Appearances can be very deceiving.
Most people have no idea that I had a brain injury. Until I included bits and pieces of the experience in a book I just wrote (Being Brain Healthy: What my recovery from brain injury taught me and how it can change your life) and started writing about brain injury from a personal perspective on my blog as part of book promotion. I was not public about the fact that I spent about 18 months thinking my way out of a fog and came out, on the other side, so different.
I was able to hide it because, even on my worst days, I looked so normal. No outward signs of struggle. No casts, no stitches, no visible scars – just a normal person walking through a normal life doing normal things in the middle of other normal people.
My imperfect brain, with all its challenges and gifts, showed up after my head was forced to slam back and forth repeatedly, during a car accident.
Those brain imperfections can pop up after chemo-therapy or anesthesia or as a result of some other medication / treatment intended to make something better. Those very same imperfections might come as part of the package post-stroke or heart attack and definitely appear with diseases like Parkinson’s, Alzheimer’s, ALS, MS, and other neuromuscular conditions. This week new research says that cognitive decline that can be linked to changes in the brain is also pretty common among those who have had Type II diabetes for more than two years. That is a pretty freaking wide net.
In the vast majority of the cases, each one of those conditions produces relatively normal looking people – or normal for the circumstance at least. The struggle is on the inside, silent, and hidden from view. Doctors don’t talk about it, therapists don’t talk about it, and we who are in the middle of the fog are sometimes not even equipped to talk about it.
A couple weeks ago we saw the movie The Judge starring Robert Downey, Jr. and Robert Duvall. Taking my friend and amazing movie critic, Lois’ advice, here is a major spoiler alert. If you have not seen this movie and want to see it, I am about to reveal a huge piece and something key to the plot – something unexpected and might ruin the ending for you so if you don’t want to know, stop reading, after you read Lois’ beautiful review HERE.
Yes, this was a very powerful movie with incredible performances that laid out a complicated and contentious family dynamic but there was a critical brain piece, one that made the story turn on a dime. The Judge (Robert Duvall) was losing huge chunks of his life and could not remember critical events (like potentially running someone off the road and killing him) directly tied to chemo-therapy.
Chemo-therapy is intended to kill cells – brain cells included – so chemo-brain, a documented condition that causes fuzzy and foggy thinking, is a common side effect of this type of cancer treatment. What is implied in The Judge but not explained is that when chemo-therapy is coupled with stress, lack of sleep, and emotional turmoil thinking, memory, reasoning, and emotional control are diminished even more. No one knew the judge had cancer no less was being treated. He looked so normal for man his age who was losing sleep and lost his wife – no one knew or suspected and that is exactly how he wanted it.
This movie shows, in very clear terms, just how devastating a treatment for a disease can be to brain functioning – mostly temporarily but significant none-the-less.
Signs of imperfections show up as changes – changes that are open for interpretation. Changes in level of engagement in life, changes in reactions, changes in speech, changes in willingness to communicate, changes in emotional control, and changes in relationships all might be signaling changes in brain function.
When in the midst of any kind of brain fog, it feels safer – less vulnerable – to remain silent so picking up on what is really going on inside a brain that’s even temporarily imperfect is tough. You need to pay close attention and watch for changes, ask questions, and be prepared to shift how you think about thinking.