Monday, 27 August 2012

Overdoing it

I don't want to dwell on matters neurological but my journey back to health continues on its lurching rollercoaster path and it was suggested to me that writing it down at each stage might be helpful. I confess that the linear act of committing complex happenings into a narrative is very therapeutic for me and helps me make sense of what is going on in my still below par brain. So, I shall continue to document it and should you find it tedious, other content will soon appear which might be more interesting. Or not. Either way, I will point to that in the final paragraph, so if you are still reading and even mildly interested, but the find the rest of the rambling tedious, you could always skip to there.

So, after such a lovely two weeks' holiday with all the attendant joys of music and revelry and absolutely no intellectual activity at all, it came as rather a shock to go back to work. Opening my inbox to find 1496 unread messages as initially unsurprising, but once I had knocked off the easy corporate-spam, the  remaining 972 suddenly seemed quite overwhelming.
The nature of email is such that multiple threads of conversation can arise from a single initial question, copied to many people who then respond with their contributions to various different distribution lists. The result is a tangled mess of communication of varying relevance and currency. In fact I wonder how I ever managed it, or anyone does in fact!

Anyway, my brain crashed. Like a PC with too many windows open and too little memory for the new operating environment, the hourglass popped up and the whole thing ground to a halt. I sat there looking like I had been hit with a mallet.
Then the phone rang and I was "invited" to attend a meeting in Dusseldorf for which I would have had to have left at 4 a.m. tomorrow morning. My requests to change the date were rejected and my confidence and mental coherence crumbled into abject distress. In a state of agitation, I was forced to call Occupational Health and gibbered incoherently down the phone for half an hour until the nice lady calmed me down a little.
What followed was several days where The headache returned and I had to resort to painkillers to get some relief and eventually sleep.

And it becomes clear to me: The neurologist had said to me "You will make a full recovery, but it will take six to twelve months before you are back to normal. In the meantime, executive function will remain impaired. You can go back to work, but you will be disappointed."
He explained about cellular debris and what the pre-frontal cortex does and some of the effects I would continue to experience.

I did go back to work and I am disappointed.

Physical injury is no stranger to me. Over the course of my life, I have partaken in various daft activities and occasionally a hare-brained scheme would leave me with some injury or other. In each case, the doctor would say "Six weeks..." and I would think "Four weeks then.." and usually, I was right. The medical profession is by necessity somewhat pessimistic.

So when the learned fellow said "six to twelve months" I heard "Four months".
But I was grossly mistaken. Brains don't work that way. Ok, you see here a coherent thread issuing forth from a "working" brain. But what I hadn't anticipated was the subtle but profound problems associated with the remaining impairment. Categorising and comprehending information, and then adding it to an existing context is still incredibly difficult and this is pathological - something was damaged and needs to be repaired. It's quite fascinating in its way.

Each email I read contains information which swims before me like a myriad of tiny fishes, slipping out of my grasp and taunting me by darting away before I can even see what shape they are. It frustrates me beyond belief and must be a nightmare for those around me who merely want a straight answer to what seems a simple question. I just can't get it together (yet).

But it will get better. The necessary neural pathways just need to be built and reinforced. It will take patience and practise.

So, what can one do? Well, I was advised to attempt cryptic crosswords. I tried. It felt like writers cramp in the forefront of my brain. And anyway, there are too many conventions in each newspaper for me to know what is expected.
Then there is the Roald Dahl approach of puzzles and suchlike to challenge the brain. This was a helpful suggestion I received here (thank you Kay) which I am still researching and which shows promise.

But a friend suggested, as I lamented the dearth of plums this year, that I write down my wine recipes and methods. I do, though I say so myself, make excellent home made wine. My ginger had caused trained wine tasters to exult loudly and call for rich fruit cake as a worthy accompaniment and my damson has caused long minutes of silence with its richness and velvety gorgeousness. (The secret with the ginger wine is to put a couple of bananas in the must. But more of that elsewhere)
Last year's pink plum wine. Cheers!

