the get-go, so my muscles can get re-acclimated to moving in that specialized way. I’ll need to make sure I do some light lifting on a regular basis, and ease into the heavier weights slowly but surely. And I’ll leave plenty of time for rest. If there’s one thing that knocks the stuffing out of weight-trainers and compromises the quality of their training, it’s lack of rest. And poor nutrition. In training, I’ll need to eat right — and have plenty of protein. Keep the carbs as complex as I can get them — but don’t eliminate them entirely. My brain needs to quality glucose. No sense in getting physically fit, if my brain suffers as a result!

Balance. It’s all about balance. And as a former thrower, I know all too well what improper balance can do to someone who’s handling very heavy weights. It’s a recipe for serious injury. I’ve already been injured — plenty of times. The last thing I need, is more.

So, onward and upward. Back to the movements. Back to the sensation. Back to the muscle and sweat and fitness.

Back…

Yesterday was a wash

… Just about.

I had carefully made up a list of all the things I needed to get done — I’m on deadline at work, and it’s vital that I get the things done that I started, and that I do them on time. But I never checked my list until about 3:30 p.m., and then it was too late to do a lot of it.

I was just exhausted from the weekend — lots of activity and staying out too late. It was fun at the time, but it took its toll. And the people I’m working with are not pleased.

I’ve just got to let it go. I can’t start out today feeling bad about yesterday. It’s a new day. And I also have to remember that I’m not the only one in my group who’s struggling with work, right now. We all are, pretty much. We’re a challenged bunch of people with divided attention, conflicting interests, and way too much going on in our lives, overall. We’re also getting used to working together in new ways. There’s old bad blood that keeps people stuck, and there’s new opportunity to move forward. Main thing is, keep moving forward. But yesterday that didn’t happen nearly as much or as well as it should have.

I have to do something about this. I have to get out in front of my tasks. I know better than to do this. But the part of me that was playing all weekend wanted to keep playing, so I ended up messing up some stuff — and feeling badly about it.

More than anything, what takes the biggest toll is the emotional stuff. Feeling badly about myself. Feeling badly about how I’m doing. Feeling incapable and incompetent. And then, even if I’m doing okay by most people’s standards, my performance is thrown off even more. Because I’m feeling badly about myself and my abilities.

But it’s a waste of time to feel badly. My brain is just different now, than it was before my fall in 2004. It just has different needs and inclinations, which I have to factor in and accommodate/adjust to, if I’m going to have the level of ability that I desire. If I’m going to accomplish what I set out to, I need to use my tools — my planner, my notebook, my to-do list.

And I need to have just enough things on my list to keep me moving, without overwhelming me.

The thing about lists, though, is that I have to keep all the items I have on my plate (short- and long-term) in front of me in some way. I have to keep all my priority items in plain view, or I just forget about them. Other people look at my list, and they get all freaked out.  They tell me “It’s too much!” But for me, it works. I don’t mind all that stuff in front of me. I’d rather have it there, than forget about it — which is what I’ve done in the past … only to remember that I’d forgotten things I seriously needed to remember.

Until I find a way to remember everything — or hire a secretary/executive assistant to do the remembering for me — the stuff I need to do eventually is going to stay on the list.

But back to yesterday. What did I do which didn’t work, that I can do differently today?

  1. I didn’t check my list, first thing in the a.m. — I’ve checked my list for today already, so I’m good with that.
  2. I got down on myself for falling behind — I’m not going to do that today… get down on myself. I’m going to try the best I can, and leave the rest to fate.
  3. I thought the whole problem was me — I know I’m not the only one having issues. It’s just that the other folks I work with are really good at covering up their shortcomings and problems, and so of course (since I’m very open about the areas where I am lagging), I end up looking like the one who’s bringing everyone down. Matter of fact, I’m not — in fact, one of the reasons I’m behind on my tasks is that the folks I’m working with made a total friggin’ mess of it before, and nobody bothered to sort it out, till I came along and said, “This will never do!”
  4. I didn’t take time to plan my day and catch myself up — Today I am taking the train to work, so I can read and prepare.
  5. I let myself lollygag around in the afternoon, when I was tired –– Today, I need to pace myself and do at least something in the p.m, when I hit my low point (as I always do). If I plan for my lull, and I do something like walk around the office or take a break away from my desk when I’m tapering off, I may have better luck. There is a common work area I can go to that’s far away from my desk — I’ll try going there today and see if the change of scenery helps.

