How I Rescued My Brain (22 page)

‘This isn't easy,' he says, ‘and it plays with your mind. Some can't handle it. The key thing the instructor told us was that we have to know how to exit the compartment
before
we land in the water. We have to have our hand or arm on the exit lever
before
we crash, because under the water — in most conditions — you can't see in front of your face.'

As he is describing this, I'm aware of a growing sense of discomfort. I'm being transported into my nightmare, where the family and I are driving in the failing daylight, and the van runs off a bridge and into a river. What he has just told me confirms that I would not be able to see the children in the back seat. I could not even know exactly where they were. I would have enough trouble trying to get out myself, without trying to help them. In my dream I could see them, and I would struggle to free them from their seatbelts, pushing them out the door to the surface. But with what Craig has just told me, they would surely drown.

I thought I had dealt with this nightmare in therapy, put it behind me. But here it is, stalking me again.

I'm shaking, and I don't know if Craig notices. I have to get out of the room. I interrupt him and say that I have to go out for air. There's no one in the waiting room. I grab a glass of water and stand by the window.
We are sinking into the river, the water is pouring in through the windows and the gaps of the car, and now I can't see the kids.
This is bad. My chest is heaving. My breath is coming in waves. I try to jemmy the drowning images out of my head. I breathe and breathe and breathe, willing my breath to slow down; I press my face against the window, drinking the water slowly and hoping the chill of it will bring me back to the present.
It's not really happening. You're in a lawyer's office. You're all right. It's daytime.

After a while, the images and the physical sensations of the nightmare loosen their hold. It's like being on a train that is slowing down as it comes into the station, and the snapshot view of the platform through the window lasts longer and longer. The view of the skyscrapers through the glass begins to last longer, becoming more solid, and finally fixed. At last, I really do feel I am in the waiting room of a high-rise building, in the office of a legal firm, with a turkey-necked barrister who wants to squash me. And the thought of returning to do battle with him isn't as gruesome as the nightmare.

After my legal team has knocked heads in ‘secret lawyers' business' with Turkey Neck and his sidekick, they emerge from the second conference room. Andrew declares, ‘It's useless. We didn't come here to debate the case, but to settle. We've wasted our time. We may as well all go home.'

All this trouble for nothing.

TO MY RELIEF,
the calls between Simon and Turkey Neck start the next business day. Turkey Neck is finally in the mood to settle. Simon rings me almost every day, telling me with excitement that Turkey Neck has raised his offer, and we discuss a counteroffer. I imagine Simon and Turkey Neck as two medieval knights jousting, their telephone receivers their lances.

I wonder why we have to play this silly game. Why doesn't the insurer just say what dollar amount they are prepared to go up to, and we can either accept it or not? In the end, it will cost the insurer much more to play this game than if they had been reasonable with me in the beginning, before the lawyers got involved; and I will get less out of the settlement because of the legal fees I'll have to pay. The only winners are the lawyers.

Some days later, we get an offer. It is at the bottom end of the range of what Simon and Andrew thought we could achieve. I have to accept it. It is two-thirds of what we were claiming, and when I get my lawyer's bill, I'm left with two-thirds of this amount again. The money will allow Anna and I to meet all our loan repayments and expenses for the next six months or so. After this, the battle for financial survival will start again.

AT THE START
of April, some better news arrives — in the form of my Brain Fitness program, which turns up in the mail. I'm eager to get started. I need to get my brain working again; I'm not going to get out of this mess without it. Anna says she has no time to do the program, so I'm on my own.

For optimum results, Posit Science recommends the completion of forty hours of training over eight weeks — five days a week, one hour per session. On the first day, I only manage thirty minutes; after this, rubber brain threatens to overtake me. The next day is the same, as is the following. This shows me that I'm working to my limit. At this rate, it's going to take me six months or more to complete it.

The program concentrates on building the basic auditory skills first (pitch and phonemes), and then the components of speech (syllables and sentences), and finally comprehension (narratives). It contains six different exercises, which I work through progressively. The first, ‘High or Low', trains for pitch in speech, drawing on the frequencies found in spoken consonants and vowels. It does this by frequency sweeps: a computer-generated sound begins low and rises in pitch, or begins high and lowers. It's a sound like a zipper being opened or closed quickly. I listen to the pairs of sweeps in my headphones. I have to decide if each sweep in a pair has gone upward or downward, and use my mouse to click on the correct sequence of up and down arrows on the screen. The program picks up on my progress, making the sweeps quicker and reducing the time gap between them. The brain needs to be pushed beyond its current limit to improve. I quickly reach my threshold, and it becomes difficult to tell whether the sweep is going up or down.

The second exercise, ‘Tell Us Apart', uses phonemes — the individual sounds that make up words. In the word ‘dog', for example, there are
d
,
o
, and
g
sounds. The program presents similar-sounding phonemes: for example, the sounds ‘dah' and ‘gah'. The sounds are hard to tell apart. I perform very badly.

The program notes indicate that the voice saying the phonemes has been modified to alter the speed at which the phonemes are said and how much emphasis is put on the consonant. A faster speed and less emphasis makes it harder to tell them apart. Some phonemes are easier for me to work out than others. For some reason, my brain finds certain consonants harder to process than others. This shows me why I find the comprehension of others' speech, such as that of the lawyers, so tiring: my brain is working overtime, trying to make sense out of fuzzy engrams.

