Embracing Hope After Traumatic Brain Injury

Finding Eden

Michael S. Arthur

• Publisher: Routledge
• Year: 2022
• ISBN:
  9781000540178
• Edition: 1
• Topic: Medicine
• Subtopic: Medicine Biographies

This important book provides a firsthand accountof a university professor who experienced traumatic brain injury. It tells the story of Michael Arthur, who had recently accepted a position as vice principal of a new high school. After only two weeks on the job, he was involved in a car accident while driving through an intersection in northern Utah.

Through his personal account, he takes the reader into the dark interworkings of his mind as he tries to cope with his new reality. He provides insight into how he learned how to process information and even speak without stumbling on his words while also sharing how his significant relationships suffered as he tried to navigate the restless seas of doubt while trying to circumvent his unyielding symptoms.

The book is about finding optimism and gaining insight into the struggles of the brain-injured patient and about trying to understand the perspectives of lovedones who can't quite grasp the idea of an invisible injury. From the sudden onset of garbled speech to the challenges of processing information, the changing dynamic of the author's life is highlighted to help family members and healthcare workers better understand.

1A Moment in Time

10.4324/9781003216056-1

Introduction

On the weekend before the accident, our visit to the mountain town of Eden seemed metaphoric on how we were feeling. We had entered a special place, and it was a garden of possibilities. Eden sat in the hill country lying between the north and middle fork of the Ogden River and was home to the Powder Mountain Ski Resort. With the higher elevation and a peaceful lake off in the distance, the small town provided the perfect getaway for falling in love all over again. We strolled a quiet street near an old general store as a gentle breeze rustled the trees and nudged our conversation toward dreams about the future.

We approached a historic building and found a large unlocked door. Most businesses in Utah were closed on Sundays, so we were careful as we entered a smallish-sized room. To our surprise, there was a fully stocked coffee bar with a barista who politely welcomed us in. She had a pleasant smile and didn’t say much as we studied the menu behind her. We ordered two lattes and waited as she worked her magic. The drinks were gently crafted and handed to us with the same attention to detail. “That’s on the house,” she said softly. Noticing us taken aback, she explained that the business was actually closed and she had simply forgotten to lock the door but was happy to serve us.

The small-town barista represented so many people we’d met in Utah. Most were kind, attentive, and caring. This, too, was adding to our confidence about our new life in this Western US state. I had accepted a position as vice principal of a high school just outside of Ogden. The state of Oregon was our home for many years, but Utah offered more than just a new career. Its awe-inspiring Wasatch Mountains were unfathomable. They exemplified the handiwork of creative genius and spoke their own special language. It wasn’t a known dialect but uniquely clear and beautiful.

On the morning of the accident, I had just completed another training for my new position and was making my way across town. As I drove toward that infamous intersection, I noticed a 1940s craftsman-style home that sat on the corner of 30th and Wall. I’ve always admired the architects of yesteryear and how they toiled working at drafting tables before the dawn of computer-aided design. This particular home sat proud for close to a hundred years but was beginning to show its age. It wasn’t the house that encroached the intersection; it was the other way around. The city grew, and so did many of its roads. Unfortunately, the front of the house was positioned very close to the street, obstructing the view for drivers headed eastbound.

As I approached the intersection, the historic home sat immediately to my left, and green lights were just ahead. Nothing seemed out of the ordinary. I’ve always considered myself a defensive driver and was aware the home created a barrier. It’s the risk drivers have to take. This was the case with the home sitting so close to the street; I simply couldn’t see the cross traffic and trusted that things would be fine. After all, they’ve always been fine before. In all my years of driving, I have never witnessed a car blow through a red light and slam into another vehicle. And I had certainly never been involved in that type of collision myself.

I sensed that something was amiss as my car first crossed into the intersection. Through my periphery, I noticed something was out of place. I had just enough time to turn my head ever so slightly, moving my eyes even more. That’s when I saw her face. She had a look of confusion but never pressed her brakes. She seemed in another world and not taking into account the brevity of the moment. Although I don’t remember every detail of the accident, it still comes to my mind. I’ve even sat up quickly in the midst of a nightmare, sensing her car rushing toward me. It’s always the same scene, her vehicle about to hit mine. That’s what I remember most, that brief moment before the accident and bracing for the unknown.

In that very brief moment before the crash, I don’t remember being afraid. Everything seemed in living color and hyper-sensitized. I quickly gripped the steering wheel and braced for impact, no matter what that would entail. There wasn’t time for fight or flight. There wasn’t time to think about my spouse, family, or friends. There certainly wasn’t time to call out to God. There was only the immediate circumstance, and I needed to hold on tight. There was an opposing vehicle traveling at full speed, and it was about to hit me. It wouldn’t be making contact with the front or rear portions of my car. The vehicle blowing through the intersection was laser-focused at the center of my vehicle and body.

