Prognosis
PRAISE FOR PROGNOSIS
“The morning after a fall from a horse, Sarah Vallance entered her kitchen to find she’d stored her reading lamp in the refrigerator, her groceries in the sink, and her toaster in the freezer. Diagnosed with a traumatic brain injury, Vallance went from holding down a senior government position to unemployed, with an IQ of around 80. Prognosis: A Memoir of My Brain tells the story of her journey back, aided by her loving rescue dogs, George, Bess, Sofia, and Scout, who ‘robbed her of her reason for dying.’ Vallance works to revitalize her brain, finally earning a PhD, reconciling with her impossible mother, and finding a loving marriage. Prognosis, beautifully wrought and essential, stands as testament to the power of human reclamation and recovery.”
—Susanne Antonetta, author of A Mind Apart
“A lot of memoirs are about redemption and survival, but Sarah Vallance has outdone most by writing a rather brilliant and compulsively compelling book about her harrowing traumatic brain injury without an ounce of self-pity, but with irony, wit, and a lack of the kind of self-absorption that critics sometimes see as the hallmark of the contemporary memoir. If you want to find redemption and a story of overcoming the odds, yes, you can certainly find it here, but I’d rather commend it for its crystalline prose, and Vallance’s skills as a consummate stylist and storyteller.”
—Robin Hemley, author of Nola: A Memoir of Faith, Art, and Madness
“Sarah Vallance’s Prognosis isn’t just a riveting account of life before and after a traumatic brain injury or a meditation on what happens to the mind when the brain (almost) stops working. It’s a book about what it means to care for others—parents, dogs, friends, patients—and how we can learn to care for ourselves.”
—Jess Row, author of Your Face in Mine and White Flights: Race, Fiction, and the American Imagination
“In direct and unflinching language, Sarah Vallance faces the existential question of whether our cognitive perception constitutes the totality of who we are. Fortunately for her, and for her readers, it does not. The head injury Vallance suffers begins a journey on which she discovers that her openness to the world, to friends, lovers, and family, is crucial to her recovery. While Prognosis is about physical, mental, and emotional wellness, it has even more to say about the larger question of how to live a full and authentic life. This is a brave and necessary book.”
—Sue William Silverman, author of The Pat Boone Fan Club: My Life as a White Anglo-Saxon Jew
“In Prognosis, Sarah Vallance has produced a harrowing but absorbingly immersive account of survival, rendering a life’s worth of pain and trauma with clear-eyed and measured precision. Also, I loved the dogs.”
—Matthew Vollmer, author of Permanent Exhibit
“Spanning continents, lovers, dogs, and decades, Prognosis is a memoir of Sarah Vallance’s amazing perseverance in the face of a traumatic brain injury, asking the crucial question of what our brain’s relationship is to our sense of self. As she unravels the effects of her neurological symptoms in prose as distinctive and meticulously crafted as William Styron or Joan Didion, we learn about our own mortal bodies, our relationship to grief and time, the legacy of the families into which we were born, and ultimately our irrefutable ability for self-determination. In the end, this is a timeless love story told by a skeptical and wildly funny narrator who leads us into the landscape of her own gray matter—both biological and social—with such care and insight that we can’t help but rethink our own relationships to illness, sex, aging, and one another. Prognosis is an astonishing debut by a writer from whom we are sure to hear much more.”
—Ravi Shankar, Pushcart Prize–winning author and editor of W. W. Norton’s Language for a New Century
“Sarah Vallance’s Prognosis is a triumphant blend of candid personal writing and meticulous research into the modern epidemic of traumatic brain injuries. With artistry and sensitivity, Vallance weaves together her own often-hazy memories into a vivid narrative in which her personal relationships—both human and canine—proved instrumental to her recovery. A must-read for anyone whose life has been touched by a TBI or memory loss.”
