Simple Things (Puffy Books)

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The fight was three rounds, and each round was three minutes with a minute in between to pause.

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Apparently, he came back from having been knocked out, determined to finish the match. The lost memories are probably the result of difficulty in the seahorse-shaped sections of the brain, called the hippocampus, Mullally tells me. These structures — there are two in a normal brain — are very sensitive to a lack of blood flow and changes in electrical activity.

And so he and I have gaps in our memory — he while boxing, and me, in the ER — where we were perfectly awake. When my memory started again, I was in a small room. A nurse was trying to make me comfortable. I was ravenously hungry, and requested food. She nodded and left, pulling the door most of the way closed behind her.

I located my phone — under the blankets with me, I discovered — and began informing people that I had inconvenienced them. Where was my food? Suddenly, the hunger turned to nausea. I began looking for a call button, a way of alerting someone that I required a bucket. Mood changes are common with concussion, and mine started the moment I woke up.

Yes, I was confused; I was also, maybe more accurately, bemused.

All I needed to do was lie in bed and let people examine me. It was a lot like floating on an inner tube down a river: I remained still and the scenery changed.

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But now the people were gone, and I was alone in the room. My chin was scraped, as was my nose.


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My left eye was at half-mast, but overall, it was fine. Besides, my eyebrows and hair looked great. Immediately after getting a good look at me, he seated himself quickly on the floor and put his head between his knees. My face, I understood, was so disturbing that he had nearly fainted.

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After Andrew had recovered from the shock, I made the first catalog of my injuries. My face hurt, of course, but so did my left shoulder, hip, and knee. All would later produce technicolor bruises. I had chipped a tooth. That was it. The most damage was on my face. I must have landed directly on my head. When I stood up for the first time since the crash, I discovered standing made The Headache worse. I had only the vaguest sense of where my limbs were and whether my feet were aligned correctly with the floor.

My body had become a clumsy mecha suit, and I was trapped inside, trying to operate what felt like a large hunk of metal. Then, I was discharged.

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We went home in a cab big enough to hold the two of us and my totaled bike. I figured my recovery would take a week. I was wrong. I alarmed people pretty much every time I mentioned my concussion. Never mind that the actual injury was not scary to me — it scared everyone around me.

The brain lives pretty close in our imaginations to the self. This belief is probably why brain injuries scare people. Personality is a major part of how we understand ourselves; in fact, we use it as a reference for famous people, like a television personality. To have your personality altered by brain trauma seems to upset people more than having it altered by, for instance, emotional trauma. Or rather, I was a pessimist before I hit my head; I am slowly returning to it now. But I spent about a month after the crash incapable of doing anything other than looking on the bright side.

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I could go on playing with both hands, but only the top half of the keyboard was available. While I was in the ER, it occurred to me: what if I am stuck like this forever? But there would probably be another job I could do. If I thought I was my brain, probably I would have found the injury more upsetting. After surgery, his leg no longer felt like his own. The mood change did make memory lapses easier to endure, though.

I had always been bad with names, but I was noticeably worse: no new names stuck. Viewing it as a game made it less frustrating and a little more fun, so I chose to do that. That diary entry shows more cross-outs and uncertain spellings than any of the previous ones. As I continued writing, later, the number of cross-outs and bum spellings declined. But it was clear: there was a before, and there was an after. But the brain-body connection is relevant here, too. Most concussion patients have difficulty with light and noise; they often isolate themselves in dark, quiet rooms in response.

In people without concussion, this kind of behavior creates depression and anxiety. So, did the depression and anxiety come from the brain injury, or the self-imposed isolation afterward? For a long time, doctors thought that patients needed to rest totally after a concussion until all symptoms were relieved, Leddy says. They get anxious and some get depressed and they get irritable. Recovery was different every time, though he never experienced chronic headaches.

Light sensitivity, though — that he remembers. After the fourth concussion, he was diagnosed with amnesia. That recovery process was different because it was more severe. The biggest changes concussion caused for Utecht were cognitive: he struggled with the skills we rely on to manage time and pay attention, called executive function, and his memory deteriorated. When Utecht joined the Cincinnati Bengals, learning their offensive system was harder. He received his final concussion during training in ; after that, he ended his football career. His mood tanked: he was depressed, and anxious, and his patience was nonexistent.

What improved his mood, he told me, was an intensive brain-training program. Having a hard time remembering his calendar, remembering names, and remembering the right words made things more frustrating. There is no treatment for concussion except for patience and time, but people seem not to believe that. Well-meaning friends suggested I supplement with omega-3 fatty acids and eat extra protein.

There is no evidence either make a difference for concussion. Lowinsky doesn't use a frangipane at all: instead she adds a layer of ground almonds on top of the jam, and then tops it with a mixture made from butter, sugar, eggs and breadcrumbs, with a hefty dose of lemon juice.