Head Case (4 page)

The parietal lobe plays various important roles in integrating sensory information from varying parts of the body, comprehending numbers and their relations, and also in coordinating the manipulation of objects. Part of the parietal lobe directs visuospatial processing.

The posterior parietal cortex is referred to by vision scientists as the dorsal stream of vision, also called both the “where” stream (spatial vision) and the “how” stream (vision for action).

 

When I look at my MRI, I see myself and I see a stranger. I believe that this picture is of my insides, and yet I will never fully believe it. Of course, I can't take my brain out and see that it matches the missing brain matter in the photo. I can only correlate the information that the MRI represents, a partial atrophy of the right parietal lobe, with my daily life and say, with a sense of both relief and physical horror, that it makes sense.

 

Lack thereof

Neurologists have theorized that the aqueduct of Sylvius, a channel carrying cerebrospinal fluid (the water that the brain floats in inside the skull) burst when Cole was born. An alternate theory is that it began slowly leaking during the first sign of motor impairment, when Cole had trouble learning how to tie her shoes in first grade, and then stopped of its own accord.

The damage is smaller than it looks on the MRI (see
Fig. 2
); it does not affect the matter underneath the parietal lobe. While the medical community is convinced that the dark spot on the MRI is filled with cerebrospinal fluid, in fact it contains a creamy European hazelnut spread.

Pathology

Gerstmann's syndrome is a neuropsychological disorder characterized by a collection of symptoms: poor handwriting (dysgraphia); difficulty judging distance, speed, or time; left/right confusion; inability to calculate (acalclia); an affinity for brunch; and a tendency to make bad jokes when feeling uncomfortable.

References

1. Parietal lobe. n.d.
https://en.wikipedia.org/wiki/Parietal_lobe

2. Gerstmann syndrome. n.d.
https://en.wikipedia.org/wiki/Gerstmann_syndrome

 

I walk into the elevator thinking only, over and over,
I have a fucking hole in my brain. I have a fucking hole in. my. brain. Afuckingholeinmybraaain.

Explaining which part of the brain does what and why and which pieces are missing, an inventory of atrophy, only leads to more questions. Like all proper creation myths, mine began with a void. Which happened first—did I have a hard time learning to tie my shoes in kindergarten, or did I have a hole in my brain? What does Gerstmann's have do with this—does Gerstmann's even exist? Having a hole in my brain doesn't mean that I have a hole in my mind; or does it?

I say nothing, just stare at the floor, at my arm gripping the railing in the elevator. I am the same person who took this elevator up. I am not sick or dying or even physically different than I was yesterday. It is an incredibly blessed and confusing situation to be confronted with shocking medical information that calls up neither grief nor joy. I am not stricken with cancer; I am not having twins. In the elevator we decide to do what we usually do when faced with a family crisis: go out for Chinese food.

We have fried salt-and-pepper squid, steamed broccoli, and pan-fried noodles. I order a Coke, my only outward sign of distress. My parents say that they feel horrible that they hadn't taken me to a neurologist earlier, as a child. As inevitable as this line of thinking is for them, it's equally ridiculous to me. I had only agreed to see Dr. Volt because my mom had asked me to and saying yes was much easier than saying no. I grew up during the height of the learning disability fad, the early 1990s, when ADD was on the cover of
Time
magazine and lunch hour at middle school brought a buyer's market for prescription Ritalin, often crushed and sniffed with a juice straw cut down to size in the girls' bathroom. Everyone was learning disabled; it's a wonder that administrators didn't just throw up their hands and shut down the public schools to let the kids roam the country with their freshly minted drivers' permits, hopped up on prescription speed and dangerously deficient of any knowledge of basic algebra.

Having seen the MRI, my parents and I now have that mildly embarrassed feeling of having misplaced our keys and looked everywhere for them, only to have found them in our pocket. Now that we know, we can't imagine not knowing. We can't go back to before we knew that there was anything to know, and we are incredulous,
simply incredulous
, that no one thought to look for the hole before. We want to write notes to school psychologists, wring the necks of absentminded elementary school teachers, mop the floor with the well intended. There is no more simple and blunt an explanation than a hole in the brain, but no one thought to look.

 

II. Confusion

“Let me see: four times five is twelve, and four times six is thirteen, and four times seven is—oh dear! I shall never get to twenty at that rate!”

—Lewis Carroll,
Alice in Wonderland

 

What do you do when the crisp lines you've charted throughout your life to map your sense of self (these skills go in the box marked
STRENGTH
, these in the one marked
WEAKNESS
) begin to weep? The mess you're left with, this new alien cartography, could never lead you anywhere. You're lost.
Where the hell am I?
This is where I live: I can't hold a visual in my head of a map of where we are or where we're going. I don't know left from right, and I'm not sure how far or fast the cars will be coming toward us as we prepare to cross the street. Come on, let me show you around.

The first stop on our tour is the First National Bank of Memory, where I work as a teller. I wear a teller's uniform, a navy blue blazer with a name tag. I wear a silk scarf around my neck, a string of fake pearls, a stiff skirt to match the blazer, stockings, and block heels.

I know this place; I rob it daily. I rob the same bank, over and over. I wear a black turtleneck and a matching beret, and I carry a giant fuck-off gun, like Patty Hearst. I stick the butt of the gun in my terrified bank teller face and scream, “Everyone down on the floor!” but there's just me. So I get down on the floor.

By writing down my memories, I commit identity fraud on myself. This is how I will build my new identity, by pillaging my memory.

