Sunday, September 19, 2010

As a Matter of Fact it is a Laughing Matter

Recently I got an email from a dear old-new friend. In it, she told me about all the life challenges she’s currently facing. It was a long list of serious problems, so long in fact, it would have been more than understandable if most days, she stayed in bed with the covers pulled over her head.

But she doesn’t. Instead, she gets up every day and goes to work in a human service organization where she strives to improve the quality of people’s lives. Her email was honest and painful and poignant and funny. She commented on the latter noting “Well at least I still have my sense of humor.”

I would venture to say that her gift for laughter plays an important role in her ability to get up every day and make the world a better place. This realization confirmed what I had already felt . My friend and I resonate on the same frequency.

Those of you who know me, know that laughter is a key component of my strategy for dealing with the too often unavoidable painful realities in life. In a motivational speech I give entitled “Building a Life You Like Even When It’s Not the One You Wanted”, I talk about the importance of humor.

If you’ve ever taken Psychology 101 you may remember that there are a number of Schools Of Thought within psychology, Psychoanalytical, Behavioral and Cognitive, to name a few. Each provides a framework through which we are suppose to see our world, our fellow humans and ourselves.

In the past 15 post brain injury years, I’ve developed my own School of Thought. I’ve kept it simple; I do have a brain injury ya know. :) I call mine the Bumper Sticker Approach to Life. One of the cornerstones of my framework, one of my favorite bumper stickers is Find the Funny.

Finding the humorous anicdote in life's most embarrasing moments can completely eliminate their ability to shame us.

I have to confess that when it comes to this particular principle of my philosophy, I have a distinct tactical advantage. First, I come from a long line of Irish story tellers who have refined sarcasm to an art form, so I have both nature and nurture on my side. Plus, when you have a brain injury and when everywhere you go you bring a large dog, (and I do mean everywhere), if you are looking the “right” way, funny stuff happens to you all the time.

For example, there was the time at the grocery when an older woman in a very, very short skirt was choosing apples to buy. As Stone and I walked past, she leaned in, reaching for the apples in the back of the bin and my sweet, innocent, brilliant, well trained, impeccably behaved service dog stuck his snoot right up her skirt

She was not amused. Clearly, the rest of us sure were.

Public restrooms are a routine source of laughter for me. There’s nothing quite like the reaction of a woman who’s using the restroom when a large dog snoot suddenly appears poking in from the stall next to hers. Heck, he’s just trying to be friendly.

The deficits form my brain injury are often a great source of amusement for me. Frequently, I have “word finding” problems. Sometimes I draw a blank and stumble and stutter ‘till the word I’m seeking finally comes to mind. But sometimes, while I’m talking, without my even realizing my brain couldn’t come up with the word I intended to say, the completely wrong word comes out of my mouth. Often, I don’t notice I’ve said the wrong word, no matter how non-sensical my sentence has become because of it.

This vocabulary mix-up is a very common symptom for people with brain injuries. When it happens to me, most of the time, the word that comes out of my mouth sounds similar to the word I meant to say, even when their meanings aren’t remotely the same. So, for example, if I meant to say “hat” I might instead say “bat”, then I’d just go right on talking without noticing my mistake. As you might imagine, this deficit can lead to some pretty entertaining conversations.

There was the time a few years ago when I was talking with a small group of acquaintances about the advice an Arborist had given us to ensure our old growth trees survived the summer of draught. It’s important to note here that these were only acquaintances, not friends. By now, many of my friends are quite used to helping me find the funny in my vocabulary mistakes. I was talking for probably several minutes about what the tree specialist had told us, when it occurred to me that no one else was participating in the conversation. I looked around and saw that every single one of them stood in stunned silence looking at me, jaws hanging open. One woman had gone quite pale. A brave gentleman cleared his throat uncomfortably and then asked “You had an abortionist come to your house to look at your trees?”


Reading is often another source of amusement at my house. Since my injury, when I’m reading, my eyes and brain are often out of synch. My eyes move faster than my brain can read. To compensate, my brain will often read the first part of a word and in it’s struggle to keep pace with my eyes, it then makes an educated guess about what the rest of the word is. Basically, without my even being aware, my brain simply makes stuff up. Typically, when I get to the end of the paragraph I realize something does not compute. As I write this, I’m suddenly seeing visions of Lucy and Ethel trying to keep pace with the assembly line conveyer belt at the candy factory. In either case, laughter ensues.

Just last week I was reading an email from a Rehabilitation on-line discussion group/ list-serve to which I subscribe. Rehab. Psychologists use the group to seek advice and share resources and expertise. A group member sent an email requesting recommendations for treatment strategies when working with a client with Capgras Syndrome, a serious and rare disorder in which an individual believes his spouse has been replaced by an identical imposter. I read the opening sentence of the email and this time it took me only seconds to realize something definitely did not compute. I stopped mid sentence and asked myself out loud “When on earth did Crap-Gas become a psychiatric disorder?”

When I realized my mistake I have to admit I wished there were a 12 year old boy in the house who would fully appreciate the humor.