—Justin Hocking, author of The Great Floodgates of the Wonderworld: A Memoir
“Combining love, loss, and the restorative power of animals, Prognosis is a powerful testament from a writer who has experienced life-altering brain injury. Vallance writes in exquisite detail and with fierce honesty about what appears to be a minor bump, but her brain injury will continue to reverberate through her life as she, society, and the field of neuroscience learn and grow to better understand this all-too-common condition.”
—Justin Hill, author of The Drink and Dream Teahouse, Washington Post Book of the Year, and Shieldwall, Sunday Times Book of the Year
Text copyright © 2019 by Sarah Vallance
All rights reserved.
This is a work of creative nonfiction. The events, scenes, and dialogue are written and portrayed to the best of the author’s memory. Some names and identifying details have been changed.
No part of this book may be reproduced, or stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without express written permission of the publisher.
Published by Little A, New York
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ISBN-13: 9781542043021 (hardcover)
ISBN-10: 1542043026 (hardcover)
ISBN-13: 9781542004206 (paperback)
ISBN-10: 1542004209 (paperback)
Cover design by Zoe Norvell
First edition
In loving memory of George and Bess
CONTENTS
AUTHOR’S NOTE
1 ACCIDENTS WILL HAPPEN
2 THE POCKMARK ON THE WALL
3 BUILDING A NEW BRAIN (PART ONE)
4 METAMORPHOSIS
5 IMPULSES THAT WON’T BE CONTROLLED
6 DOGS ARE THE BEST PEOPLE
7 BUILDING A NEW BRAIN (PART TWO)
8 AMERICA
9 ANGER IS A (NOT SO) SHORT MADNESS HORACE (EPISTLES BOOK 1) (WITH A SLIGHT MODIFICATION)
10 YOU CAN RUN, BUT YOU CAN’T HIDE
11 THE UNRAVELING
12 MELANCHOLIA
13 NEXT OF KIN
14 SYNCHRONICITY
ACKNOWLEDGMENTS
ENDNOTES
ABOUT THE AUTHOR
AUTHOR’S NOTE
I started work on this memoir during my MFA at City University in Hong Kong. I hadn’t planned to write a memoir, and it took some time for me to get my head around the idea of exposing a large chunk of my life that I had kept private for so long to a group of eight strangers in a workshop, much less a broader audience. My memory had been deteriorating for some time, and I was terrified about the longer-term consequences of my head injury. To begin with, my motivation was to write about my life so I could remember and record it, but I had also hoped that the act of writing might help keep my brain active. It had worked for me once before; perhaps it would work again.
The more I wrote, the more convinced I became that mine was a story that needed to be told. Not for me, but for the hundreds of thousands of people that suffer traumatic brain injuries (TBIs) every year who are not able to tell their stories. TBI is often an invisible problem and one that is poorly understood, not just by the medical community but also by the friends and family and acquaintances of the individual who has suffered the injury. If this book broadens the understanding of what it is like to experience a traumatic brain injury, then it has served its purpose.
Like many people, including those who have not suffered a head injury, I have forgotten a lot, but my chief problem i
n writing this book has been determining correct chronology and timing. I have spent months researching parts of my own life, trying to determine accurate timings and sequences of events, relying wherever possible upon documents, passports, and the corroboration of others.
I have not written anything in this book I do not believe to be true.
1
ACCIDENTS WILL HAPPEN
Death is stalking me.
She finds me on a sheep farm in Crookwell, a three-hour drive inland from Sydney. I have come to visit my friend Tim and his wife, Belinda, and to see Tim’s new quad bike. I’m traveling with my closest companions, George and Bess—city-slicker dogs who love nothing more than to pretend they belong in the country, riding around in flatbed trucks, tearing after stray sheep, hanging with the farm dogs who see right through them and sniff them with scorn. It is a sweltering day in early January 1995, during the peak of the Australian summer. The sun has leeched the color from the grass and torn open the earth below. This weather is ripe for bushfires.
