Struck by Genius: How a Brain Injury Made Me a Mathematical Marvel (24 page)

The doctor continued to engage me with questions about things outside the window: “How many branches are on the tree? Is it moving left or right in the wind?” and I was able to answer.

She handed me a paper and a pen and asked me to draw her something. I asked for a ruler and was on my way. I sat like this for a very long time until I’d made a pi diagram.

She put her hand on my shoulder when I gave it to her and she smiled.

What just happened? I wondered. I was exhausted—I felt like I’d just run fifteen miles. The staff kept me after hours and ordered me a cab because they didn’t want me to drive home alone. The doctor gave me a Valium to take when I got home so I could sleep, but I just lay in my bed meditating and had no trouble falling into a deep slumber within minutes.

The next day the staff told me it was the worst panic attack they had ever seen. The doctor explained that the reason she asked me to begin counting things was to shut down the pain gateway neurologically. I asked her to explain.

“Constant pain like you have produces the chemicals that cause panic attacks to be released in your body pretty regularly,” she began. “You probably have had stomach problems as a result of this too.”

She went on to explain that there was a neurological gateway for pain, which I had to guard diligently. The basic concept, she said, was that both pain and pleasure signals traveled via nerve fibers in the spinal cord to the brain, but only so many signals at one time could make it through the gateway and into the brain. The idea was to flood the brain with pleasant feelings so the pain signals couldn’t get through. One way to do that was to rub my left arm when it hurt. What actually happened when I did this, the doctor said, was that the sensations from the rubbing kept some of the pain signals from getting through to my brain. It worked for emotions as well, and the doctor suggested I try distracting myself when I was in pain emotionally.

By asking me to count the windows and panes and other objects, she had been trying to distract me from the overwhelming thoughts making me panic and alter the chemistry of my brain. And it worked!

“We nearly called 911, and if you hadn’t responded, we would have,” she admitted. “We were afraid you were going to have a seizure.”

I was not political about many things but I now felt very strongly about the need for pain management for people everywhere. I was comforted to learn that there’s a global organization called the International Association for the Study of Pain (IASP) that’s dedicated to promoting research on chronic pain, increasing knowledge about it, and improving treatment. The group has called for the relief of pain to be a human right. I couldn’t agree more. I felt some relief just knowing that there are people out there who understood.

People couldn’t or wouldn’t stop asking me to do the things I could no longer do, but I was learning to manage my response to their ignorance much better now. I reflected sometimes on my breakdown at the clinic and realized it was the most intense wave of anguish I’d ever felt. It was just raw sadness built up for so long for so many reasons, compounded by the profound empathy I was feeling for the other people in my class and multiplied by all the people living around the world whose suffering was apparent to me at that moment. It was all my pain amplified by all their pain.

When the pain-management clinic was over, I was saddened, though my fellow patients and I promised to keep in touch. When I left, the staff gave me the yoga mat I’d come to love so I could use it at home, and another curious gift—a simple green dot sticker.

“What’s this?” I asked.

“Place it somewhere you’ll always see it,” said a staffer as he shook my hand in farewell. “And when you look at it, remind yourself to breathe deeply and relax.”

The green dot decorates the rearview mirror of my car to this day.

Chapter Fourteen

S
OMETIMES I PICTURED
my brain as a cloud producing a multitude of thunderbolts—the lightning radiating throughout my nervous system. These bolts from the blue could be moments of pure inspiration some would call genius. Other times, the lightning storm just rattled my body.

I was just beginning to feel hopeful again when it started once more: fasciculations, from my tongue to my toes. Like little earthquakes all over me, hundreds of them a day, they reminded me nearly constantly that my brain was still experiencing a kind of thunderstorm.

This had been going on for years, since right after the mugging, but lately it had become more pronounced.

