Head Cases: Stories of Brain Injury and Its Aftermath

Head Cases Book Cover

In All Earnestness

Joshu earnestly asked Nansen, “What is the Way?”
Nansen answered, “The ordinary mind is the Way.”
— from case 19, The Gateless Gate

So much snow, so much snow. Melissa rode in the backseat, watching the night whirl white with its first snowfall of the season. As the car she rode in passed slower vehicles, the wheels pulled and crunched and slid against icy patches. The driver, a doctor named Darrell, wasn’t accustomed to Thunder Bay’s blizzards—he drove as if he were back home, hundreds of miles south. He, Melissa, and two other passengers had carpooled to a housewarming party together, and Melissa’s condo downtown was the first stop on the return home. She directed Darrell to take the next exit because it was a safer route.

Up ahead, on the hill, a pair of headlights flashed on and off again repeatedly. As the lights drew closer, Melissa could see the pair of lights sweep away to the left before reappearing moments later. The car ahead was lost in pirouettes, like a child’s top, awkwardly spinning out of control and careening toward their vehicle. Darrell didn’t have enough time to slow, but he managed to yell out to his passengers.

“Brace yourselves!” he cried.

Melissa lunged against her restraint and her hands flew instinctively around her face. Glass sprayed over coats and scarves. The impact pinned her, unconscious, in the backseat. The unbelted woman in the front seat crumpled under the dashboard. When Melissa awoke a few moments later, it was as though the whole of reality were occurring inside a snow globe. Everything was quiet and slow, so slow it might be death, she thought. She sat in the backseat and told herself that if she were dead, she wouldn’t be looking at the wreck through her own eyes, and yet she didn’t feel quite alive. Minutes later, though, the sense of life returned, along with pockets of sound and time and touch.

More than ten years later, Melissa Felteau’s world is still returning to her, bit by bit. She no longer concerns herself with its fragments. Melissa doesn’t long for the world she left that day; she is pleased, maybe even in love, with the world before her. For now, that world happens to be Ottawa, Canada, where she’s conducting research aimed at helping other brain injury survivors cope with their impairments.

When Melissa greets me with a hug at the airport, I see nothing of the woman she was supposed to have been before the wreck. I’m usually uncomfortable around type-A corporate executives—the competitiveness and the moneyed optimism is all too much. Melissa radiates a warmth independent of station and geography. She’s overly bundled in a camel hair overcoat. With her blonde hair and rosy cheeks, Melissa looks like the friend you want to call after good news or a hard day. Right away, you get the impression she is on your side.

We have a break before her research group meets, so we walk around a bit downtown and find a quiet restaurant for lunch. The brain injury is still there, but only when you’re looking for it. Melissa talks in loops, circumstantially, dancing near the topic. She tells me that the driver in the other car began wandering the scene barefooted and dazed, and she likes this place because the food is great but the waiters are delicious. An off-duty emergency responder pulled over and offered a hand—remind me to tell you a story about him, Percy, the responder, I saw him years later, she says. Percy said that there were wrecks all over town and to expect a long delay for an ambulance. Thunder Bay is so rural, you know. The woman under the dashboard, Darrell’s poor, poor mother, was making a wretched noise each time she exhaled, causing everyone to wonder if the following breath would be her last, so, no, I did not focus on myself. Darrell was hanging halfway out of the car. Percy made a quick assessment of the scene, and when he noticed me sitting calmly he put in a call requesting priority service. I was in the worst trouble: I didn’t complain of any pain.

The more Melissa talks, the tighter the loop gets, as if her brain is working to reel itself in. After a few minutes, she’s locked on topic. Knowing the extent of her injury, it’s an impressive feat.

“I kept going within and within,” she tells me. “I felt less able to breathe, like I was fading away.”

First a fire truck arrives. A fireman hops off the truck and begins diverting the traffic for the ambulance’s arrival. Another fireman looks into Melissa’s eyes and straps an oxygen mask to her face. When the ambulance finally appears, forty-five patchy minutes have passed. Melissa watches calmly as they strap her to a spineboard and immobilize her neck. In the ambulance, they grimace as her vital signs weaken. A tech tells her to hold on for five more minutes, and she does.

The buzz and brightness of the emergency room jolts Melissa awake. In a matter of seconds, she is stripped nude. One breast looks as though it has been ripped off, and X-rays reveal four broken ribs. Her abdomen is swollen from internal bleeding, a ruptured spleen. Get her stabilized, go, go, go. Melissa is injected, bandaged, and whisked away, and anything that might have happened to her brain is a mere afterthought. She had survived, she would be fine, she tells herself.

