Unwanted Memories

"I'm sorry, but we just don't know."

That phrase, and its myriad variations, was one I'd heard a lot in the past three months. That's how long Liz had been in her coma. She was driving home late from her office, and then... something happened. Her car went off the road and flipped multiple times. The injuries were severe; multiple broken bones, internal bleeding, a lacerated liver, and more. A traumatic brain injury had placed her in a coma which she had not awoken from yet.

In some ways, that was a blessing; most of the major surgeries had been done, and her body was able to mend more rapidly since she was at rest. She didn't have to suffer through all of that pain. The downside, though, was that we didn't know if or when she would wake up. I say "we," but I mostly mean me, her husband. She has no siblings, and her parents passed away before we were married ten years ago. Some of her coworkers and friends visited, but most of those had stopped showing up as the days turned to weeks; the rest when the weeks turned to months.

I had been told "we just don't know" about how long her recovery would be, if she'd wake up from the coma, what the effects would be on her brain, if she'd be able to have a normal life again, why her car went off the road, and so many more things that I can't even remember. The only solid answers I had gotten were that her physical recovery was coming along well, and that I needed to be prepared for the worst.

I sighed. I knew Dr. Taggart was just trying to set expectations, but the expectations she was setting were essentially that I should have no expectations. I slumped in my chair. "So... hell, Doc, what do you suggest I do, then?"

Her voice was soft and kind as she looked at me from across her desk. "John, I know that this has been very hard for you. But the truth is..." She smiled. "It's rare that we see a spouse as devoted as you've been. You've been here every day and slept here most nights. But honestly? None of that is going to help her."

She steepled her fingers. "What I suggest is that you go back to living your life as best you can. The few spouses I've seen that do what you're doing... they either try to get back into the world and hope for the best, or they end up putting their entire life on hold for months, years even, and..." She trailed off. "Liz may come back to you, John. I hope she does. But is it even going to be 'you' if you've spent every waking hour here with her? What's going to be left of 'you?'"

Of all of the doctors I'd dealt with, Ellen Taggart was my favorite. A little older than me and Liz from a chronological standpoint, but with wisdom far beyond her years. I nodded unhappily. "... Yeah. Yeah, I get it. I just..." I sighed. "I always-- I hated when you'd see a woman get sick and her husband abandoned her. Asked her for a divorce. It was just so... cowardly. Disloyal. I don't want to be that guy. I want to..." I searched for words, but they wouldn't come.

Ellen smiled. "You want to be supportive. I get that, John. If Liz were here, really here, that's exactly what you'd be doing. But she's not. You're not supporting her by being here; you're just tearing yourself down." I started to object, but she raised a hand. "I'm not saying don't visit. But your life is outside these walls, even if the biggest part of it is trapped inside. We'll take care of her. I promise. And if she comes back to you, you'll-- being out there, being yourself for you, that will fortify you for what you'll need to do. It'll give you a reserve to draw on, one you're spending right now by being here every day worrying."

"And what if she doesn't come back?"

"Then you'll find a way to let her go." That was something else I appreciated about her: her frankness. "You need to accept that as a possible end to this, John. You're young; you have a life ahead of you. You're not going to be able to come to grips with the fact that it might be one spent apart from Liz if you're always here. Because, while we just don't know-- "

I grimaced, and she let out a small chuckle. "Trust me, I hate saying that phrase almost as much as you hate hearing it. " Then her manner was back to the kind, if slightly grim, one I was used to seeing. "While we just don't know, the outlook isn't good. If she hasn't woken up by now, the odds of her ever doing so are low. The odds of her coming out unchanged are almost nil. And you need to prepare yourself for that."

I knew this, of course. I'd had plenty of time to research it in the hospital, sitting next to Liz's bed or in the waiting room as she went through surgery after surgery. But hearing the kind doctor I'd grown so fond of laying it out for me? That made it all really sink in. I felt tears well up in my eyes and nodded. "Okay. Okay. I'll-- Thank you, Doc."

