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Anne Lagamayo | Longreads | May 11, 2023 | 4,252 words (15 minutes)
Don’t drive when it snows.
Okay, that’s not realistic, so it’s really more like: Always check the weather before you go on a four-hour road trip in the dead of winter to see your friend Jen in Bend, Oregon, during the height of the pandemic.
But let’s rewind a bit, since there were other ways to die on this long journey to reach Jen. You first flew across the country from New York to Oregon. You could have died then, too, gambling with your life with that five-hour flight, breathing the same stuffy plane air as everyone else.
Remember when you were advised to stay at least six feet away from people, or else risk getting COVID? Then possibly dying? That four-hour car ride on the final leg of your trip, then, was both a foolish and fitting thing to do.
Because it’s on this drive from the coast of Oregon to Bend that your car slips on the snow and crashes into the highway barrier. You find out later — see, this is why you should always check the weather before you drive — that that day was the first heavy snowfall of the season, and you’re in one of many car accidents around town, just half an hour away from Jen and her husband, who put all their belongings in storage and decided to rent an Airbnb in town indefinitely. (People did that during the pandemic, in that uncertain time between the fear of succumbing to the disease and the boredom of staying at home.)
You have photos of this carnage and general mayhem and, much later — after all this is more or less over — gleefully show them to people who ask, while watching kind of sadistically as they squirm and wince and gravely tell you they’re glad you’re alive.
Designate someone you trust as an emergency contact.
Especially if your family is in the Philippines, a few thousand miles away. In this case, your emergency contact is your roommate Miya, who’s back in New York. You’ve never thought about how the police identify people in a car accident, especially if the victim is from out of town, and you’re impressed by the lengths everyone goes through just to call Jen, who’s the only person you know in Bend.
Here’s how they identify you:
Remember you’re 32 years old.
It’s usually hard to forget how many years you’ve been in this world, but after you wake up in the hospital a good week after the accident, you turn to Jen and ask for confirmation. I’m 32, right?
By this time, your doctor has told you about your traumatic brain injury. Just to be sure you get it, your nurses and all six of your speech, occupational, and physical therapists repeat that you have diffuse axonal injury, or your brain was jiggled so hard inside your head during the crash that a lot of connecting nerve tissues were torn. You always get stuck on the medical term “jiggle.”
Some symptoms include: completely forgetting how to upload a video on Instagram. You know how to record one — you’ve filmed yourself six different ways lying in your hospital bed, the TV on but muted in the background, colors reflecting on the planes of your face, while saying in a death-warmed-over voice, Hi everyone, I’m alive but I have a trau-ma-tic brain injury.
You forget how long you shift from the camera to your photo library to — what’s the app that puts things up on the internet again? — but eventually your brain hurts from the effort (and judging from your energy level in those first few months, you can gamely say it was a solid five minutes), and you give up.
Your brain can’t regenerate the neurons it’s lost. Use ’em or lose ’em. You had no idea your brain operated like annual dental benefits.
A nurse comes in and asks, Hon, are you okay? after seeing your dejected face, because you’re frustrated and annoyed that uploading a video on the internet is. So. Hard.
Your parents fly in from Manila, and you remember seeing them walk into the room as you sit in your wheelchair and smile like they just stopped by for brunch. It’s impossible to faze you at this stage, maybe because you are in a state of shock, and, well, you’re a few marbles short of a full set.
Another early symptom: the inability to tell dreams from reality. You dream once that you’re horseback riding on the beach with one of the leggy real estate agents from Selling Sunset, and she invites you to her wedding. You blink, sure that just two minutes ago your horse was waiting for you to mount. You ask a nurse who walks into your room to take your blood pressure: Are we by the beach? No? You sure? Okay.
Listen to your speech therapist. Especially when she says things like: You’ll never go back to work again.
You highly doubt she sounds like a Disney villain — if Disney ever makes a movie about corporate America — but you’re living in your sort of beat-up head at the moment. Since you told her you produce a science podcast for a living, she makes you read elementary school-level science articles out loud, which goes like this:
You: A normal resting heart rate is 60-100 beats per minute.
Your therapist: How many beats is a normal resting heart rate?
Your therapist (kindly): That’s okay, read it out loud again.
You: A normal resting heart rate is 60-100 beats per minute.
Your therapist: Now cover that sentence with your hand. What is the normal resting heart rate?
With a TBI, you have a hard time retaining facts. Your therapist asks: What is it that you do? You’re a journalist? You may not be able to go back to work again.
It’s possible that your speech therapist says this in a gentle way: There is a small chance, if you don’t fully recover, that you can’t perform the same way you did before. Memory is tricky. And you need that for your work, don’t you?
