Part of why I think I feel so drawn to these stories of explorers, so compelled to read them and listen to them, is that I myself don’t have a map. My recovery process is uncharted territory, my view of the way forward as limited as the infinite whiteness of a snowstorm on the Antarctic tundra. The doctors treating spinal CSF leaks are only beginning to understand the true mechanisms of injury and how to repair it, and most information pertaining to recovery is focused on the immediate physical experience of healing from repair procedures and avoiding recurrence of any leaks. And if there is a paucity of research on spinal CSF leaks and their effective treatment, there is little to no research at all on what happens to the brain while cerebrospinal fluid is leaking, or what happens to the brain in the aftermath of having had a spinal leak. I was given instructions to follow when I went home in terms of my physical recovery—no bending, no twisting, no lifting, limited caffeine and salt, the practical-life accommodations I must make—but no instruction at all for how to help my brain recover, other than to just rest and give it time, wait it out. And so I am drawn to these stories of people who mapped out previously unmapped places, who set out to explore places no humans had been before and mark the path for others, who were also trying to survive in parts unknown, with limited guidance, if any.
As part of my instinctive quest for stories, for ways to understand the ways that the brain protects itself and heals from injury, I also listen to neuroscience podcasts and read books about the plasticity of the brain, and the ways in which the brain is able to adapt and change in response to behavior, even in the case of severe trauma. I learn that, contrary to what science used to teach us, the brain does not become a fixed and unchangeable thing after childhood, and that in fact it is capable of growth and change and reorganization—what neuroscientists call “neuroplasticity”—throughout all of life, even well into adulthood. Brains are resilient.
One book in particular, The Brain’s Way of Healing, by the Canadian psychiatrist Norman Doidge, offers a fascinating look into the history of medical thinking about the brain and how our concept of the brain has changed as we’ve learned more about it, and how thinking of the brain as a thing capable of change has opened up new ways of understanding and treating brains injured by stroke or concussion or other trauma. He writes of patients with Parkinson’s, chronic pain, dementia, multiple sclerosis, traumatic brain injury, epilepsy, stroke, all able to modulate their symptoms through a range of techniques designed to encourage the brain’s natural capacity for change. Some of these techniques I am familiar with, like biofeedback (using information you receive about your body’s functions to learn to control those functions—one example of this is when a patient is hooked up to a sensor that displays their heart rate, allowing the patient to see the difference that is made by breathing faster or slower, and thus to learn to lower their heart rate on their own); others involve specialized medical devices still in development or not otherwise available to the general public. But much of the research seemed to point to focused, small, physical movements requiring intense concentration—such as practical-life exercises, like using a stroke-impaired hand to stack cups or wipe countertops—as being the most useful thing for patients suffering brain damage due to illness, trauma, or stroke.
In the book Soft-Wired: How the New Science of Brain Plasticity Can Change Your Life, Dr. Michael Merzenich discusses the circumstances under which the brain’s natural neuroplasticity can be harnessed to create focused neurological change. One important factor he notes is that change is more likely to take place in a brain that is prepared to take advantage of it. Being engaged and motivated helps prep the brain, neurochemically, for learning and change. Being distracted and merely going through the motions of something without making much effort doesn’t require a high level of engagement, and thus the brain doesn’t “pay attention” to the opportunity for change. In addition, the more focused and alert a person is on the task at hand, the greater the possibility of change. And since part of what is changing when you are focused on mastering a task and engaged in the process is the strengthening of connections between neurons working together, the more you practice and work at whatever task you’re focusing on, the more those strengthened connections become lasting change. This cooperation between neurons also helps the brain become able to rely on those newly established connections, and be able to better understand and predict patterns, anticipating what comes next.
Change, of course, in the beginning, in almost any context, is temporary: Doing something once doesn’t ensure that you’ve learned it forever, no matter how alert or engaged you are. Change becomes permanent through repetition, and also, somewhat contradictorily, through novelty. So part of making change happen is doing a thing over and over while finding ways to focus and concentrate and renew your engagement each time, so that your brain finds the experience novel enough to make it a part of your permanent
