This appeared in the Jan.-Feb. 2005 issue of Science & Spirit.

In my favorite photo of us, we’re astride Ken’s BMW motorcycle in our Tucson driveway. Ken is laughing at the camera as I, sitting behind him with arms clasped around his waist, kiss his ear. We wore none of our usual protective equipment—full-face helmets, boots, jackets, gloves—because we had jumped on the bike strictly for the photo. Months later, Ken was wearing all his gear when he took his other motorcycle, a Ducati sport bike,  to run some errands. But when a white sedan turned suddenly in front of him, there was nothing he or his equipment could do to prevent what happened next. Ken hit the passenger side near the back wheel; helmet striking steel, face smashing into helmet, brain slamming into skull. He crashed to the asphalt. The sedan disappeared.

An injury to the brain is unlike any other. Along with physical functions, the brain controls awareness, personality, temperament, and cognitive processes like memory—all those things that commingle to form a “self.” And while that self does not necessarily reside in the brain, the brain is the part of us that animates it. So a traumatic brain injury can kidnap the dear self of someone you love, dragging him far from shore as a riptide does a swimmer, sometimes beyond rescue, even though in reality he is holding your hand or smiling at you across the dinner table.

The day of the accident, exactly nine months after our wedding, Ken left around noon and had planned be home in a couple of hours. Instead, I found myself at the University of Arizona Medical Center’s ICU around 7 p.m., staggered by the sight of my husband. There was a ventilator tube in his mouth; a cervical collar around his neck; a stitched cut above his left eyebrow; left eye purple and swollen shut, right eye nearly so; nostrils filled with crusted blood; broken right hand captured in a sling; left hand tethered to the bed rail. Naked under a single sheet and his face streaked with dirt, Ken moaned and tossed in delirium.

A CT scan showed two minimal contusions on Ken’s brain. The neurologists told me worse injuries invisible to imaging machines were likely. The brain floats within the skull, and if the head’s momentum stops suddenly, as Ken’s did when it came to an instant halt against the car, the brain rebounds within its bony home in a motion called coup contrecoup. Neurons are sheared off: Millions of connections in that tiny, internal universe can, like exploding stars, blink out of existence in an instant.

That Ken had suffered a traumatic brain injury (TBI) became apparent when he could talk again, four or five days after the collision. Much of his speech consisted of parroting words in a sing-song voice. After developing aspiration pneumonia, he tried to cough but couldn’t cough deeply enough for relief. Smiling at him and stroking his forehead, I said, ”Bummer.” He sang back, “Bummer, bummer, bummer,” much as a toddler would.

Next, he began repeating nonsense phrases. The first was, “Happiness is, happiness is,” in a gentle rhythm. I added, “Happiness is a warm puppy,” which he chanted for a while and gradually transformed to “Happiness is a warm country.”

But as Ken began to speak in complete sentences, I grew more alarmed.

“I have to rewire your circuitry so I can manage you better,” he told me in all delusional sincerity. He claimed his staid, sevety-seven-year-old parents were members of a steel drum band; no, wait, a plastic drum band. He insisted he had to get up and care for his patients (he’s a software engineer) and that Scott, his chiropractor, repaired his motorcycles. One night, when he couldn’t even sit up without help, he somehow clambered over the bed rail, wandered down the hall, and fell, hitting his head. Fortunately, he incurred no further injury. The nurse who called me said he kept repeating, “I have to find the motion. My wife and I have to find the motion.” He didn’t know where he was or what was happening. Even worse, he didn’t know that he didn’t know—a very bad sign.

After this incident, Ken was placed in a Vail bed, a mesh-sided, enclosed bed that zips from the outside. Much better than putting him in restraints, the nurse told me.

Ken’s short-term memory also had been damaged. He recognized everyone who came to visit but for weeks could not recall that anyone but me ever had. His speech therapist hung signs in his room as memory aids: “I was in a motorcycle vs. car accident on December 29” and “My wife’s name is Barbara.” She also started a memory book for him, to which I added photos of our wedding, his kids, our house, and our cat, along with affirmations proclaiming good health and normal life.

During the first few weeks, even though Ken carried on long—if sometimes weird and oddly chatty—conversations, he never really engaged with anyone. He spoke animatedly, but his gaze was distant, unconnected. Although physically in the room, he was not present; he existed in some inward place, unable to transcend the damage to his frontal lobes.

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