PICK­ING UP THE PIECES

Timothy Giles was punched in the head, twice. He ex­plains how his life has changed for­ever.

Weekend Herald - Canvas - - CONTENTS - I took the punch, like glass. I didn’t break, I shat­tered. from Col­li­sion, by Sam Hunt

Ac­ci­den­tal blows to the head left Timothy Giles with more than a headache. He ex­plains how his life has changed for­ever.

It was two punches that shat­tered my life and I’ve spent years pick­ing up the pieces. More than a decade on I ac­cept that some bits will al­ways elude my reach. The chal­lenge I live with is piec­ing to­gether a rich and happy life with what I have. Trau­matic Brain In­jury (TBI) isn’t rare, thou­sands of New Zealan­ders live with its ef­fects. Mine are pretty com­mon place: fa­tigue, headaches, con­fu­sion and me­mory loss. But these aren’t the hard bits for me, mood and emo­tion are my big­gest post-TBI dif­fi­cul­ties.

Per­son­al­ity is an in­ter­est­ing thing to de­fine, the at­tributes that make us who we are. An im­pact of my brain in­jury is a pro­found per­son­al­ity change. It’s been a slow re­al­i­sa­tion that I am not the man I was. I’m grumpier, less pa­tient. Not as kind or for­giv­ing. Part of this could be a con­se­quence of the ev­er­p­re­sent fa­tigue. The need for af­ter­noon naps and some­times morn­ing ones too, is im­mensely frus­trat­ing. I’ve lived since my mid-30s with the nap sus­tained pat­tern best known to par­ents of tod­dlers.

My life with TBI comes with an awareness of fragility, of vul­ner­a­bil­ity to in­jury and im­pair­ment. Pre-in­jury, I loved the phys­i­cal­ity of an ac­tive life, sport, ski­ing, off-road­ing, rid­ing, wa­ter-ski­ing, surf­ing, adrenalin-seek­ing. I’d

have a go and loved it all. Now I am at best a cau­tious par­tic­i­pant and, too of­ten, an ha­bit­ual spec­ta­tor.

NOW TO the too-of­ten asked ques­tion: how did it hap­pen? Two sep­a­rate events, a ran­dom late-night as­sault, two punches, both ver­sions of the cow­ardly punch — one to the back of my head, the se­cond, also from be­hind, to my left tem­ple. Dam­ag­ing and life-chang­ing. The se­cond event, some years later, a clash of heads in so­cial foot­ball, knocked me out. Fall­ing un­con­scious, to an un­usu­ally hard win­ter sports field, I copped a se­cond blow as my head hit the ground. This set my re­cov­ery back years and I seemed to show a sus­cep­ti­bil­ity to con­cus­sion that had clin­i­cians rec­om­mend a qui­eter, more cau­tious life, sus­tain­ing re­cov­ery by a fo­cus on con­cus­sion pre­ven­tion.

THERE IS more to these in­ju­ri­ous events and I am aware that your cu­rios­ity may not be sat­is­fied. But it is a te­dious topic. Like ev­ery­body I have ever met with trauma-re­lated im­pair­ment, I tire of re­count­ing an his­toric event that now car­ries min­i­mal, if any, use­ful in­for­ma­tion. The rel­e­vant ques­tions of “what is life like now?” and “how does it im­pact daily ex­pe­ri­ence?”

That daily ex­pe­ri­ence is life-defin­ing and un­re­lated to the his­toric cause.

My days are shaped by fa­tigue, which means I sleep more than I want to and more than any other healthy adults I know. Phys­i­cally, I am for­tu­nate to be fit and well, with few symp­toms. Headaches are per­sis­tent, dif­fer­ent types of vary­ing in­ten­sity. Some re­lated to my sen­si­tiv­ity to light and noise. That peo­ple en­joy noisy cafes or chat hap­pily on a busy street, amazes me. Friends ex­pect me to dim both lights and music, to sit faced away from sunny win­dows. This lessens headaches and length­ens time I can fo­cus.

