What a Coma Can Teach You

Is being in a coma for twenty five days a good thing or a bad thing? As some of us have figured out, two things can be true at the same time. So, the answer is both. The bad part is pretty straightforward and I’ll get to that in a bit. The good part is somewhat counter-intuitive so we’ll start there.

First, the condensed back story. The proximate cause of the coma was rapid and almost complete blood loss. This event occurred a couple of years after recovering from a near fatal stroke and several years prior to an emergency colostomy resulting in a months long stint with the bag. So this wasn’t my first or last medical rodeo. (I’m also a recovering alcoholic-10+years) and an ex-smoker so I’ve got that going for me…which is nice. Anyway, stories for another time.

The mechanics of the coma were pretty simple. I was sitting in America’s most chaotic ER waiting for what seemed like a bit too long while bleeding profusely and feeling faint. Twenty five days later I was awake (I’m not sure conscious would be accurate at this point). I should note that most of the memories and many of the lessons occurred from this point forward. My memory of the part where I was actually in the coma is still a little sketchy.

That transition moment (point of inflection, event horizon, liquidity event, big bang, awakening, take your pick) is indescribable. After many years of searching and countless hours of introspection the closest I’ve come is a phrase I came across somewhere: “the absence of knowing”. The explanation being that this is not a telenovela moment where you wake up from amnesia. In that scenario you know what you are: a person, where you are: a hospital. There are other people around who seem to know stuff about you. You’re missing some specifics but the structure is familiar; you just need to fill in the blanks. In my case I’m describing having no structure, no context, no history. There is nothing to remember or forget because those things don’t exist. Even tabula rasa (a blank slate) assumes a slate. There is no slate so it can’t be blank. I could go on forever but for me, at least, the description is asymptotic, I may get close but I’ll never get there.

Back to the chronology. Next are what I assume are physical primal urges. Apparently the human digestive system is well acquainted with the concept of starting with a clean slate so there’s that. Then an overwhelming desire to stand up explodes into the mind. It’s at this point that I believe that actual consciousness kicks in because I realized standing was not physically possible due to being strapped in tighter than Hannibal Lecter. (the movie references came later).

Once this glimmer of consciousness appeared the processes accelerated rapidly. I believe, partially, because my attempt to stand seemed to be a catalyst for two very large, quite agitated beings to forcefully dissuade me from any further movement (much later when my first spoonful of pudding landed closer to my navel than my mouth I understood their reasoning). This was another transition event, less radical than the first, but transformative nonetheless. From this time forward my consciousness and cognitive abilities began to increase logarithmically.

Tangentially, I also began to have memories of what I’ll call dreams. I’m not at all sure when these dreams occurred while losing consciousness, during the coma proper, or as I was coming out of it (or some other unknown point on the space/time continuum). For whatever reason I have a totally unsupported feeling that these things manifested in the instant before I ‘woke up’. I can say that surreal doesn’t begin to describe what I remember of these things. Imagine Terry Gillam and David Lynch collaborating on Human Centipede: The Musical, written entirely in Haiku and you will start to have a whisper of a notion of the carnage in my brain at that point.

Lesson #1
Human understanding of the brain, consciousness, essence, soul, metaphysics, existentialism, existence is beyond human capability at this point (sorry Descartes-”I think therefore I am” is glib and quotable but…). Since the coma, anytime I hear someone opine on any of this I feel like I’m taking Harpsichord lessons from a Salamander. Of course, I could still be in a coma for all I know.

We’ll leave the navel gazing part of the program now and move into a practical lesson. This set of circumstances speak to sociology in the broadest sense with some communications theory sprinkled throughout. After making enough progress to handle some basic physical tasks (spoon aiming etc.) I was moved to a rehab facility (nursing home) where I progressed into more aggressive physical, and occupational therapy regimens. After some time I came to a place where I could start to reflect back on the more mundane aspects of recovery.

I came to find out that there were six people who were the main sources of information about what occurred while I was indisposed. The group consisted of a combination of close friends and “first degree” family members. These were people who knew me very well and for a very long time. There was unanimous agreement on only one point. The doctors would not predict when or if I would come out of the coma. If there was a Venn diagram this would be the only point of overlap. Absent this area it would appear as six congruent circles. Maybe I was naive, but I found this phenomenon extraordinary. On one hand these six individuals were a mixed bag in terms of age, race, education, life experience, geography, almost any axis (save a lack of Y chromosomes) yet I shared a common personal connection to each of them. Still what emerged were wildly divergent versions of what would appear to be a singular fact pattern. I should note that not everyone was physically present during the process. Some took the under-number on the wake-up I guess.

Lesson #2
The terms “my truth” “your truth” are marketing puffery. Individuals can have their version of events but a version and a truth are not synonymous in any way. The accurate and meaningful approach is “we all look out our own window”

There is an objective “truth” in that in every case something did actually happen. Your version isn’t that.

Humans do not have the sensory or cognitive tools, nor in most cases the incentive or resolve to accurately identify the objective truth. Maybe in some distant evolutionary future that changes. In the interim keep your strategic skepticism reserve topped off.

Lesson #3
Again, we’ll move from the esoteric to the practical. Based on the daunting objective of returning my brain to its previous state I had to adapt some of the self improvement protocols that I had become comfortable with over time. I was a firm believer that the best way to improve one’s performance was to begin with the most basic fundamentals and to add improvements incrementally (sometimes referred to as ‘stacking successes’).

One day my Occupational Therapist came in and introduced herself. (an extraordinary person who after 10 years as a Wall Street trader switched careers to help people who really needed it. Seriously, I had a bit of a hill to climb but nothing compared to what some of the folks in this facility were facing. It inspires me every time I think about the people who are willing to do the actual work needed to improve somebody else’s present).

We began with the standard approach by practicing mazes and puzzles, and a few simple word association games all on roughly a first grade level. Fortunately I handled the challenges with aplomb and was approved for a promotion the next day. Then I had a stone cold epiphany. While I understood and conceptually agreed with the approach we were taking, this was brain function we were talking about. For me, there could be nothing more existential. So, I made a risky, potentially destructive decision to look over the horizon to see what I was facing. This meant pausing the safer, time tested incremental success stacking approach. The risk of seeing a potentially spirit crushing outcome was chilling. Even the best case scenario would be a long, slow, arduous grind. So I hiked up my big boy pants and asked her to print some high school level algebra word problems. They were hard. They were not impossible.

I’m still not sure why I did it. Fear? Masochism? My Viking ‘burn the boats’ heritage. Doesn’t matter really. The result was a road back. I was able to build new pathways in my brain and can now function at a high enough level to pursue my current goals. Sure there were an infinite number of alternate outcomes. They didn’t happen, this one did and I’m good with that.

For me, the lessons ended up being simple:

Be humble–There’s a lot of stuff you don’t know

Be grateful–You already have a lot

Be strong–Because you are

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