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Stories That Helped Her Fill In the Blanks

Writer Karen Brennan used narrative to aid her daughter's recovery from a major brain injury


Now, almost seven years after the motorcycle accident that left her 24-year-old daughter severely brain-damaged, Karen Brennan struggles to put into words how "the most profound experience" of her life changed her, fearful of sounding too New Age-y as she speaks of having become more spiritual, of having a new view of the world.

Brennan has chronicled the experience movingly--with an occasional dose of black humor--in her new book, "Being With Rachel: A Story of Memory and Survival" (W.W. Norton).

A professor of creative writing at the University of Utah, fiction writer and poet, Brennan deals daily in narratives and, as she sat bedside through her daughter's four-month coma, she would try to break through to Rachel by telling her daughter over and over who she was, from her premature birth to her years as a school track star in Arizona. Inventing what she couldn't remember, Brennan would persist above the beeps and hisses and gurgles of the machines that were keeping Rachel alive.

The smallest flicker of an eyelid would give Brennan hope. Then, one day, Rachel whispered, "I want my mom." "When she woke up she was pretty oriented to who she was and where she was," Brennan says. At first she was in a wheelchair, but after months of physical therapy she is now able to walk with the aid of a cane, albeit it slowly and off-balance.

As she recovered, "I'd give her little writing assignments, try to get her to think of narratives," Brennan said. Rachel had lost her short-term memory, and, Brennan reasoned, "Maybe narrative generates memory instead of vice versa." Over and over, she answered her daughter's questions: "Where am I? What day is it? What year is it?"

Brennan knew that the function of the brain cells, or neurons, is to convey information accumulating along a complex circuitry of other neurons to produce thoughts and actions--and that when either transmitters or receptors are interfered with, memory is incapacitated. She began to see parallels between brain theory and the theories of narrative she taught her graduate students--that an author's style and chosen structure might be a kind of map of the brain and, therefore, a map to the way a person remembers.

Brennan thought encouraging Rachel to write stories might jump-start her memory. The experiment met with limited success. "Tell me a story," Brennan would urge. "Make something up." At first, Rachel's stories were far from being narratives. She would write, "There is Justine with a bee on her head." When Brennan prompted, "What about Justine? What about the bee?" Rachel shrugged, "That's it. The end."

In time, "she did improve, up to a point," Brennan says, but even when she began giving her stories endings, they were "childlike, really primitive," and when Brennan would praise her effort--"not bad"--Rachel was apt to ask, "What was the story again?"

Brennan persisted and saw the payoff. "As Rachel's narrative sense gets better, her memory gets better. People are always astounded [to see] a person with brain injury who is eloquent and very funny. She did a [bookstore] reading with me the other night, and she was terrific. Years ago she would have gotten confused halfway through. She's much more sequential now."

Rachel has retrograde amnesia, typical of those who have suffered severe brain injury and lengthy coma, which means that she may recall things from the remote past, but not things that happened more recently. Erich Hansen, a Tucson neuropsychologist who has worked with Rachel, believes Brennan's approach was "immensely important" in redeveloping Rachel's sense of self by "cueing her to remember things that she had remembered well but had trouble retrieving."

Hansen says Brennan's use of narrative to jog Rachel's memory helped give Rachel some coherence in her drastically disrupted life. But, he adds, "I don't think the narrative approach would necessarily facilitate new learning."

Poor Prognosis

"Being With Rachel" begins in August 1995, with an early morning phone call from a neurosurgeon at Denver General Hospital to Brennan, who was summering in San Miguel de Allende, Mexico. Rachel had been in a motorcycle accident near Steamboat Springs, Colo., and was in a coma. The doctor said her CAT scan was "very, very ugly."

She had not been wearing a helmet. The diagnosis: Diffuse axonal injury. Or, as Brennan puts it, "It was kind of like a giant whiplash." Despite being prepared for the worst--including grim predictions from a social worker described by Brennan as "queen of the false-hope cops"--Brennan refused to have her hopes dashed.

Post-accident, Brennan's team included her two ex-husbands--Rachel's father and stepfather--as well as brothers Chris and Geoff, sister Margot and Margot's husband, Steve Kerr, the professional basketball player now with the Portland Trailblazers. On a recent visit at the Pacific Palisades home of Kerr's mother, Ann, Brennan talked about Rachel and the book.

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