Tim and I met when we worked in Corrections. I was Tim’s boss. We spent our days visiting every prison in New South Wales. Tim was my bodyguard, the one shoving aside inmates who rubbed themselves against me as we walked through the prison kitchens and dining areas. After we’d been friends for a couple of years, Tim told me that his mother was doing time in Mulawa prison for fraud. She had done something dodgy with the accounts at one of his father’s car dealerships. Tim felt funny visiting her, he said: the staff knew him as the policy adviser to the Minister for Corrections. Yet his mother was locked up inside.
Tim’s bike is red and black with monstrous tires, and looks either like a lot of fun or like a death trap. “Be careful, you two!” Belinda shouts from the porch as Tim revs up the engine. She knows trouble follows Tim and me wherever we go. We unleash each other’s inner lunatic.
“Don’t worry!” Tim yells back and blows Belinda a kiss.
I hop on the back and let Tim drive me around the fields before demanding that it’s my turn to drive. He lifts himself off, stands to one side, and tells me to drive up the side of the mountain. I do as I am told, Tim running behind me, trying to keep pace with his new toy. Near the top I grow bored and decide to change course, turning a sharp left.
“No!” Tim shouts, appearing out of nowhere, hurling himself at the side of the bike to keep it upright and stop it from rolling down the side of the mountain, with me on top.
“You can only go up or down on a mountain. Go sideways and you’ll roll!”
“Calm down. I’m fine.”
He holds the bike in place while I dismount, and as soon as I am standing, he folds himself onto a rock, his head between his hands. “It nearly killed you!” he says.
Waiting for Tim to get up, I ponder what it would be like to be crushed by a rolling quad bike. It scares me less than it should.
Nearly two years have passed since my father died from bowel cancer. He was sixty-four, and I was twenty-nine. I drank my way through the first weeks after his death, doing my best to forget I was alive. One particularly grim night, I lay on the road in the middle of Oxford Street, the drinking mecca of gay Sydney, arranging myself neatly inside the painted outline of a body, where a pedestrian had been killed. Friends had to scoop me off the road just as the traffic lights changed. These days I try to distract myself with work, but grief still has me in a headlock. I seem to have lost the ability to make sense of the world. My grip on life feels fragile.
I knew that a rolling quad bike would never kill me, even if I wanted it to. It couldn’t. No matter what I did, no harm could visit me. I was protected by an invisible lifesaving ring that I’d first become aware of as a child. It had allowed me to do things other kids couldn’t, like lying facedown on my skateboard and riding from the top of our steep hill, around a blind corner, and down another hill before rolling to a stop on a street in the next suburb. When the other kids tried it, they all wound up headfirst in the gutter, their arms and legs embedded with gravel.
I was also a fast runner and a long jumper, which only fed my delusions of power. I had a remarkable ability to jump between branches of trees, to leap walls, to scale the mesh fences that surrounded tennis courts.
Most children outgrow such delusions. Not me. I harbored them right through adolescence into adulthood. If anything, age seemed to embolden me. The older I got, the more I enjoyed walking down dark alleys at night alone, venturing into places I knew to be dangerous and pitching myself against whatever fate might hold.
My father and I fought during my adolescence, but by my early twenties, I realized that—apart from his intelligence, which eclipsed mine, and my love of animals, which confounded him—I was his carbon copy. Combative, contemptuous of authority in almost all its guises, and driven by a compulsion to be right, I seemed to be the only person who understood him, and him me. He was the only person with whom I could be myself. I sought his counsel on everything, although I didn’t always follow it. My mother and I had never been close and, as our relationship disintegrated, the bond I shared with my father became unbreakable. At twenty-nine, I had lost the only person I trusted, the only person I respected, the only person who loved me without conditions. My father’s love had made me strong. Without that love I was rudderless. Part of me had died too.
“We’re different, you and I,” my father said to me on his deathbed. “We’re not like Mum, not like your brother. You’re the pea and I’m the pod.”