Melissa spends Saturday spraying vomit into her bedpan and vehemently denying anything is wrong with her. She laughs and cries and rages within moments of one another and complains that she cannot see the ceiling. Her parents, exhausted from the overnight vigil, wonder how much morphine the doctors have given Melissa to cause her to act this strangely. Eventually, a resident on his rounds takes notice and schedules lab work and a consultation with a neurologist for Sunday, just to be sure.

A CAT scan returns inconclusive, so the neurologist delivers a vague but distressing diagnosis: postconcussive syndrome (PCS). Some of the most tragic cases I have seen  resulted from a PCS. Because a person can move about and consciously respond, they’re presumed to be well when they’re far from it. The adverse symptoms snowball over a course of days. In the impact, Melissa’s position in the vehicle made her prone to a concentration of forces that shook, turned, and rattled her brain, causing widespread disruptions on microscopic levels. Detailed scans a year later will reveal that Melissa’s brain was riddled with focal defects, pockets of arbitrarily traumatized tissue encapsulated within healthy brain. Sheering injuries in her occipital lobe disrupted key functioning in her visual cortex; diffuse axonal injuries severed untold neuronal connections within the right frontal lobe, compromising her self-regulation. Cellular injuries to her parietal lobe interrupted the normal processing of sensory input. The microscopic defects elude the CAT scan, however, and consequently the neurologist. He writes down his diagnosis and offers no follow-up care, not even the hint that she should keep an eye out for any life changes.

Prior to the accident, Melissa Felteau was a paragon of modern womanhood, the embodiment of every contemporary virtue.

“I was a real catch,” she says, giggling a little at her own cheekiness. “A healthy northern girl.”

As a master swimmer, she outpaced men twice her size; on cross-country skis, she sailed past teenagers; and in whitewater kayaking, nobody could rival her quick rolls. Yet her athletic skills were the least of her talents. Throughout her education, high marks filled her transcript with only minimal effort. She won awards as a writer, she earned applause as a quick-witted public speaker, and she was being singled out for the chair of an international business association. Ambition filled her veins, self-reliance and independence exuded from her smile. Of course the guys lined up; she had sixty-five flower arrangements to take home  after her hospital stay.

Melissa brought the same aggressive, competitive energy she used in sports to the boardroom table. As director of public relations for Lakehead Psychiatric Hospital, Melissa’s vivacious appeal mirrored the image the hospital wanted to present to the surrounding community. She turbocharged the organization with new, socially minded initiatives, such as the provincial mental health strategy. Doctors turned shy in her presence and coworkers gossiped about her availability. In every instance, she exemplified the exceptional. At just thirty-one years of age, Melissa Felteau felt the adoration and envy of the world around her. And she enjoyed it, perhaps a little too much.

The truth of her postinjury life unveiled itself in the most casual heartbreaks. Each day served up a reminder of skills she had lost. At first, her sisters commented that she sounded strange on the telephone, when, in fact, she had developed a stutter. After Melissa returned home under her parents’ care, she moved about as though sedated, even after the pain medications wore off. She couldn’t shake the slumber. Her vision was plagued with floaters. Coffee mugs and books fumbled from her uncoordinated fingers. She tumbled from table to bed to sofa and back again. After days of tripping over herself, she realized that she couldn’t seem to regain her balance.

Canada’s healthcare system allotted for an unhurried two months’ convalescence, an interminable period of rest for Melissa. She yearned to return to work, to get back on track with her life. She ignored any cautions from doctors and family as unhealthy pessimism, hardly noticing that fewer friends were calling or visiting. The first day at work, however, was a distressing confrontation with reality. At first, she could not figure out which of her keys opened her office. They all looked the same to her. She then tried to read a memo on her desk and found that she couldn’t understand a simple paragraph. The hum of her computer drove her crazy, and the ringing in her ears wouldn’t go away. When she attempted to visit coworkers, she lost herself in the once familiar hallways. After she found the right department, she couldn’t remember the name of the person she intended to visit.

“Names are very important to me,” she says. “You can imagine how embarrassing it was for me to be the public relations director and not remember names.”

