On April 9, 2019, I hit my head. I was on a bus in Berlin, the city I’d moved to nine months prior, on my way home from work. The driver hit the brakes hard at the same time as I was jumping up from my raised seat and ― clack ― the top of my skull smashed into the horizontal holding bar.
Now, the second before the bus braked, my only exposure to the notion of a long-lasting concussion came from Canadian hockey player Sidney Crosby (and that was likely due to having two brothers). I knew what a concussion was ― I’d even had one myself a few years back, but it had healed itself in 10 days with no medical intervention. It didn’t seem possible to me that a bump to the head, something that happened to clumsy people like me all the time, could pivot an entire life.
But then, in what would become a trend, my brain proved me wrong.
Immediately after my skull connected with that holding bar, I felt the striking pain. But it wasn’t until I was a few steps down the sidewalk outside that I let myself focus on it. I reached my fingers into my hair ― please don’t be a thing, I chanted inwardly, as I brought them back in front of my eyes.
To my surprise (and glee), there was no blood. I kept walking, relieved that my life could keep on uninterrupted. After all, my life couldn’t afford an interruption ― especially not one that called my productivity into question.
For all of my adult life ― and most of my adolescent one, too ― productivity had been my driving force. I pushed through exhaustion and sickness to meet deadlines and outwork peers, partly because I was addicted to the pressure and partly because I craved reaching higher. At 23, I graduated with a master’s degree, and at 24, I was the lead writer at a publishing startup’s new app.
Like any early-stage startup employee will tell you, we worked hard. Hours were long, pressure was high, and I was responsible for a team of writers and the content they produced, in addition to spearheading an intensive round of hiring. I was obsessed with my job and the progress the app had been making, and I simply did not have the time to be injured.
As I repeated that last part to myself, walking to the grocery store as planned, I looked at my clean fingers again. My relief deepened. In fact, it wasn’t until eight hours later, when I was in the back of an Uber speeding to a German emergency room, the piercing pain and violent dizziness too much to bear, that it disappeared.
What became immediately apparent, as soon as I got home from my first hospital stay, was that my concussion didn’t care whether I had time for it or not. I was unable to think clearly, to walk straight, or to take a breath without feeling pain radiate through every cell in my skull. For the first time in my life, I could not work.
I’ll be gone until the end of the week, I reasoned with myself, repeating the sentence in a text to my boss. As I squinted at the bright screen, willing my fingers to hit the correct letters and wondering why everything seemed so damn hard, I wasn’t anything more than annoyed.
The symptoms, the inability to do anything, the time off ― it was all one big, unnecessary grievance. As the days carried on and my self-appointed orders to get better were not realized, my frustration grew. But still, my symptoms were nothing more than a challenge.
When my constant nausea made it nearly impossible to eat, I stuffed protein bars down my throat and walked around with a plastic bag, just in case. When my dizziness and lightheadedness made it difficult to walk the three blocks to my grocery store, I took a break halfway, sitting on the curb and waiting until I was pretty sure I wouldn’t pass out before I continued.
Since my first concussion had cleared in 10 days, I figured that, despite my symptoms being way more intense this time, I’d be good to go just as fast. I staked my sanity on that week-and-a-half turnaround. But when the 10th day hit and I had already endured two hospital stays, an MRI, a lumbar puncture and enough pain medication to numb a small village, it dawned on me that I was still not good to go. In fact, I was even less good to go than before.
Now that the fantasy expiration date I’d given my brain injury had been debunked, l was left with the seriousness of my symptoms. They were no longer just annoying ― they were debilitating, constant and prone to intensifying without warning. And they had made it clear to me that they weren’t just going to up and leave.
Chief among all of my (plentiful, colorful) symptoms was the head pain. Sometimes it was background noise, but it could also be extreme and all-consuming. When it was the latter, it typically (though not always) came in the form of agonizing pressure. The type of pressure that felt like my skull was trying to compress my brain at the same time as my brain was trying to burst free from my skull. Sometimes it lasted hours, sometimes it lasted days.
The first time I experienced that ― a “flare-up,” as I’d come to refer to it ― it was Day 6. The pressure intensified vehemently enough that I went back to the ER in a panic, scenes from “Grey’s Anatomy” playing through my mind. But my brain wasn’t bleeding, and other than recommend more drugs that made me care less about my brain’s impending implosion, there was nothing else the neurologists could offer.
For the better part of my concussion journey, flare-ups controlled my life. When I wasn’t in excruciating pain, I was thinking about the next time I would be. But there was no pattern I could latch onto for proactive avoidance. Sometimes the episodes came from exertion, and other times from nothing at all.
Once, after having a couple of good days in a row, I got excited and went to my office; after staying for two meetings and getting applauded for my health’s return, I went home and suffered a flare-up that lasted three days. Another time, I was FaceTiming a friend, listening to her tell a story. Another time, I was in the middle of a guided meditation, lying flat on my back in the dark.
Because I didn’t know what would incite a flare-up, and because inciting a flare-up was the worst thing that could happen, I stopped seeking out activity. The potential for (and fear of) that unbearable pain stopped me from working, from seeing friends, from going outside. The idea of looking at a screen long enough to have a text conversation was laughable; the idea of getting into a car absurd.
When I was nearing the two-month mark, it dawned on me that I couldn’t remember the last time I’d felt no pain. The desire to fight my symptoms had been depleted, and I didn’t have the energy to hold on to expectations anymore. I stopped assuming I’d be back at work the next week, because my brain had already proven me wrong seven times. I stopped making plans with friends “for when I was normal,” because I was sick of canceling ― of admitting my brain still wasn’t strong enough. For probably the first time in my life, I had relinquished control over a situation, resigning myself to the notion that my brain would heal when it wanted to.
But weeks continued to pass, and even as I accepted that stance, I knew I had to make some heavy life changes. Treatment beyond “rest” didn’t exist in Europe, so three and a half months into my concussion, I moved back to Toronto.
Before I continue, I’d like to point out that my concussion journey, while traumatic and tough in its own right, has been padded by privilege; my work benefits gave me medical insurance and paid leave, and I was able to travel to see specialists. I’ve had access to treatments ranging from neuro-optometry and acupuncture to functional neurology, from physiatry and physiotherapy to reiki energy healing, and I am well aware that most of the millions experiencing concussions each year will not have the same, or even similar, opportunity. That’s a problem.
It’s been four months since that day in April. Since then, I’ve quit my job, moved back in with my (loving, supportive, gracious) parents, and put every part of me on pause ― none of which was on my overachiever’s to-do list. But amid the chaos of a changing life, I’ve borne witness to humanity; whether from co-workers, friends, family, or the strangers who haven’t balked at my wearing sunglasses inside, compassion has been everywhere ― even when understanding has not. For that, I am lucky.
This injury has taken a lot away from me, but it’s also taught me quite a bit. About concussions and about life. Since I’m saving the latter wisdom for my memoir, I’ll let you in on the most pertinent piece of concussion-specific knowledge I’ve learned so far.
They happen, and they’re uncontrollable.
We have no idea who will get a concussion from what; some concussions heal themselves quickly, and others ― ahem ― take their sweet time. The one common thread is that concussions, all of them, are an invisible injury. But the marks they leave on the lives of those who experience them ― and especially the longer-lasting ones ― are dramatically visible.
The point of this essay wasn’t to evoke fear or sympathy, but to bring some much-needed attention to the injury with the power to destruct. Millions and millions of people on this continent alone will begin their own concussion journey this year, and hopefully, when they do, it won’t feel as isolated a trek.