The most frequent tremor I experienced was in my upper left thigh, just below where I used to keep my cell phone in my pocket. Now I couldn’t keep my phone there because I’d likely ignore it, thinking it was my condition. Friends told me they also sometimes heard phantom phone rings or felt vibrations in the places where they usually kept their phones. I found it fascinating that a similar phenomenon was affecting them (it’s known by various inventive terms, such as
ringxiety, hypovibrochondria,
and
faux-cell-alarm
), but in my case, the sensation could occur anywhere on my body—not just where I kept my phone—and never with disembodied sounds, like my friends reported. Both conditions are mysterious and not yet well understood, though mine is neurological, and
ringxiety
may be either neurological or psychiatric in nature. I was told there was nothing doctors could prescribe for my condition. I would just have to tolerate it. It was not painful; just annoying.

I worked on distracting myself when it happened, remembering to breathe from my stomach to draw in more breath and relax, and I did my best to ignore it. It would have driven me crazy if I acknowledged it fully every time—it was as if someone were poking me, again and again and again.

One thing the doctors did tell me is that in most cases, the symptoms can be greatly reduced by lowering overall daily stress. Stress can wreak havoc on your muscles and nerves, they told me, due to a rush of hormones and increased blood flow. I would need to exercise, get plenty of sleep, continue with my meditation practice, and lower my caffeine intake.

Adrenaline plays the most central role in creating the tremors—
adrenaline
is another name for the hormone epinephrine, which is released in response to any kind of stress. It serves to increase cardiorespiratory abilities, making it easier to fight or flee.

I’d been exercising again, and that might have been contributing to my tremors. Exercise caused higher adrenaline levels in the body, the doctors said. Untrained people will have a greater rush of the hormone than athletes. I didn’t want to stop exercising, so I just had to hope the tremors would improve along with my conditioning level.

Little is known about the origins of fasciculations; no one is sure if they’re brain-based or muscle-based, but the fact that they started so soon after my head trauma made me believe they came from the brain. I wondered if the seat of this phenomenon could be the parietal lobe—the very same area that likely gave me conscious awareness of the processes of math. It remained to be seen what that part of my brain looked like in depth; I hoped the testing in Helsinki after the Stockholm conference would give me some answers.

As exhausting as my challenges were, and as sad as they made me, I continued to try to move ahead. Sometimes my life felt like one step forward and two steps back. I regained my ability to draw—a giant leap forward—then had the biggest panic attack anyone had ever seen at the pain-management clinic. Must I forever push the boulder up the hill only to watch it roll back down and then have to begin again?

I knew that I was much more fortunate than most savants, many of whom struggle with overwhelming disabilities; some, like the sculptor Alonzo Clemons, are barely able to form sentences. The man on whom
Rain Man
was based, Kim Peek, couldn’t even tie his own shoes. My tradeoffs might not have been as severe, but they were legion. Some days they felt like death by a thousand paper cuts—tiny but really annoying little wounds, sharp as knives.

Though my muscle twitches were ever present and distracting, they were not the worst of my tradeoffs. The majority of the unpleasant side effects of becoming a savant had to do with my OCD. It thickened the atmosphere around me; made it seem as if I were moving through molasses. I used to move through life like quicksilver, darting from one experience to the next, and now it was like my feet were in cement. When I climbed stairs, I had to count the steps; when I brushed my teeth, the brush had to go under the water a specific number of times; when someone shook my hand, I practically had to bathe in antibacterial lotion afterward. I even counted the waves of my muscle twitches when I was unable to ignore them. All of the things most people do in the course of a day without even noticing—insignificant little actions—stopped me cold. Everything felt so damn slow, despite a mind, or part of a mind, that moved faster through intellectual pursuits than ever before. It was very frustrating. The most curious thing about it was that I was totally aware of it and desperately wanted to change it but was powerless to do so.

A couple of weeks out of the clinic, I hit a wall. All of the physical and emotional burdens were adding up to a funk that I knew I must finally face—it was depression. I’d battled it after the mugging and had overcome it, but it was back, fogging up the windshield of my mind. I spent more time now in sadness and found it harder and harder to recover. The panic attack in the clinic made me realize things were getting to me deeply and I must face the fact that my new life didn’t come without costs.

