Traumatic Brain Injury: A Dark Time Recalled
On September 17, 1992, I was a freshman in high school in Winston-Salem, North Carolina. Tired and hungry, I had just returned home from cheering at a football game. My friends Evan and Rich stopped by to take me out for a hamburger, and my mother was hesitant to let me to go. At fifteen, I was a bit young to go out at night with boys. After much pleading and bargaining, I ran out into a very dark night barefoot and happy. I did not return for a very long time.
The car crashed on a curving road near my home, fortunately in the yard of a medical doctor. The boys and I do not remember the wreck which sent us plunging into a telephone pole and snapping it in two. They recall waking, and having Dr. Fisherman call 911 to send me to the trauma center at Wake Forest University Baptist Hospital. My parents received a call relating the events of the 10:20 PM wreck, which sent them flying to the emergency room where I waited - deep in coma, near death.
In layman's terms, my head struck the dashboard causing my brain to have a whiplash reaction. This caused injury and bleeding on the back left side of my brain in addition to the right frontal area. I suffered brain stem injury, and trauma to the left back (occipital) portion of the brain, and I suffered from shearing, or the jostling and breaking of many tiny neurons that join the brain to the rest of the body.
Thus I, coordinated and intelligent student, Kelly V. Bouldin, lay without word or motion in the hands of strangers. Perhaps I was saved by a telephone call to 911. Or the medical machinery that placed me deeper still into a medically-induced coma which oxygenated my brain in order to reduce swelling. Or perhaps by the brilliant team of neurosurgeons who attended to me minutes after my arrival in the ER ultimately saved me. Surely, even though I was helpless, certain exceptional people began the saving of my life.
During my first hour in intensive care, a pressure monitor was inserted into my brain, and remained there for many days. This machine informed the ICU team of the pressure level inside of my head. If the level rose into the 20's, emergency surgery allowing my brain to swell outside of my skull could perhaps alleviate the pressure and save my life. Ironically, my girlfriends begged the doctors not to shave my head, declaring that to lose my long hair would kill me! Fortunately it didn't, and my parents watched the monitor religiously. My pressure level remained between two and fifteen, usually staying closer to two.
Many times people have asked me if I had near-death experiences, or if I suffered while in coma. I had none and I did not. I only recall waking as if from a deep, deep sleep, to find myself in a very strange place where I definitely did not want to be.
After many days I could open my eyes, and I saw my Mother. I gave her the Vulcan salute with my right hand, which the doctors did not recognize as "purposeful movement"; yet she did. My Mother knew I was alert and alive inside my injured body. (Only a Star Trek fan could fully appreciate this piece of trivia.) My mind continued to remain rather numb. I was not sad or scared, only irritated by the nurses and doctors who wouldn't allow me to get out of bed. I struggled against my wrist restraints, and being double-jointed, often pulled out my feeding tube with my toes. I listened to Pearl Jam on the earphone radio my Mother placed on my head. Ironically, my favorite song was "I'm Alive!"
How I longed to be able to escape the tubes and hug my parents. All I could do was try to smile at them, to tell them I was all right and that I loved them. In my dreamland I did not worry overmuch, but I did so wish to speak. My first word after weeks of silence was typical of any teenager. The phone rang beside my bed, and I instinctively picked it up (my right hand was then free of restraint) and said, "Hey!" This was difficult with a tube down my throat, but my desire to speak made it possible. Soon after a speech therapist taught me to breathe out other words around the tube, like "Mother" and "I love you."
After days of practice, I managed to call 911 when my nurse Pam was in the bathroom. "Take me home!" I begged the emergency operator. "Where are you?" she queried. "I don't know, but I want to go home!" I shrieked into the receiver before the nurse intercepted and canceled my call. Couldn't anyone understand me? I was angry that no one seemed to be listening.
Fortunately, a therapist gave me pen and paper. She released my right hand one morning and asked me to write the numbers one to ten. Aggravated by all of the seemingly condescending questions (as "Where are you? What day is this?"), I wrote the correct numbers in Spanish. They thought it was gibberish until a bilingual scrub nurse told them I was indeed lucid and responding correctly to their question. When asked to write whatever I wanted, I scrawled the sentence, "I'm lost in my mind." This pretty well described what I was feeling at that time. My mother held me close to her, promising to find me and to take my home soon.
And not being able to communicate was far more degrading than merely frustrating. I was just beginning to regain bladder control when physical therapists began, twice daily, to roll me in a wheelchair to the therapy wing. Often I would try to express my need to go to the restroom, but my jumbled words went either unheeded or unheard. Once a therapist correctly guessed my need for a toilet, but simply told me, "We can't get off schedule, Kelly, so just wet the towels in the chair." Demeaned and outraged, I swore that I would somehow regain my power to talk, or for that matter, to yell.
Skipping forward in time, I was allowed to leave after a month, and to be transferred to a rehabilitation hospital I call "Charlotte Rehab." Movement and communication were still terribly hard due to my short term memory deficits. I couldn't tell my parents about my therapy sessions because I forgot all previous actions within minutes. This "anterograde amnesia" became less and less over many years, but has hindered me greatly in my ability to respond correctly to others.
