Features and Occasionals

A Strange Gift

By Alice Toler

Greg Nordfelt experienced a traumatic brain injury that closed some doors forever, but opened others onto a compelling and beautiful world he had previously barely glimpsed. In honor of March as Traumatic Brain Injury Awareness month, CATALYST speaks with local banker and traumatic brain injury (TBI) survivor Greg Nordfelt. Greg shares with us the story of his remarkable journey through injury and coma, and his unusual subjective experience of “coming back” from a partially wrecked brain to reconstruct his body, his personality and his life.

In honor of March as Traumatic Brain Injury Awareness month, CATALYST speaks with local banker and traumatic brain injury (TBI) survivor Greg Nordfelt. Greg shares with us the story of his remarkable journey through injury and coma, and his unusual subjective experience of “coming back” from a partially wrecked brain to reconstruct his body, his personality and his life.

The accident

In spite of all the great scientific leaps of knowledge about the brain since the mid-1800s, we still don’t know where consciousness comes from. The prevailing scientific model assumes that some interactive event occurs in the neurons and glia that creates a fractally resplendent and self-aware mind out of gross matter. Some dissenters suggest that consciousness may somehow exist in a field outside the body, and that the brain may focus this field into an individual mind in a similar fashion to the way the eye focuses light into a coherent image on the retina. The truth is, we just don’t know what’s really going on. The territory of the brain is a frontier, only just now being mapped, and Greg Nordfelt’s accident pushed him into this frontier territory.

As senior vice president at Zions bank, neither neuroscience nor spiritual experience showed up on Greg’s bucket list. Greg was a driven man in more traditional ways: “I was driven in my career as a banker: to be successful in my job, to earn a living and take care of our family from a financial standpoint. And I was driven to have fun.” To that end, he and his wife, Laura, spent their free time motorcycling, skiing, boating, wave running, water skiing, scuba diving. “Anything related to water or the mountains—we did all of that together,” Greg recollects.

On August 15, 2011, Greg, Laura and their friend Jimmy were riding their Harley Davidsons along a scenic section of highway 95, about 60 miles south of Coeur d’Alene, Idaho. Greg wasn’t feeling too good that day—he was fighting a bout of food poisoning contracted at a diner near Kooskia the night before—but it was important to him to press on to Coeur d’Alene, so the three riders continued north. It was getting cold and then coming on to rain, so they pulled over to put on their coats and chaps—a detail that undoubtedly saved Greg some extra physical injury later on.

Greg’s memory of that morning is hazy. At a convenience store, he bought a 7-up for his stomach and texted his children to tell them that he loved them—something he says had never occurred to him to do on vacation before. He remembers riding out of the parking lot. That was his last coherent awareness for the next 11 days.

At around 1:30 p.m., Laura saw Greg’s head drop to the side; he had passed out while riding his bike. His body went limp and fell to the right, steering the Harley off the road, down an embankment, and toward a ditch filled with lava rocks. Laura says Greg may have come to during his ride off the road; he seemed to be trying to regain control of his bike, but it was too late. He held onto the handlebars while the bike went airborne after hitting a first set of rocks, but the Harley turned on the other side of the embankment and slammed sideways back into the lava bed, pinning Greg to the ground. His helmet saved his right forehead from being split open on the rocks. His right leg was crushed by his bike.

Several motorists stopped to help, including a doctor and a nurse who happened to be on the road at the same time. The EMT and Highway Patrol arrived, and Greg was helicoptered out to Kootenai Medical Center in Coeur d’Alene. The Life Flight crew wrote that Greg was combative and irrational, and had to be restrained to a backboard before a nurse could get an IV into him. A paramedic describes him as being unresponsive other than screaming from pain. Greg was officially in a coma, with a Glasgow coma rating of 8—on this 15 point scale, any rating of less than 9 is classed as “severe.”

Even though Greg had smashed the right front of his skull, the resulting brain injury turned out to be on the left side. This is known as a contrecoup injury, where the jelly-like brain ricochets off the skull and sustains the most damage on the side opposite from the impact. He had a subdural hematoma on his left frontal lobe extending back into his occipital lobe, and bleeding on his right frontal lobe. This was compressing the brain tissue.

His right leg was a mess, and required extensive surgery to stabilize it. The doctors in Coeur d’Alene put Greg’s leg back together again on Tuesday night, but his coma rating decreased to a 6. Laura sat by his side in anguish.

