The
Beginning
of
Everything
Andrea J. Buchanan
To Emi and Nate
Contents
Introduction
PART ONE: The Fog
PART TWO: A Mystery
PART THREE: Floating
PART FOUR: Insight
PART FIVE: Rebound
PART SIX: Year Zero
Resources
Further Reading And Listening
Acknowledgments
Introduction
I lost my mind on the way to brunch one particularly bitter Sunday in March of 2015. It is a moment I return to over and over again: the wind biting at my face, my body sweaty with fever, my throat fiery with virus as I crossed the street, inhaled that March wind, and choked on it.
There was a lot I was choking on that day. Sending my kids off for the weekend with their father, even though my son had woken up with a 103-degree fever, his face pink, curls filigreed to his cheeks and forehead. The dread of my own fever aching through me as I began sinking into sickness myself. The knot in my stomach of my divorce, the fighting and lawyering, a seemingly endless battle. The guilt of failing, as a partner, as a mother.
And so I coughed as the wind sucked itself into me, lodging itself in my throat. I doubled over in the midst of the intersection, unable to escape the chokehold of the vicious tickle I couldn’t displace. At the time, my worry was that I would vomit on the street due to the cough’s intensity, and I remember feeling relieved when I was finally able to breathe again, to drink some water, to talk without my throat seizing up. I thought it was over.
I couldn’t have been more wrong.
Because when I stood hunched over in the wind in the middle of the street, I also stood in the middle of a perfect confluence of events. Because when I coughed and coughed the wind out of my throat that day, when I choked on everything that was choking me that day, I also, somehow, ripped a small tear in my dura mater, the tough membrane covering my brain and spinal cord. But I didn’t know that yet. Instead, I crossed the street, wiped away the tears running down my face from the wind, walked to the restaurant with my friend and drank water and shivered through my fever and ate French toast, all completely unaware that at that moment, my cerebrospinal fluid was already beginning to leak out of the tiny, jagged tear somewhere along my thoracic spine.
What followed was nine months of intractable pain and the inability to be upright for more than minutes at a time. A constant ache at the back of my head as my brain, no longer cushioned by a healthy waterbed of fluid, sank to the bottom of my skull. A confusion of neurological symptoms, of brain fog and cognitive impairment to the point where I couldn’t think, couldn’t write, couldn’t follow instructions or watch television or hold conversations or make sense of even the most basic concepts. At a time in my life when I needed to be as independent and autonomous and clear-thinking as possible—in the midst of a divorce after twenty years of marriage, with two teenaged children to shepherd through the upheaval of their lives and everything they’d come to depend on—I was trapped by my brain, stuck in bed, unable to do anything more than lie flat and stare at the ceiling and hope for sleep to edge out the pain that had become the defining characteristic of my consciousness.
My diagnosis of spontaneous intracranial hypotension confounded the doctors I saw, none of whom could agree on where, precisely, this “brain leak,” as one of them had called it, might be located, or how to cure it. I floated through the fog from one specialist to another, enduring skepticism and condescension and strange, barbaric-seeming procedures, before finally arriving in North Carolina, at Duke University, where a team of neuroradiologists immediately recognized my constellation of symptoms and set about fixing me.
As I began the long, slow process of recovery, and as my brain slowly began to return to me, finally cushioned by enough cerebrospinal fluid to float the way it should, all those cramped and squashed nerves stretching back to their previous form, I had a lot of time to think about what had happened. While it was happening, of course, I had only fleeting moments of lucidity: My world, during the leak, was pain, fog, uncertainty, frustration; but I couldn’t think much deeper than that. As I began to heal, I realized that my brain’s inability to function at any level other than the most basic had, ironically, helped me keep going during that time, as the existential terror of it all only began to fully sink in once I was able to think again.
I kept trying to find ways to understand it, to go back in time and prevent it, to give it a narrative that made sense. All the stories I told myself were bound up in blame, in guilt, in personal culpability. Even though I recognized how powerless I was to control any of it—the tear in my dura, the regulation of my CSF fluid, the sinking of my brain—in the foggy chain of events I invented to explain myself, the only thing that made sense was some deficiency on my part, some simple thing I could have done, or not done, if only I’d been better, smarter, somehow more deserving. For surely I must have deserved this, it couldn’t be a mere accident that this accident happened now, in the midst of my ripping apart my family for something as insignificant and self-indulgent as my own happiness.
And yet even my still-foggy brain, desperate for puzzle pieces that soothingly, predictably fit together, was aware of the fundamental self-indulgence of that narrative, and the ultimate futility of trying to trace back the source. What good would it do to understand the precise nature of the moment my body tore in some mysterious spot? Would it make me tougher once I realized the fragility of my own choices? Even if I could pinpoint the inciting incident, could absolving