Fa­tigue un­does all my good work, ev­ery day. It is the defin­ing ex­pe­ri­ence of my cog­ni­tive im­pair­ment. Just as the phys­i­cal fa­tigue makes a nap in­evitable, men­tal fa­tigue is in­escapable. Morn­ings are good, long or in­tense days are not. In some ways brain in­jury is an in­trigu­ing ex­pe­ri­ence, I can feel my think­ing work well and slow­ing when it doesn’t. Frus­trat­ing yes, but an in­ter­est­ing ex­pe­ri­ence. To man­age it, I have grown skilled at ob­serv­ing the ebb and flow of my men­tal en­ergy and ca­pac­ity to think and func­tion. Pre­ven­tion is again re­cov­ery’s theme. Keep my days short, rest be­fore and af­ter busy times. A pro­duc­tive day at work de­mands a few quiet nights at home. Plan­ning and rest­ing to per­form. The bal­ance de­manded by a tir­ing brain is, when I ap­proach it pos­i­tively, an in­ter­est­ing life puzzle.

NOT SO in­trigu­ing is the ex­pe­ri­ence of me­mory loss. Con­fu­sion too. I men­tion them to­gether as I think they are ver­sions of the same cog­ni­tive loss. Con­fu­sion can over­take me any­time, any­where and usu­ally ar­rives mid-sen­tence. We all get con­fused, we all know the feel­ing, los­ing our bear­ings, con­text, the thread. Usu­ally due to over­load, of stim­uli, stress or tired­ness. For me, it is like rain in Auck­land, comes from nowhere, hap­pily doesn’t al­ways hang around, but is guar­an­teed to re­turn.

Me­mory loss feels sim­i­lar, though less pre­dictable. I have whole years of my life I don’t re­call. Build­ings I know I worked in and the com­pa­nies I worked for. But the most I can ac­cess be­yond that, is a few snapshot like mem­o­ries of a col­league or three, and the oc­ca­sional de­light­ful or out­ra­geous cus­tomer. Emo­tion holds me­mory too. I feel good about times in a place, but can’t ex­plain why. I just ac­cept emo­tion as me­mory and as­sume I en­joyed be­ing there, that I learnt things, had friends.

Mem­o­ries of my high-school years are scant, episodic. A bit like the post­cards my brother used to send from his var­i­ous trips. Sup­ple­mented by the sto­ries he’d later re­count for amuse­ment or shock value, colour­ing in the static im­age. Old col­leagues and school­mates are sim­i­larly help­ful. They back-fill holes in my me­mory. Nostal­gic friends and ac­quain­tances are a rich me­mory re­source, their rec­ol­lec­tions an­i­mate my static men­tal im­agery. I get to lis­ten and choose to take their re­call as my own — or not. It’s a cre­ative form of re­cov­ered me­mory. Emo­tion is a source of re­mem­bered mean­ing. An old friend con­nect­ing on so­cial me­dia may not prompt much for me in the way of de­tail, but will of­ten spur an emo­tion. Some­times fond­ness, car­ing, amuse­ment, at other times it’s shame, sus­pi­cion, fear. Get­ting to know these peo­ple again, I’ve learned to trust my emo­tional me­mory. I have learned enough to oc­ca­sion­ally apol­o­gise for er­rors and omis­sions I only hazily re­call. I have apol­o­gised a lot and have plenty more to go.

APOL­OGY IS a pow­er­ful force in heal­ing and en­joy­ment of the life I now have. It sur­prises me that it wasn’t in­cluded in the treat­ment I re­ceived and I’ve been blessed by some gen­er­ous clin­i­cal and heal­ing in­put. I sep­a­rate heal­ing be­cause I’ve met just three clin­i­cians who I ex­pe­ri­enced as skilled and com­mit­ted to help­ing me heal.

One neuro-psy­chol­o­gist, who in his own time, un­paid, vis­ited my daugh­ter, phoned her mum and sat with my then-part­ner, to ex­plain the ill-man­nered, in­con­sid­er­ate and of­fen­sive ig­no­ra­mus who had taken pos­ses­sion of the man they had known and loved. Thank you James. I was still some years from re­cov­er­ing the in­sight re­quired for that con­ver­sa­tion. His ex­cel­lence tes­ta­ment less to pro­fes­sion­al­ism than love.

