From Injury to Enlightenment
I don’t remember anything about the 2008 car crash we now call “The Accident“—and only much later did my husband realize why a medic, calling for him to meet us at Loyola University Medical Center in Chicago as I was being loaded into a helicopter, urged him to hurry.
It was to give him a chance to say goodbye.
When I awoke in the hospital a week later with a broken body and a traumatic brain injury, no one knew if I’d ever be the same. After a month, I still couldn’t retain short-term memories. I’d recognized my husband and daughter right away (but how had she gotten older?). No problem recalling Dad or my many siblings either, but I kept asking if Mom was still alive. She’d died of cancer in 2007.
Such is the sometimes amusing, sometimes emotionally wrenching and always baffling world of the TBI patient. According to brainline.org, a TBI is “a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain.” Such injuries affect 1.7 million people a year (and cause 52,000 deaths) in the United States alone.
In my case, the diagnosis was “moderate” TBI. Among other scary things I’ve found in trying to review the data my husband has summarized into a 3-inch-thick binder over the years, this diagnosis had to do with my rating on the Glasgow Coma Scale (not so good, apparently), my initial decerebrate posture”–a rigid body position with legs straight, toes down and neck arched–and seizures. I also read about “my months of physical and cognitive therapy and my “residual neuro-cognitive problems,” depression, hampered mobility and trouble with “activities of daily living.” As much as I resisted it, we arranged for a home-care assistant.
Finally, I looked through my husband’s transcription of my “seizure diary,” a combination of my thoughts and his descriptions of my seizures, some of which he’d captured on video so the doctors could witness them. This trip down “no-memory lane” was my attempt to figure out the year I started yoga (2011? 2012? I’m not so good with numbers anymore), but I couldn’t stop reading about my now-extremely rare episodes. This one, from March 2012, was from a night Ted was working late:
“I get ready for bed early, multitasking brushing my teeth on the john, when I hear my phone. … Feel a seizure coming on and lean forward. Next thing I remember, Ted’s home and he’s coming to bed. It’s hours later. I’d gotten myself cleaned up, into bed, lights out. (Discover a sore on outside of lip the next day, another inside–from my teeth. Also blood and toothpaste in my hair.)”
Today, as we approach our seven-year “Acci-versary,” it’s hard to identify with that version of myself, a newspaper editor forced to face a new reality. So much has changed—my physical recovery and return to fitness, new neurologists, the right medications, a deeper relationship with my husband … and yoga.
Ted (who’s become so knowledgeable that people think he’s a doctor) had urged me to try tai chi for its intense focus. I wanted something more athletic, so the instructor directed me to a yoga class taught by his wife, Lynda.
I now understand why Ted was drawn to tai chi as a therapy for me. In Dr. Norman Doige’s 2007 bestseller, “The Brain That Changes Itself,” the author discusses why people tend to become forgetful as they age. He explains that the nucleus basalis, a group of neurons in the brain, is designed to secrete acetylcholine, which helps form clear memories. Those neurons get neglected from a lack of mental stimulation, or from being “set in our ways.”
“Anything that requires highly focused attention will help that system—new physical activities, challenging puzzles, new careers that require learning new skills,” neuroscientist Michael Merzenich says in the book. He also touts the brain benefits of learning a new language in adulthood (Sanskrit, anyone?) and getting “sensory input from our feet.“
Learning something new? Check. Focusing intensely? Check. Going barefoot? Check. Whatever, I was sold.
I began attending classes three times a week, jogging the mile to the community center since I no longer drove. It felt good to work my muscles in new ways and to see myself in the big mirror holding (what I considered) perfect poses. But soon something inside me began to change. I’d catch a glimpse of my face in that mirror, and I’d be grinning, not grimacing. I’d see a classmate’s pose and think, “You can do it!” instead of feeling self-conscious or competitive, my default modes. And after class, I’d feel calm.
These are not unusual effects of yoga and meditation—of “being in the present moment,” I’ve learned. Antoine Lutz, Ph.D., and Richard Davidson of the University of Wisconsin at Madison have studied Vipassana or “insight” meditation for years. According to Psychology Today (Dec. 12, 2012), they found that the practice improved emotional regulation and stress control even when their test subjects were not meditating. When the researchers trained a different group in “compassion meditation“—having them focus on loved ones and then wish them “well-being and freedom from suffering“—this group showed evidence of increased empathy. In the brain, that meant more activation in the right amygdala in response to images of human suffering.