Maybe it’s like that after all. You’re not entirely sure — you can’t even remember what the normal resting heart rate is. But the takeaway is the same: You’ll never be able to work again. You’re doomed forever to live in your parents’ home, sucking their money and time like a parasite when they’re this close to retirement, all of you sitting in your wheelchairs together in front of the TV in the evenings.
You imagine life seeping out of you, like helium escaping a balloon. The ending of life a non-event as the beginning was pain and drama and blood.
But it’s not about work at all. You’ve lost something vital. You’re changed forever. The world will never be the same to you again, and you will never be the same to the world. You remember a nurse coming into your room, sitting on your bed and saying, You know what, what even is normal? Who the hell determines what that means? You’re you, and you’re very lucky to be alive.
That day in the hospital is fuzzy. But it remains the only time you’ve wanted to kill yourself. Not actively. Maybe if you just expired like a package of forgotten salmon filets, and someone threw you in the trash. You imagine life seeping out of you, like helium escaping a balloon. The ending of life a non-event as the beginning was pain and drama and blood.
But that’s the only time.
Don’t listen to your speech therapist.
You’re deep into mental images of expired salmon when you call your friend Stephanie, a neurosurgeon, on the phone.
Some TBI patients don’t have the capacity to map out the future or plan in advance, both of which require the part of your brain in charge of executive function. And that is precisely the part of your brain that’s MIA at the moment. In your speech therapy activities, you’re deciding which clothes go on a hanger and which ones you have to fold in the drawers. Future work prospects are part of a college-level course, and your brain is stuck repeating the second grade. Will you go back to the Philippines? Will you give up everything you’ve built in the U.S.? Will you stay home with your parents? These are questions you can’t think about at the moment. But you know enough to be mopey and think of expired salmon.
Stephanie calls bullshit on speech therapists. They’re looking out for their bottom line. They’re overly cautious, so they will give you the worst-case scenario. They also don’t want to be sued, so their predictions are always conservative. But I’ve seen way worse in my line of work. And I’ve seen people recover. Just read a lot! Practice reading. Read everything. Do all the exercises your speech therapists tell you to do. Work hard. If you want to improve your memory, work on memory exercises. Your brain is always changing — it’ll adapt based on repetition. What you put in is what you get out. Okay? I gotta go.
Always be exercising.
Your doctors tell you that you have your whole life to recover, but also that you have a window of just six months when your brain is most primed to relearn everything you’ve forgotten. So, no pressure. Your brain can’t regenerate the neurons it’s lost. Use ’em or lose ’em. You had no idea your brain operated like annual dental benefits.
But the brain is always growing and changing and reorganizing neural pathways, so while you can’t ever get the neurons back, it can make new ones. As long as you keep doing something over and over, like practicing scales on the piano or reciting the multiplication table 10 times over until it becomes as easy as breathing, you too can eventually learn to retain facts and remember what the normal resting heart rate is.
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The six-month period after a TBI is when your brain is at a heightened state of healing, like Superman being blasted with solar power. You throw yourself into your therapy sessions, read all of the magazines in your Airbnb in Bend, borrow books at the local library, hit a 60-day streak in Duolingo, and download an app with different brain exercises to improve your memory, attention, and problem solving. Your speech therapist makes you read an article in The New Yorker while listening to music, to practice dividing your focus and attention between two different things. Your physical therapist helps prepare you for the streets of New York City by designing an obstacle course in the gym with chairs and yoga blocks scattered across the floor, meant to simulate rats on the sidewalk and tourists blocking the road while gawking at the Empire State Building.
Eventually, you make it to the graduate lesson of walking up stairs. Your occupational therapist role-plays how to make small talk with a hair stylist, because your brain isn’t quick enough to respond to normal conversation. (And then when she asks you why you have a walker, what do you say?)
You once thought all these things were so easy — reading, walking, talking. (You’re a journalist, you talk for a living!) But it turns out that three decades of living is hard to condense into a few months, and you have to start somewhere.
When it all gets to be too much, close your eyes, transport yourself away from whatever godforsaken place you’re in at the moment, and visualize the beach. Or someplace nice and similarly clichéd.
Your speech therapist — you’re making it seem like your speech therapist has 10 different personalities but really, you’ve had five of them so for the sake of not introducing a new character every few sentences, you’re just going to call all of them “your speech therapist” in the form of a benevolent amalgamated clay monster — anyway, your speech therapist, whose iteration this time is a hokey, crystal ball-gazing, maple-granola-from-scratch-making hippie (you’re in the Pacific Northwest after all), tells you that your brain is powerful. If you tell it that you’re in a peaceful place, it will tell the rest of your body that you’re okay. Even if you’re really not.