Melissa endured two weeks of work before she requested a vacation. The additional time off didn’t do the trick. When Melissa resumed her job, she once more attempted to pick up the rhythm she had sustained for the previous six years. A presentation that normally would have taken her an afternoon or two required all of her focus for weeks. Without realizing that her executive functioning was impaired, she struggled with duties involving multitasking, decision making, and organizing. There were awkward moments when she cried at the slightest provocation or snapped at her assistant. She had once excelled at complicated managerial tasks; now the most menial chore, such as writing a complete sentence, proved a challenge.

“I was overwhelmed,” Melissa confesses. “I was having major problems and didn’t want people to think I was stupid, so I stopped hanging around people from work.”

Social engagements became opportunities for embarrassment and ridicule, causing Melissa terrible personal conflicts. She wanted to be out among the crowds, but simultaneously felt vulnerable and frightened by them. Melissa sank into long sulks and quiet withdrawals. The invitations stopped coming and the phone rarely rang. Of the sixty-five well-wishers, only one person remained a friend.

Melissa exchanged dates with doctors for appointments with doctors. On a visit to one doctor’s office for her pain issues, she happened across some literature on brain injury that had been left in the lobby. The brochure listed the wide-ranging side effects of brain injury: mood lability, agitation, poor attention, memory problems, coordination difficulties, and disorientation.

“I saw it and realized, ‘Oh my god, this is what I’ve got,’” she says.

Once I’ve finished my evaluation of a brain injury survivor, after I’ve put my file back in my case and put away the pen, I often wait around until I sense they’re ready for me to leave. They’ll ask me about my job, comment that I look tired, invite me to stay for dinner, show me pictures, ask if I have any pictures of my baby. It’s the best part of my job. It’s in that space, away from the clinical microscope, that the damaged blossom. They will admit that they haven’t felt like their old selves, or they will confess, with a little shame, about how they never paid any attention to disabled people until now, and look at me, I can’t believe I am one of them. “I’m not me anymore,” one survivor told me, “but I’m still me.” I take those statements as an indication of deeper musings. Every so often a survivor, speaking to themselves more than to me, will ask the most spiritual question.

The most spiritual question in the world is not whether there is a god, or how we came to be in the universe. The most spiritual question in the world does not concern itself with knowing why there is suffering or why we are here; those ponderings stem from the most spiritual question. The aim of every mystical tradition in any religion is a sincere and relentless pursuit of the answer to the most spiritual question. The most spiritual question is about you. The question is: Who am I, really? Brain injury, above all other anguishes known to man, perpetually invites us to embark on the search for our selves. Who are we, other than our brains, really?

Different spiritual practices offer various methods for inner investigations, but few religious traditions are so doggedly concerned with the matter of self-discovery as Zen Buddhism. If a person is able to clearly realize their true nature, the thinking goes, then they will experience a freeness of being that acts as a boundless source of strength. One glimpse of your true nature is enough to dislodge former perceptions of your self, and you begin acting from your new understanding.

After the initial confrontation with their true selves, certain Zen students begin a rigorous curriculum of enlightenment that begins with the study of one of the world’s most enigmatic and profound sacred texts, The Gateless Gate.1 Compiled in the thirteenth century by the Chinese monk Mumon, the writings contain dozens of koans, any one of which could take years for a Zen practitioner to complete. The koans are brief, sometimes irrational vignettes that relay encounters between monks and Zen masters. In the exchanges, some monks attain enlightenment, while others simply go on about their business. Any koan has the potential to trigger a direct experience of the sublime, a deeper realization of the self.

Beat culture popularized some of The Gateless Gate’s koans, such as “Does a dog have Buddha nature?” or “What is the Buddha? (answer: three pounds of flax).” Though they’re publicly received as absurd and ridiculous parables, to the Zen student koans are keys to unlocking truths not otherwise accessible. Taken individually, koans have a subversive effect on the rational mind; part of their power is in their ability to confuse and deflate any attempts at intellectualization. A Zen master might put his shoes  on his head, or simply advise a monk to wash his bowl. Viewed collectively, however, the koans yield other rich subtleties.