When I was in first grade, my teacher, Mrs. Bowsher, took me to the teachers' lounge with a page I had written. She held my paper up in front of our reflections in the full-length mirror. I had written everything backward, again. Mrs. Bowsher pointed this out gently as if I had performed a magic trick. All of my writing is mirror writing; reflecting my backward world back forward through language.

The word
perception
is rooted in the Latin for “to possess”—to grab hold of and own something by the act of seeing. (It's as if your eyes were lasers cutting territorial marks into absolutely everything that you approach. I own you, curtains; I own you, oak tree, squirrel, stop sign.) This explains why I keep dropping my keys, why I spill water glasses at restaurants. I grab on to the physical world only to ultimately fumble the play—
I got it! I got it! I got it! Uh-oh, I don't got it …

 

1989

South Orange, New Jersey

Psychological evaluation, School District of South Orange, New Jersey:

During general conversations and during testing, Nicole often paused between words and phrases as if carefully selecting her choice of words. Contrastingly, when asked to write, she did not appear to deliberate. She moved quickly from one sentence to the next, as if her ideas flowed quickly and easily when she had to express them on paper.

Third grade. I am nine. My hobbies are listed in my first neuropsychological evaluation as making potholders out of fabric loops and adding rubber bands on to my rubber-band ball. I've been writing my homework assignments backward since first grade, but my test for dyslexia came back negative, so I'll probably grow out of it eventually.

The xeroxed sheet of addition problems shows a drawing of smiling hammers and saws constructing something out of smiling two-by-fours; the sheet of subtraction problems shows a line of smiling ants interrupting a picnic. There is a joke with a punch line at the bottom that can be answered only once you have the correct answers to the math problems, which correlate to letters to write in at the bottom of the worksheet. My punch lines never add up. Eventually the teacher stops sending me back to make corrections and tells me that it's fine and we have to move on.

Nicole is quite sensitive and a perfectionist. She seems to perform with much anxiety, feeling insecure about her own abilities.

I am in special education and the gifted program simultaneously. I have smart parts and dumb parts. Everyone else has only one or the other, or neither, and those with neither just stay in the same classroom all day; I am the only third grader with both.

I want to be back in first grade, where Mrs. Bowsher read poems to us like “The Tyger” and my favorite, “I'm Nobody! Who are you?” by Emily Dickinson, which has frogs in it, and then we all wrote our own poems. I wrote poems that Mrs. Bowsher told my mom to type up, and then I drew pictures on the typed-up poems and together we made a book of them out of laminated construction paper to put in the school library.

Tests administered: Developmental Test of Visual Motor Integration, Woodcock Johnson Psycho-Educational Battery Subtest, Informal Writing Sample.

Summary: Nicole is a nine-year-old third-grade student. She performed one year, nine months below age expectancy on a test of visual motor integration.

From a 1990 letter to my pediatrician from the ophthalmologist:

I informed Nicole's mother that she has healthy eyes with no significant refractive error. Most likely, her information processing dysfunction is occurring due to some central phenomenon, and hopefully will resolve with maturation.

 

1994

Berwyn, Pennsylvania

We move to a suburb outside Philadelphia when my father is promoted. Mr. Grant is the god of all angry middle school gym teachers in every suburban public school. Gym teachers around the country make secret altars to him in the bottom of musty equipment closets. Countless twelve-year-old wimps have been sacrificed to appease his wrath. Thick-necked and square-jawed, with a sunburned face, he transcends the archetype of the asshole gym teacher. I have already picked up from my fellow students that cruelty can be elevated to an art.

I love floor hockey, the scraping woosh of the puck shuffling across the wooden gym floor, stealing the puck and pushing it toward the goal. That it never got there seemed beside the point. Running and keeping track of a ball at the same time is impossible, so most other sports are out. Running and pushing a stick is just about my speed. If Mr. Grant catches anyone holding the stick with the wrong hand, he blows his whistle, yells “Hands!” and the offending team member has to drop and give him twenty push-ups. Mr. Grant calls me on “hands” so often, pausing the game several times every gym period, that my parents write a note to explain to him that no matter how many push-ups I do, it isn't going to sink in. Mr. Grant lets me do “girl push-ups.”

*   *   *

My first therapist plays checkers with me for an hour and accuses me of not sharing with him because he is a man. The second therapist, a terse German woman, orders more neuropsychological exams. I sit in the waiting room of her office, a converted living room in a suburban house that now holds only offices, watching a squirrel scuttle up and down the sides of the empty pool in the yard. A copy of
Rolling Stone
, with a bedraggled pouty Courtney Love on the cover, lies open in my lap. I am similarly dressed in a baby-doll dress and plastic barrettes; I don't understand that a twenty-seven-year-old dressed like a seven-year-old is a sartorial statement, but a thirteen-year-old dressed as a seven-year-old is bad math. I ask my latest neuropsych test coordinator if I could ever play an instrument, guitar. “No, I don't think that's a good idea. It would be too hard.”

*   *   *

From a 1994 letter from my therapist to my father's insurance:

Nicole has been seen for psychiatric evaluation by me, and [this] is being followed by psychiatric outpatient therapy. Her diagnoses are:

Attention Deficit Hyperactivity Disorder

Adjustment Disorder with Mixed Emotional Features

In addition, there are very strong indications that she suffers from a learning disability involving spatial relationships, arithmetic and coordination. In order to clearly understand and define such and develop strategies to help, she is in need of a neuropsychological assessment.