Transforming Experiences

"Stella" October 29, 2002

Barbara Wade describes her health history up until March 13, 1999 as being "medically uninteresting." What happened on that day changed much more than her health history; it changed her life.

After returning from an errand, she slipped in the mud near her patio, and fell headlong into a board that protruded from the framing around her door. "It felt like I'd been hit with the sharp edge of an axe," she recalls.

Barbara is not certain how long she was unconscious. She was eventually able to call 911 and was taken by ambulance to Saint Marys Hospital in Rochester. A CAT scan revealed a massive hematoma between the skull and skin. There was no internal bleeding, swelling or external fractures. She returned home with pain medication.

Besides excruciating pain, Barbara experienced swelling and bruising to her face and head that was so severe she rarely went out in public for more than a month. Living in a fog of pain, she was still unaware of the ramifications of her fall.

Life before ... and after

Barbara had always lived a full life. She was the proud mother of a daughter who was successful in her work. Barbara was invigorated by learning through reading, travel and meeting people.

Barbara had also enjoyed a varied professional life, having worked as a social worker, art teacher, and sales representative. She had created and managed a folk art gallery and a marketing company.

Barbara's first illustration on August 8, 2002.

Not long before her accident, Barbara had quit a job in sales and was in the process of looking for something new. Then the accident happened. Ten days later, her mother passed away. In the midst of grief and physical pain, securing a new job became a major hurdle. "I would get in an interview and I'd space out and stare," she says. Unable to earn an adequate income, she put her belongings in storage and moved in with a friend.

Through persistence, she was able to secure jobs in retail, food service and health-care-related work, but unfortunately the jobs didn't last. In little more than three years since her accident, she had 11 different jobs.

Even sounds most people take for granted become distracting and fatiguing to Barbara. "I worked in sales in a department store, but the PA system and music were painful for me to listen to," she says. "Even the sound of several people talking was difficult for me. I couldn't sort out their voices and deal with the background noise. I would get extremely tired and have a hard time focusing."

In the summer of 2000, after a referral to the Mayo Brain Rehabilitation Program, she had a neuropsychological evaluation by James Malec, Ph.D., and was diagnosed with a traumatic brain injury. After yet another unsuccessful attempt at working, she decided to return to school. "I knew I had a problem with noise and concentration," Barbara says. "I thought if I could earn a degree in Digital Arts at Rochester Community and Technical College, along with my Bachelor of Science degree in art, I could work in a quiet environment doing work I enjoy. I was convinced that if I just tried hard enough, this would help me put my life back together."

Barbara's second illustration, drawn three hours later on August 8, 2002, shows the effect of fatigue on her style.

But school exhausted her, and listening to the hum of a computer for hours had a cumulative effect. Barbara was compelled to drop classes and ultimately to abandon her plan to finish the program.

A new brain

Disappointed, confused and frustrated by her inability to be successful at things that had once been so easy for her, Barbara again made an appointment with Dr. Malec. "He helped me understand how the difficulties I was having were related to the injury," she says. "My solution to everything was to try harder and, in this case, it not only wasn't working, it actually made things worse. When he said I had cognitive problems, I said, 'Oh great, now I'll be stupid too.'"

Dr. Malec reassured Barbara that while she is still intelligent, her brain cannot access information as it once did. "My brain has to find new paths to information, and that routing process takes longer," notes Barbara. "I had to find new ways of doing things."

Barbara began cognitive therapy, meeting regularly with a licensed clinical medical social worker and occupational therapist in the Brain Rehabilitation Program. "They helped me understand what had happened to me and how my injury manifests itself," says Barbara. "I've learned coping skills. The injury isn't going to go away, but they've taught me ways to work more efficiently with the 'new brain' I now have." After several months, Barbara began Cognitive Rehabilitation Therapeutic Group, which has helped her make a habit of organizing daily activities, making more realistic plans and using the coping strategies she has learned.

"When I get tired, a cascade of things happens," Barbara explains. "My balance can be affected and I have difficulty staying focused, concentrating and sorting things out. Writing, spelling, and talking become more difficult. Sometimes I can't do things I know perfectly well how to do. My mind simply becomes inaccessible to me. Each of us with a brain injury has some manifestation that is unique to us. The brain injury also causes an emotional response. In my case, I felt like a loss of self that was both confusing and frightening."

Self portrait, October 3,2002

Painting a new future

Now when Barbara reads, she stops frequently to rest her brain, enabling her to read longer. She recognizes changes in capacity for thinking, as well as her emotional response to the injury. "I overload more easily. I am more easily frustrated."

Barbara has found new clarity in an old skill — art. Once a painter of landscapes and architecture, she now draws portraits of an amazing cast of women with names such as Stella, Blue Lady and The Singer. A look at the changing technique in her drawings, which she began doing only months ago, reveals a rapidly evolving mixed-media style, influenced by her love of Latin American and African art. Her drawings can also change dramatically from a simpler to more complex style, which she attributes to variations in her energy level.

No one is more surprised by her art than Barbara herself. "I often look at a piece and wonder how I did it. It is so unlike the way I used to draw, but I like this." The evolution of her artistic style is reflective of her thoughts on what happens to a person who has suffered a brain injury. "This experience is different for each one of us who has suffered a brain injury. Yet we all share something in common. Each of us has to learn to live with a new brain."