Time, Time, Time, See What's Become of Me

"The only reason for time is so that everything doesn't happen at once." - Albert Einstein

Trauma disrupts time. This applies to psychological and physical traumas alike. An outdated definition of trauma refers to it as being "outside normal experience," and, in a very real sense, that is correct. Trauma disrupts the normal linear framework of life. In the traumatic moment, the personal narrative changes, dilating, drifting, sometimes leaving amnestic gaps, and then time stops.

After the accident it was almost as though my brain became a malfunctioning VCR, with the tape of my life playing in either slow motion or fast forward. I had no normal perception of time. Repeatedly, I would miscalculate the time it would take to complete tasks. Hours would lose themselves as I read email or cooked dinner. Knowing the problem existed, I would watch the clock if I had an appointment, being sure to monitor myself as the pre-ordained hour approached. I would consistently misread the clock, or, having told myself that I had "an hour until I need to get ready to go" I would look up to find that, unbelievably, not only had the hour passed, but an additional twenty-five minutes as well. The sense of futility and lack of control that ensued became very familiar in the months following the accident and with each additional "slip" I became more and more frustrated. Episodes like this would often leave me crying in frustration as I quickly gathered my things and dashed out of the house hoping my Doctor was running as late as I was. Lucky for me most of my appointments were with Doctors and my twenty minute delay usually meant I was right on time to meet the Doc. Sadly, this did not diminish the stress and anger in the moment I discovered my "lost time" or during the subsequent rush. In addition, my "new improved" brain had a knack for forgetting important things; things like wallets, and keys, and checkbooks, and phones, always at the most inopportune moments.

Stress, forgetfulness, and lateness exist in a particularly evil positive feedback loop. I am late. I get stressed. I forget things. I get more stressed. I get later. I get even more stressed. I forget something else. You can see how this just keeps on going. Now, imagine going through this routine every day.

Imagine going through this routine every day for the last two years.

There are things that help. Usually it's the simplest things that make the most sense. Keeping important items in one specific place is a huge help. Using timers, as insulting as it sounds, has worked more than once. It's also not a bad idea to build redundancy into your scheduling and reminders. By that I mean, telling your family, telling your friends, and asking them to gently remind you of appointments. (The gently part is key. Constantly having friends and family telling you about appointments, especially when already running at an 8 out of 10 stress level can easily be interpreted as nagging, especially when coupled with frustration and other brain issues.) In addition, keeping things as routine as possible also helps immeasurably. Sometimes this is difficult to work out, especially with Doctors. Physical therapy appointments may be easier to schedule. Recalling an appointment that is always on a Tuesday and always at 2:30, even if it happens every two or three weeks, is much easier on the injured brain than remembering different days and times.

I find that writing down appointments and times helps me. I've always been a visual person and that is one of the ways I learn best. If I can visualize my calendar, it's more likely that I can recall the information I need.

True to form I have overestimated my new abilities again. In this entry, I had hoped to address various ways that the perception of time can be changed by a brain injury but I find myself running out of steam and I think a discussion on "lost time" following an injury deserves a more in depth treatment. ("Lost time" in this sense refers to a more expanded sense of both time and loss, as in, "I feel like I've lost a whole year recovering from this injury".

So, in closing, time management problems may be minimized by employing any of the following:

Perfect Placement. Keep essential items (keys, wallet, purse, phone, etc.) in a convenient location. ALWAYS put them back in the designated space. Make sure family members know where these items belong and ask them to put the items there if you accidentally leave them elsewhere. In addition, keep extra sets of keys available for emergencies.

Redundant Reminders. Write yourself notes - multiple notes if necessary. Tell family and friends about your appointments and ask them to remind you, multiple times if necessary.

Create Routine. If possible, try to schedule appointments on the same day and at the same time. For example, if you know that your Neurologist appointments are always on Tuesdays and always at 2:30, you will be more likely to remember them. Another way to approach this would be to designate certain days as "Doctor Days". This method limits appointments to certain days. For example, you might only schedule appointments on Tuesdays and Thursdays. This way, you would know to check your calendar each Tuesday and Thursday morning to see if you had any appointments. (I'll write more about Creating Routine in future posts because it can be helpful with many other brain injury issues.)

Write it Down! This one should be obvious but it isn't, especially with regard to medical appointments. Most doctor's offices had out those handy little reminder cards with your next appointment date and time already filled in. While these are wonderfully convenient for most non-injured brains, for brain injured people they can provide a false sense of security. Little cards get lost with alarming ease. Not only that, ALL those appointment cards look the exactly the same, so if you're collecting multiple cards from multiple doctors it can get confusing. I'm not saying don't take the card; not at all. Take the card. Just WRITE the appointment in your calendar at the same time, that way, ALL your appointments are listed in one place and you're not searching around for one tiny little card. Which leads me to the final suggestion...

Keep a Calendar. Keep all your appointments and pertinent information in one place. Carry a calendar with you. This could be a traditional paper calendar booklet, a PDA or a smart phone. Experiment if you have to in order to determine which format works best for you. If you are a visual, sensory learner, you might prefer to physically write out your appointments on a paper calendar like I do. I know other people who love gadgets and find using digital calendars work better for them.

Dealing with a brain injury, even if it is classified as "mild" is an ongoing process. This is not "recovery", instead it is a process of adaptation and the challenge is to learn who you are now and how to best support yourself as you navigate this uncharted interior territory.