In addition, the compassion group also showed reduced rates of depression, as measured by psychological tests. “Davidson and Lutz’s work suggests that through mindfulness training, people can develop skills that promote happiness and compassion,” Psychology Today says. “People are not just stuck at their respective set points. We can take advantage of the brain’s plasticity and train it to enhance these qualities.“
Which brings me to brain plasticity, otherwise known as neuroplasticity. I remember hearing a lot about this property of my noggin, even in the early days, when I didn’t quite know what Ted was talking about. What it means is the brain is capable of sort of stretching to accommodate more knowledge. Doige explains it much better in “The Brain That Changes Itself”:
“Clearly, when we learn, we increase what we know, but Merz’s claim,” he says, referring to Merzenich, “is that we can also change the very structure of the brain itself and increase its capacity to learn. Unlike a computer, the brain is constantly adapting.”
But the old “use-it-or-lose-it” principle is also at work here. “Merzinich thinks our neglect of intensive learning as we age leads the systems in the brain that modulate, regulate and control plasticity to waste away,” Doige says.
“Intensive learning,” eh? I have a feeling my husband took that phrase to heart when he … encouraged? … suggested? … okay, pushed me to sign up for teacher training at Prairie Yoga in the neighboring suburb of Lisle in 2015. Sure, I loved my yoga classes at the community center. I adored Lynda’s warm, witty style, and I had made a group of wonderful friends, even if I couldn’t always put the right name with the right face (and still, to my embarrassment, sometimes call Jim “Steve” and Cathy “Cindy”).
Hmm. At this point, I’m thinking I’d better back up and fill the reader in on the rest of my lingering … let’s say “peculiarities.”
Gail Denton, Ph.D., who suffered a mild TBI herself in a 1991 skating accident, discusses the issue in the book “Brain-Lash: Maximize Your Recovery From Mild Brain Injury,” which she calls “an outwardly invisible illness.” Although my case is moderate (in between mild and severe), I still appear normal … well, depending on what I’m wearing! See Exhibit A.
What people don’t see (unless they’re my husband) are the emotional fragility, the intense need for routine and especially the mental fogginess when it’s nearing time for my 10 to 12 hours of nightly sleep. In her book, Denton says TBI patients tend to get mentally fatigued because they lack the energy reserves that keep “normal” people from getting overwhelmed.
Denton also lists a number of deficits in the brain’s executive functioning that are so me:
• Processing speed. This is why, when new yoga cues are given, I often tilt my head quizzically and then just copy what my neighbor is doing.
• Attention span. Oh, look! My cat just woke up!
• Sensory overload. I don’t wear the dark glasses just to look like Mrs Cool. Also, big crowds, noise? I’m outta there.
• Word finding. That’s gotten much better, but … who did you say you were again?
• Disinhibition. Uh-oh. My childlike lack of decorum (“I’ll break into song at the grocery store if I want to!“) Also, see Exhibit B.
• Multitasking. Gah! Go, away, cat, I’m trying to write a thesis.
• Follow-through. Oh, I’ll write that one later …
• Sense of humor. Ha! See above.
There. Now back to your regularly scheduled thesis.
Numerous other studies have pointed to the benefits of yoga and meditation for TBI patients. One that I found especially interesting was the yoga program for soldiers returning from Afghanistan and Iraq at Eisenhower Army Medical Center in Fort Gordon, GA. Dr. John Rigg, director of the TBI Clinic at the base, describes on NPR’s All Things Considered how a blast in combat can affect a soldier:
“What happens is that primitive animal instinct, which is located in the subcortical brain, becomes hyper-aroused. … The subcortical brain doesn’t understand geography and stays hyper-aroused. Their muscles are tightened up.”
But after a short time in yoga, he says, participants report better sleep, relaxed muscles and a better outlook.
“It’s an enlightening factor, even for people who don’t continue in yoga, to see that they can use breath and physical movement to actually change the way they feel.”
As if I didn’t know that! Still, I was one nervous yogini when I showed up for teacher training my first day.