Life has its seasons, and trials can press down hard beyond measure. King Solomon concluded there are times and seasons for everything under heaven. There is a time for weeping and a time for laughing. A time to be silent and a time to speak. There is a time to mourn and a time to dance (The Holy Bible, New International Version [NIV], 1973/2011, Ecclesiastes 3). Everyone experiences the dichotomies of life. No one is exempt from the highs or the lows. The healthy and the not so healthy. Each of us has our own journey, and even car accidents are unique with their own circumstance and outcome. And this was the case in our experience. We had embraced Eden in all of her glory. She was within our reach, and we were ready. It was our determination that a new day had begun in our lives, but we didn’t know what lay just ahead.

I remember there was silence for a moment as smoke came through the dash in front of me. The airbags had all deployed, as well, adding to the dramatic scene. After that brief moment of quiet, it was as though a stagehand had moved up the volume, ever so steadily. My heart started to pound harder as I pressed into the door with my shoulder, trying to escape. It was jammed. I quickly crawled over the center console to the passenger door and threw it open. I crawled through the space and stood just outside in disbelief. I had just experienced a serious traffic accident, even being T-boned in my driver’s door, and I was alive and standing on the street.

This was not supposed to be part of our Eden experience. When we walked the road in that breathtaking mountain town just two days prior, we were over the moon in our imaginations. We were hopeful and optimistic. Life has challenges, but we did that already. In a seemingly short period of time, we had lost loved ones. We had been sick and suffered financial setbacks. It was assuredly our turn for Eden. I remember whispering my prayer before we even departed for Utah. I asked for a time of respite by the still waters spoken of in the Psalms. I made these verses my hope as we left the West Coast and sincerely believed it was our time for something special and new.

After pulling myself from the car, I stood for a minute on the street and took in the scene. There was still smoke coming from my car though it was now faint. It was another surreal movie scene with all characters in place waiting for the director’s cue. However, I would not play the protagonist this time but the victim. I was the unsuspecting person instantly removed from his normal way of life for something much different. I wasn’t able to see the person who ran the red light, but I could see her vehicle. I also noticed a third vehicle involved in the accident as a man ran toward me to let me know he had called for help. Then, right on cue, as the surreal experience would dictate, I heard the distant sounds of emergency vehicles on their way.

The day was long, but we gathered our emotions and were thankful that I was not hurt badly or even killed. One of the officers at the scene stopped by the hospital to ask some questions. He was surprised to see that I was no worse for wear, given the condition of the other vehicles involved in the crash. We were surprised too. In fact, other than feeling like I had just collided with a football player, I felt OK. I mulled the accident in my mind over and over: I had a green light and was driving through the intersection. There was a historic home blocking my view. A vehicle ran through a red light and slammed into mine. It was a direct hit. I was T-boned at full speed and had no real injuries to show for it. These were my thoughts for days to come.

Tragic events have a way of instilling retrospection in the soul. On the day following my accident, I waxed philosophical as we drove past the state capitol building. Somehow, the grandeur of the structure and my recent near-death experience prompted me toward a conversation about life and its brevity and ultimate significance. This was the backdrop during my first encounter with what could be referred to as a brain-mouth disconnect. When I tried to speak, my words became garbled and unintelligible. I remember pointing toward the architecture as I tried to make my point, but it was the precise moment I fumbled every word. It was a nerve-racking experience that prompted us to call our doctor right away.

When I was a teenager, I had the opportunity to visit my good friend who lived in a big city, about five hours from my home. David Johnston had a great sense of humor and was always at the top of his class. I spent a week with him at his folks’ house over one summer break. On a Saturday night, we decided to take a stroll to the nearest convenience store. We thought ourselves highly advanced linguists and loved to make up silly words, like “sweave,” a combination of “swerve” and “weave.” While maybe not the usual sort of fun for teens barely 16 years old, it was important to us. We spent countless hours twisting the English language to fit our ideas on how the world should communicate. Being able to articulate well was important to David and me. Not that we would ever attain the eloquence of William Shakespeare, but it was our lofty goal. When I think back to that night, David and I laughed so hard, we cried; it was all related to word usage. And now that my words were escaping me, it was a very big deal. Word retrieval, or word finding, is one of the common challenges for people who’ve suffered specific types of brain injury. Especially if one is injured while driving a vehicle, it’s the left hemisphere or the frontal and temporal lobes that are commonly affected. I would later learn that when patients like me have trouble speaking, it’s because that specific part of the head has been hurt.

The loss of intelligible words was the first sign that I might have been hurt worse than originally thought. My word finding wasn’t merely a brief experience that came and went like the kurinji shrub of south India. The stumbling became increasingly common over the coming weeks and months. It was a disconcerting experience that permeated our concerns and gave rise to a growing list of questions, such as the following: If I did have a “mild” TBI, or concussion, how long would it last? If most football players recover quickly from concussions, would I do the same? Why do I stumble on my words and most football players don’t? Can a person die from a “mild” TBI? What happens if someone sustains a second concussion not long after the first? Are medications available that help with the speech? How soon would I be able to return to full-time work?

