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Tim Requarth is a freelance journalist, as well as Lecturer in Science & Writing at New York University. His writing has appeared in publications such as The New York Times, The Nation, The New Republic, Slate, Foreign Policy, and Scientific American. He received his PhD in neuroscience from Columbia University, and for nine years he directed NeuWrite, an international network of workshops for scientists and writers. He was a 2018 UC Berkeley-11th Hour Food & Farming Journalism Fellow.

The Final Five Percent

Illustration by Glenn Harvey

Tim Requarth| Longreads | October 2019 | 27 minutes (6,723 words)

* Some names have been changed to protect the privacy of individuals.

When the motorcycle accident dealt my brother’s brain an irreversible blow, he and his wife were living in their newly purchased farmhouse on the fringes of suburban Chicago. Conway* had been waiting to move out of the city’s inner-ring suburbs for years, and each morning on the forested property he woke up exuberant. Shortly after moving in, he built an extraordinary tree house some 60 feet in the air, spanning two trees, with sliding joists under the floor to accommodate sway and a hammock to lie in during sunsets. He loved riding his motorcycle, and before work he’d sometimes take his bike out for a spin on the open roads just a few miles away. His wife, Caroline, loved antiques, and the area was full of shops. They were in their 50s and living in a house they planned to grow old in together. Then, after dinner on a fall day in 2007, Conway hopped on his Harley Softail Classic to go buy ice cream and cigarettes. A drunk driver barreled into him. Conway’s left femur snapped and his skull struck the traffic-warmed asphalt, splattering blood all the way to the road’s shoulder. 

Conway’s body was battered, but the real threat, the injury warranting a helicopter ride to the closest hospital with a neurosurgeon on call, was a hemorrhage beneath the subarachnoid membrane, a thin sheath of triple-helixed collagen fibers intertwined with blood vessels that protects the brain’s private chemical harbor of cerebrospinal fluid from the open waters of the body’s blood. The sons of a doctor ourselves, my brother and I had heard stories about neurosurgeons called in at midnight, and those stories didn’t have happy endings.

In the weeks after the accident, I watched Conway wake, recognize familiar faces, and begin to walk. Some signs of progress were cause for celebration; other developments were more worrisome. He’d rarely ever raised his voice at Caroline, but now he called her a “worthless cunt” and a “bitch.” He was lewd to the nurses, exposing himself and laughing. When a speech therapist gently reminded him that she would return for another session later that afternoon, Conway retorted, “No you won’t, because I’ll be fucking you in my van outside!”

At first, the doctors assured us that this inappropriate behavior was a passing recovery phase of traumatic brain injury, or TBI. The lewd remarks eventually subsided, but his behavior took another ominous turn. “He always had a wild streak,” Caroline told me. It’s true that before the accident, Conway had loved flouting the rules. He’d cut across an empty park on his motorcycle to avoid traffic, or build a towering bonfire in his backyard for kicks. “But there was no violence,” she said. After the accident, Conway flew into rages so vicious the hospital staff put a cage over his bed to contain him. When he finally left the hospital, Conway attempted to return to his former life, but he struggled to run his business and pay the bills. He and Caroline’s marriage began to fray. Hopes for a full recovery waned, and eventually Conway’s neuropsychologist confirmed our fears that the personality change might be permanent. “He’s recovered 95 percent brain function,” she said, “But the final 5 percent, it might never return.” Read more…