These are just a few of the things I can do differently today. I already feel better.

No one has a clue how hard this is for me

Even I don’t, sometimes.

Seriously. I walk through my days, going about my regular business, living my life, interacting with people, doing what I do, making mistakes, making it right… working (hard) to keep up. And I do manage to keep up. Most of the time.

At least, that’s how it looks on the outside. I’ve learned, over years, to present in a certain way… to project a certain image… to do a passable job of fitting in, by mirroring the mannerisms and “social pacing” of people around me. And it works. I had to figure it out by trial-and-error, but I did eventually figure it out.

In my early childhood, when I was first learning about how to live outside my parents’ house — in school, especially — I had a very hard time fitting into my surroundings. My early grade-school years were rocky and rough, and I went through a lot of bullying and teasing and marginalization. I also had a very, very hard time dealing with academic requirements. I could pretty much get by, but it was — again — trial and error. I remember working so very, very hard to make my teachers happy… without fully understanding why they were asking me to learn certain things and complete certain lessons.

I think part of the problem was that, despite having a hard time keeping up with what was going on around me, I was ahead of the kids around me, subject-wise. I grew up in a family that valued education and spent a lot of time exploring the world of ideas. My parents were — and still are — very well read, and my grandparents were experts in their fields. I was well accustomed to sitting around talking about complex subjects… more comfortable doing that, in fact, than spending time playing with the kids around me.

And it was awkward. Very awkward for everyone. At least, I think it was. I didn’t understand my peers very well, and they didn’t seem to understand me at all. Or maybe my perceptions were skewed because of my TBIs — poor judgment, slowed information processing, and misperception of the actions and/or intentions of others are all hallmarks of TBI. Maybe everyone was fine with me; I just wasn’t fine with them (or myself).

Anyway, I don’t want to harp on all my difficulties. Let’s just say my childhood was somewhat challenging.

All that started to change, however, when I started getting connected with kids who were several years older than me. My family had moved to a new area, and we had started attending a new church. That church did not have a very large concentration of kids exactly my age — they were either several years older than me or several years younger. My parents talked to the youth director and managed to get me “in” with the older kids in the young adult youth group.

I really wasn’t sure about it, when I started. I was painfully shy — no, shy isn’t the word for it. I was completely out of my depth. All the boys and girls — young men and young women, actually — who were part of the youth group seemed so with it, so together, so … grown up. They seemed like they knew what everyone was saying when they talked, and they seemed to know how to act around other people.

I was amazed. I couldn’t for the life of me figure out how to initiate conversations that weren’t about some academic matter, and I sure as hell didn’t know how to keep a conversation going. I was petrified, the first months I hung out with the other kids. But fortunately, some of the most popular kids in the “gang” at church were second cousins of mine, and they knew me from family reunions. So, I was “in” with the crowd, even when I couldn’t manage to put two words together.

It would be really easy for me to focus on how challenging those years were for me. But I’d rather focus on how much I gained from meeting those challenges head-on, and learning from them. Those several years with the older kids — I spent about 3 years among kids who were several years my senior — taught me volumes about how to make my way in the world. By watching them and seeing how they interacted with others, I was able to model my behavior on something positive — and types of behavior that obviously worked. I watched the kids who were clearly popular and having a great time being alive, and I mirrored their words and actions. I’m sure I looked a bit spastic, at times, tagging along and clumsily imitating everyone at the start, but eventually I learned how to smooth it all out and “deliver a seamless presentation” of the kinds of behavior I saw other people using — that worked well for them in social situations.

I could tell things worked, if people laughed at jokes. I could tell things worked for them, if other people smiled when they approached. I could tell things were “clicking” socially, if everyone was relaxed and enjoying each others’ company. It probably sounds pretty remedial and basic, but that’s how I learned. And I learned pretty quickly, too — so long as I could be a part of the group, but still be able to withdraw, now and then, when I got overwhelmed. Because I was with kids who were some years older than me, I was able to get “special dispensation” because I was younger. I was “just a kid” so I was allowed to mess up, now and then. Not all the time, but they tended to cut me some slack, which was helpful.

