Authors: Louise Jensen
The sharpness of my hip bone digging into the too-thin mattress recedes as I close my eyes. It feels like I’ve been here for a lifetime and it’s hard to believe it’s still Sunday. I’m utterly exhausted and as I hear the curtains swish open it feels arduous to even turn my head.
‘Mrs Taylor,’ the doctor says, and I wonder if he was the one I saw before. ‘Is your brother here?’
‘He’s gone to grab a coffee.’
‘Is there anything you’d like to share while we’re alone?’
‘No.’ I pick at the edge of the fraying sheet with my fingers. ‘I fell. That’s all.’
‘Yes, you said. And the bruises on your arm came from your brother lifting you up?’ There’s
a weariness to his voice as though he’s heard all this before, and he probably has. The ‘I walked into a door’ or ‘I slipped in the bath’. Excuses as flimsy as ‘the swelling to my neck was caused by me singing too loudly’, as though I’d been having the best night out ever.
Please. Stop. I don’t want to.
‘Don’t you want to talk to the police?’ Ben had asked when I’d begged him to
lie to the doctor for me. To fill in the spaces in my fabricated story. ‘Find out what happened to you?’
‘I just want to go home.’
‘You can’t be on your own if you’re concussed.’
Ben had texted Chrissy, to check she was okay, without telling her that I’m in hospital; I don’t want to worry her. She’d replied she was staying with a guy. I had thought she was seeing someone;
she’d been out more than usual lately. She’d said she was sorry she couldn’t find me at the end of last night, and she’d assumed I’d gone home with Ewan.
‘Whatever happened is over now. I just want to forget it.’
Ben understands. We had trusted the police before and they had lied to us. Promised to keep us safe. Safe was the last thing we were. I don’t want to put myself through
anything like that again. I don’t want to put Ben through anything like that again. The trial tore our family apart. And, if I’m honest, I don’t want to risk the police questioning my friends and Matt finding out I was on a date.
But there is a nagging part of me that thinks if Ewan has done something to me, he’ll likely do something to someone else and I really should report him, but I
wasn’t asked for my address when I signed up for the dating app, so Ewan wouldn’t have been either. I don’t think the police would even be able to trace him.
‘Your brother told you that you fell,’ says the doctor. ‘But you still don’t remember. Don’t you think it’s possible?…’
‘I fell,’ I say again with finality.
The doctor sighs and I can feel disapproval rolling off him
in waves. When he continues, his tone is sharper now. ‘If you say so. I thought you might like to know your urine tests are clear. There’s no sign of any drugs, but that doesn’t necessarily mean you didn’t ingest something. Generally, Rohypnol can be detected for seventy-two hours and GHB for twelve hours, though these times can fluctuate; and, of course, now we could be a good twelve hours from anything
that might have been administered without your knowledge. You know. In case that was the cause of you
‘And the other tests? The faces… Your face. You said I’d met you before? I don’t remember.’ My words are thick, coated with tears.
‘That brings me to your CT scan. There has been some bleeding to the brain.’
‘Oh God.’ I clutch the sheet tightly to me.
‘I’ve shown the scan to the surgeons, and we’re not going to operate. There is some abnormality to the temporal lobe, specifically the right fusiform gyrus.’ He pauses as though that should tell me all I need to know. It doesn’t.
‘So?’ My voice is too high. Too loud.
‘It’s too early to tell and not my place to diagnose, Mrs Taylor; the right fusiform gyrus coordinates the neural system
that controls the ability to recognise faces. It is possible the head injury you have sustained has triggered a loss of facial recognition. This could well be a side effect of a bang on the head but we’ll know more once you’ve had an MRI.’
Once more, that crushing feeling. I’m being suffocated by medical terminology I don’t understand.
‘Try not to worry,’ he says, pressing his fingers
against my wrist to take my pulse.
‘But I’ll be okay? It will only be temporary?’
The doctor writes something illegible on his clipboard but doesn’t meet my eye. ‘Try not to worry,’ he says again.
I’ve been admitted for observation and rest and partly as a curiosity, I think, for the group of junior doctors who crowded around my bed this afternoon, staring at me as
though I’m part of a freak show – ‘you actually can’t recognise yourself?’; ‘you honestly wouldn’t know me if I came back in five minutes?’ – while shame at my ineptness painted pink spots on my cheeks. Despite the pounding in my head and my bruised and aching body, I’m longing to go home. Already I am thinking about tomorrow. Wondering who will fill in for me at the care home. I love my job. The
residents, Mrs Thorn and her endless supply of After Eight mints; Mr Linton and his knock-knock jokes. Who will call the numbers for the Monday lunchtime bingo if I am not there?
Ben bundles the clothes I came in wearing into a bag – the smell of hospitals has permeated the fabric – and leaves to fetch my pyjamas and toothbrush. I turn to face the wall, curling up into a lonely ball.