"Ellen. I think we're on a first name basis by now, John." She took a deep breath and sat up. "I know it's hard to hear all of this. And it-- it might feel like giving up. But it's not. It's not a retreat or a surrender. It's-- you're a runner, right? I think you mentioned that you and Liz used to do that together."

There were a lot of things that Liz and I used to do together that we hadn't in some time. "Yeah, that's right. Let me guess, 'it's a marathon, not a sprint.'"

She laughed. It was really a very charming laugh. "Hey, now, those are my cliches. I'm still using them!"

With a chuckle, I wiped my eyes. "Sorry. I... yeah, I know. I just-- it's hard. But you're right. I'm not doing her any good here, and I've just been wallowing." It was true; even from a practical standpoint, I needed to get back to work. My boss had been extremely understanding, but I didn't want to take advantage of that kindness. Especially since, if she ever did wake up, I'd need more time to help with Liz's recovery.

"I'm going to give you some literature and some referrals. You're sadly not the first person that's had to deal with this; I think you'll find there are a lot of people that are going to want to help you through it."

She was right. There were support groups, books, specialty therapists, all sorts of resources. I got back to work; I'm a software development consultant. My previous duties had been to act as a sort of hired gun, riding into town and doing code reviews, personnel assessments, whipping teams into shape, and then riding into the sunset. That meant that I had to travel a lot, sometimes for weeks at a time. It was lucrative, but it came at a cost: my marriage.

I can't put it all on myself, of course. Liz was... difficult. It was hard to admit this while she was lying in a coma, but when I came home from my most recent trip, I had been ready to divorce her. She'd grown distant; cruel even, at times. Our lives were headed in two different directions, she as a successful realtor and me in my career. We were both competitive people, and it rankled her that, even with her successes, she still earned less. We used to run together as a way to stay connected, but with my travel, I fell off. She was able to run further and faster; at first, we'd go together and she'd just smoke me. Later, she stopped asking me to go with her at all.

I know that sounds petty, and it was; it's not like running was the basis of our relationship. But it was indicative of other things going wrong. We used to try to do everything we could together: trying new foods, traveling, talking about our jobs and helping each other find solutions, even just sitting quietly and watching TV or reading. It was the togetherness that mattered.

That slowed and eventually stopped. I traveled more for work, getting to see places we'd wanted to visit together. Admittedly, I mostly saw their airports and hotels, but it was something, in her mind, I was doing without her. At home, almost in retaliation, she'd go to try new restaurants by herself, then tell me she wasn't interested in going back once I got there. "Nothing very interesting, sorry." We stopped relying on each other as sounding boards. Eventually, we even got to the point where even when we were in the same room, we weren't together.

It hadn't always been like this. We had met fairly young, just out of college. Nothing particularly special about our tale, just two people that met through friends, had a spark, and found that it became a roaring bonfire. We were happy for a long time. But in the last couple of years, we just weren't anymore. Any attempt to reconcile by me was seen as weakness by Liz. Any attempt by Liz was seen as disingenuity brought on through guilt by me. It was a nasty spiral that would have certainly ended in divorce.

Except.

Except, one night, when I happened to be home in between trips, I received the call that told me Liz had been in an accident. All of the shit that had come before, my work, the running, the petty nonsense about travel and restaurants and fighting over the remote before separating to other rooms: it all became crystal clear that it was just bullshit. I threw myself into waiting by Liz's bedside for months, being the loyal watchdog for her. And... and it didn't matter. She didn't come back to me. And now it was time to return to the real world, or at least to a limbo that resembled it.

I was able to change my work duties; more code reviews, less of the rest of it. Some additional actual programming work, which I had always preferred. I was greeted back in the office with... well, people tried to be kind. But there's a primitive fear of tragedy, even as we try to be kind to those suffering it. It's the same instinct that made our ancestors look for witches when harvests failed, the terror in admitting that sometimes bad things just happen, and they could happen to you. No one wants to be reminded of that; I wasn't exactly a leper, but I didn't get invited out to happy hours much, either.