The fact that all this took place in a church environment, where there were very strict rules about how you did and did not behave was very helpful also. All the boys were well-behaved, and all the girls kept to very high standards of behavior. Even though a lot of us eventually left the church and went our own ways, far from organized religion, the fact that there were clear guidelines in place for us to follow made it pretty straightforward for me to figure out how I should — and should not — behave around others. The kids who were ahead of me modeled acceptable behavior, and I followed their example. I was part of a “gang” — but the gang was all good Christian kids, so I had the benefit of being in a group of pressuring peers who pressured me in directions that did not lead towards drugs, alcohol, petty crime, and teen sex.  (That pressure took place in the other “gangs” I ran with, several years later, in school and at jobs I held.)

During those early teen years in the church youth group, I learned how to integrate socially through the various activities we had — Sunday School, prayer meetings, weeknight services, organized youth group activities, like trips and outings, Bible quiz team, and countless other get-togethers that were organized by the youth leaders. They really did have a good program, I realize in retrospect, and I benefitted from it a lot. Being able to be around kids who were older than me gave me license to just be who and what I was — a little dorky, a little geeky, gangly and awkward and prone to say dumb things that were out of context — and be accepted, anyway, because I was young. I don’t remember being stigmatized, probably because it was generally expected that I was supposed to be different — but that was because of my age, not because I was a queer little brain-damaged freak who couldn’t fit in with my peer group.

What a relief it was, to be allowed to be different! I had been battling against my social surroundings for years, but that had gotten me nowhere. And I mean, nowhere. Standing out as being different (which was my “default setting”), had resulted in a lot of bullying, ridicule, and general hardship for me. It had also not helped my academic performance or my general ability to get by in the world. But being able to hang out with kids who were not only older than me and showed me how to behave, but being given some leeway with how I behaved, totally took the pressure off.

I was finally able to relax, socially. And I was able to learn. I was able to pattern my demeanor after the most socially successful members of the youth group — the guys and gals who were the most capable, the most popular, the smartest, the most respected-by-adults. I’m sure I looked kind of dense, stumbling and bumbling my way after them. But you know what? No matter how dorky I looked around the older kids, when I was around my own peer group, those behaviors and mannerisms made me look a lot more mature than I felt. I didn’t need to understand exactly why someone would say certain things (like social pleasantries) or do certain things (like strike up a conversation with people you’ve never met before in your life). I only needed to understand how they did it, and that it worked for them… and perfect my impressions of the most socially successful people I knew.

Granted, my “performance” wasn’t always perfect, and there were a lot of false moves over the years that got me in trouble with older kids and teachers and other authority figures, but you know what? By practicing and practicing and practicing some more… observing carefully when others did things that made them look good… by rehearsing the “role” I wanted to play in the world in the privacy of my own bedroom, out in the woods where I could have some alone-time… by constantly checking and re-checking the results of what I’d done, learning my lessons and “taking my lumps” as I went, I was able to build a really compelling and convincing repertoire of social graces that have stood me in good staid.

Okay, so my parents were probably pretty concerned throughout the course of my life, when I’d spend hours just talking to myself. And I’m sure they’ve often wondered about me walking around having animated, in-depth conversations about topics I’m passionate about… with no one in particular. To this day, I still have extended animated converstions with myself when I’m alone or in the car driving. I do it — and have always done it — to work on my vocal pacing, my delivery, my presentation. I have a role to play in the world, and I know well enough (inside my own woolly head) how hard it can be for me to keep my act together. I get lost all too quickly, so I need to keep my composure skills up, and “running the lines” my life does it for me. This “regular life” stuff doesn’t come easily to me, so I have to work at it, work at it, work at it some more. All the time, whenever I get a chance.

Fortunately, I enjoy it, and when I’m having intense, protracted discussions with myself, pretending to talk to another person — breaking now and then to let “them” get a word in — I’m usually going on about something that captures and holds my interest. So it’s not work as much as it is effortful play. And it pays off.

In countless ways. Can I just tell you, the best validation of my efforts has been all these people telling me, over the course of the past year or so, that they never would have guessed I had a head injury, let alone half a dozen. It never would have occurred to them that I was anything less than perfectly normal. On the outside, then, my presentation is intact. And all my hard work has paid off. The countless hours I’ve spent analyzing my interactions with the world, checking and double-checking the results of my relating to others… the untold time I’ve spent carefully tweaking my demeanor during the course of converstaions… the tricks I’ve picked up about how to interact effectively with others… it’s all paid off. Big time.