Coma

On Thursday, however, Greg improved. He was still going in and out of consciousness, and he began to be capable of interacting with people…but he was on autopilot. Here is where his story departs from the more typical subjective experience of TBI.

His body was seriously injured, but Greg didn’t experience pain. He describes being enveloped in an amazing sensation of universal peace, love and connection with his family and friends.

Although he finds the experience nearly impossible to articulate, what happened while he was unconscious remains as fresh in his mind as if it happened yesterday.

Greg and Laura were once active LDS church members, born and bred to the culture. They had been going through a transition over recent years and were no longer active. Greg describes himself as being “unsure about theology.” However, he says the gifts he was given allowed him to experience connection with others in a way that was beyond theological boundaries.

There were moments, he says, when he was able to connect with Laura to a depth he’d never experienced before. He had this same experience with his sister and his children, when they visited him in ICU— a connection that was “breathtaking and beautiful.” He describes feeling completely calm, with no fear or negative thoughts at all—a new experience, even though he’d had connection to those kinds of feelings in the past. But this was complete euphoria.

He found out later about the major trauma his body was going through: severe injury with open wounds for a couple of days. That should have all been very painful, but Greg didn’t feel any of it. “I felt complete peace…the opposite of what my body was going through. I was in a very content, safe place. The peace was incredible,” he says.

“And then there was the feeling of love. I express it more like being surrounded by warmth”— a radiance he could sense also coming to him from everywhere. “I was surrounded by this endless sea of warmth and love. The supply was forever. That’s a place you would never want to leave. The possibility of it going away never entered my mind. I felt that I would just go on forever in this place.” Greg was having a near-death experience (NDE), but unlike the many descriptions of “going toward the light” that others have reported, Greg remained deeply connected to the Earth and to his loved ones, and felt no urge at all to leave his body. He describes it as a realm adjacent to consensus reality, and also very real.

Greg’s body was healing quickly; in fact, there is some reported correlation between brain injury and increased speed of healing for bone fractures, although nobody can say why this is. Greg feels that his blissed-out emotional state helped him heal.

Greg was intermittently responsive, but his interactions often made no sense. At one point he insisted his name was Beuford, that he was from North Carolina, and that his wife’s name was Suzy! Disinhibited, he would speak his mind with no filters. His behavior was strange and impulsive, and he had to be tied to a chair so he wouldn’t attempt to get up on his broken leg and walk away.

Greg was a stubborn patient, and Laura describes him as being emotionally equivalent to a 10 or 12 year old boy. Even his voice changed: He spoke in a much higher register than his previously bass tones, and he began to have problems with stuttering, as he used to when he was a small boy.tbi

“But here’s the magic,” Greg says. While Greg was still in a coma, someone in the ICU was playing guitar for another patient. Laura and Greg’s sister were with him. The guitarist played a song he knew well, from one of Greg’s favorite films, O Brother Where Art Thou, ‘Go Down to the River to Pray.’ “Out of nowhere, I began to sing. The guitarist wasn’t singing, but his music reached into me and must have touched me somehow—the words just came out of me. Someone asked what I was singing and I couldn’t answer, but the song came through me.”

On August 24, Greg was flown to Salt Lake City. He has a fuzzy memory of arriving at Intermountain Medical Center in Murray. He was beginning to connect emotionally with his family again there, but he was still wrapped up in his “safe place.” The next day, 11 days after his crash, as he was pushing a walker on his way to the bathroom, consensus reality descended upon him. He panicked in confusion. Where was he? What had happened to him?

Although Laura had explained to him repeatedly what had happened, this time he was able to form a proper memory and store it away so that he could begin to really comprehend the situation. Greg had lost 40 pounds. His leg was broken in several places. He found it difficult to speak, read and write. His rehab journey was getting underway.

Recovery

Greg had what is known as “motor expressive aphasia,” or an inability to speak and express himself linguistically. He would sometimes sound normal when he spoke, but he also had “receptive aphasia,” which means he had difficulties in understanding other people’s speech. He had a tendency to use the words “loan presentation” or other banking terms to stand in for any word he could not remember. A skilled neuro rehab team worked with him, though, and even though he had left the euphoric place of warmth and love that had enveloped him during his coma, he still possessed the gifts and his innate ambition, along with a strong desire to please those around him.