The thinking is, and it seems sound to me, that by putting the recipes and techniques into writing, I can take complex information and organise it, thereby getting the hang of the whole logical sequential approach thing originating from an amorphous cloud of knowledge and information. I think it might help.
I had been meaning to write a book on this for some time and had started my sister blog in preparation for this very purpose. But it rather fell into disrepair. Well, perhaps now it is time to put it all together. So that's what I shall do!
But if anyone has any idea how to get better at cryptic crosswords, I would be very grateful!

Friday, 17 August 2012


I was in a cafe today in Bath. It is Cafe Retro which is one of my favourite places to get a coffee or lunch when I am about town. I find it cheerful and unpretentious and the coffee is excellent. Coffee has been a great help to me these recent months. It helps me focus and clears away the confusion for a bit.
However, what struck me today was the hum of conversation in the place. Now, I have had some trouble with my brain of late, as you probably know. Some bits subsequently weren't working very well, causing me to feel a bit thick on occasion and to have trouble concentrating when there was a lot going on. A crowded place, with a lot of conversation has been a challenge to me, causing me to sometimes have to go and sit outside somewhere quiet whilst my brain cools down.

As an aside, I have had the last two weeks off as annual holiday.
Van in the mountains
We piled up the van with all manner of stuff and headed to a friend's farm in North Wales, where every year for the past, oh, maybe seven, he has cleaned out the barn and used it to host a private mini-festival. Everyone present is selected from friends and aquaintances and amongst those are a number of members of most excellent bands.  During the days, living was communal and if I picked up my guitar or banjo to play, often someone with a guitar would wander across to join in and ere long, a small session would be taking place.

Tents and vans appear in a freshly mowed field and we stayed from Thursday to Monday, helping where we could with preparations, clearing up and most importantly, haymaking. After all, it is a farm.
Children of the Revolution
So, the festivities and outdoor living carried on over the weekend and there was much singing, dancing and consuming of beer. 
Soundcheck in the now-clean barn.
Dogs roamed around with stolen sausages, children chased them laughing and not a care in the world was entertained for the whole time. It was a bohemian dream for a few days where pleasure, music and company dominated everyones' consciousness. I am chilled in a way I find hard to describe.

Party in the barn: Somewhere in this night, I got my brain back
And somewhere in that weekend, a switch seems to have been flicked in my brain. Something came back which I have previously lamented the  loss of. I feel complete again. More than complete in fact, if I articulate a feeling that is hard to explain. The experiences of the ghastly happening and subsequent recovery have left a mark which will stay with me forever. From the rudimentary consciousness of those first few weeks through the headaches and regaining of physical coordination and mental faculties, I have learned a tremendous amount which provides an almost endless supply of inspiration for curiosity. And gratitude. I met recently, before my malaise occurred, a survivor of a much more serious SAH and he was significantly different from his former self. I realise how much I have to be grateful for and shall never ever take my life, or my brain, for granted. It could do easily have been otherwise.

And so, as I was sitting in the cafe today, i remarked to myself how the hubbub of voices would have caused me a major "moment" a few weeks ago as my brain tried to make sense of it all at the same time.
But now, I find I can "float" on top of it all and "tune in" to individual conversations or voices. This is an improvement I welcome. But also, it gives me cause for thought.

Normally, where we direct our attention is not consciously under our control. Ok, we may sit writing an email in the office, or watching television, thinking we are concentrating, but if a man cam in wielding a knife or even wearing a silly hat, our attention would be drawn to him and away from the task in hand. This makes sense and is to be expected. However, it becomes clear that some process in our unconscious constantly monitors our surroundings and takes note of what to ascribe significance to and the relative weightings of pieces of information in our environment. And this is not visible to us, or even a process we are aware of.
Well, this has not been working in my brain for some months. All information is equally significant and my brain has been trying to process the whole lot simultaneously. This is obviously impossible and the attempts have caused me some distress. However, today, I sat in the cafe and realised that not only can I focus now and allow this repaired process to do its job, but that I am actually aware of its exixtence and of its operation. Where it was "below the waterline" before, now its workings are apparent to me.
And it is utterly fascinating!