Your peaceful place is on the Oregon coast a week before the accident, before the drive to Bend. You were in Lincoln City, which was cold and rugged and devoid of people, with the predictability of the crashing waves. When you’re there it’s just you at the end of the world, and life — with all of its everyday concerns — fades away with the tide.
You think about this place a lot because you’re in pretty beat-up shape for a human being. Like, you’d avert your eyes and dole out platitudes if you see you in the hospital, while slowly backing away in search of the nearest fire exit. You’re not bleeding from any orifices, and you didn’t break any bones or tear skin, but you have a granny walker to help you get around because you’re a walking hazard to society and yourself. Your brain controls balance and coordination, and your TBI makes you teeter whenever you stand (you have a hospital bracelet that labels you a fall risk, and humiliatingly, nurses have to watch you shower and go to the bathroom).
Your muscles are weak, and you have to relearn how to walk — your physical therapist (also an amalgamated clay monster because you have seven of them) has a metronome to remind you that this is when you put one foot out in front of the other, this is how fast you should be going. You live in New York City, you remind him, so this is the pace that grandmothers or tourists walk, and you’ve wanted to push both in front of oncoming traffic a few times.
Hopefully other New Yorkers will be understanding, he says cluelessly.
That day in the hospital is fuzzy. But it remains the only time you’ve wanted to kill yourself. Not actively. Maybe if you just expired like a package of forgotten salmon filets, and someone threw you in the trash.
You also have really bad double vision. Your neuro-optometrist says, This will all go away in two months. Or you’ll be like this forever. Honestly either option is possible.
A nurse tells you to get an eyepatch to make it easier to focus on one image. On paper, this sounds insanely cool because you have visions of yourself as a badass war reporter like Marie Colvin or a drunk pirate like Jack Sparrow. But you also have glasses, so the nurse just tapes the right side of your frames with medical tape and you look so much like a bullied fifth grader that you feel the urge to stuff yourself in a locker.
You can’t cut your nails yourself because you might have survived a car accident only to succumb to death by accidental nail cutter stabbing, seeing two toenails and misjudging which is the real one, so you ask your mom to cut your nails for you like a sad little toddler. She does such a poor job because she’s afraid of hurting you (you want your nails very short — if you’re not this close to bleeding then why even bother).
Sure, it’s humiliating, infantilizing, and pretty bleak, but all that doesn’t matter right now — you’re on the Oregon coast at sunset, bundled up in a warm sweater as you huddle along a sand dune with a Thermos of coffee, the icy waves crashing in, then going back out to sea.
It’s perfectly normal to see death everywhere, so no, you don’t need to get your eyes checked.
A few months after the accident, you and your parents fly to Ohio, where you can continue your therapy at your uncle’s place. The Airbnb in Bend was getting expensive, and you don’t really have the cash to live there indefinitely. You’ve been on countless plane rides before, but the one from Oregon to Ohio is unique in that it almost kills you.
Okay, you’re being overdramatic. After the accident, you think there must have been a mistake when you survived, that you cheated death and sooner or later God or Allah or Buddha or the grim reaper would come waving a pink slip saying, Whoops, my bad, there was an error in accounting and we should’ve taken you ages ago!
Death is a hovering specter you can’t shake. It’s in the promise of ominous things, like your Airbnb’s too-quiet location, beside a hill with no street lamps, that feels like the perfect backdrop for a serial killer’s next crime. But also in seemingly harmless ones, like crossing the street or your dad hitting the car brakes too abruptly or banging your arm in the shower, which has become a deadly place to you ever since your occupational therapists warned you that your balance issues could make you slip and crack your head open like an egg.
During the turbulent plane ride to Ohio, you’re sure that the plane will crash. You used to love turbulence like a weirdo, delighting in its stomach-churning ebbs and flows. Now every sudden jolt, every bump and violent shift is a sign that the plane is plunging into the water, and you’re sure that it’ll happen in the next moment. No, the next one. But it’s okay, it’s just the universe balancing its assets and liabilities.
You read later that this is all a normal PTSD response, your body still on guard and constantly bracing itself to protect you. Over time, you develop a zen attitude toward death, ready to look it right in the face the next time you see it out of the corner of your eye.
It’s a rule of life and storytelling that once you hit rock bottom, things can only go up, so be sure not to miss the signs.
The first sign that you’re getting better is when you finish Kazuo Ishiguro’s Klara and the Sun. Do you remember it? Not entirely. The novel took you two months to read, and the protagonist is a robot so it reads like a sixth grader wrote it, but goddammit it’s the first book you finish.