Maybe I should have taken a look at the following recent study first: Harvard psychologist John Denninger and his colleagues divided their subjects, all of whom had reported high levels of stress, into three groups. One group was taught Kundalini yoga—which includes meditation, breathing exercises or pranayama, and the chanting of mantras in addition to physical yoga postures; the second only meditated; and the third listened to relaxation recordings. Based on questionnaires, brain scans and gene analyses of blood samples, the yoga group showed an increase in the expression of genes for energy metabolism and a decrease in the expression of genes for pain and stress, according to a November 2013 article by Bloomberg News.
One of Denninger’s colleagues on the study, Harvard physician Herbert Bensen, had literally written the book on stress relief in 1975. In “The Relaxation Response,” he called his work a “validation of age-old wisdom,” rather than a breakthrough, that presented “a simple version of Transcendental Meditation for people in the Western World.” The book, which has since been updated, shows methods of activating the parasympathetic nervous system when the “fight-or-flight” response kicks in. He calls two of the steps essential:
1. Focusing on a mantra or activity “to keep the mind from wandering.” (I can testify to this one. Yoga, meditation and walks in nature do quiet my mile-a-minute thought patterns.)
2. Having a “passive attitude.” (Working on it. Does passive-aggressive count? (I kid, I kid. See Exhibit C.
Brain injury and all, I was accepted into Prairie Yoga’s teacher training program with open arms, thanks in no small part to a recommendation from Lynda to studio owner Lori Gaspar. Lori trusted Lynda, a Prairie veteran who continues to teach and take classes there, so Lori added me to her own 200-hour trainee group. This was an Iyengar-based class, meaning the emphasis was on holding each yoga position precisely and for a long time, rather than “flowing” from pose to pose.
I loved it! I got to do challenging poses and make close friends. Still, the written homework was hard at first, and it wasn’t easy for my unpracticed brain to retain what I was learning about body alignment, hands-on adjustment, anatomy, yoga history and philosophy, Sanskrit and … oh, geez, other stuff. Then there was that scary new technology on my phone—the Uber app—that I had to master since I don’t live anywhere near jogging distance of Prairie.
I also faced my fear of failure during the weeks my two group partners and I fretted over the free public class we were assigned to “sequence” and teach. (A weird aside: Remember those executive brain functions I listed that take a hit after TBI? One I left out is Sequencing. So maybe yoga helps with that too, since our class went just fine.)
And now, back to science. In other brain-positive research, a 2013 study at Beth Israel Deaconess Medical Center in Boston compared MRI scans of cognitively impaired people after an eight-week program of yoga, meditation and mindfulness with those of similar patients who had gotten standard care. According to the April-May 2015 edition of Neurology Now, the program group showed better connectivity in the hippocampus, which is related to learning and memory. (Score! The hippocampus is where most of my damage is!)
And then there’s this, from the June 2015 edition of the medical journal Disability and Rehabilitation: An eight-week mixed-methods case study in which yoga teachers worked individually with TBI patients showed a 36 percent improvement in balance (a biggie for me; I still struggle with those types of poses). Other benefits, as measured by physical assessments and interviews, were confidence, lower-extremity strength and endurance.
Said one patient: “I mean, it’s rocked my world. It’s changed my life—I mean, all the different aspects. I mean, physically, emotionally, mentally—it’s given me, you know, my life back.”
Physically, emotionally, mentally. … I know, right? But for me there’s more.
In “BrainLash,” Denton concludes with what she calls a “take-it-or-leave-it” chapter that “introduces the concept of an increased or newly installed skill known as extrasensory awareness. It is a potential product acquired with brain injury. It serves your pleasure.”
So I guess this is what I’d call the “take-it-or-leave-it” part of my thesis. It’s hard to describe, but I feel a new sense of connectedness now. Things happen because they’re supposed to happen; everything works out. If The Accident made me who I am today, I’m glad. I like myself better now. I think this awareness came several years later, when I was no longer in “survival” mode, going from seizure to seizure, so maybe my brain had a chance to heal somewhat.
The feeling grew when I started yoga—and exploded when I learned to meditate. In fact, shortly after a three-day seminar on the topic at Prairie by visiting teacher Nicolai Bachman that, honestly, did not hold my interest, I became aware of a strange phenomenon. When I closed my eyes, I could “see” what looked like an open eye at about the bridge of my nose. Being an idiot, I mentioned this to a classmate, figuring it was some bizarre “neurological thingy” from my old TBI. She said something like, “Whoa, that’s really advanced.” So I did some reading (in my own Teacher Training Manual, for gosh sakes) and concluded that I was seeing that famed “Third Eye” that lets you “see from a deeper place” and “trust your own intuition.”
