My Neurodoc is into the dribs and drabs method the last few months. For most of my post-brain injury years, I’ve roared ahead at top speed, first trying to get back as quickly as possible to my life, then to regain necessary skills as quickly as possible, then to normalize some skills and continue to drive hard to regain critical-to-me ones while at the same time to become financially independent.
Then last year happened. (Can’t believe 2014 is last year and not my current reality. So glad of it.) You cannot control other people; your health care and recovery are by necessity dependent on others. And when they don’t listen, you can either scream and stomp off, go with the flow and not heal much, or keep pushing. And pushing and pushing while your PTSD hits the stratosphere as parts of your recovery slow to a crawl.
At some point, I stopped driving hard. It was almost a relief to move into the frozen lane. My neurodoc was probably relieved too, for he felt a tad overwhelmed and he’d realized before me that pushing therapy could tip me over the edge emotionally.
As for me reading books and long form articles, it halted altogether. That’s why my neurodoc said we are starting from zero with respect to my reading. Anything I do is an improvement, no matter how small.
In his words: as a non-expert, he is “willing to brainstorm and prepared to present various strategies which may be helpful to people with brain injury.”
But first he needed to see what ground zero looks like. He had me read an article from the Wall Street Journal.
For several weeks, I have been reading a chapter to him every session from a book I know well: one of mine. I usually refresh my memory on the way there as to what the next chapter is about. You would think I’d have no problem recalling a book I lived with for years thinking, writing, revising, editing, publishing, and talking about. But nope. I do.
When I read a chapter of my book out loud, I do at least recognize the characters and scenes as I go along, and so I can read at a reasonable speed and put in intonation. In my neurodoc’s estimation, I read well, albeit this week with a few hiccups because I was tired and couldn’t put in as much effort in controlling my voice and reading.
But that’s reading work familiar to me.
This week I also read unfamiliar work: the WSJ article . . . well, after we went back and forth as he dithered about whether I should read out loud or silently. Your choice, I told him. You’re the one observing — you decide! OK, OK, he laughed. Out loud, he said. I began.
Oh boy, I was in trouble.
I had no previous knowledge of the text, and to my ears, it was immediately apparent. My voice was flat and hesitant. I wasn’t taking in the content.
I stopped. Do you want me to just read or read for comprehension, for integrating the information, I asked him. He decided on the latter.
I’ll pause here to say my neurodoc has this non-judgemental and calm aura. I knew I wasn’t going to have to manage pity or sympathetic glances or impatient interruptions. I also knew that when he pays attention he has insight few others do. He is one sharp dude. He’d listen, observe, ask questions to aid his understanding and perhaps if it fit into his dribs and drabs approach, ask questions to elicit my emotional responses. And he’d make matter-of-fact comments as well as encouraging ones.
This approach meant I wasn’t self-conscious when I began to read out loud the way I do silently. It was weird to hear my voice speak the way I read silently to myself, but he can’t help me unless he knows and understands my reality.
I restarted the second paragraph. And restarted it. And restarted it. Finally, my sputtering reading engine coughed into life, and I absorbed the content. I kept going in that flat, slow, hesitant reading voice for a little bit. Then I had to back up because once again I’d forgotten what the point was and needed to reread to integrate the beginning of the sentence and paragraph into what I was reading.
I began to fatigue.
I felt cold creep into my forehead. The very beginning of a concentration headache. I haven’t had one in eons. I was thinking I should stop when he told me to. Oh, thank God, I blurted out.
With the end of the cognitive effort, the concentration headache immediately receded.
He asked me what I was experiencing, what my interest level was. (Later, he would ask me to work on describing what I am experiencing exactly when I repeat.)
He saw that I was struggling to assimilate and integrate the text. He saw I was having memory issues. But he is not done observing. He will be considering other kinds of materials for me to read, like, for example, poetry, to see how I do with different levels and vocabulary. Ideally, it would be good to have someone assess my eye tracking and brain activity while I read to augment his direct clinical observations. I have to look for such a person.
Emotionally, having someone in reading hell with you makes you feel less crushed.
I don’t need to rely on myself anymore for initiative, for encouragement, for keeping going.
I’m truly not alone in this anymore.