Claudia Osborn wrote her autobiography of being a doctor but losing her occupation and almost her life through a serious brain injury. Claudia, a 42-year-old doctor and clinical professor of medicine, describes the aftermath of the brain injury nine years previous. She was stripped of her occupation and therefore her livelihood, for years deprived of intellectual companionship, and was challenged to do even the simplest tasks like reading a book, shopping for groceries or even sorting the mail.
In Over My Head: A Doctor's Story of Head Injury from the Inside Looking Out she writes her story. After extensive therapy she regained a lot of function (she takes copious notes on all aspects of what she's doing, what she did already, leaves herself phone reminders, has her GPS programmed to get her to key places and also programmed to get her home when leaving from unfamiliar places). She is capable of writing, although her sentences are a bit stilted at times. She has very reliable people supporting her emotionally, and physically when necessary, and her mother, a very strong woman and advocate for Claudia to maintain her independence as much as possible, was the editor and advisor for this book.
Some interesting points in the book:
Immediately after Claudia's catapult from the bicycle to the pavement and lying unconscious, she moved. A policeman and his son were the first on the scene, having witnessed the accident. The policeman was exulted when Claudia finally moved, but Marcia, the doctor-friend and housemate riding with Claudia, was not reassured as Claudia rigidly pulled her arms up to her chest in a reflexive, involuntary gesture of someone with serious brain stem injury. The extensiveness wasn't apparent with testing and a few hours later Claudia was allowed to go home under the indirect care of Marcia. Claudia was never the same again.
She attempted to go to work the next day, but circled in the bathroom aimlessly not remembering why she had gone in there. Marcia handed her her toothbrush and asked how she could practice medicine if she couldn't brush her teeth without guidance. Claudia responded "I know medicine" as she proceeded to put hand lotion on her toothbrush.
After going to the office for a month, letters and mail were really beginning to pile up. She opened a letter which contained "The ... lab ... results ... on ..." but had no idea which lab, what results could they possibly be, and tossed the letter aside. Daily she faked her way through work with phrases like "it's interesting", the staff around her picking up the slack allowing her recovery time.
Her family and friends encouraged her but with her not getting better and frustration mounting, Claudia felt pushed to go to the recommended Head Trauma Program (HTP) in New York City. To be admitted she had to have a two-week screening-evaluation and then would be in the program for five months.
Her mother would often call her, encouraged her, get her to talk, and then help her make simple decisions for her day, like the first day Claudia had gone to NY for brain injury assessment and was staying with a friend who was out working:
"... The good part is that the search will show that I'm basically okay."
"That is true, darling. All the tests will reveal your strengths. Eat now, please don't forget."
I wrote EAT on my phone pad and underlined it. "Lori has food here."
"I'm sure. Why don't you make a simple list. It would remind you to eat and help you choose the menu."
"Why? I know what I'm going to eat." I've done it often enough. Who needed to plan to eat?
"You often forget. Tell me, what will you eat tonight?"
"I'm too tired to think." Silence. "Uhm ... twisted juice, for one thing." I'd become better with multiple-choice questions than essays.
"I've never heard of it."
"Well, it's common." I had an image of the carton with the picture of oranges. "You know, flattened oranges."
"Ah! Squeezed, not concentrate. What else?"
"Postage ... crumbled cereal." I add quickly, "That's not quite right. I only have the brand name right."
"Postage isn't a brand. It's Post, like Post Raisin Bran."
I rolled my eyes and said with studied patience, "Mama, I was using the past tense."
"Postage ... paste tense for Post." She laughed. "That would be fine. Now humor me. When we hang up, go to the kitchen and see what's in the refrigerator and cupboards. Write down two things. Then fix them. Will you do that?"
I curled up on the couch and closed my eyes. "OK, Mama."
"Then you'll go to bed, right?"
I didn't need to write it down. I did it first.
Claudia's day was filled with confusing moments. On one particularly day she was sure she had rolled up tissue and put it in her pocket, but in public when she pulled out the tissue, out came her bra ... the one she had forgotten to put on that morning. That was once, but oh so frequently she would go to get groceries but without a list, she couldn't make decisions, once coming home with $20 worth of Pepsi. When asked how she carried it home, she replied it was only a six-pack. She hadn't bothered to get the change.
Ronald Geller said, 'Words are the clothes that thoughts wear.'
My thoughts were pitifully naked.
Claudia perceived quickly that she was not on friendly terms with spoken language. To quote her, "Words elude me and refuse to come to my aid. I am incredulous, not to mention irritated, by the poor quality of my conversation. Ronald Geller has written, 'Words are the clothes that thoughts wear.' Frequently my thoughts were pitifully naked."
She was fascinated by Ronald Reagan's reputation as The Great Communicator during his presidency. She said he was a great speech reader, but his deficits became apparent when he was asked direct questions. For instance, when he was asked, "Can nuclear war be limited to tactical weapons?" he replied, "Well, I would, if they realized that we -- again if -- if we led them back to that stalemate only because that our retaliatory power, our seconds, or strike at them after our first strike, would be so destructive that they couldn't afford it, that would hold them off." People expected Reagan to perform well because he was the president and so the public made excuses for such oddity and rationalized the strangeness away. Like Reagan, people who didn't know Claudia didn't understand the extent of her not being able to function. What they perceived as "normal" was hidden behind the wall of limited interaction with her.
Claudia misses the person who she once was, the intelligent, snappy-minded, full-of-energy person with ambition and leadership. But that person died in 1988. She admits she wasn't a fun person, had a limited social life, steeped herself in work and was often unavailable for family and friends. She misses who she once was but has adjusted herself to accept who she presently is, a person with a very poor memory, a person who burns meals, loses car keys (and sometimes cars), forgets appointments, fails to return library books, and embarrasses herself (and others) regularly in public. That said, she can do things now she never did before. Now she paints .... and she writes. She has dreams now too, not her former dreams, but dreams nevertheless. Achievable dreams which she is carving out for herself. And she closes the book thinking of her dreams:
"I was a happy woman before my injury.
I am a happy one today."