I must have dozed because the next thing I am aware of is the sound of my tray on wheels squeaking over to my bed, a dinner plate clattering.
‘Grub’s up, Ali,’ says a voice, with a soft Welsh lilt.
It’s one I’ve heard before. There’s a split second where hope skips in my stomach and I wonder if perhaps it’s all over. The nightmare of this never-ending day. I turn my aching
body. The nurse is smiling at me as she says: ‘jacket spud, cheese and beans with a nice salad – that’ll sort you out. You feeling any better?’ Miserably, I shake my head. I don’t recognise her face, just her accent.
‘You’ll be OK. Your brother will be back soon, and it’ll be nice to have your own night things on. Better than that gown with your arse crack showing.’ She sloshes water into
The food on my plate is cold and unappetising. A small potato with pale skin, obviously microwaved, not dark and crispy the way I like them. Congealed melted cheese, a small heap of drying baked beans and a few wilted leaves imitating a salad. Food I recognise but I begin to doubt that what I see is what is really there.
When Ben and I were young, Mum used to fill Nan’s
silver tea tray with small items and we’d try to memorise each one. Kim’s Game, she called it. She’d cover up the tray with a red gingham tea towel, and me and Ben would frown with concentration, counting with our fingers, a pencil sharpener, a safety pin, a satsuma. I’d remember everything, my memory had always been good, but Ben always remembered what he wanted to be there rather than what he saw,
a chocolate bar, a pound coin, a football card. I’d often pretend to get things wrong, to let Ben win, but I always, always knew what was under that tea towel.
Now, I test myself again, covering my face with my hands, counting slowly to ten. Relief swamps me when I uncover my eyes. It’s still a baked potato, cheese and beans and that must be a good sign, I think. It’s only faces that seem
to change each time I look away, and if there’s just one thing wrong it must be easier to fix, mustn’t it? I hold on to that thought as though it’s a precious prize, curling my fingers tightly around it as I once held on to the ten pence piece I won for coming second, because believing my facial recognition will return is better than the alternative. If Ewan attacked me and comes back, I won’t
be able to identify him.
I’ll never feel safe again.
Ben is sitting to my left. He was supposed to be in Edinburgh today. He became acting assistant manager for a small but expanding chain of hotels. Although head office is located here, he often has to travel around the UK.
‘I don’t want to get you into trouble for missing
your meeting,’ I’d protested.
‘You think I’d leave you now?’ He looked hurt. ‘You’d be on your own.’
The doctor had restricted visiting to family only. It’s too distressing for me seeing faces I should know but don’t. We’re only a family of three. I knew stepping foot in a hospital would be too much for Aunt Iris, so I told her not to visit; yet, irrationally, feel disappointed she
hasn’t come, and I try not to equate it with the way she let us down before. We were
. Still, my heart breaks for all we’ve been through. Ben has been my only visitor and I’m worried about the pressure on him, feeling he has to be by my side, day and night. He’s exhausted and tense. Stale menthol smoke clings to him, and I know he is smoking again. He always turns to cigarettes in times
of stress. Although he was so young, I wonder if the smell of the ward is bringing it all back for him too. Jules, my best and oldest friend, and her cousin, James, who she lives with, have sent a card, along with a huge red and white bouquet that takes up so much space on my bedside cabinet there isn’t enough room for my water jug. There are cards from Mr Henderson, my old neighbour, and Matt too.
I’d spent ages analysing his message, the ‘love’ written in his looping script, wondering if he meant it.
My nerves are fluttering. Today I should get some answers and I’m glad Ben is here.
In my peripheral vision, I see his hands are clenched into fists as they rest upon his knees which jiggle up and down to a beat only he can hear. Directly in front of me, in an executive chair
that swivels as he talks, is Dr Saunders, the clinical neurologist upon whom I pin all my hopes. I don’t look directly at either of them. Instead I keep my eyes fixed on the shaft of sunlight streaking across the mottled lino.
‘Ali can’t remember anything about that night, can you?’ Ben says.
‘No.’ Although there’s something awfully disconcerting about not being able to remember
the details, in a way it’s a relief. But the not knowing doesn’t stop the cord of panic tightening around my neck whenever I wonder what happened to me, as I frequently do. As soon as Dr Saunders has fixed me and I’m back at home, back at work, it will be easier, I’m sure.
‘Your sister took quite a knock to the head when she fell,’ Dr Saunders says. They both speak as though I am not here.
‘But her memory will come back?’ Ben asks.
‘Possibly, although it’s not guaranteed; and if it does, it might be incomplete. The cerebral shock Ali suffered could have been fatal. You really are quite lucky.’ His chair moves again. Left to right. I fight the impulse to grab hold of the arms and keep it still. I feel sick, angry, scared. Anything but lucky. My teeth clench together
and again there is the shooting pain in my head.