Perhaps the biggest side effect of my depression was that I was unable to handle confrontation at the store. There were plenty of opportunities for conflict, from the colorful customers to the sales and delivery staff. I found myself withdrawing and needing more and more time on my own. But it was more than that—I was withdrawing from even benign encounters now. Only a few months after meeting Maureen in New York and only a few weeks before the Stockholm conference, I stopped returning Maureen’s calls and e-mails. I felt bad about it, especially when she was so intent on helping me. I didn’t know if anyone understood, but despite my general empathy and sympathy for other people, I was closing off. The walls were going up around me. I made time for Elena and Megan and not much else. I know they were worried about me. And I worried and still worry a lot about them. Megan had been brought to tears a couple of times by my health problems. I began to think that it must be weird living with me. I knew they loved me, and I loved them. But I also knew it was hard for them and tiring to hear about my issues all the time—both the euphoric math monologues and the downtimes when I didn’t feel well. In fact, I’d begun to make it a point to talk less about these things around them, even though I couldn’t help myself a lot of the time.

One night when I was lying in bed, I began to think about how much easier it would be to just be dead. I was alarmed by this thought. I’d never felt this way before. How could this be happening now, when I was on the verge of a breakthrough with the upcoming conference and diagnostic testing? I even thought about using the gun I usually took with me to the store for self-defense. It was as though I had two minds: one that wanted to harm me and one that wanted to protect me. When I started thinking about the gun, I realized I needed help and went to the emergency room at the local hospital, and they kept me for six hours. Once they were convinced I was past the worst of it, they released me. I took the bullets out of my gun and put them in one end of the house; the gun with its empty chamber I put in a safe in the opposite end of the house. I didn’t want to act on this thought that bubbled up, and I was not taking any chances. The walk I would have to take from one end of the house to the other might be enough time for the bad thoughts to dissipate. I was shocked and ashamed that it had come to this sort of thinking.

At this point, I began therapy. The trip to the ER was the last straw. I had insurance for the first time in years and could finally seek some help. My doctor put me on the antidepressant Zoloft. Three days after starting it, I woke in the middle of the night. I was hyperventilating and having a full-out panic attack again. I just couldn’t catch my breath and I was sweating profusely. I paced the floors, trying to walk it out, as though it were only additional energy and I could just burn it off. Not wanting a six-hour stay in the emergency room again, I decided to wait it out. It felt like an eternity until my doctor’s office opened at nine. He told me this could possibly be a side effect of the medicine. He weaned me off the pills and we tried the antianxiety medicine Xanax as well as talk therapy for a while instead. I began to feel more stable.

I learned that the pain medications I had been on could also have depressive side effects, so I had my doctor wean me off Dilaudid. Dilaudid is a very strong opioid drug and terribly addictive. It’s a derivative of morphine, and it’s a narcotic. They had put me on morphine in the hospital but I immediately suffered morphine headaches and needed a change. The withdrawal from Dilaudid was one thousand times harder than when I gave up chewing tobacco years ago. I had the worst withdrawal symptoms, from bowel problems to the shakes. My skin burned like I was on fire then switched to freezing. I would sweat and simultaneously feel like there were icicles hanging off me, the hot-and-cold cycles were so rapid.

I meditated regularly to lessen the side effects and headed back to my computer to find out if my depression could have anything to do with my brain injury. A few clicks on my keyboard and I quickly realized that depression is one of the most common symptoms of TBI. In fact, some statistics show that more than half of all TBI survivors develop the mood disorder within the first year, and nearly two-thirds have it within seven years. Somehow, I had made it almost ten years before falling into its clutches, but I learned that, like all TBI survivors, I would be at increased risk for depression for the rest of my life. According to some reports, I was ten times more likely to have it at some point during my lifetime than a person without a brain injury.