The Japanese phrase chinami ni, for example, appears in fourteen of the forty-eight koans. Contextually translated as “in all earnestness” or simply “earnestly,” the phrase describes the attitude of a monk who is seeking illumination. A monk will approach a teacher in all earnestness, a question will be posed earnestly, a gesture is conducted in all earnestness. As each koan encounter relays a moment ripe with the potential for enlightenment, the virtue of earnestness is regularly dealt a passing reference. Earnestness, the sacred text implies, is a prerequisite for revelation. Six months after the injury, Melissa arranged for her first neuropsychological evaluation. The testing took several hours to administer and consisted of the Halstead-Reitan neuropsychological battery, along with ancillary measures such as the Weschler scale, the Wide Range Achievement Test, the Peabody Individual Achievement Test, the Detroit Tests of Learning Aptitude, the Rey-Osterrieth Complex Figure Test, the California Verbal Learning Test, and the Minnesota Multiphasic Personality Inventory. The testing left her feeling depleted. At least she would finally have a solid idea about what kind of problems she was having, she thought. She could not have anticipated the actual results:

Lengthy or complex auditory/verbal information is assimilated with difficulty, with relatively greater decrements in recall demonstrated for this type of information after delay. Significant difficulty is demonstrated in the initial assimilation, processing, retention, and later recall of nonverbal information . . . A general slowness in the efficiency and processing of information is demonstrated by an individual who also encounters difficulty with more complex types of cognitive tasks . . . There is no doubt, however, that given this individual’s industrious and hard-driving style that compromised mentation and an inability to execute her normal occupational responsibilities and social obligations have tended to exert a profound and negative impact upon her psychological and emotional functioning at this time.

As Melissa flipped back and forth through the thirteen pages of the report, the words struck her like a litany of shortcomings. Even in areas she considered innate strengths, such as verbal ability and comprehension, she now appeared average or slow. She cringed at the psychological impact demonstrated in the findings, sensing that they were more accurate than she wanted to admit. The neuropsychologist had identified over a dozen general areas of cognitive impairment and detailed more than forty distinct impairments. In his report, he suggested follow-up appointments at the Organization for the Multi-Disabled, a crushing blow to a woman who so recently considered herself extraordinarily able. According to the conclusion on the report, there was no longer anything exceptional about Melissa Felteau.

For six years after the evaluation, Melissa endured all the same frustrations and setbacks common to brain injury survivors. The neuropsychologist had recommended a specific course of treatment, but in the end, the healthcare system in Canada was no better equipped to handle brain injury than that of any other country. She struggled to find service providers and was forced to travel hundreds of miles to see specialists who could do very little for her. One occupational therapist came into her home and offered to organize her closet by color, so that she could pick her clothes out more efficiently. Melissa felt humiliated by the therapist’s perception of her. She didn’t need help getting dressed; she needed her old brain back.

Because of the continuing costs of her care, her case mushroomed into a long-standing litigation with her insurer, which brought her more stress and health problems. As a particularly malicious tactic often used in similar cases, the insurance company claimed they had overpaid her, so that she would be put into financial duress. The tactic worked. Her financial life teetered on the brink of bankruptcy; even her parents suffered setbacks to their retirement on her behalf. She eventually resigned from her job, feeling conquered and inadequate because she simply could not meet her responsibilities.

Physically, Melissa had deteriorated significantly. She ached to return to a swimming pool or lake, but when she entered the water the motion caused her to lose her bearings to the point where she couldn’t figure out which direction she faced. Swimming felt like drowning. As if the prison of inactivity wasn’t restrictive enough, Melissa developed regular bouts of idiopathic anaphylaxis, a severe, stress-related allergic reaction that required her to be within forty-five minutes of a hospital at all times. Almost twice a year, Melissa’s body would revolt with anaphylactic shock. Her throat would constrict until it closed, her eyes would swell shut, and hives covered her body until a strong-enough steroid could be administered in an emergency room. She was well aware that the reaction could someday bring with it another brain injury, or possibly death.

Melissa might have been rendered helpless against her brain injury, but she felt certain she could find a way to minimize the anaphylaxis. She began to research stress reduction techniques and eventually stumbled onto a holistic center that offered a five-day integrative program based on techniques developed by the University of Massachusetts Medical School. The core principle of the program was the cultivation of mindfulness through guided meditations. As Melissa studied the program in detail, she worried that her brain injury might not allow her to fully benefit from the program. She decided to enroll anyway.

“Those five days were grueling,” she recalls. “We would start with gentle yoga, then meditate until nine at night.” During that retreat Melissa learned about the various attitudes of mindfulness, and she participated in self-discovery exercises. The point, as she understood it, was to tap into the powerfully curative characteristic of awareness and to generate so much of it that she might be able to apply it to ordinary everyday life. Even the most mundane act, like washing dishes, could be transformed by simply paying attention.

It was during one of the exercises that Melissa experienced a sudden clarity. She had been instructed to think about the pleasant events in her life, and she noticed that each time she did, she would undermine herself with a barrage of malicious thoughts.