Sitting listening to the hum of discussion, I note some voices demand attention more than others. Speech which is emphatic is more difficult to ignore. Emotional emphasis is flagged as more highly significant and more worthy of attention.
Some male voices are quite compelling. I cannot work out why, but a certain resonance or tone causes the attention to be drawn to it. Also, some bossy women seem more evident in the surroundings than before. I note that with the compelling or emotional voices, I am drawn to examine the content of the speech: With nagging voices, I am afraid the initial response is somewhat more visceral and less civilised.

To observe this process in action is utterly captivating. From a maelstrom of noise that would paralyse my consciousness for a period of time, now information is emerging and the process of extracting it and ascribing significance to it is becoming less of an effort and more unconscious. Unconscious and yet now transparent.

So, now there is another set of questions to occupy the curiosity: What are the criteria upon which our minds base their decisions of where to direct the spotlight of attention to?

These are questions I probably won't find answers to but out of a near-catastrophe, I have had the opportunity to examine some of the intricate functions of the human brain at first hand, as an observer. As a self-regarding mechanism, the brain does give us some wonderfully interesting insights into our own humanity.

So, next time you are in a pub, a restaurant, anywhere with a lot of enthusiastically interacting people, I urge you to just pause a moment to listen in to the whole, and then individual components of the verbal melee. And become aware of the incredible amount of work your brain is doing without you having to worry about it. It really is very impressive.

I am back! :-)
As a postscript, I would like to say thank you to those who have encouraged me to see the positive in all of my recent experiences. Your insistence that I be patient and that I was still compos mentis has been appreciated greatly. Thank you all.

Monday, 6 August 2012

Radio Silence

There's not much doing in my head these days. A cursory listen to the space between my temples shows something akin to a pub with no beer. Everyone has buggered off.
Whereas once it was a bustling, noisy place where a throng of voices clamoured for attention, now it seems to be deserted. I don't know where everyone went.
It used to be that an idea would spark a torrent of words, each one falling over itself in its rush to be expressed. One word led to another which led to another until ere long there was a number of paragraphs which somehow explained what had occurred to me and gave some release.
It's not that the words have gone. I can wield them as deflty as ever from the mace-blow of a blunt statement to the stilletto precision of a careful inference.
But the ideas seem to have departed. Things just don't pop into my head any more. Even writing this is like passing a kidney stone.

It could be that my brain is rewired after my haemorage. Indeed, given the area of my brain in question, this is quite likely. The pre-frontal cortex performs a lot of high level  executive functions and it may just be that the spontaneity of observation and reaction I relied upon, which  "just happened" just isn't working now.
I know some neurons, I don't know how many, will have died and with them some of the functions they performed. A loss of blood flow in the brain can do that, even a small interruption.
I know also that planning and attribution of significance to information is impaired. I confess, I don't feel as clever as I did before. Thinking is hard and makes me immediately fatigued. Perhaps all of this is implicated in the departure of the Muse from my life.

But I miss it painfully. I feel stupid, mentally clumsy, profoundly empty and somewhat lonely as a result of the loss of this drive to communicate. The long rambling email conversations I used to have with friends just dried up. The meandering discussions of abstract concepts, arcane but relevent to the experience of the human condition we all share just no longer happen. And I miss it all. Abjectly. I just find suddenly, I have very little to say. And I feel lesser.

Perhaps it will come back. I know the latest research on neurons seems to indicate that they do not regenerate. We do not make more of them as adults: Dead neurons are not replaced. However, there are an awful lot of them and those functions which were once performed by now defunct circuitry can be remodelled by the remaining adjacent neural machinery. This is "neural plasticity". To retrain the brain to do what it once did but is now reluctant to do takes application and persistence. I must do those things I want it to get better at. I must do them a lot. and the circuitry will gradually be built by that doing.
Whether this can return an ability that defined a character, I cannot say. Only time and experience will tell. But I am going to give it a bloody good try. And if it doesn't, then it doesn't and I will live with what I have available to me now. At least I still have my words.