Despite TBI: The Music Never Died After Brain Injury

Despite TBI: Helena Part Seven

There is a Don McLean song American Pie, with the line, the “Day the Music Died” in reference to the airplane crash that took the lives of Buddy Holly, Ritchie Valens and the Big Bopper. December 17, 2007 was not such a day. For Helena the music survived despite TBI and with it, an anchor to who she was before her accident, which an important link to finding herself afterwards.  She explains:

One of the things I want to stress I had to find out if I still had music in me (despite TBI).

So a couple of days before Christmas… I mean I was just sitting there lying in my bed, thinking about what, where is my life. And I said I have to do something, I have to.

So I asked where there was a piano. I’m on the rehab floor now, and they showed me where a piano was, and I couldn’t see, and I could hardly walk, but I played the piano from memory. My fingers knew where they were supposed to go, because that’s such old learning, and so then I thought okay, I can do that, now can I sing (despite TBI)?

And I sang a couple of Christmas carols, and it was a very frail, faulty voice, but I knew I could, and that was the time where I knew I was still me. It didn’t matter if nothing else worked, I still had music in me (despite TBI).

I also still had my sense of humor (despite TBI), which has gotten me out of trouble and gotten me through divorces all, all the time. So Santa came on the rehab ward on Christmas eve and I said to him, well Santa, you’re going to have to train Rudolph better, because the sleigh cut my head open. The nurses just went ballistic, and so when I thought those things, I thought you, your life is, is back (despite TBI).

(I didn’t) know anything else, so I went back to being an organist, and I made lots of mistakes, but that was very good cognitive stuff, because you have to look at: the music, you have to make your fingers go, you have to make your feet go for the pedals.

One of the most difficult parts to recover after any brain injury, especially one that involves injury to the brain connections to itself and to the rest of the nervous system, is to get the nerve impulses to efficiently move from the part of the brain that is commanding a task, to the part of the body that has to implement it. Any therapy that requires motor movement in conjunction with thinking is pushing the envelope of therapy far more than singular tasks.

Music may be the perfect exercise for a damaged brain as it involves thinking, remembering, emotions, all in coordination with fingers, hands, vision, hearing and rhythmic movement. While testing all such activities within an MRI tube would be invariably difficult, playing an instrument, probably activates more of the nervous system than almost anything else. It is multitasking not just in terms of multiple tasks for the brain to do, but multiple parts of the body for it to do in coordination. Helena explains:

So you’re doing about four things at the same time, and trying to play, trying to play in, the hymns so that people can sing with them.

Do you think that because you have given your neurons this music exercise despite TBI that you’ve had a better recovery than you might have otherwise had?

Absolutely. I have a friend at church who is on the faculty at Bellin College of Nursing, and she came up to me and she said the reason you are recovering so fast is because you’re a musician, and the places that do music are all over the brain. And they’re all over your body, too, so she said that, that’s why this is happening for you.

So I still couldn’t walk well, and I couldn’t play many of the pedals, but that kinesthetic sense, I mean the muscle memory from so long ago was still there

But that’s come back?

Yes. I have to be careful with it. Everything that I do now has to be slower. It has slowed me down.

Yet, while the music had not left her despite TBI, there were challenges, continue to be challenges, in her ability to do all of these multiple tasks in harmony. She explains:

If I had to adapt to new things, like finding a new key. Couldn’t do that at all. I’ve been an organist in my Episcopal church for a long, long time, and I guess by the end of January or the beginning of February, I went back to that job. But there were lots of things I couldn’t do, and, and for people that know music this will be funny.

I was playing a hymn and it was in A major, okay, and I wanted to change it, and they call modulating, putting it up, and I said okay, now I’m going to play an A sharp major. Well there isn’t an A sharp major. It doesn’t exist. But my brain said well, let’s go find it. Well, so I had to slow everything down to keep, to keep things going. That was the cognitive stuff that – it was my brain saying it’s a half step up, so half step up from A is B flat. I could not have had the concept of B flat at that time.

I have to be careful with it. Everything that I do now has to be slower. It has slowed me down.

Has the neuropsychologist explained anything to you about where the location of your injuries were, with respect to the things you could continue to do despite TBI and those things that you couldn’t?

Because it was on the right side and it was this occipital –parietal thing, I tried to do a lot of research about what does that happen and what does it mean when it’s on the right side, and he said that, that the, that the deficits would be in language, in concentration, in trying to work out puzzles, and also trying to go, I could not go at the speed that I had.

For Helena, music not only preserved the score of who she is as a person despite TBI, it has been the instrument of her burgeoning recovery.

Next in Part Eight, The Silent Song of Brain Injury