I had no GP. You see I was a typ­i­cally bul­let­proof bloke un­til, I sud­denly and trau­mat­i­cally, wasn’t. Some­how through the per­sis­tent fog of brain in­jury, I found my­self in the care of one, so ex­pert in his field that he prac­tises hu­mil­ity and lis­ten­ing. Part­ner­ing me in our fight for well-be­ing. Be­liev­ing I know some­thing of my own ex­pe­ri­ence and how to per­sist through its malev­o­lent em­brace. David, kia ora.

I for­get the name of the oc­cu­pa­tional ther­a­pist who would ar­rive at my gloomy

rented apart­ment, in­sist I an­swer the door, bully me into move­ment, harry me through the hu­mil­i­a­tion of ex­er­cises to bal­ance, grip, turn, stand, sit and stand again. The tasks mas­tered in child­hood that would de­rail and rob me of ma­tu­rity, mas­culin­ity, iden­tity and hope.

The fa­mous Dr King said labour is dig­nity. To­gether, we laboured at the most ba­sic phys­i­cal move­ment. You’d be proud, for­got­ten healer. Not only can I walk stairs un­hin­dered by ver­tigo and un­aided by handrails, I can run the bas­tard things.

Heal­ing is lay­ered and long. Pain clin­ics, re­hab ses­sions, well-be­ing work­shops, raw food di­ets and med­i­ta­tion, I’ve done the lot. “You’re our model pa­tient,” a neu­rol­o­gist I never trusted, told me. Which was funny, as I’d ig­nored their ad­vice.

But I lis­tened to the ex-ath­lete who told me, “When my body was bro­ken, I led with my mind. Your mind is bro­ken, lead with your body.” Faafe­tai Michael.

Brain in­jury camp was spe­cial. A week­end away with other men, women were there, but I fell in with the men. Word­lessly, we knew. In­stant iden­ti­fi­ca­tion and ac­cep­tance across bar­ri­ers of eth­nic­ity, age, ed­u­ca­tion,

at­ti­tude, ex­pe­ri­ence, and abil­ity. Sit­ting silently to­gether in the shel­ter on the marae atea re­mains a pow­er­ful ex­pe­ri­ence of heal­ing. As ef­fi­ca­cious as it is in­ex­pli­ca­ble. At least to me. But then I’m brain-in­jured, what would I know?

I know this, there is a pop­u­lous club I am in and not a sin­gle mem­ber joined will­ingly. It is the chronic in­jury club, per­haps you, too, are a mem­ber? On qual­i­fy­ing, we each re­ceive an ac­cess all ar­eas pass to all man­ner of un­wanted life ex­pe­ri­ences. To phys­i­cal, and emo­tional tri­als, chal­leng­ing our spirit. At brain in­jury camp, and in the pain clinic, along­side a lady at weekly med­i­ta­tion class, I learned that it is a priv­i­leged club of re­mark­able peo­ple. Won­der­fully brave, hum­ble and en­cour­ag­ing types. The car­ing ac­cep­tance of some­one who is in pain is as com­fort­ing as my grand­mother’s good­night kiss. No evil can de­feat it.

But it tries. The most in­sid­i­ous evil is mood. Tired and hurt­ing it is easy to lose hope. More than a decade on it is hard to per­sist. Pre­ven­tion is my in­surance. Pre­vent­ing loss of be­lief.

I HAVE to be­lieve that my new life will be rich, though with so many years out of the work­force, fi­nan­cial riches are un­likely. I need to be­lieve that my en­er­gised mo­ments of per­for­mance make a suf­fi­cient con­tri­bu­tion to friends, whanau and my work, to bal­ance the more sus­tained medioc­racy of fa­tigue.

Re­silience has be­come a fo­cus. There are two parts to the word and I am well past half-way there. The first, re­sile from, to draw back, I’ve mas­tered. The se­cond “siliere”, the same word root as elas­tic­ity, the spring­ing back. That is what I work at now.

Here is the recipe, avail­able in any sum­mary of pos­i­tive psy­chol­ogy:

Find and ex­press grat­i­tude ev­ery day. Many mil­lions have it far worse than I, how dare I not be grate­ful? Ac­tively, de­lib­er­ately thank­ful for what I have, ex­pe­ri­ence and am.