Your vision gets better. You’ve exercised your eyes for months, following the movements of a ball on a string like an eager cat. (This sounds simple, but try doing it when you see two balls on two strings.)
In Ohio, you start to walk a little bit faster. Maybe not New York City fast yet, but you outpace a 10-year-old and take it as a victory.
But the real sign that you’re getting better is when the small town in Ohio starts to suffocate you. You’ve always joked that you have agoraphobia — the fear of wide, open spaces — but really, whenever you find yourself in a suburb with houses that have washers and dryers or yards or acres and acres of corn fields or a gigantic Walmart, you start to feel a gnawing helplessness in your chest, like an alien is about to rip itself out of you.
Now every sudden jolt, every bump and violent shift is a sign that the plane is plunging into the water, and you’re sure that it’ll happen in the next moment. No, the next one. But it’s okay, it’s just the universe balancing its assets and liabilities.
It’s the height of summer now, the point in the pandemic when there’s finally a vaccine, and most people decide to move on and restart their lives. You start picking fights with your parents, and you’re deliriously happy the first time you’re able to think on your feet to defend yourself and volley some arguments back. (For months, you only sat there dumbly, your brain not coherent enough to form a counterargument.)
New York, they say, is not the best place for a brain-damaged person; you still walk with a cane, and your parents have all these paranoid fantasies that someone will push you in front of a subway train because you’re so slow. Maybe, a friend suggests, we can get you, like, a cane sword?
But there are other things too. Things you never expected, good things, like the brunch scene in Columbus, Ohio, which you claim is much better than New York’s. (You have a brain injury, so a second opinion is required.) You celebrate Mother’s Day with your mom in person for the first time in nearly a decade, and when your dad turns 60 you throw him a small party. You hadn’t been home for any of your family’s birthday dinners in years.
These are signs that you don’t want to miss. So you hold them close to you and feel hopeful you might be okay after all, hoarding them the way your mom hoards old makeup bottles and used shopping bags. I never know when I might need all of this, okay?
You don’t actually get a free pass for almost dying, so don’t think that life gets easier from now on.
It kind of sucks because you think life is a meritocracy or something. Not that almost dying has actual merit — it’s the “almost” part that kind of makes you seem like a failure. You almost made it to Hollywood. You almost finished your novel. You almost died.
When you finally return to New York, the air is chilly again and the wind has a menacing bite. But you feel invincible. You were turned inside out and unplugged without being properly shut down, but you lived, and there is nothing in this city that can possibly do any worse to you, not even its giant rats or ridiculous apartment rentals.
But less than a year of transitioning back to work after disability leave, you get laid off. You never fully recover from the nerve pain and your lower back is constantly aggravated. You’re always in pain. You can’t run, not even after a 7 train that’s about to leave the platform. Your right hand also never completely recovers, so your handwriting looks like a very gifted six-year-old’s at best. Your balance is forever shot, so after one glass of wine, it takes you 50 times the effort to walk straight. And even your hormonal acne has come back in full force, for fuck’s sake. Your dermatologist warned you to cut back on dairy and sugar, and honestly, why did you survive in the first place if not for chocolate and cheesecake, or even better, a chocolate cheesecake?
You can’t believe you still have to deal with this shit. Haven’t you paid your debt to society 10 times over? Doesn’t the world owe you some peace, to live out the rest of your life with cute puppies that never grow up and only shit rainbows? You had been prepared for an ending and had so accepted death that life itself was the surprise.
Your friends all get married in the same year — some have babies, some lose them, others buy a house. They get new hair, new jobs. And you? You move into your first solo apartment. You travel across Europe on your own, and then later go home to Asia and travel more with friends and family. Your physical therapist is both supportive and horrified at the mangling of your body with all that intense walking and, at one point, an eight-hour motorbike ride that causes you so much pain that you feel you may be back at the scene of the accident. But hey, you rode a motorbike across the Vietnamese countryside.
You are so incandescently happy to be alive one moment, and miserable and alone and aimless the next. You no longer coast along the outskirts of life but deep within it, plunged headfirst without a life jacket. To be completely honest, sometimes you miss being excused from the business of living. Other times, you can’t imagine life any other way.
You’re trying not to compare everything to the one year you were barely alive, but you suspect it’ll be a long time before that happens. Until then, you’re cutting your own nails. Keeping up your streak in Duolingo. And not driving in the snow.
Anne Lagamayo is a documentary and podcast producer by day. By night, she is something else entirely. You can find her work at annelagamayo.com.
Editor: Cheri Lucas Rowlands
Copy-editor: Krista Stevens
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