We have no place in our culture for this kind of grief. After her brain injury, Gabrielle was still there – it just wasn’t the her I had loved

It’s strange the way that, in a crisis, your mind stops filming and starts taking polaroids; essential snapshots of sound and color and light you can hold at arm’s length afterward.

There is the call from Gabrielle*, her voice frantic: I have been in an accident, please come, please come right now.

There is me standing on the frozen street, staring at the car sprawled across two empty lanes with the driver’s side door crushed and hanging ajar, like an unfinished thought.

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There is the blood and hair, stuck to the inside of the window in the bitter, bitter January cold.

There is a paramedic talking to me. There is red glass from busted tailgates strewn across the road, shimmering like hot coals as we get into the ambulance.

There is Gabrielle on a stretcher, with her neck in a brace and her lips pale and bloody. There is her hand, slipping into mine, squeezing.

In the hospital waiting room a police officer explains to me that Gabrielle made an illegal left-hand turn and was struck by a vehicle traveling the same direction, and that the driver could not possibly have stopped.

She has a concussion, the doctor tells me as he uses a curved needle – gleaming under the sterile lights of the emergency room – to stitch her scalp up.

I come home with Gabrielle leaning heavily against my side and we wobble through the doorway of our apartment.

In bed with the lamp turned down low, she sleeps, deeply, the way old dogs or sick children sleep, so solemnly and quietly you feel compelled to see they are still breathing.

Stitches glisten black and damp and raw against her white scalp. I whisper in her ear – I love you. You are safe. I will protect you, no matter what. I turn off the light and cry, quietly, because the doctor said not to wake her.

For the first few days after the accident, things were exactly as we were told they would be. Gabrielle suffered terrible headaches and nausea, worsened by external stimuli – sound, light, strong odors – and motion. Gabrielle was unable to do more than lie on the bed or sit up in a chair.

After a week these initial symptoms began to abate, but other, more complicated ones sprang up. Her body was healing, but something in her brain appeared to be malfunctioning. She was having difficulty expressing complex thoughts, which made her angry and confused. She would often stumble trying to explain her feelings, flailing for words, or burst into tears of anger when met with a task that used to be easy. She would snap at me and blame me for things that weren’t my fault, like a broken cup, a malfunctioning printer, the phone ringing. Making choices caused her intense disorientation. Our first trip to the grocery store together, a week after the accident, selecting from the rows of products – as well as all the people, lights and music – was too much sensory data for her to process. She shut her eyes and leaned against my chest. I had to take her back to the car and shop alone. When I returned, she was curled up against the window with her eyes closed, exhausted.

Gabrielle had lost the intuition as to whether 10 minutes or 10 hours has passed. She would wake up three or four times in the night, irritable and anxious, because she was uncertain how much time had passed. The only thing that would help her get back to sleep was if I read to her, which often meant rereading the same few pages over and over, because she did not remember what she had just heard. In this broken way we enjoyed André Alexis’ masterful Fifteen Dogs together. It took two months to finish it. I still cannot bear to look at a copy.

We did not know what was happening to Gabrielle or why while all of this was happening

We did not know what was happening to Gabrielle or why while all of this was happening. All we knew for sure was that she was not like this before the accident and that the changes had to be related. It was only later, through research, that we came to understand the mechanics of the change.

A concussion is, at a fundamental level, a bruised brain. Imagine you have a mason jar that is full of thick liquid and just big enough to accommodate a peach. If you shake the jar violently, the peach sustain multiple impact points. When you take the peach out, the bruised places are visible. If you cut into the bruise, you will see the damage spreads beyond the area around the impact sites.

In a peach, these bruises taste bad. In a brain, these neurons are now “bad”; they no longer function the way they should in the context of their neural network, interrupting – and sometimes changing – the flow of information which regulates not only basic body functions, but the building blocks of who were are. This damage is thought to be largely irreversible.

The doctors in the emergency room and in her single follow-up appointment told us Gabrielle’s concussion was not severe. According to Paul van Donkelaar, a professor at the University of British Columbia and specialist in the behavioral and psychological effects of brain injury, the severity of a concussion doesn’t necessarily indicate how a person will be affected by it. “Just because [the concussion] is mild doesn’t mean the outcome is mild,” he told me. This is partly because we don’t fully understand just how far the damage spreads beyond the initial site of impact. Understanding of how the brain is damaged during a concussion is a rapidly evolving field of study, he said, but unfortunately many doctors, especially those in small towns like the one we lived in, often lack the specialized and updated training necessary to properly identify and treat concussions with the most up-to-date resources.

