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I Wanted My Brain Back Sherri Dalphonse, Washingtonian Magazine (page 1 of 6) Page 1 of 6

What happens when you’re a PhD economist and you suddenly can’t remember things or think straight? One woman’s story of perseverance reveals some of the mysteries of the brain.

It was a beautiful June Saturday afternoon. Anne Forrest steered her white Acura onto Memorial Bridge. The Lincoln Memorial rose before her.

Back from a business trip to Panama, Anne had picked up her cat from a colleague at the Environmental Law Institute, a nonprofit where she worked as an economist.

After crossing the bridge, she bore right at the Lincoln Memorial and dropped down toward Rock Creek Parkway. She craned her head to the left, watching for her chance to merge onto the parkway.

As Anne waited, a woman in an SUV hit her from behind. Both drivers got out to inspect the damage—Anne’s car had a dent in the back—and exchange information. A Park Police officer took an accident report. Anne felt shaken but looked fine; she got in her Acura and drove on.

“Who knew?” she says. “But that changed my entire life.”

The next day, June 15, 1997, Anne went to the Texas State Society Father’s Day picnic with Michael Crider, a man she was dating. Both Anne and Michael had grown up in Texas. One of their first dates, a year earlier, had been at this annual event.

Anne spent part of the picnic on the phone, trying to resolve a problem at work, but couldn’t grasp what her boss was saying.

Early Monday morning, she woke up feeling cold, nauseated, and with “the worst headache I have ever had.” At work, Anne would start to dial a phone number but couldn’t get through all the digits. She told colleagues about her accident and her headache. They urged her to see a doctor.

The primary-care physician thought Anne had whiplash. He wanted to see her twice a week to keep her under observation.

Two weeks later, Anne was on I-270, driving to church, when her right foot and right arm went numb.

“That was my wake-up call,” she says.

Neurologist Lewis Eberly diagnosed it as a mild traumatic brain injury.

When Anne’s car was rear-ended, it started a chain reaction in her head. The brain is made up of millions of nerve cells connected by fibers called axons. When Anne’s head was thrust from side to side and front to back, some axons—which carry messages between brain cells—were torn or twisted.

Traumatic brain injury has been called a “silent epidemic.” Each year, the Centers for Disease Control and Prevention say, 1.4 million Americans sustain a traumatic brain injury, or TBI—often in car accidents, falls, or sports mishaps. Experts believe the number of TBIs is higher because the estimate reflects only emergencyroom visits, and many patients never go to a hospital.

Three-quarters of cases are concussions or mild brain injuries. “Mild” means the patient was never unconscious or wasn’t unconscious for a long time. The results can be anything but mild.

If brain injury is an “epidemic,” why is it a silent one? “Because many of us have sustained a concussion, and two-thirds of individuals who sustain a concussion are back to normal by three months,” says Gregory O’Shanick, medical director for the Brain Injury Association of America.

But many who sustain a head injury have problems remembering things and concentrating. Accidents can be so minor that neither doctor nor patient makes the connection. Your teenage son is having difficulty at school? Must be inattention, not that hockey injury. You’re 50 and forgetting things? Must be age, not that fall off a bicycle months ago.

“Most physicians don’t have a clear understanding of brain injury,” says Dr. Ali Ganjei, director of the brain injury and stroke program at Inova Mount Vernon Hospital. “People would have a concussion, they’d be out for an hour or so, then regain consciousness, and we’d think everything was okay. If the person later had difficulties, we never linked it to that head injury.”

Susan Connors, president of the Brain Injury Association of America, is more direct: “Traumatic brain injury is the most misunderstood, misdiagnosed, underfunded public health problem our nation faces.”

First Months: A Roller Coaster

Even after the diagnosis of mild traumatic brain injury, Anne, 39 at the time, was struggling.

Bill payments lapsed because she couldn’t balance her checkbook. She had a hard time cooking; she’d lose track of what she was doing or make mistakes, like putting mayonnaise on the outside of a sandwich.

She’d wear the same outfit day after day; it was hard to match clothes. One day, instead of putting on her pants by sliding in her right leg first, as usual, she had started on the left. She couldn’t remember what came next. She sat on the bed and cried.

At work, she went on short-term disability. Her neurologist assured her that most patients are fine within six months.

Anne loved to play volleyball; she had played varsity at Yale. But her balance was shaky. She stayed away from sports.

Scared after the incident on I-270, she stopped driving. Even being a passenger in a car was hard. If a car merged into the next lane, she’d yell, “Watch out!”

“I couldn’t trust my brain,” Anne says. “You can imagine I was fun to drive with.”

She was still having headaches. Hours might pass before she realized she had one—often until a friend, noticing her discomfort, asked whether her head hurt. Anne wouldn’t think to take aspirin unless someone reminded her. She wrote herself a note: If you get a headache, take aspirin.

She likened reading to being on a roller coaster: Information was flying past, but she couldn’t absorb it. How would she go back to work if she couldn’t read?

Like many with mild brain injury, Anne looked fine. She was high-functioning in comparison with “moderate” and “severe” brain-injury patients, who might show signs of paralysis or impaired speech.

But on a trip that summer to Mohonk Mountain House, a resort in the Catskills, friend Michele Flynn, a special-education teacher, could tell Anne was having problems with short-term memory. When Anne cut short a hike to go back to the room by herself, Michele pinned directions to Anne’s shirt.

From the Washingtonian Magazine. Reprinted with permission. Third-party use restricted. www.washingtonian.com.

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