Still not knowing much about my injury, the symptoms became increasingly noticeable as time moved on. I was having unbearable headaches, which one healthcare worker referred to as nothing more than a migraine that may or may not be attributed to the accident. I left the appointment even more confused than before. I knew intuitively that the pain I was experiencing, which began just hours after the accident, was a direct result of the crash. I wondered why someone would make such a statement. Even if it were true, it wouldn’t be helpful to a patient experiencing multiple symptoms immediately following a traumatic event. Unfortunately, most of my questions remained unanswered for several months after the accident. Through my own research and experience, I now know that my response was common among individuals who’ve experienced a traumatic event. It simply takes time, research, and advice from a good medical team to become more familiar with head injuries and how to respond.

TBIs, even those classified as “mild,” have the potential to bring about a great many concerns for the patient. And depending on the mechanism of injury even a mild TBI, can be time-consuming and difficult to treat. Researchers at Monash University Accident Research Center in Melbourne found that side-impact car crashes, such as the one I experienced, tend to have more devastating effects on the human body than any other type of vehicle crash (2020). That’s not to overstate this type of accident above a head-on collision or rollover, only that when a vehicle is broadsided at full speed or even slower than full speed, the consequences can be devastating to the occupants within the broadsided vehicle.

I was eventually diagnosed as having a mild TBI. Unfortunately, the word use of “mild” often causes confusion among employers, fellow workers, schoolteachers, administrators, and others who might have a vested interest in your well-being. The symptoms and long-term consequences of a “mild” TBI can be anything but mild or inconsequential. In my case, in addition to severe headaches, I was experiencing pressure near my temporal areas and across my forehead. I was also experiencing difficulty concentrating and had some short-term memory issues.

In the early months following my accident, I learned the importance of assembling a team of medical professionals who specialize in TBIs. This point became especially clear after I experienced a horrible reaction to a specific medication. As directed, I took the prescription just before going to bed, and everything seemed fine as I slipped into a sound sleep. Then, just after midnight, I began to wake and slowly opened my eyes. Something wasn’t right. I turned my head and looked about the room as the nightlight illumined buckling lines and moving walls. The room was still mostly dark, but I could make out its walls and how they were now dancing out of rhythm. No longer did the floor, walls, or ceiling retain their submissive roles. They were now encroaching upon each other and moving desperately about the room. I was scared out of my mind and quickly made my way to the living area.

My heart was racing as the living room walls began to close in on me. I quickly paced the floor, back and forth. My skin felt clammy and warm. The walls continued their march toward me, closer and closer. I literally wanted to die at that moment because my perception of reality was out of control. It’s as though I couldn’t control my thoughts. They were rampant and doing their own thing, not making sense in my head. Every time I tried to create or control a thought, it escaped into a vapor. My heart pounded ever faster and faster. And when I felt the cliff getting ever so close, I ran back to my wife, who drove me to a nearby hospital emergency room.

My response to the medication is difficult to describe and more frightening than anything I had ever experienced. I don’t place blame on the doctor who prescribed the medication, but I was determined, more than ever, to assemble a medical team specifically trained in head trauma. Postconcussion syndrome (PCS) can be highly disruptive to a person’s life, and it certainly has been in mine. When we walked the awe-inspiring town of Eden just before the accident, we were hopeful. Eden, with her rolling hills and gentle spirit, became our symbol of a better day. She was where we would reside in our hearts and became our metaphor of hope. It was our turn to let the embers of life cool as we sat by the quiet waters of restoration. This was our conversation as we strolled Eden’s picturesque landscape, but an accident just two days later set us on a new and unexpected course.

A hopeful heart can become your reality even if you’ve suffered a TBI and the PCS that can follow. The days might be dark and gloomy, but it’s the sunrise that keeps us going. The darkness won’t overcome those who embrace that life has its seasons, and winter doesn’t stay around forever. Beyond the post-concussion symptoms, there is still the warmth of a rising sun with its majesty and message of another day. In time, its rays will penetrate our imaginations and teach us the meaning of hopefulness. It is in that place that one finds stillness and peace. For it’s in that quiet place where the soul can truly be restored.

Eden has mostly remained a garden of hope for me in spite of my accident on that autumn afternoon in northern Utah. But there are days when the symptoms press in harder and harder, and hope seems to fade into an abyss of fear and doubt. When I’ve struggled, Eden, in all her glory, escapes me and is nowhere to be found. J. M. Coetzee’s translation of Ina Rousseau’s poem, “Somewhere in Eden,” describes a very special garden also distant from her original purpose:

Somewhere in Eden, after all this time,
does there still stand, abandoned, like
a ruined city, gates sealed with grisly nails,
the luckless garden?

Is sultry day still followed there
by sultry dusk, sultry night,
where on the branches sallow and purple
the fruit hangs rotting?

Is there still, underground,
spreading like lace among the rocks
a network of unexploited lodes,
onyx and gold?

Through the lush greenery
their wash echoing afar
do there still flow the four glassy streams
of which no mortal drinks?

Somewhere in Eden, after all this time,
does there still stand, like a city in ruins,
forsaken, doomed to slow decay,
the failed garden?

As our light of hope seemed to fade behind the Wasatch Mountains, we finally determined that the beautiful state of Utah might not be our final destination. We needed another “new beginning,” a place where our little family could not only start over but flourish. As my wife had done in previous years, she encouraged a move to her former home in the southern United States. As a young resident of Texas, she experienced the wide-open spaces and hospitality the ...