Tim rocks back and forth on the ground, apoplectic, as I ponder my own invincibility. Finally, he pulls himself up. A bull ant marches across my shoe, and I flick it off with a stick. Moments later, Tim throws his leg over the side of the bike, pats the seat behind—officially now “my seat”—and drives us, in a straight line, down the mountain and back to the house where we sit down to the meal Belinda has prepared.
Ripe for a new thrill after lunch, I ask to ride Tim’s horse. I have no clue that horses are more dangerous than quad bikes,1 or that they are considered to be twenty times more dangerous than motorbikes,2 due in part to their unpredictability and in part to the fact that the distance to the ground from a horse’s saddle is much greater than the distance to the ground from the seat of a motorcycle. None of that even occurs to me. Mac is a big horse—sixteen hands at least—and Tim says he’s docile. “You’ll be lucky to get him to do much more than eat,” he says.
“That’s okay,” I answer.
Tim goes off to the barn to get a saddle and bridle, and I introduce myself to Mac. I have an apple in my pocket that he swipes before I know what’s happening. “Help yourself,” I say, and rub his muzzle. He likes me. Why would he not? I have a way with animals, although my experience with horses is patchy.
My mother won hundreds of ribbons at pony shows when she was a girl. Most of the ribbons were blue or red. She sewed each ribbon together with the next and made bedspreads with them, so her equestrian triumphs could be displayed in the bedrooms of her family home. It was the same home I grew up in. Nigel, the piebald pony she had been given when she was twelve, lived on a paddock two blocks from that home in Roseville, a leafy suburb on Sydney’s north shore. By the time I was born, single-story redbrick houses had sprouted up where the paddocks once were, and no one in our neighborhood owned ponies anymore.
My mother had hung an oil painting of Nigel on my bedroom wall, as if to preserve his memory in my young mind as well as hers.
For my seventh birthday, she baked me a horse-in-a-field cake. She used desiccated coconut soaked in green vegetable dye for the grass and chocolate fingers for the fence. From a toy store, she bought a plastic horse that bore a reasonable likeness to Nigel, and stood him in the middle of the cake. It was my favorite birthday cake, and the fondest memory I have of my mother.
By the time I was nine, I was obsessed with horses. An aunt had given me a book called The Love of Horses for Christmas, which I kept hidden under my bed, and at night I’d gaze at the photos with wonderment. I loved ho
rses, although I don’t remember ever meeting any. Nor do I recall having any desire to ride them. My ambitions went only so far as patting them, grooming them, and feeding them carrots.
For my tenth birthday, my mother surprised me with four riding lessons at the Terrey Hills riding academy in Sydney. She had given me the riding hat she used as a child, which I wore proudly as I sat astride the fence in our backyard. I had never needed a horse to indulge my riding fantasies. My parents didn’t have much money, and my mother had scrimped for those lessons. She had every reason to believe it would be a good investment. She was a good rider; I was her child.
After the first lesson, it was apparent that I hadn’t inherited any of her horsewomanship, and on the drive home she chanted, “Sit up straight, heels back in the stirrups, hands down.” “Alright,” I said. I would try to remember that next time.
By the end of my fourth riding lesson, my mother wore a look of defeat I would come to dread. I had failed her. She never said it, but her silence in the car and then the words, “Perhaps you would be better at the piano; let’s try that next,” after we pulled into our driveway left me in no doubt how she felt. In four hours over four consecutive weeks, I had convinced her I would never be a rider. Riding was the first of many things for which I exhibited no talent. Next came the piano, then the violin, and then anything that involved numbers or foreign languages.
Mac waits placidly while Tim saddles him up. I haven’t ridden a horse in more than a decade. I try to count the times I have even been on a horse in my thirty-one years. Six? Seven? At lunch, I had a couple of glasses of chardonnay, which may be hampering my memory.
After a few ungainly attempts, I manage to mount him. He takes a moment to study the scenery, ambling toward a thick clump of dried grass next to a fence post. I pat his neck as if to say, Take your time, Mac.
“Kick his sides,” Tim says.
I don’t have time to.