‘We’ve already discussed your CT scan and MRI results. It certainly appears that the unusual shape of the lesion you sustained from a blow to the head has caused an abnormality to the temporal lobe, which is involved with face processing. It’s this that’s causing the loss of recognition. I want to carry out some more tests, if you’re feeling
up to it, Ali? A cognitive assessment session. Nothing too taxing.’
The last thing I feel like are more tests, but the sooner he can diagnose me the quicker he can cure me and so I nod my head, the room shifting as the ever-present nausea wells up.
‘Are you sure? You look so pale.’ Ben threads his fingers through mine and gives a gentle squeeze.
I flash him a grateful smile
that dies on my lips as my eyes fall on his unrecognisable face, flickering between his mouth, his nose, his eyes. I pull my hand away and wipe my palm on my dressing gown.
The anger flares from nowhere, pulling me to my feet.
‘It’s too hard.’ I pace across the room, putting my palms against the window, resting my forehead forward. My breath fogs the glass and I wipe it with the balled-up tissue that’s permanently clasped in my fist. ‘I don’t understand what’s happening to me.’ For the past hour I’ve been asked to memorise faces I’ve never seen before
and identify them again. I can’t. Dr Saunders’s ballpoint pen scratches against my notes.
‘Sit back down and we’ll try some famous faces now.’
Even as I’m shaking my head, I’m sitting back down. What choice do I have? He shows me the first picture. From the hairstyle and facial hair I can tell it’s a man but I’ve never seen him before.
‘Come on, Ali.’ The agitation in Ben’s
‘I’m not doing this on purpose.’
this one,’ he insists. ‘You wanted to marry him once.’
‘Well done,’ Dr Saunders says and there’s the scratch-scratch-scratch of the pen again. We all know I wouldn’t have guessed right if it weren’t for Ben’s clue, but I allow myself to feel one small victory all the same.
something different now,’ Dr Saunders says, and I feel he’s giving up on me.
As hard as I try it isn’t any easier to spot similarities or differences between faces during the next test, even when their pictures are next to each other. Judging age, gender or emotional expressions is slightly easier and I don’t feel quite so useless. Already I am learning to pick up clues, long hair, beards,
‘That’s all the facial recognition tests.’ Dr Saunders clicks the end of his ballpoint as he speaks. I hope I can rest before treatment starts, tiredness burns behind my eyes.
‘What’s wrong with her?’ Ben asks.
‘Just a couple more things and then I’ll tell you what I think. I’m going to evaluate your IQ, Ali.’
‘You think I’m stupid?’ I
stupid. I can’t
believe I didn’t recognise Channing Tatum. Dr Saunders doesn’t answer.
It feels as though I’ve been in this tiny, airless room for days. Dr Saunders has excused himself to make a phone call. I sip at warm water from a styrofoam cup. Ben checks his phone again. I feel lost without mine but arranging a replacement has been the last thing on my mind.
‘I’ve had the locks changed,
by the way,’ Ben says. ‘I had a scout around your bedroom, but I couldn’t find the bag you said you took out with you, the grab?’
‘Right. I thought it best to change the locks. Not that I think anyone would try to get in the house,’ he adds to reassure me, but his voice is terse and I know he’s worried too.
‘But when Chrissy comes back she won’t be able—’
‘I’ve texted to let her know there’s a new key for her next door with Jules. I couldn’t remember the code to your key safe. Matt rang again to ask how you are. He says if there’s anything else he can do…’
‘I wish you hadn’t taken Branwell there.’
‘I can hardly bring him here, can I? Besides he’s half Matt’s dog. Matt is still legally your husband.’
The word husband has
lost its spikiness. I’ve too much time to think here and Matt has been much on my mind. Although everything seemed so broken between us before, I can’t help wondering if it’s too late to put things right. The shock of being faced with my own mortality has left me feeling disempowered and vulnerable and longing for a sense of permanence. Life suddenly seems impossibly precious. Impossibly short. ‘Does
Matt know I went on a date, Ben?’
‘He hasn’t mentioned it.’
The door swings open and we fall into silence as Dr Saunders slips behind his desk. Suddenly I’m nervous.
‘Ali, I’ve combined the results of all your tests including the MRI and the CT scan and, aside from the memory loss we’ve already discussed, I’m quite confident in saying you have prosopagnosia, although I’ve
never come across a case in clinic before.’ I detect a faint hint of excitement in his voice and irrationally I hate him, as though it’s all his fault.
‘And what does that mean?’ Ben asks.
‘Ali’s mind can no longer identify features. She’ll be unable to recognise faces, even those of close family and friends.’