I got back into running. I was pretty out of shape, and it felt good to have something I could control. I thought of the times Liz and I had run together. Tried not to think of the times when she started to shut me out. The nice thing about having half an hour, and then later an hour, of running time all to myself is that it gave me plenty of time to listen to audiobooks. Some of them were about my immediate issues; Ellen had been right, there were a lot of options there.

But some of them were about other things. Books on rebuilding intimacy, something I knew we'd need to do if Liz came back to me. Science fiction, both good and trash; thought provoking hard scifi and "Max Steelglare and the Harems of Beta Fuckzor 7" both found space on my iPhone.

Philosophy, too. The Stoics were useful to me, but I found great comfort in Buddhist philosophy as well, and found even more in the places where the two converged: the notion that the source of suffering was longing, the idea that the way to peace was to accept what was happening as it happened. Not being passive, but also understanding that there was only so much you could do to change your situation, and that accepting that was a key to happiness.

I can't claim I was ready to be a bodhisattva or anything, but I was coming to terms with my new reality. Work had stabilized, and I was feeling healthier physically and mentally. I still made time to go sit with Liz and read to her once or twice a week, or just talk about life with her. Things were balanced. Stable.

"John. You need to come to the hospital. Liz is awake." Ellen's voice was on the phone, urgency barely veiled behind her kind professionalism. One hundred seventy three days after the gentle intervention in her office, the one that told me I needed to figure out how to adjust to my new normal, she was upsetting it again.

I was in my office when I received the call. It takes thirty minutes to get from there to the hospital. Nineteen minutes after I answered the phone, Ellen was meeting me at the front door as I ran through. "Wait! John, wait. You can't go up there yet. We need to talk."

I skidded to a stop. "What? Why? Is something wrong? Is-- "

Ellen sighed. "She's..." She looked around at the comings and goings in the lobby. "Come on. Let's go talk somewhere private."

She led me to the elevator and to her office. I was almost vibrating with anxiety during that three minute trip, but she stayed silent. That made me feel even more anxious. Once inside her office, she motioned me towards a chair while she sat behind her desk. Her "concerned doctor" face was on now.

"Physically, she's in very good shape, all things considered. There's been muscle atrophy, obviously, but she's had plenty of time to heal from her broken bones and surgeries. She was disoriented, but that's also to be expected. It's been a few hours, and the immediate disorientation seems to have passed. She understands where she is, what's happened to her, and people she's talking to. That's all very positive. The problem..." She sighed. "The real problem is that she seems to have lost almost all of her memories."

"What?!"

She nodded. "A certain amount of memory loss is common; it's rare that a patient with that level of trauma remembers everything, or even anything, surrounding the incident that caused it. But she doesn't remember-- John, she doesn't even remember her name. When we said 'Elizabeth,' she just looked at us like she didn't know who that was. Same with 'Liz,' 'Ms. O'Neill,' and 'Mrs. Barnes.' The 'Mrs.' one really upset her, though; she doesn't-- doesn't remember you, either."

I couldn't speak, just sat there with my mouth hanging open.

Dr. Taggart pressed on. "She has knowledge of things, concepts, ideas. She knows what a car is, but doesn't remember what type of car she owned, or even that she's ever driven one. Her skills seem to be there still. We asked her how one should evaluate a house for sale, and she started to rattle off a checklist. So there are some things still there. And, of course, her language skills seem unimpaired."

She leaned forward, a sympathetic frown on her face. "John, I need you to understand: this is going to be one of the most upsetting things that's ever going to happen to you. More than Liz's accident, maybe. I can tell you 'she doesn't remember you,' and I know that you'll understand that. But you're not really going to understand it until you walk in the room and she looks at you with a blank expression. And it's going to..." She bit her lip, trying to decide whether she should continue.

Her face took on a new resolve, a sad, pained look. "When I was a resident, I worked with a number of patients with traumatic brain injuries. The most hurt I've ever seen on a husband's face wasn't when I had to tell them their wife was dead. It was when a wife had had a stroke and had lost her memory, and she not only couldn't remember him, but recoiled from him. You are-- you're going to be a stranger to her. I've explained that you were married, but-- but you need to be ready for the possibility that you're the only one that will remember even a hint of that.