Now there are some days, of course, when I feel a lot more like a fraud than I feel functional. I feel like I’m just walking through my days playing a role that has nothing to do with me. I’m sure a lot of people feel that way — especially as they age and start to examine their lives. But with me, it’s especially pronounced, because there are many, many times I say and do things without even thinking about them which don’t sound anything like me, or what interests me, or what I care about. There are times when I’ll get to the end of a conversation or a complex interaction with someone and realize that I have no idea what just happened — I wasn’t even personally involved in the interaction. I didn’t even say what I meant or thought or felt. I just mirrored that other person, without even knowing what I was mirroring. They thought for sure that I agreed with them wholeheartedly and was validating their point of view by repeating it back to them, but I was really just saying and doing the bare minimum to get in and out of the conversation without getting too turned around.

Indeed, this is the great pitfall of this approach, socially successful as it may be: that I can get swept up in a chain of events that I don’t agree with, don’t care about, don’t even want to participate in… because the action is moving a lot faster than my little brain is, and I’ve unconsciously mirrored everyone so well, that they enlisted my help and swept me into their grand designs without my ever consciously assenting to it. And they think that because I’m able to mirror them so well, I’ve consciously chosen the path they’re taking because I’m as totally into it as they are… But I haven’t deliberately chosen.  And I’m not totally into it. I’m totally into nothing more than just participating and navigating the situation successfully enough to not be found out as a head-injured dimwit.

It can be a problem. Especially when I try to slow down the action long enough to say, “Hey – I need a while to think this through before I get involved.” Slowing things down is terribly difficult for me, in the first place, because I tend to be highly impulsive and get swept up into the energy of things. I also hate feeling as slow as I am, and I hate feeling so friggin’ retarded — as in the literal meaning “to be delayed”, which is exactly what I am at times. I have developed an elaborate and effective cover/compensatory strategy for my limitations, and I like how I feel when I’m “under cover”. I like feeling whole and hale and hearty and fast and smooth and with it. I like feeling complete and well-integrated. But when I “buy my cover” and forget that it’s just that — well, things can break down pretty quickly.

I suppose it’s all a balancing act.  There’s no way I’m going to just dispense with my compensatory behaviors — why should I? Everyone needs a little cover, now and then, and plenty of people say “yes-yes-yes” while they’re trying to buy time to think things through on their own, in the privacy of their own heads. But I don’t want to fool myself into thinking that everything is perfectly alright, since I can present well, articulate, keep my act together in very controlled circumstances. I don’t want to fall into the habit of thinking that because I can function very well in a highly structured environment where I’m literally just mimicking people around me and able to perform well as a result, than I can duplicate that same level of effectiveness out on my own.

I’ve tried it, and it doesn’t work. I once thought that my on-the-job skills at my highly routinized, heavily project-managed 9-to-5 position at an established corporation would translate into the same level of effectiveness and success when I started my own company. But I was wrong, and that experiment ended very, very badly. I’m still picking up the pieces.

I once thought that because I saw other people conducting workshops and I understood the form and structure of them, that I could duplicate their efforts and do just as well. What happened was, I got 10 minutes into the workshop and lost control of the “flow” and ended up riding a wild bucking bronco of a workshop where everyone talked out of turn and wouldn’t stay on-topic — very similar to what happens inside my head when I’m tired and overwhelmed.

I once thought that because I had worked in financial services for many years, and I had a burning interest in financial planning, that I could and should become a financial planner. But I ended up enrolling in a program for a bunch of money and then was unable to even finish two of the six courses. I was also unable to get more than a C grade in the two tests I took. And I had no idea why! As so many times in my past, I actually forgot about the program for a while and wandered off to do other things… and it didn’t fully sink in that I was supposed to be working on it until I got a notice that I had all of six… then three months left to complete the 18-month course. It slipped my mind, for the most part… and I couldn’t finish the program. What could — and should — have been a simple matter for me turned out to be a whole lot more complicated than I thought it would be. And I was a whole lot less up to the task, than I had assumed.

I once thought that because I had worked with many different kinds of lawyers for many years, that I could read and analyze and understand important legal documents for my family, but I ended up really turned around and confused, and if it weren’t for the fact that I had a good lawyer waiting in the wings, I could have really screwed things up.