“That was my biggest problem,” she tells me. “I realized that I was always comparing myself to my preinjury self. I was trapped in a vicious cycle of rumination and depression.”

That one instant of awareness shed enough light to convince her to continue in her development of mindfulness. Maybe this was something she could be good at, at last. After the retreat, Melissa began a disciplined schedule of daily meditation and yoga. Although her initial intent was to alleviate the likelihood of anaphylactic shock, she began to notice other changes.

“Right away it improved my concentration, and it improved my mood swings,” she says. “I was a lot less irritable, and my memory started improving because I could attend more. My family was even starting to notice all this.”

During a trip with her parents and her sister, Melissa began to see the signs herself. Prior to meditating, she would get sickened just watching the trees whip past the car window. Typically, one day of family interaction exposed her to so much stimulation that she needed to withdraw out of exhaustion. On this trip, however, she stopped cocooning herself in her cabin room. The headaches and dizziness had evaporated, along with the agitation and moodiness. When Melissa emerged from her room the following day and joined her family, they were shocked at her presence.

“You can be around us again!” her sister said.

The changes were so significant that Melissa wondered if mindfulness could benefit other brain injury survivors. Knowing that graduate school might prove an insurmountable hurdle, she applied and was accepted into a master’s  program in adult and continuing education. Through her  affiliation with a local university, the encouragement of her professors, and support from a hospital, Melissa made an arrangement to conduct her first foray into research. She had chosen a group of brain injury survivors who agreed to engage in a seven-week training in mindfulness. Melissa would then track the group for any indicators that the practice changed their lives.

Case 19 in The Gateless Gate contains the following koan:

Joshu earnestly asked Nansen, “What is the Way?” Nansen answered, “The ordinary mind is the Way.” Joshu asked, “Should I direct myself toward it or not?” Nansen said, “If you try to turn toward it, you go against it.” Joshu asked, “If I do not try to turn toward it, how can I know it is the Way?” Nansen answered, “The Way does not belong to knowing or not-knowing. Knowing is delusion, not-knowing is blank consciousness. When you have really reached the true Way beyond all doubt, you will find it vast and boundless as the great empty firmament. How can it be talked about on a level of right and wrong?” At these words, Joshu was suddenly enlightened.

Mumon, the compiler of the koans, included a brief commentary and a verse with each koan. The verse that accompanies Case 19 offers a delicate hint toward unlocking the koan’s peculiar teaching.

The spring flowers, the moon in autumn,
The cool breezes of summer, the winter’s snow;
If idle concerns do not cloud the mind,
This is man’s happiest season.

Although Case 19 begins simply enough, it appears to fall back on itself with contradictions, pitting action against inaction, the dual against the non-dual. For contemporary readers, though, the koan presents a more literal complexity. What, exactly, is meant by “mind?” The most commonly held belief among neuroscientists is that “mind” refers to the by-product of brain; it is the whir of our cognitive wheels spinning. In academic journals and the common vernacular, the terms “mind,” “consciousness,” “ego,” “soul,” and “awareness,” are all used interchangeably, as though  they refer to the same process.

Tibetans, the great investigators of the inner universe, delineate between multiple types of consciousness—an acceptable number includes about eight kinds in various Eastern philosophies. For decades, our researchers have bemoaned the woeful ambiguity of the terms “mind” and “consciousness,” and they note its tendency to obfuscate the outcomes of serious neuroscience.Western science has yet to offer a standardized definition. It is at this semantic junction that we can most pointedly feel the shocking depths of what little we actually know about the brain. We can place shunts in the middle of someone’s head and we can shock depression out of the skull, but we don’t know the foggiest thing about ordinary mind. Science can tell you the molecular composition of each neurotransmitter suspended in your brain, but it cannot tell you who you are.

Melissa drives me to a large hospital where she’s conducting her third study on the effects of mindfulness-based therapy on brain injury survivors. The first two studies yielded such impressive results in areas such as quality of life and the relief of depression that Melissa received a grant from the Ontario Neurotrauma Foundation to continue her research. Although she can manage only two treatment arms in her current location, she already has thirteen hospitals throughout Canada eager to participate in the study.

The research room contains four rectangular folding tables arranged in a large square, and by the time I arrive eight of the participants are already seated. The participants range from nineteen years of age to sixty, and none of their injuries are immediately evident, though several of them wear head coverings. I look around the room and see no wires or electrodes, no fancy sensors or expensive scanners. There are simply eight humans, each with a damaged brain, and their faces are serious. For them, this could be the most important change in their lives. Melissa introduces me to the group, and I smile at everyone and wave a hand, and beg them to ignore me altogether. I just want to observe, I explain, and they return nods and smiles and are gracious enough to let me stay.

