The Background

N THE SPRING OF 1988, as I sat in the office of Dr. Ronald Ruff at UCSD Head Injury Center, studying his reaction to a question I had just asked him, the four that I have just posed weren’t even formed yet in my mind.

A really important one to me was though. I had come to Dr. Ruff under the recommendation of Dr. Randall Smith, who at the time was resident neurosurgeon at Sharp Memorial Hospital in San Diego, and chief neurosurgeon for the Chargers football team. Ron was the head of a research facility that had earned wide acclaim for newly developed techniques in brain injury rehabilitation. He was a congenial, gentle man, younger than I would have expected one so respected in that field to be, with sandy hair, bright eyes and always a smile that was almost imperceptible on his round, clean-shaven face. It was a smile that seemed to say, “I know something wonderful,” and it was very comforting. He appeared to be in his late thirties, maybe early forties to me, and as he contemplated what I had just asked him, I noticed a trait of his that I would come to see as one of his trademark signs of listening. He sat across from me at his desk, relaxed, with his elbows on the edges of his soft chair, his fingertips pressed lightly together in front of his chin, the way one does to imitate a spider doing pushups on a mirror,
peering at me from just behind them. The way he looked at me made me feel like I had just asked him for the answers to the secrets of the universe, or so it seemed to me. He was silent for a long pause by my reckoning, then he said, “I’ve never had a patient ask me that, but it’s interesting that you did.” Then as he stood to walk over to his well-stocked library’s bookshelves to put one back, he added, “Let me tell you some things.”
The question I had asked him was really threefold, and it was of great concern to me that I found an answer. I was indeed a new patient of Dr. Ruff’s, and I really did need a lot of help from him back then. Our formal introduction came about after two months of post-op healing from a head injury I had sustained in a fall, from about twelve feet, headfirst, onto concrete. Chance would have it that on the day I was life-flighted to Sharp Memorial’s trauma unit, Dr. Randy Smith, just about the best neurosurgeon anyone could ask to have on their side in such an event, was the attending surgeon on hand when paramedics flew me there. I did not break my neck; an incredible thing in itself, and the surgical team was able to put Humpty Dumpty back together, so to speak. With multiple skull, jaw, and wrist fractures, and two ruptured arteries leaking blood onto the epidural, or outer lining of my brain, Dr. Smith and his team had some work cut out for them, but they saved my life. After keeping watch over me for twelve days in the hospital and another month with a nurse looking in on me at my home, he was assured he had done all he could with my hardware, as he put it. Dr. Smith felt confident that turning me over to the care of Dr. Ruff and his facility was the best way to see how my software had fared, and how to fix it.
“Am I not dreaming, or am I just not able to remember them, and is this permanent?”