The wild thing was — I had gotten myself into all these messes at the urging of others around me. Others who were so very, very sure that I could handle myself perfectly well, that I was perfectly capable, that I was perfectly equipped to deal with all of this… who had no idea at the time (as I) that there were some serious neurological impairments holding me back. There weren’t a lot, but there were enough.

And as a result, I have danced on the edge of disaster repeatedly throughout the course of my adulthood — and I’m still running into instances where I overestimate my capabilities. They’re less and less pronounced, and I’m getting more acclimated to “quality controlling” my assumptions, but the risk still exists that I might overreach and not realize I need to take special care to compensate for my limits.

I suspect that these may be good examples of anosognosic hazard — having lacking self-awareness get in the way of living your life. I know that they’re good examples of how buying my own cover can get me into trouble.

The thing is, I don’t feel like being disabled, I don’t feel like being head-injured, I don’t feel like making special exceptions for myself. But when I don’t at least consider that my broken brain may be complicating my life needlessly… getting me into trouble, yet again… well, the feeling of being in hot water is far worse than the feeling of tending to my relatively few special needs.

I really, really hate having to consider how difficult some things are for me. I detest having to bumble and fumble and stumble my way through situations until I figure out how to handle them. I cannot stand having trouble with sequential steps and not being able to remember stuff that “should” come easily to me. Most of all, I hate the idea of revealing to others how hard I have to work to do the most basic of things, like getting up and going through my routine each morning, and actually getting to work on time. It’s embarrassing, it’s disconcerting, it’s a total downer. But that’s how it is.

And even if I don’t show it to everyone else, it’s important that I not lose sight of it inside my own head.

‘Cause you can’t fix something, if you don’t know it’s broken.

How severe was my injury when I was 8?

My parents are coming to visit me next weekend,and I’ve been thinking a lot about my earlier injuries and how they affected my childhood. How they affected my development, how they affected my interactions with people, how they affected my future. When I was seven, I fell down a flight of stairs and was very dazed and confused and wasn’t able to talk. And when I was eight, I was hit in the head with a rock and knocked out for a while. (I tell that story here.)

In the ensuing years of my childhood and youth, I had more injuries — concussions and falls. It was not uncommon for me, while playing, to fall hard and/or hit my head and get up a little dazed and confused… but keep playing. Just keep playing.

Now, concussions alone could account for a lot of the problems I had when I was a kid — problems understanding what people were saying to me, problems with distractability, problems with temper outbursts, problems with getting really turned around and confused… lots and lots of mood and behavioral problems that my parents handled with faith and prayer and lots of structure, rather than pharmaceuticals.

In retrospect, I think it really helped, when I was young.  The structure gave me a framework to live within, the faith gave me something bigger to hang onto, and prayer offered me a way to ask for help from a Higher Power when I couldn’t find the words or the means to ask for it from human beings. It was a pretty exacting way to live, though. My family was very religious, and my parents were very strict (at that time) about what was permitted and what was not… what was sinful and “worldly” and what they considered pleasing to the Lord.

But while that faith and prayer gave me a much-needed support system when I was young, when I entered my teen years, it backfired. As I grew older, I still had a hard time, cognitively and behaviorally speaking. The problem was, I wasn’t just having troubles at home, I was having troubles out in the world. Teen years are marked by increasing social activities outside the home, and I just didn’t do a very good job of handling myself. I was alternately shy… and openly rebellious. I was alternately a high achiever and a slacking ne’er do well. I did a lot of good and helpful things in my youth, including saving an elderly lady who was trapped when the open door of her car (it was not in park) rolled and pinned her leg to a very large object (I can’t remember what it was, but she was pinned, and the metal of the door cut into her leg — I can still recall the sight of the inside of her fleshy thigh cut open — I guess my brain selectively records images). But I also sold drugs and bought liquor underage and distributed it to friends. I wasn’t a big-time criminal, but my later youth was marked by a lot of the warning-sign activities of criminals in the making.

Jekyll and Hyde… or head injury? Given the number of injuries I’ve had over the years, and the fact that a lot of my rebellious and “alternative” behavior was directly connected with an internal storm of confusion and agitation and rage that never disappeared, only subsided a little, I think the latter applies.