Gabrielle and I knew none of this before her accident. We were sent home from the hospital with a single sheet of paper that read “How to care for someone with a concussion” at the top.

I lived in a state of chronic exhaustion. I worked from home as the editor of a small weekly paper – a job which demanded consistent overtime. I often slipped out of bed after Gabrielle was asleep to edit copy or return emails. I was never “off-duty”, either at the paper or for Gabrielle.

I realize now I should have asked for help, but even if I had, I don’t know to whom I would have appealed. Her parents lived on the other side of the country and did not speak English. Doctors often did not believe Gabrielle when she tried to tell them what was wrong with her. Our friends could not see the seriousness of the problem; Gabrielle could appear to be frustratingly normal for brief stretches of time, only to completely break down later, when there was only me there to see these things.

I felt that as long as I believed in her, she would get better

I began drinking heavily. I lost so much weight I started missing periods. I took caffeine tablets when I had to drive, because I was so sleep deprived I worried it was unsafe. I often thought of leaving her; once I even went so far as to pack my truck and drive out of town. I got outside the city limits and turned around. I felt that as long as I believed in her, she would get better.

Then, six months after the accident, I went camping for three weeks without her. Gabrielle didn’t want me to go but I felt I had to start taking care of myself again. I was gone for less than two weeks when she cheated on me.

She told me she had met someone and had been unfaithful, very calmly. She was not calling to apologize; she was calling me to ask if I would mind if she did it again.

She said she had simply not been thinking about me. It was only cheating if she didn’t tell me about it, she said. We were not in an open relationship. We had been together for two years. I did not yell. I did not cry. I just kept asking, over and over, How could you do this to me? I was stunned. The last time I had come into town, she had begged me to end my vacation early.

She held on to her curious logic with childlike tenacity, warbling between emotionless repetition of her beliefs – it wasn’t cheating, she had done nothing wrong – and angry outbursts. She accused me of not loving her, claiming I had only taken care of her to control her. She said, over and over, that she owed me nothing.

She was half-right. She didn’t owe me anything. But I loved her more than I had loved my own health and happiness.

At the time all this was happening I was hurt so deeply I was unable to see the familiar pattern, one I had observed countless times since her accident: confronted with something emotionally and cognitively difficult – her behaviour, my emotions, her breakup – she was shutting down, flattening out and then, when pushed beyond what she could tolerate, lashing out.

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I believe she genuinely did not understand what she had done was wrong; she was not in a place where she could organize the linear events of how her actions had affected me, could not process my own reactions, could not handle the emotional, social and intellectual intricacies being asked of her. She was possibly as hurt and confused and frustrated as I was.

I balk to write that; it seems patronizing or dismissive. But I think back on the way she treated me after the accident – her inability to see when I was exhausted, the way she would lash out at me for things I couldn’t possibly be responsible for – and I cannot help but believe that. I don’t think she understood what the words I was telling her meant or felt the emotional impact they should have drawn.

Following this, I spiraled into a black depression; already taxed to breaking by six months of caring for Gabrielle, I had no emotional reserves left for this blow. It took me almost two years to understand that the hurt was not just heartbreak, but that what I was feeling was grief and loss. Someone had, as I intuited, actually died. I expected that, in exchange for my labors, I would get my girlfriend back, or at least a close approximation of her, but I was wrong. It must have been a terrible burden for her – the new her – to carry that expectation.

The woman I had known and loved – Gabrielle of the easy smile and quick laugh, Gabrielle of the fingers on the back of my neck as we drove – was dead. She had died the moment she made a careless mistake and turned without signaling, when her head had struck the glass and neurons began to die.

We have no place in our culture for this kind of grief; when someone dies, we have a funeral, and everyone comes and holds the people who are left behind and says We are so sorry for your loss. This was unavailable to me. I faced this grief alone. Gabrielle was still there – it just wasn’t the her I had loved. That woman is gone and she is never coming back.

*Name has been changed