The Ghost in My Brain

by Clark Elliott

  I am disoriented because I can’t look down, and so have to get my visual bearings from watching parts of the tree, which are themselves swaying in the wind. It’s all one chaotic swirl of sunlit green. My balance system is shot, and I have to rely on my eyes only to know which way is up. The flood of data from my senses is overwhelming: the roar from the chainsaw engine; the smell of oil burning on the muffler; the feel of branches pressing against me everywhere; sawdust, salty sweat, and stinging two-stroke exhaust in my eyes and that I taste in my mouth. I am having difficulty managing the geometry of placing myself—my body, and the chainsaw I’m holding—within the context of the moving tree. It’s as though I’ve lost my sense of the demarcation point of—the boundary between—my inner self and the outer world around me. Except for what my eyes can tell me as I stare intensely through the fog of my safety glasses at both my boot, and the saw ripping through the branch on which that boot is standing, I have no way of distinguishing between the two. I have to manually, continually, walk myself through the connections in the branching of the tree, and the differential branching of my body. I can’t tell the difference between the two. Terrifying—given the circumstances, but also fascinating . . .

  It goes without saying that after I climbed down I was unable to walk, or even to stand up. Having to manage the chainsaw without the natural protection of knowing where my body ended was intense, and the base fear this truly odd experience generated was extreme. It took me a week to get the tree down, and another two weeks after that before my brain recovered.

  BALANCE AND HEARING. Balance is also linked indirectly to our aural processing systems because most of us process the meaning of audio input in a visual/symbolic way, and this in turn can compete with the visual processing needed for balance.

  An extreme illustration of this can be found in my notes from August, two years after the crash. I was driving back east with my friend James to attend my aunt’s funeral, and to visit James’s relatives in Maine. Even though James knew me well, like so many others he didn’t “get” that there was anything really wrong with me. James wanted to do all the driving, and traveling as a passenger in his car was a challenge. I had to keep my eyes continually focused on the horizon to help keep my equilibrium.

  James liked listening to the news on the radio, but this was a problem for me: I was unable to filter out the talk-audio stream, which meant that my visual system was being used—regardless of whether I wanted it to be—to create images of scenes from the radio news. This in turn meant that my visual system was unavailable to be used for balance, and I started to become both nauseated and disoriented. I managed to get by, sort of, until evening, but it took a heavy toll on me. My deep batteries were drained.

  When it grew dark, the problem got worse because the distant horizon was no longer available for me to use for keeping my balance. And James had to have the radio on to help him stay awake.

  We decided to stop driving for the night, but unfortunately we were unable to find a motel room. It seems that this was peak season for paintball, Mohican powwows, car shows, and other summer attractions in Indiana and Ohio. James grew increasingly fatigued, and frustrated, and began to whip the car around corners at each interstate exit as we tried over and over again to find a place to stay.

  This violent motion of the car, combined with the extreme fatigue of my visual systems, and especially the processing demands from the car radio audio stream, made it impossible for me to keep my balance, and in the end put me over the edge. I asked James to stop the car, but he thought I was just being difficult. So at midnight, at a stoplight, a mile away from the most recent interstate exit we had taken, I poured myself out of the car and into the street. There was a brief conversation about money in my pocket, which I didn’t understand, and then James drove off. I crawled over to a grassy patch under a lighted billboard, next to a truck-repair parking lot.

  From the environment, I knew that I was in a seedy part of a decaying midwestern industrial town in the middle of the night. Other than that I had no idea where I was, how I got there, or even who I was. I just needed the world to stop spinning inside of me, and outside of me. I needed the bell of nausea in which I was living to open and let me out. I stared up at the billboard, and the city lights reflecting off the cloudy sky above it, unable to comprehend anything at all.

  An hour later, James, relenting, came back to get me. He had found a motel. After we drove there, he went up to the room and went to sleep, leaving me alone to arrange my own belongings. I sat on the curb next to the car, without the slightest clue about how to proceed. A gang of toughs came by, carrying bottles of liquor in paper bags. They jeered at me, shoving me with their feet. I thought they might steal my things, or beat me up, but in the end they left. It took me an hour of intense work to get from the car to room 201, which was only fifty feet away, guiding myself through the chaos one inch at a time. I inched my way up the stairs and into the room, then fell asleep on the floor with my eyes open.

  BALANCE AS A COMPONENT OF THOUGHT. It is seldom considered, but in fact balance is linked to basic cognition, and is part of the way we construct multifaceted symbols in our brain. Without the orienting-within-space grounding of the balance system it becomes almost impossible to think clearly. When I lost my own sense of balance during times of brain distress, I also coincidentally found that the symbols I used for all kinds of problem solving became impoverished as well.

  For example, we think of the concept of a symmetric relationship as being “the same in each direction.” But the subconcept of direction, at least for me, includes as part of it a sense of space, a sense of objects being present in that space, and the idea of potential motion from one of the objects to the other. With symmetry, whatever “happens to” one of the objects also “happens to” the other object, albeit in a reversed direction. But each of these images—direction, space, objects in space, motion, “happens to,” and reversal—in turn tends to involve the even more basic concept of a horizon, and upness and downness, and leftness and rightness as well, each grounded in our balanced orientation in the world.

