At this point I didn’t know much about my brain injury at all. I wasn’t in any pain, so my thoughts about my new condition were unfocused and fleeting. Instead of being occupied by questions about why I was in the hospital and what had happened to me, my mind was engrossed in an entirely different set of perceptions. The smallest of activities would enthrall me. Dressing myself, I was awed by the orbital distance between cloth and flesh. Brushing my teeth, I was enchanted by the stiffness of the bristles and the sponginess of my gums. I also spent an inordinate amount of time looking out the window. My view was mainly of the hospital’s rooftop, with its gray and untextured panels, though I developed a lot of interest in a nearby tree. I could only make out the tops of the branches, but I’d watch this section of needles and boughs intently, fascinated by how the slightest wind would change the shape entirely. It was always and never the same tree.
Very few things disturbed me during this period of time. But even in this formless daydream I remember the moment that most closely resembled real distress. Or, at least, when I became aware of an actual loss.
It must have been midday because the sunlight was falling across my body, and that slat of light emphasized the white nightstand on my left. My parents had filled the shelves inside with clothing, and the nurses made sure there were plenty of liquids for me to drink in there, too. On this day, I noticed that there was a stack of magazines on the nightstand, as well as a book. I am not sure how long they had been there—for all I knew, they could have even predated my arrival—but this was the first time they piqued my interest.
The high gloss of the magazine cover felt wet in my hands. And as I opened it up, I was instantly bombarded with photos of red carpet parades and illustrated makeup tips, a circus of color and distraction. I couldn’t linger anywhere. It felt as if the magazine were shouting at me. Closing it was a relief.
I turned to the book. It was a novel by Agatha Christie, something I had probably read many years earlier. I opened to Chapter One and flipped slowly and evenly through the first few pages, a motion that seemed to come naturally to me. But on the third page, I stopped. I returned to the first page and started again. Slower this time. Much slower. My eyes focused and refocused in the bright sunlight, but I continued to only see the black, blocked shapes where words used to be.
Thinking about it now, I don’t know how I could be so certain that it was an Agatha Christie novel, especially since this was the very moment I became aware I couldn’t read anymore. With this simultaneously familiar and unfamiliar book in my hands, I first took in the actual loss of words. For my entire life, language had been at the forefront of every personal or professional achievement, and very few things had brought me as much joy and purpose. If I had ever been warned that I might be robbed of my ability to read, even for a limited amount of time, it would have been a devastation too cruel to bear. Or so I would have thought. But a day did come when I couldn’t read the book in front of me, when paragraphs appeared to be nothing more than senseless jumbles, and the way I actually processed this massive loss was surprisingly mild. The knowledge of the failure was jarring, without a doubt, but was there any misery or angst? No. My reaction was much less sharp. A vague sense of disappointment swept through me, but then … my inability to use words in this way just felt like transient information. Now that the ability was gone, I could no longer think of how or why it should have any influence on my life whatsoever.
My trouble with spoken language was mirrored in my written language. I discovered as I progressed in my sessions with Anne that I had not completely forgotten the alphabet, but I had forgotten its order. If I isolated single letters at a time, I could still identify them on a page. It took a lot of guidance from Anne, but with her by my side, I could slowly sound out these letters, occasionally creating a very fragile word. Anne noted: “There are frequent errors reading aloud, especially words with irregular pronunciations, and Lauren finds it difficult to know if she is correct or not.” So, while I had not lost my ability to read entirely, “reading” in this new iteration of my life involved a razor-sharp focus, accommodating only a word at a time. I also wasn’t able to know my own accuracy without someone else’s support. I would slowly sound out a word, but it took so long that when I went on to tackle the next one, I often would forget what I had just read. Perhaps that was what had happened with the Agatha Christie book I had attempted to read by myself. I had been expecting the language on the page to behave the way it used to, and when it didn’t, the whole picture crumbled in front of me. Words could be approachable in small, isolated units. But a full sentence? That was beyond imagining.
The rupture had originated on the middle cerebral artery in the left hemisphere of my brain, bleeding into the Sylvian fissures and my left basal ganglia. This cerebral artery supplies the blood for the two language centers of the brain—Broca’s area and Wernicke’s area. The basal ganglia are usually associated with motor control, but they also affect habits, cognition, and emotion. Some basal injuries can blunt emotional awareness and slow “goal-directed” activity. With such a wide range of influences, the alterations to the basal ganglia were probably affecting me in many ways at the time, but after the rupture, it was my faltering language that was my most visible symptom.
(Lauren Marks)