The newsletter of the Memory Disorders Project at Rutgers University

Five years after his injury, Bill stood in his bathroom gazing at his reflection. "I stood there a good half hour and just looked in the mirror," he says. "It was like I saw myself for the first time in a long time. I went right to my desk and started writing about how I felt. After a rough draft I turned it into a poem."

The poem titled reflections

It is a meditation on the aftermath of a 1993 brain injury that left Bill with serious memory impairment. We visited Bill recently at his home in rural New England to talk about his experience with memory loss. A soft-spoken and scrupulously polite man in his 40s, Bill received us with a friendly grin and a plate of Danish. The loudest sound in his tidy home is the gurgling of hot water through the heating pipes. Bill says it's the perfect environment for him. "Even now, if I get nervous or upset, my memory goes," he says.

The easygoing man we spent an afternoon with seems at odds with the portrait Bill paints of himself before the accident. He was a hard-driving manager of bakeries in a major supermarket chain. He worked long hours, but Bill says he was missing something along the way. "I was too busy working, making money for a house that I was never in, for stuff that I never got to enjoy because I never had the time."

One day changed all that. He rose at 3 a.m., dressed for work, and went to his garage. Next thing he knew, he was in the hospital. He had lost consciousness, and exposure to the exhaust fumes from his car had starved his brain of oxygen. This damaged his hippocampus, a region of the brain important to memory, and particularly vulnerable to oxygen deprivation. As a result, Bill has a condition called anterograde amnesia, which is an impairment in the brain's ability to form new memories.

In the aftermath of his accident, Bill faced a few challenges. For one thing, he had to struggle to get the level of medical care he felt he needed. After a month of in-patient care at a rehabilitation center, his insurance company wanted him to become an out-patient, which would mean a long daily commute from home.

Fortunately, Bill's parents helped him find a spot in a center closer to home, and a social worker found funding to support his treatment for six months. He relearned basic skills like how to manage his finances and how to cook a meal. He also learned some ways to compensate for his memory loss for example, how to use an ordinary check register to keep track of his bills.

While he was still in the hospital, Bill discovered another powerful tool: writing. Bill's parents gave him a notebook, which he used to keep track of daily events. It eased his anxieties. "I kept a daily journal of who came to visit me every day, what we talked about, things that I had to remember to do," Bill says. "It helped me to remember what I needed to remember, but it also helped me to get my feelings into perspective."

Bill's perspective has changed a lot since the accident. "There was a time initially right after my brain injury when I was very, very depressed," he says. "I would just sit and stare into space for hours." Things started to change when he encountered other patients at the rehabilitation center. "It was good for me to see that there are people with brain injuries a lot worse off then I was," he says. "That made me realize how lucky I was. I couldn't just sit there and feel sorry for myself."

And that eventually led him to write his poem. "I wanted to start a new page in my life, a new chapter," he says. "The bottom line for me is that it's really not that bad, because I'm still alive and I can still enjoy life. I have time to smell the roses." To Bill, "smelling the roses" includes weekly visits with his three children, staying in touch with his friends and family via his home computer, and working two nights per week in a local restaurant, surrounded by old friends and work mates. "It's good therapy for me," he says. "When we start going back and forth about the things we used to do, it helps me remember the type of person that I am or was."

Although his journal writing days are done, Bill says he hasn't quite reached the final chapter of his story. "The biggest thing I got out of this is that they can't really predict how you're going to turn out," he says. "After all these years, I still surprise myself. I just thought that after a year I would be as good as I was going to get, but I still see myself not relying so much on my little strategies and tools as I had to before." He grins, adding, "Sometimes I can actually find my car without writing it down."

Bill's Poem - Remembering to Smell the Roses

After a traumatic
brain injury.....

My mirror's reflection -
it's been the same for years
Only it's a little different now.
When did those gray hairs appear?
And what is it that is so different
When I look into my eyes?
They really are not the same as before,
Oh yeah, I just remembered
I nearly died.

They said that my sight
would probably be impaired.
But beauty I never noticed before
I now truly hold dear.
That numbness in my hand?
It really isn't so bad.
I can still extend a hand to a friend.....

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