  Furthermore, these thought-objects are placed in space, often in front of our foreheads, certainly not behind our ears or our knees, so our own orientation within the thinking landscape is part of our reference. When the balance system is malfunctioning, essential elements (our perspective, orientation in space, “leftness,” “upness,” etc.) of each of these basic features (“happens to,” direction, motion, etc.) of the basic symbols of thought (symmetry, relationship, etc.) leave us. We can still think, and still manipulate symbols, but once again the visual system has to overfunction to make up for the absent natural richness of the original symbols. This is very fatiguing, and often not maintainable for more than a few minutes.*

  Maintaining balance in our lives goes far beyond merely staying upright.

  VISUAL/SPATIAL PATTERNS, SHAPES, RELATIONSHIPS

  WHEN GEOMETRY LOSES ITS STRUCTURE. In the few months prior to the crash, I had started to gut the burned house I was living in, so that I could rebuild it. I had four brick walls, three doors, and a few newly replaced windows, as my home. I was using a duct-taped garden hose and a laundry tub for a shower, and most important—with the Chicago winter looming—I was soon to have no roof. It was unfortunate that it was at this point in the rebuilding process that I got the concussion.

  Because funds were so extremely dear, I felt I had no choice but to continue with the rebuilding, working with subcontractors and doing much of the work myself. But this meant that with almost no ability to form or understand plans, I still had to be on the job every day managing all aspects of this large project.

  I did virtually all of the shopping for parts and supplies myself. On a typical shopping day, I might arrive at Home Depot with a list of a hundred complicated parts that the plumber needed that day in order to keep working: twelve 60° angled male-to-female ¾ inch PVC joints, four ¾ inch copper
sweat-fit right-angle joints, an inverted water-tank pressure-relief valve, and so on.

  Scanning for items in a store is a highly structured visual process that makes use of much conceptual information in the brain to rapidly interpret the massive amounts of visual data coming in. The data is sorted and filtered according to the concepts: horizontal shelves, and the vertical stacking of those shelves; shelves arranged in bays; the bays in aisles; the aisles in departments. The objects on the shelves have sizes, shapes, and colors, and these are used to index and chunk together the store items in an organized way.

  For example, if you see a can of Glidden latex paint, which has an easily identifiable Glidden label, and your peripheral vision indicates that all the other objects on the same horizontal plane have the same labels, the same colors, the same sizes, and the same shapes, then there is an immediate, visceral understanding that this is a shelf full of Glidden paint. If you are looking for Behr paint, whose cans have the same shape as Glidden cans, but differently colored labels, or are looking for plumbing parts, which have a different shape entirely from that of paint cans, then a normal brain will immediately, through a low-level visual-symbolic process, remove all bays containing Glidden paint from the search. It is not necessary to look at each can of paint and try to decide if it is the object you are looking for.

  With the kind of visual disturbance I suffered, searching for my plumbing parts soon deteriorated into a process that can be imagined as follows:

  Take all four thousand objects that will pass across your field of vision when walking through the plumbing aisle and randomly place them in a large patch of open floor. Take the cardboard tubes from the middle of a pair of paper-towel rolls and tape them over your eyes so that you can only see what is directly in the center of your field of vision, and so that what you are seeing has no peripheral context at all. Now, for the first item on your shopping list, start walking through the store items that are randomly placed on the floor. For each object on the floor, pick it up, and without naming it, describe the details of it to your brain to see whether it matches the first item on your list, which you are now trying to find: the color, the shape, the corners, the texture, its mass, and any interesting features it might have. Taken all together, do these features constitute the PVC elbow joint that you are looking for? If so, then try to locate your cart and put the elbow joint in it. Otherwise, put it back on the floor. Having located the first item on your list in this way, move on to the next one.

  Note that in walking through the four thousand items that are strewn about the floor there is no way to recognize whether you have returned to some spot you have already visited. There is no global field of vision. And, too, there are only the tiny component features (e.g., color, texture, angles) that make up the objects themselves: you’ve lost the ability to automatically translate these features of the objects into the gestalt of the “thing” itself.

  As you grow more brain-fatigued, the tubes over your eyes get smaller in diameter, and your ability to describe the features of the items to your brain deteriorates as well. You move ever more slowly. At some point what’s known as thrashing sets in: you are taking so long to examine any one object that by the time you have gotten around to describing the last of its features to your brain, you have forgotten what the first features were, and you have to go back to refresh that part of your description—in an endless loop. Ultimately, you have to stop.

  This is what it is like to go shopping for plumbing parts when you have concussion brain damage.

  After five minutes of searching through shelves and bins, my head would start to hurt. After ten minutes I would have to hold on to the shelving to stand up. In twenty minutes the nausea would be problematic. After thirty minutes I would be almost completely unable to make sense of the visual scene, apprehending only the component features of items directly in front of me, in the center of my vision: a bit of texture, some color, a shadowing, an angle formed by the joining of two edges, and so on.