But, my all time favorite opportunity to find the funny, occurred a few years ago at a health club. I was recovering from a stress fracture in my leg. (It turns out if your brain doesn’t have complete control over one of your legs, jogging isn’t a good idea. Who knew?) I decided swimming would be great exercise while I was recuperating. Since my brain injury, I hadn’t been in a pool except with a Physical Therapist and I hadn’t even done that since the first two years after my accident. Even with a Therapist by my side, the experience was… well… let’s just say challenging.

As Stone and I rode the bus to the health club, I began to get nervous, wondering if perhaps this time my eyes really were too big for my stomach, figuratively speaking of course. I assured myself I would be fine, after all the pool had a lifeguard. The battle between my nervous self and my I can do this self lasted the entire ride. In the end, the knowledge a lifeguard would be there if I had a problem, convinced me to ignore my nervous inner voice who wanted to delay my swimming debut until someone could go with me to the pool.

Naturally, when I got to the pool the first thing I looked for was the lifeguard. He was there all right, but not only did he look as if he were nearly 70 years old, he was asleep. I was, shall we say, somewhat discombobulated.

I was so stunned in fact, I didn’t notice the sign outside the locker room door I entered. I wish I had, because it said “Men’s ”. (Yes, as a matter of fact, the word “Oops” is a regular part of my daily life.) I walked in past the unnoticed sign, turned the corner and right in front of my eyes was an 82 year old gentleman sitting naked in the hot tub. We were both surprised.

I mumbled a hurried apology and quickly made my escape. Can you imagine the conversation that poor man had when he got home? “You’re telling me a woman and a dog walked in on you when you were naked in the locker room. Henry, you promised you’d stop drinking during the day.”

Yes, my life is rich with opportunities to find the funny, happily so.

And so, my dear friend who’s email inspired this entry, my wish for you is that you continue to laugh when you can and cry when you have to. Please know, I will be right here handing you virtual Kleenex whether your tears are from laughter or pain.

Tuesday, September 7, 2010

The Before Part of Before and After: Life with Stone

In the last six weeks, as we've been talking with doggy cardiologists, learning about dilated cardiomyopathy and implementing a plan to increase the length of Stone's healthy life, I've been thinking a lot about all this amazing dog has done for me. To simply say he's transformed my life would undoubtedly make me the master of the understatement.

To truly understand the bond Stone and I share, to truly appreciate the contrast between the Before Stone and After Stone, you first have to get a snapshot of the Before photo.

When I woke up on the morning of June 26, 1995, my guess is my life was a lot like many of yours. I worked in a non-profit human service organization that provided services to people with disabilities, which basically means I worked absurdly long hours for absurdly low pay.

When I wasn’t working, I was spending time with family and friends, volunteering for other under-funded nonprofits or completing the litany of tasks that come with life (the cooking and cleaning and waiting for the cable guy). I read voraciously, (not Tolstoy mind you), and sort of kept up with the latest trends in music. (In my defense, I grew up spending summers on the Jersey shore listening to Bruce Springsteen and really what new artist can compare to that?) I traveled whenever I could, found digging in the dirt in my garden therapeutic and with varying degrees of success, tried to find time to exercise.

That was in the morning on June 26th.

By the end of that day, an auto accident left me with a traumatic brain injury and in a few short moments on a highway in Philadelphia, I traveled from social worker to client.

In the months and then years that followed, my list of rehab goals seemed endless.

I wanted to walk without falling down or walking into things; to consistently be able to feed myself, speak in full sentences and tie my own shoe laces; to read without struggling and then to actually remember what I read; to accurately add, subtract, multiply and divide and not draw a complete blank when I saw the number 0; to concentrate at least long enough to use the phone. (“Press one for customer service. Press two to place an order…); to understand the evening news; to stop getting disabling dizzy when I moved my head; to once again sing loudly and off key to Bruce Springsteen’s Rosalita; to return to approaching conflicts diplomatically and solving problems creatively and perhaps most of all, I longed for the return of my sense of intuition, without which I felt as if I were seeing the world in only black and white.

When I finally gave up the delusion that I’d be back to “normal” any day now (and then any month now), I wanted to recover emotionally as well by finding a way to accept and integrate the new realities of my life.

The eternal optimist in me told myself I’d be such a better social worker because of this experience and that the good thing about everything being hard was that every activity was rehabilitative.

Sometimes I even believed me.

A team of eager and talented rehab professionals worked with me on all of those goals and more. With their help, I worked to retrieve lost knowledge, relearn skills and develop strategies to compensate for my deficits. But forever complicating the rehab process was a persistent and pervasive cognitive fatigue that to a large extent continues to limit my life and control my choices.

Cognitive fatigue is the “jargon” professionals use to describe what happens when our brains get tired and the supply of neurochemicals is significantly depleted.

When your brain injury symptoms include cognitive fatigue, you will be differently able at different times and in different situations. When our brains are well rested and the environment we’re in isn't overly distracting, we function at our peak. When our brains are tired most of us function significantly less well, which means one day we may be quite capable and the next, barely able to take care of ourselves.

The truth is the experience of living with a brain injury when your brain is well rested is completely different than the experience of living with a brain injury when you’re fatigued.

Don’t get me wrong, they both suck, but one sucks a heck of a lot more than the other.