While it’s not “like I have ESPN or something” (to reference one of my daughter’s favorite movies from high school, “Mean Girls”; See Exhibit D. I do get little intuitions. For example, long after I’d finished the previous paragraph, I got a mental tug telling me I’d misspelled “Nicolai.” I looked it up, and sure enough I’d added an H. Also, if I ever need inspiration, I just close my eyes. (How do you think I’m getting through the writing process?)
Mostly, though, this Third Eye brings me comfort. Says Denton in “BrainLash“: “You may experience an increased interest in spiritual matters … for which you had no interest. This may be a general awakening to a higher power.”
That has certainly been the case for me. I was raised in a church-going family, but at a young age I found religious doctrine illogical. The idea of God didn’t make sense to me, though I wasn’t about to admit this to my parents. Decades later, though, I had an epiphany, but it’s unclear exactly when. My husband says I found God a few years ago, after The Accident but before meditation—and very shortly before a recurrence of severe seizures that led to an episode of post-ictal psychosis (think “The Exorcist”) for which I was hospitalized for a month.
(No, that “Exorcist” line was a joke, but Ted says I got spooky-religious and was even convinced at one point that a male orderly was God.)
The only religious awakening I do remember was a gradual one, when the peace of meditation became a way to connect with the Universe, with God.
Or maybe I’m nuts. But my shrink assures me I’m not.
“Your participation in yoga helped you to shift to a level of being more peaceful inside,” says psychologist Joseph Keegan of Naperville, with whom I’ve worked for I forget how many years now. “Prior to that, you were at more of a frenetic pace—anxious, pensive. Yoga provided you with a sense of equanimity and altered your sense of interconnection with the world.“
He says yoga “opened up a door to a sense of spirituality” and even points out that my habit of picking up litter and recycling as I walk home “reflects that you feel you have a place in the universe.”
But my progress hasn’t all been because of yoga. Not giving a thought to the possibility that he might screw up my thesis, Keegan attributes some of my improvements in cognition and memory to playing the piano. (Actually, it’s an electronic keyboard; I just keep it on “grand piano” setting so as not to sound like an ’80s “hair band” member.) Ted, knowing that learning piano, especially in adulthood, works wonders for the brain, had given it to me for Christmas one year.
“With your decision to play the keyboard, you moved on to challenge yourself with music—to challenge yourself in a positive way, a different cognitive way,” Keegan said. “And it gave you positive, resonating feedback.”
So I guess the point of all this is that yoga and meditation—plus music, nature, friends, family (especially a devoted, selfless spouse) and faith are the keys to coping with brain injury—and I’m living proof. Oh, and prescription drugs. And excellent doctors. (I highly recommend Dr. Elizabeth Gerard at Northwestern Memorial.)
… And did I mention the drugs?
One last note: Thank you to my teacher trainer, Lori, for rejecting my first thesis idea—autobiographical song parodies—because she wanted me to learn something from the process. All this research and writing was hard, but I see now that it was just what my brain needed. Just for fun, though, I’ll leave you with this:
(To the tune of “Lola” by The Kinks)
Had a steady desk job
At the paper in town
When a nasty car crash
Turned our lives upside down
In a moment.
They airlifted me
And they worked on my brain,
But they still didn’t know
Why I wouldn’t come out of a coma.
I almost died.
My family cried.
Ted fell to his knees.
Then I looked at him and he at me.
Now, that’s not the way
that it went down that day.
But I’m still here today,
so there’s that. Hip-hooray!
Now there’s yoga.
Now, I’d left my home gym
just a month before,
And I’d never, ever kicked
to handstand before.
But Lori smiled and demo’ed
for the class,
And I did the pose! Didn’t fall
on my a – – !
And that’s the way
that I want it to stay.
Yes, I always want it to be that way
For my yoga.
Now, I’m not dumb,
but I can’t understand
Why my memory’s so bad—
oh, now wait—yes, I can,
Thanks to yoga,
That research for yoga.
(Repeat and fade out)