  By this point I would lose the spatial sense of being “in an aisle” in the store. I would lose all concept of horizontal space, and could no longer see “shelfness.” I was moving in slow motion. I had to support myself by holding on to the shopping cart if I moved down the aisle.

  Sometimes I could find a plumbing associate in the store who would help me find some of the parts. But this was tricky. If I asked them where to find an “inverter plate,” which was written down on my list but not something with which I was familiar, it might turn out that it was right in front of me. But if the associate said, “It’s right there next to the green shutoff valves on the top shelf,” it could be trouble. I couldn’t rapidly retrieve the concepts of “shelf,” “top,” and “green,” and what a valve looked like (valves? valve?—circular motion . . . , piston . . . , tubelike object . . . ?). I would typically say something like, “I’m really sorry, but I don’t have my correct glasses on, and can’t see very well. Could you point to it?” But I did not look like a person who could not see. After pointing out two or three items, associates would get impatient with my slowness and drift off to help other customers.

  At some point I would give up and head for the checkout counter, doing my best to appear normal. Several times, early on, I pushed myself too far, and had to leave my cart in an aisle and go to my car to rest. The sensory overload from the unfiltered sights and sounds was too much for me.

  Lines at the checkout counter could also be problematic; once my body stopped moving I would get stuck, resting my head on the shopping cart and unable to move forward when a gap opened up. It was difficult to understand speech. If the cashier asked any questions about an item (“Is this washer galvanized?”), I just had them put it back, saying, “I’m very sorry. I don’t want it now.” Over time I learned how to push myself just far enough that I could still pay for my items, find my car, and get home.

  After checkout came what was often the most difficult part of a shopping trip, especially if it was during the winter and cold: finding my car in the parking lot.

  I would stand by the exit doors, not having a clue where my car was, not able to get my legs to move, viewing the world as though everything were a mile away. I could make no sense of the spatial characteristics of parking lots after shopping: the grids, the compass orientation, the parking aisles, the colors and shapes of the cars. And because my memory of where I had parked the car was stored using these low-level concepts, I had no idea where to look for it. I might wander around a parking lot for half an hour, examining the minute details of each car as I came up next to it, trying to decide whether it was mine. In the winter I was often freezing by the time I found my car. Then I had to wait a long time before my brain settled and I knew it was safe to drive.

  I often thought longingly about those handicap parking spaces near the entrance of the store. Having a handicap sticker would have been such a godsend! But government regulations did not make allowances for a long-distance runner who was yet often unable to walk to navigate a parking lot after shopping.*

  NORTH SOUTH EAST WEST. You will recall that on the day of the accident I had trouble navigating to the police station to retrieve my driver’s license. Within a few days I realized that I’d completely lost my sense of direction, which had always been grounded in the North-South-East-West (NSEW) grid that can be laid over the earth. My former sense of direction had been so acute that I had once intuitively retraced my steps for fifteen miles, through entirely urban terrain, to a house in an obscure and anonymous neighborhood full of curving streets, which I had visited exactly once—when buying a car from a stranger five years earlier.*

  By contrast, my friend Jake had no NSEW grounding whatsoever. Before my concussion, our contrasting styles of navigation used to clash when traveling: Jake had a Garmin GPS device in his car, and always set it so that maps were displayed with north pointing up. This drove me out of my mind, and if I wore Jake down enough he’d relent and f
inally let me set the Garmin so that north pointed north. Similarly, if we had a map laid out on a table, Jake would set the map so north was facing up, away from him, but I would always turn the map so that it corresponded to the real face of the earth—even if it meant I was reading the words upside down. At a visceral level it was hard for me to imagine always being as lost in the world as Jake seemed, to me, to be.

  When I lost my “perfect direction” sense in the moment of the crash, I lost all of my absolute grounding in the directional-symbolic world as well. This loss is much more profound than simply having to relearn how to get around the city, using a map. I found that many of the basic symbols of my intellectual-mathematical life had also been grounded in my directional sense, and having lost it I also lost important parts of them. Thus I lost foundational, elemental pieces that gave meaning to numbers, relations, analogies, and functions. I could no longer, for example, “see” the number seven in the same way, and when I tried to use it in even simple arithmetical calculations, I struggled. For me, the number seven had always in some obscure way stretched east, a component concept that no longer had any internal meaning.

  I also had trouble with dreams. Ordinarily, it was my experience that dreams helped me work out—in a highly symbolic way—ongoing problems that arose during my waking life. But for me the linking between the two worlds—dream and real—was highly spatial in nature, including directionally spatial. That is, formerly the concept of “north” actually was north—in my dreams and in the real world—and this was an important linkage between the two. In this way, for example, some dream-vision of a long green-lit corridor with a red-striped carpet, and through which I was walking, would of course be oriented northeast/southwest, because my conception of the corresponding real-world difficulty was also oriented in that diagonal way on the face of the earth—say representing a conflict between two friends whose houses lay in that particular northeast/southwest orientation. Although I continued to have the same types of shape- and relationship-filled dreams, I would wake up with the distinct feeling that they had taken place in a groundless, disoriented world, and could no longer be linked to real life in a way that carried meaning. Thus my dreams were often no longer productive in the same way. I’d lost the perfect reference in which I could work out problems.