"And I need you to be prepared, because, as much as I like you, John, ultimately it's Liz that's my patient. The last time we were here, you told me how much you wanted to support her. I need you to do that now, even if it's the worst pain you've ever felt. Because whether you face this today or in ten days, it's not going to get any better."

I nodded, the teachings of the Stoics foremost in my mind. I couldn't control this, but I could endeavor to control myself. "Okay." It came out weaker than I meant it to. I cleared my throat and said clearly and firmly, "Okay."

Liz's doctor smiled a brave little smile. "Thank you, John."

"She's my wife. Of course I..." I shook my head. "What... is she ever going to get her memory back? Please don't say 'I'm sorry, but we just don't know.'" Her mouth opened and closed quickly. "Give me as realistic an assessment as you can."

"Unfortunately, that is the most realistic assessment I can give. We-- the truth is, in terms of neuroscience, we're barely past the leeches and humours era. She may wake up tomorrow and remember everything. She may never remember a single thing. It's most likely going to be somewhere in the middle."

Great. "Is there anything I can do to help it along? Take her places she knows, that kind of thing?"

She shook her head. "It doesn't really work like that. Memory is very complex. It's one of the most complex issues in neuroscience. Most people think that it's like a computer, where you store a bunch of stuff and then recall it; it's not. As best we can tell, it's a series of connections between collections of neurons that let you put together a story that you tell to yourself each time you remember a specific occurrence. That story may or may not be accurate, and as you recall the same memory under different conditions, the act of remembering can actually change a memory.

"But that's... there are a bunch of different types of memory. 'Muscle memory' you've probably heard of. There's the related phenomenon of 'procedural memory,' like Liz's recall of how to judge a house's value. And then there are the triggers that can allow us to access memories we wouldn't otherwise be able to: scent, music, all sorts of other things.

"You're probably not going to be able to take her to your house and have her go 'Ah! I remember my life now!' She might remember something about the house, and that might set off a chain reaction to let her get back a few other things: an emotional memory about your first dinner there, or your first fight. Maybe that chains off to remind her of something else. But those chains are probably going to be short and weak. If she has any favorite scents, those are a strong way to provoke memories. Particular pieces of music, especially if she's intentionally tied one to memory; the ABC song is a common example for most people."

Her face darkened. "You also need to be aware that... there's a chance she's going to feel ambushed by memories if she has them out in the world. She might have a panic attack as she tries to realign her current self with something she learns. She's going to feel... unreal for a while, until she either remembers enough to feel stable, or until she builds enough new memories to build a new sense of self. But when she learns something that upsets that stability, it's probably going to be hard."

I nodded. "Okay. I think I get it. So... what do you need me to do?"

A broad smile appeared on her face. "She really is lucky to have you, John. A lot of people would have already insisted on going to see her, and even now, instead of asking for that, you asked how you can help. If you keep that attitude... she may not get her memory back, but she'll have a strong foundation to rebuild from.

"As to what I want you to do, I want you to go see her. If she doesn't remember you, I won't ask you to not be upset, but try to be understanding. If you can't deal with it, I'll be there, and I'll help you get out of the room without upsetting her; just follow my lead. Can you do that?"

"I'll try."

"That's all anyone can ask. Come on."

She entered Liz's room first, then popped her head out a few moments later. "Okay, come in." I entered the room and saw Liz sitting up for the first time in half a year. She was reclined against the bed, but it had been brought upright; I didn't know yet, but she was too weak to sit on her own.

My breath caught for just a moment; I knew she'd become emaciated by her stay in the hospital, but sitting up, it became really apparent. Her hazel eyes were sunken and tired; her beautiful strawberry blonde hair was matted with sweat, sweat from what I later realized was the exertion of just being awake. I forced a smile onto my face, and Dr. Taggart asked, "Liz, this is your husband, John. Do you recognize him?"

My wife looked at me, studying my face, tilting her head on one side as if a change of perspective might bring some new insight. I could see the lack of recognition on her face, and it was quickly followed by surprise, then disappointment. "I'm... I'm sorry, I don't." I couldn't tell if the apology was to me, the doctor, or herself.