There is one exercise I enjoy. ‘Match It' is like the card game Memory. A matrix of cards is presented facedown on the screen. Each card has a syllable associated with it, and within the matrix there are pairs of syllables. Some of the syllables are dissimilar in sound: for example, ‘baa', ‘fo', and ‘pu'. Other syllables sound similar: for example, ‘sho', ‘stu', and ‘sa'. I am allowed to click on two cards, one after the other, and hear the sounds they represent being spoken. I work my way through the matrix, activating each card to find the pairs. This is training my working memory for spoken words, with a spatial-memory component. The matrices increase from eight to sixteen to twenty-four to thirty cards. I excel at ‘Match It', compared with the other exercises; it's encouraging to still be good at something. Perhaps it shows that when I can use my visual memory, it aids my overall memory.

As I progress onto the larger matrices, I notice that I can let go of mentally rehearsing the sequence of sounds I've just heard. Instead, when I click on a new card to hear a sound I've heard before, I let my mouse hand drift over to the card that ‘feels' like the match and click on this. Most often, it is correct. Somehow, my subconscious processing has become faster and more accurate.

I'd love to spend more time doing the ‘Match It' exercise, but the Brain Fitness program, like a good teacher, soon learns my weak areas and focuses on the exercises that most challenge my brain. One of these is ‘Sound Replay'. It presents syllables such as ‘baa', ‘fo', and ‘laa' as a memory-span exercise, asking me to remember a series of such sounds, as if I am learning a list. The voice names a random sequence of syllables, starting with two and then moving on to three, four, five, and more. I need to indicate which syllables were said, and in what order. This is training my capacity to discriminate sounds and is building my auditory working memory. It reminds me of the paired-words test I did with the neuropsychologist. Like then, I do poorly on this exercise — the sounds quickly enter the fog. I can only remember two syllables, and occasionally three syllables, for a long time.

‘Sound Replay' and ‘Tell Us Apart' are the hardest of all the exercises, for me. After the first few weeks of training, I remain on the lower levels for these exercises, wondering how I'm ever going to progress beyond this.

In ‘Listen and Do', I am presented with the visuals of a street scene that contains people, animals, and objects in the foreground, and buildings in the background. I hear a set of instructions: a sequence of people and objects that I am to click on. Once the instructions are given, I need to click on the objects in the same order. As the exercise advances to higher levels, I have to move a person or an animal to a new location. (For example, ‘Move the redheaded girl to the left of the brunette girl', or ‘Move the black dog to the right of the hospital.')

I'm okay with this exercise, once I develop a strategy for it. I draw imaginary lines between each named object, giving me a visual shape I can remember, which aids in recall. This resembles my real-life task of visualising a mental list of things to do and staying on track until they are all completed.

The final exercise, ‘Storyteller', is the most enjoyable. The voice tells a story of everyday interactions and events happening between people. At its completion, I need to answer ten, fifteen, or twenty questions about the story I've just heard. The answers are in multiple-choice form. The stories, five in all, become progressively more complex. This is training short-term memory and comprehension — being able to remember and understand details in spoken conversation. I recall the short stories the neuropsychologist read to me and how poor my memory was; I can see already that I've definitely improved on this type of task since then.

Progress bars appear on the screen during each exercise, and I strain to get to the next level of difficulty. There's a sense of achievement (a dopamine hit) when I reach a new level, and the program rewards me with animated fireworks and music. At the end of every session I can access a summary page, which lets me know how I'm going with each exercise. This is reassuring (even though it shows how poorly I'm performing in most exercises): it gives me a baseline from which I can see increments of improvement.

As I get into the rhythm of the program, most days I advance on an exercise or stay at the same level. But sometimes I have an off day. That's when I see, in the form of the progress bar, how dramatically my performance drops off when I'm mentally or physically fatigued — the clearest indication so far that fatigue really does affect my day-to-day capacity to function.

After one month of doing thirty minutes most days of the week, I have progressed up the ladder to some degree in all exercises. But I haven't noticed a great difference in my auditory processing outside these exercises. I'm a little discouraged by this. Yet the cheerful male voice that explains what each exercise does and why it is useful shows a picture of the brain with coloured lines connecting the areas that each exercise works on, reassuring me that I am making new neural connections. If it doesn't work, I've only wasted some time and some dollars.

I'm consistent with the Brain Fitness training, even when I'm feeling off, or stressed and anxious. At first I do the session mid-afternoon, before I get rubber brain for the day, and after I've done a decent amount of wrangling with lawyers, real-estate agents, and creditors. But after a while, I realise that I make better progress if it is done earlier in the day. I change tack, doing the training session just before lunch. Yet on the mornings when I attend a medical or psychological appointment, I can't do this: these sessions knock me around for most of the day.

By the six-week mark, I've noticed a real difference. My progress has been gradual, but all of a sudden the world is easier to comprehend, as if a door has opened. Other people's speech seems clearer; it's less of a strain to listen to them, and easier to understand what's being said. Everyday social conversation with another person is simpler, and I'm less fatigued afterwards. I still lose track in longer, more involved conversations, and I get fatigued after group conversations, but I'm confident now that I'm showing real improvement. My brain is coming back online and is starting to work with me.

In time, I also notice that the individual notes in the music that Nick and I play, or the sounds that other musicians make, stand out more than they have since my stroke. Phone calls remain taxing, and I'm still easily distracted by noise or other disruptions. But I'm remembering the names of familiar acquaintances easily now, and I think that my sense of direction has improved a little too — although it's nothing like it used to be.

I catch up with Wayne again and, after we've talked for a while, he says, ‘You're looking brighter. Do you realise you haven't asked me once to repeat a question?' Gee, is the difference that obvious? I can't help but smile.

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