‘And is it common? This proso…’ I falter. How can I have a condition
I can’t pronounce?
‘Pros-o-pag-nosia.’ He breaks it up. ‘It comes from the Greek
meaning face and
for not knowing. It’s also known as Face Blindness.’
The word ‘blindness’ terrifies me, and my eyes flash around the room drinking in the spindly spider plant on the windowsill with its brown and trailing leaves, the square black clock on the wall, as though reassuring
myself I can still see.
‘There are two types, the first of which is developmental prosopagnosia. You’re generally born with this type, and it’s far more common than you think. Roughly two per cent of the UK, or 1.2 million people, suffer from varying degrees of facial blindness. Many of them don’t know they have it, often thinking they have a bad memory for faces or people look more alike
than they actually do; if they have similar hairstyles for instance. It’s often inherited although we haven’t yet found a specific gene for developmental prosopagnosia. It’s interesting that—’
‘So I was born with this but it’s only surfacing now? Our parents didn’t have this, did they, Ben?’ He’s too young to properly remember Dad but we’d have known if this ran in our family, surely.
‘No. You have acquired prosopagnosia, Ali. This occurs after a stroke or head injury. It’s much less common than developmental. We already know from your scan there’s some abnormality to the right fusion gyrus. This would be consistent with your head injury. Damage to this area can cause two subtypes: apperceptive prosopagnosia and associative—’
‘How long will it take before I’m back
to normal?’ I cut in. It’s all I care about right now.
There’s an awkward pause. The creak of the chair spinning left to right. The click of the ballpoint pen.
‘It’s likely to be permanent, I’m afraid.’ His voice sounds as though he is shouting from a large hole.
I can’t process what I’m hearing. I take another sip of my drink. The styrofoam crumples beneath my fingers and
water trickles onto my lap, but I can’t cross the room to pluck tissues from the box of Kleenex on the windowsill. Dr Saunders’s words have pinned me to my seat.
‘So, Ali won’t recognise anyone? That’s crazy!’ Ben says. ‘I can’t imagine.’
‘It’s difficult for those without the condition to understand,’ Dr Saunders says. ‘Face recognition is such an automatic process that many people
can’t imagine facial blindness is even possible. I’ve been involved in studies where patients have come in with their families and we’ve asked their families to change clothes and stand silently in a room with a small crowd of people and asked the patients to then identify their loved ones. It’s heartbreaking to see the patient’s distress when they can’t. Children don’t recognise their parents,
wives don’t recognise their husbands. Men, in particular, are so hard to identify, being often very similar when you take away their features, short hair, casual clothes. You’ll come across a lack of empathy and understanding, and the best way to deal with this is education. Be honest with people. Don’t be ashamed.’
But ashamed is exactly how I feel.
‘There must be something you
can do?’ There’s a pleading in Ben’s voice I haven’t heard for years. He used the same tone once to beg me to read just one more of the silly poems he loved.
They sailed away, for a year and a day, to the land where the Bong-tree grows.
This must be a nightmare, it has to be, because the alternative, that this is real, is more than
I can bear.
‘Certainly there are things we can do,’ Dr Saunders starts, and I am pulled back into the room, but the swelling of hope his words brought deflates quickly when he adds: ‘There are lots of compensatory techniques that can help you day-to-day.’ His words blur into each other. Permanent. This is permanent. Already I feel I cannot cope. As Dr Saunders answers Ben’s questions about
the condition, he taps on his keyboard and the printer whirrs to life. ‘I’ve spoken to Stonehill University – you know it?’
I nod. It’s about an hour away, in the city.
‘They work very closely with the National Hospital for Neurology and Neuroscience in London. You’ll be in safe hands. There’s a specialist, Dr Wilcox, based there running a research programme. I’ve just spoken to
him, and he’s eager to meet you. There’s a trial for transcranial magnetic stimulation which may get some function back. It’s not my area of expertise,’ he adds quickly, cutting off my questions. ‘He’s writing to you directly with an appointment, it shouldn’t take too long. In the meantime he’s sent through a handout with some more information and coping strategies. I’ll discharge you now. I bet you’ll
be glad to go—’
‘Wait! I’ll never recognise anyone again? You can’t just send me home.’
Dr Saunders must notice the utter misery on my face, the tears filling my eyes, because his voice is sympathetic as he speaks again.
‘You’ll probably recognise one in a thousand people. Not much admittedly, but perhaps better than nothing. That’s usual and, if it happens, try not to get
your hopes up. It doesn’t mean you’re recovering. It’s a lot to take in, I know. Physically there’s nothing else we can do for you here and emotionally…’ He clears his throat. ‘Look, I appreciate it’s tough but we really need the beds. You know how stretched the NHS is. Sorry. I’ll see you again though. Make an appointment with my secretary on the way out. Do you work?’