Okay, so all that being said, I have been wondering a lot, lately, just how severely I was injured when I was 8. I was knocked out with a rock thrown by some kids who didn’t like my looks and had been taunting and teasing me and my sibling from a distance. We didn’t respond, and they started to throw rocks. My sibling wanted to leave, but I said “NO, we’re staying right here.” I still feel awful about it; they could have been injured, instead of me. But I was hard-headed and stubborn, and I didn’t want anyone to chase me away from doing what I was doing.

Anyway, after a number of rocks landed closer and closer to us, one clocked me on the head. I recall feeling a dull-sharp impact and thinking, “What was that…?” and then I went down.

The next thing I remember, I was looking up and my sibling was hovering over me, crying, with tears streaming down their face. I was woozy and wobbly and at first I wanted to stay and keep playing, but they were so upset, I realized I couldn’t keep us there. I was also not feeling so great, and they led me home to my parents, who had me lie down on the couch while they called a friend who was a nurse, to find out what to do. I didn’t want to do what they told me to — I didn’t want to lie down, I didn’t want to hold still, I wanted to either get up and move around or go to sleep. I remember trying to sleep, but they kept me awake. I seem to recall being really tired, but also kind of punchy and agitated and restless. Eventually, as I recall, after checking my eyes with a flashlight a number of times, they let me get up and move around. And my life went on.

When I think back on that time, it seems to me that it was a pretty serious deal – but I’m not sure how aware of it my parents were.  Or anyone was, for that matter. And when I think back, I honestly can’t say how long I was knocked out for. I might have been out for a few seconds, a few minutes, even an hour or more. It’s impossible to say. My sibling can’t recall the event clearly, so I can only guess at how long it was.

And up till recently, I’ve been thinking I was out cold for a relatively short time. But it could have been longer. I can’t recall the kids who attacked us being in the field when I came to — I can’t recall how the light of the day was, and I’m not sure if my parents were concerned about my sibling and me being out longer than we should have been.

But to be accurate, there is a chance that I was knocked out for longer than a few minutes. It could have been much longer. And from what I understand, the length of unconciousness is an indicator of the severity of an injury, which can also be an indicator of long-term problems. Given the level of difficulty I had when I was a kid — particularly during and after 3rd grade… from that point on, life was one big obstacle course for me — I have to wonder if maybe I wasn’t injured worse than I thought I have been thinking I was.

I need to do some more research on this… It could be a good thing to learn. And I think it might help me talk to my parents about my childhood. Because despite learning a lot and putting a lot of things together over the past year and a half, I haven’t yet discussed my TBIs with them. I haven’t discussed them with anyone in my family. But next weekend, I think that’s going to change.

Figuring out how to talk to my parents about my childhood TBIs is actually one of the big action items on my plate, these days (in addition to working like a mad person to keep my job and keep up with my work… organizing my study in a way that helps me, not hinders me… clearing out old files and projects that were artifacts of TBI-induced agitation, rather than being something that would ever bear fruit… and tending to my marriage and home life). My folks have been saying for years that they can’t figure out what they did wrong to make me so unhappy when I was little. They can’t  figure out why I took so many wrong turns.  They can’t understand why I was so angry and rammy and difficult — what did they do wrong?

I have to tell them, it wasn’t them that caused the bulk of my many issues. It was TBIs. Getting hit on the head. Hard. And at an early enough age that it sheared and skewed the connections in my developing brain so it couldn’t develop “normally,” no matter what they tried. I have to tell them it wasn’t all their fault, and that all things considered, they actually helped more than they hurt.

For all their flaws, for all the things they might have done differently, my parents did create a home where I was able to develop habits of self-inspection and introspective reflection. They created a very structured and well-organized environment in which I could safely do things like paint and draw and write stories and express myself and learn things and be my own unique (and sometimes very weird) self. Certainly, it might have been helpful, if they had taken my shortcomings into consideration more and not overwhelmed me constantly with so much friggin’ input (my mother has always been a manic force of nature, God love her). But the fact that I’m still here, still standing, still able to keep motoring on, despite pain and agitation and confusion and generally feeling like I live my life in the dark and have to just bumble/stumble through a lot of things the first time, before I figure out how the heck to do stuff… Well, I have my parents to thank for that.

Even if my TBI at age 8 was more than mild — even if it was moderate — they raised me in a way that made it possible to keep going, keep moving, keep making my life the best that it could be.

And for that I am eternally grateful.

Now, I have to figure out a way to tell them, when they come to visit. I don’t think I could live with myself if I didn’t.