De­mure daily from the slights, frus­tra­tions, hos­til­i­ties and harm. Favour in­stead the thing that en­riched me to­day. Made me hap­pier, wiser, more hum­ble, more amused, more com­fort­able in me, as and where I am. Com­mit to telling some­one this thing ev­ery day, in per­son, phone email, any­thing. Af­ter a while the hunt­ing those mo­ments makes it habit not just to no­tice them, but to dwell on them and to find they shape a day, a week and I hope, a life.

Lastly is so­cial connection. When I lost, they tell me, 60 per cent of my vo­cab­u­lary, I wouldn’t leave the house. From pre­sent­ing tele­vi­sion, host­ing talk­back and run­ning a dy­namic lit­tle PR firm, I couldn’t find ev­ery­day words, had for­got­ten how to ca­su­ally ko­rero. If I didn’t know how to com­mu­ni­cate, I didn’t know who I was and not know­ing that, how could I leave the house?

Only by the grace of oth­ers was I dragged into connection again. Here, in the en­ergy, ac­cep­tance and in­clu­sion of oth­ers, I find the bar­rier to the black dog or what­ever it is that dark­ens my mood, con­sumes hope.

So each day I find a gra­cious ac­knowl­edge­ment, spot in some­one an act or choice not to act, that makes this a bet­ter place to be. It is gra­cious be­cause I can­not thank some­one for some­thing they do that ben­e­fits me. The chal­lenge is to tell ac­knowl­edge, val­i­date, praise some­one for what they do (or re­frain from do­ing) to an­other. Search­ing for these of­ten small choices of oth­ers helps even an in­jured

Find and ex­press grat­i­tude ev­ery day. Many mil­lions have it far worse than I, how dare I not be grate­ful? Ac­tively, de­lib­er­ately thank­ful.

brain un­der­stand the good­ness and lov­ing that is all around us. It is an in­vest­ment I draw on in the days that I can’t see it.

AT 49 I am age­ing, and here is the sil­ver lin­ing in my brain in­jury cloud. My ath­lete mate and men­tor beat the med­i­cal fra­ter­nity to it when he got me back to the gym, in­sisted I first walk, then jog around the block.

“So what if you sit down ev­ery 10 me­tres? Af­ter two reps? You are in the game.” And I am. I’ve run marathons since brain in­jury, com­pleted a half-iron­man, swum across some big, beau­ti­ful har­bours and rid­den round Lake Taupo with a mate who, by wait­ing for me at 5am, forced me into win­ter’s icy pre-dawn dark. Kia kaha, Todd. I am fit and strong be­cause if I ex­er­cise six days a week, my brain works bet­ter. I sleep less. The headaches can’t take hold and mood is more of an ally. I have no doubt I am phys­i­cally far fit­ter than I would have been with­out TBI. Grate­ful.

The re­gret I hold is the loss of friends. Ev­ery time it is my bad. How many times do you in­vite a friend for din­ner, lunch, drinks, cof­fee, when he en­thu­si­as­ti­cally agrees, only to not turn up? In my ex­pe­ri­ence the best friends last a dozen or maybe more, be­fore it gets too much. In this I haven’t yet got any bet­ter. A big day means a quiet night. A busy week a soli­tary week­end. I owe a lot of apolo­gies.

But there is al­ways hope, at least, on the good days there is. My task is to cre­ate more good days. Af­ter trauma, it is re­silience that cre­ates the good days. To re­sile from and then to spring back. Or per­haps for­ward. I can’t spring back into my old life, that is lost to me. That fa­ther, brother, friend and part­ner, lost to those who mat­tered most to me. He is equally as lost to me.

Spring for­ward then, into a new dif­fer­ent life. A new but not im­proved me. It’s all you’ve got, so ac­cept it and make it mean­ing­ful. Start by be­ing grate­ful for the mo­ments, the bless­ings and priv­i­lege, the light if not the shade.

I am grate­ful, for ex­am­ple, that I fi­nally wrote this. I’ve been think­ing it over for years. I used to be paid to write, this is an­other piece of life I’ve fi­nally man­aged to gather up. Now what can I do? The op­por­tu­ni­ties are end­less, ex­cit­ing.

But first, I think I’ll take a nap.

10

Timothy Giles

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