Melissa opens the group with a brief review of the exercises they completed last week, and she calls for completed “homework” assignments to be handed in. As part of their responsibilities, the participants agreed that they would dutifully complete assignments given to them. Without exception, each one turns in a form to Melissa that charts the duration of their meditations and the types of mindfulness exercises they conducted at home. Melissa then announces that she’ll begin with the first mindfulness exercise, and all around the room the participants sit upright on the edges of their chairs, each of them poised but relaxed. I decide to join them in the exercise, so I set down my notes and lay my hands in my lap.

Melissa begins talking in a low, calm tone, and she encourages the group to pay attention to their bodies. She tells us to intentionally relax the tensed areas and to notice any painful areas. She directs us to breathe deeply, and her voice, now slow and patient, continues to massage the room. After several minutes of stillness, she resumes her talk and encourages us to pay attention to our thoughts. It’s okay to have them, she says, but it’s not okay to feel bad about them. Just watch them without judging, she says. I rebel and peek around the room. Everyone’s eyes are lowered, and their faces are slack. They look as if they’ve had a long rest already, and we’ve only just begun.

The script Melissa follows comes from the same series of guided meditations she first encountered at the retreat center. In various ways, they encourage and exercise the different tenets of mindfulness, from patience and trust to acceptance and letting go. Participants are then taught how to apply their new insights toward their personal lives. Melissa’s hope is that everyone in her group is able to find some respite from the many challenges that plague them daily. Once this particular eight-week group has concluded, she’ll continue to follow up the research through questionnaires in order to test the durability of her experiment.

Mindfulness has its effect on us. It takes about forty-five minutes for Melissa to narrate the entire meditation, which is no small achievement for several people in the room who struggle with attention deficits. One woman breaks into tears at the end of the exercise, crying out that she’s not sure if she’s doing it right. A younger man confesses that he almost fell asleep during the talk, which was strange for him, because he has problems sleeping. Another woman tells the group how her anxieties are finally starting to let up, and the group nods, as though this is a common sentiment among them. They continue to process their experience for a few minutes, and then Melissa gives them their assignments for the following week and encourages them to contact her with any questions that arise later. Some of them stop to thank her on the way out, and soon they are all gone. From the stillness I draw a curiosity, and I approach Melissa to ask her how mindfulness works.

“It gives you a new way of looking at life,” she tells me. “This type of therapy teaches you how to stop wanting something different than the life you have, and there is incredible freedom in that. We come to realize we are whole, no matter the deficits, and that there is more right with us than there is wrong. To really embrace that is transformative.”

I tell Melissa that it sounds like a wonderful and noble pursuit and that I hope her research opens up new solutions for survivors in the future. Then, being unable to resist, I ask her what mindfulness training has done to her sense of self.

“Who are you, really?” I ask.

“I love myself the way I am now,” she says. “I appreciate that I am not my brain injury. It was a traumatic experience, to be sure, but it deepened my relationship to myself and to others. I have become a more loving person. I am a lot more empathetic, and I know what compassion is now.”

The neuropsychological evaluation portrayed a woman about whom nothing seemed special, and in a sense, there is nothing special about Melissa Felteau anymore. She gets a little confused with directions, and she still goes off topic in conversation. She becomes a little flustered when she tries to parallel park, and she laughs at herself when she trips over a rise in the sidewalk. She is a student conducting her research, and she is a daughter who loves her parents. The spring flowers, the moon in autumn. Melissa is brain injured and she is wonderfully whole. Using only her ordinary mind, she has found her way.

* * *

Notes and Sources

  1. There are numerous renderings of The Gateless Gate; for the purpose of this chapter, I have used examples from Koun Yamada's translation.
  2. For an excellent starting point on the semantic complications regarding consciousness, take a look at "On the Neurophysiology of Consciousness" by the acclaimed researcher Joseph Bogen, in Consciousness and Cognition 4 (1995): 55-62 and 137-58.

From Head Cases by Michael Paul Mason, published by Farrar, Straus and Giroux, LLC. Copyright © 2008 by Michael Paul Mason. All rights reserved. To view or the book, go to www.amazon.com. For more information about author and brain injury case manager Michael Paul Mason, go to www.michaelpaulmason.com.

Posted on BrainLine August 15, 2008

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