Even though I now have full ability to think, speak, and write, I cannot truly tell you of the terror I felt in a rehabilitation hospital for those with paralysis and brain injuries due to similar tragedies. People who wake from a coma wake unevenly, and not all at once like you see in soap operas. They wake up angry, cussing and screaming at the world. The "filter" that makes the brain recognize tact is still asleep. I did my share of hollering, but I was not as "otherworldly" as my cellmates (the doors of our ward were kept locked. This was another frightening experience, to be under lock and key).
I remember the "Elephant Man," a teenager in a wheelchair (as I was) who screamed like an elephant from dawn to dark. He was laboring to make his fingers work on a voice board, so that artificial sounds could make his needs known to those around him. I also remember the "Dam Man," who fell off an eighty foot dam and was in a full body cast. He struggled to whisper to anyone around him, to please roll his bed outside so that he could smoke through the small mouth hole in his cast. My Mother remembered a girl named Misty, who was sitting by the wall whispering to herself. Mother walked over to ask if she needed anything. "They bathed me in cold water,” she moaned softly with tears in her eyes. Well, it didn't take very long for my Mom to find Misty’s doctor, several nurses and the Mother, and I doubt they'll forget my Mother’s tirade. I couldn’t and still have trouble believing that the aides abused a child just because they didn't think she could tell on them.
And then I met John, who though paralyzed from the waist down, was coherent and physically attractive. Let me state that at this time, I did not have the muscular control to walk unassisted. My left side was very weak, and I fell whenever I tried to take steps alone. Thus I was only able to get around in a wheelchair or with someone supporting me on each side of my body. Head injuries cause muscles to more or less lose contact with the thinking mind, the neurons that tell them when and how to perform.
John, like me, was confined to a rolling chair, but he amazed me by doing "wheelies" around the therapy rooms, and by his seeming enjoyment of the activity. One day my PT (physical therapist) Susie, was insisting that I walk about ten feet towards her without help. I politely refused. "I don’t think so" I whispered. John then zoomed up in his chair and yelled out, "Walk for me, Kelly!" Annoyed, I stared at him and asked, "Why are you here?" (People in rehab tend to be blunt, having little time for idle conversation). John then proceeded to tell me his heart-wrenching story.
"I am 26 years old, married, with a three year old daughter, Kelly. One night I went out to my car from out apartment. It was about 9 PM, and I didn't see a man crouched down beside my car. He had robbed a branch bank, and evidently thought I was a policeman coming after him. Anyway, as I approached he jumped up, jabbed a knife into my spine, and ran away. I haven't been able to walk since."
"So why are you smiling, John?" I asked in all seriousness.
"Because God blessed me. I have a loving wife, a child who loves me, and I'll never have another, and I have a good job that I can perform in a wheelchair! I could have been stabbed before I was married, Kelly, so I have a great deal to be happy about and thankful for. But I can't walk, Kelly, and you can if you try. So walk for me, little Kelly."
I walked unassisted that day, and was so terrified that I would fall. John's words resonated with my soul perhaps, for I did so want to please him. Unfortunately I did not have the ability to verbally thank him for his inspiration, for shaming me into action. I did smile at John the next time he saw me staggering about the halls, and I pray that my unassisted limping told him what my vocal chords could not.
In the months to come, I would grieve many times for the trauma to my vocal chords (caused by days on life support), and for my inability to recall the words I wanted to express. I confused many terms, saying "Japan" when I meant to say "China." The circuits of my mind were scrambled, and my mental computer had erased myriad memory banks. How shocked I was, for instance, to discover that Great Britain and England were actually the same place. How amazed I was at the odd things that made people laugh. Humor for me was incomprehensible for the most part, and slang was nearly impossible! Why do people get blue, I would think, when their cheeks look brown or pink? And my speech came so slowly that friends couldn't spare the time to let me finish a sentence. I simply couldn't speak rapidly enough to communicate my basic needs, much less my philosophies and desires.
When I returned to school, I realized how much I had truly forgotten. I knew that my only chance to recover the powers of verbal and written expression was to frighten and humiliate myself at school every day until I was once again making "A's". I lived and breathed the fear at school because I fully believed in my own recovery. One can eat fear like fast food. It's not too good for you, but somehow it keeps you going!
I remembered wondering exactly why must one write from left to right, having forgotten this mysterious phenomenon was required by teachers. Why did I recall the Pythagorean Theorem when I could not multiply? Why could I manage a computer and not write my alphabet in sequence? My only conclusion was and is that a closed head injury affects all parts of the body - but unequally, and it was going to be a long journey back to the place that I once had taken for granted. In school and at home I could not communicate effectively, and would gladly, gratefully have traded my life for John's. People did so like him.
In my sophomore year of High School English, my teacher assigned Plato's "Allegory of the Cave" to our class. Strangely I remember its message now, when I had huge difficulty remembering it for a test years ago. In the allegory, a group of people lived far beneath the earth in caves, and never for a moment were aware of the existence of sunlight. One man dared to climb out of his underground cavern, finding himself exulting at last in the light of day. His sublime ecstasy made him wonder how he could have survived in the darkness for so long. Yet this man decided, ultimately, to return to the dark cave below. He felt responsible to those left behind, and felt called to teach them of the light up above.
I believe that it is appropriate to go back into the shadows in order to teach others about the possibility of a better life. Just like it is extremely painful for me to relive my experiences surrounding my traumatic brain injury, but I feel it is necessary in hopes that my experience may give hope to other victims. If my work could help one person like the works of other writers have helped me, I would be grateful. Writers communicate many things, but almost always the sense that one is never alone in the world.