As Greg worked to regain his brain function, his memory improved, and his speech and comprehension began to come back online.

Still, he needed to be under observation 24 hours a day due to memory lapses and the resulting behavior (for instance, trying to get out of bed onto his broken leg). For the same reason, his cellphone was confiscated.

The area of the brain that’s injured, as well as the length and depth of a coma or how long one was without oxygen, drives post-surgery, post-recovery behavior. “Folks in my rehab group were either happy, working as hard as they could, or extremely angry and pushing back against everything that was asked of them. Also some of the response, I’m told, is personality driven— who you were before.”

TBI patients may develop a host of unpleasant long-term symptoms in addition to aphasia and memory loss. For Greg, however, his experience of comfort, safety, and bliss remain and are being integrated into his post-TBI personality. “It’s taken me a while to wrap my arms around those changes, but I’m liking where I’ve ended up. I don’t have the same kind of anxiety or stress that I used to experience before the accident.”

Collateral damage

Things weren’t going so well for Laura and the rest of the family. Laura held all the responsibilities of their shared life, plus the crisis they were enduring, during this time. She was making decisions about Greg’s medical care, being point person for family worries, looking after the money and insurance issues, keeping in contact with Greg’s job (his longtime employer, Zions Bank, kept his position as senior vie-president open for him throughout his recovery), keeping up with her own business, and maintaining the practicalities of life for both of them, all by herself. It was way too much.

Laura spent part of every day with Greg in the hospital, and went home at night. Soon, Greg was off 24-hour observation, and then in September he was able to go home for half a day at a time so that he could experience a little more normality.

On September 9, he was released from IMC Hospital, and Laura became Greg’s primary caregiver.

Greg wishes he had realized the immense strain that Laura was under at this time. Everything was on her shoulders, and she was also having to adapt to the permanent changes in Greg’s personality as well. Greg’s “rehab center” on the couch was a great comfort to him, but Laura worried whether she would ever get her husband back, and whether the rehab would ever end.

Friends and family pitched in, sitting with Greg on his “rehab couch,” which was a comfort to them both. Eventually, however, she developed post traumatic stress disorder (PTSD). Laura was diagnosed a few months after Greg’s accident at an 8 out of 10 severity level. She had witnessed the crash, provided the initial roadside first aid, and then watched powerlessly as medical science did its best to save Greg’s life. She couldn’t have known whether Greg would live or die, and if he lived whether he would be permanently disabled. After it became clear that Greg would recover the majority of his former function but that his personality had been changed, Laura found herself mourning the loss of the husband she used to know, even as she was busy helping him with his daily rehab. Greg is pained by knowing this now, but his face lights up with love as he describe their life together: “We’ve always had a similar path. We work as hard as we can, taking care of our family, loving each other, connecting as much as possible, and playing as hard as we can. That release into adventure was good for both of us.”

Doctors say his ability to recover from another TBI is limited, so he is not drawn to the same kind of risk and adventure. “The more I understand how I’ve changed, I grieve that, as well. I miss being that guy. But, over time, I’m also becoming more comfortable with where I am right now, and these feelings I haven’t experienced before are

breathtaking to me, and feel good. However, that will never be complete if my best friend is still recovering from PTSD and is sad and has moments of anguish. I care very much for Laura’s recovery.” He speaks with great determination, and it is clear that his relationship with Laura is priority one for Greg.

Progress

Greg’s recovery was rapid, particularly given the severity of his injuries. He re-took the road driving test on November 15 and regained his driver’s license. He began to work at his job again, starting at two hours a week, on November 28.

Intermittent fatigue and aphasia still affect him to a minor degree, but he enjoys being back working at his job full time. While he is still a driven and passionate man, his aims are different than they were before the accident. Now, Greg describes experiencing a paradoxical state: “Two human elements are coming together that I didn’t think were possible to reconcile—being patient, and being driven: having patience at a high level and retaining drive and ambition. I always felt those two things would fight each other, but that isn’t the case.”

Greg is still feel driven to take care of his family, to have a good career, to help his team at work. He is now also extremely driven to give back to the TBI community.

“I have become a much less private person through my experience and recovery. In my former life, I would never share anything that was so personal [as what I’m sharing here]. But I feel so much drive and passion about giving back to those who cared for me, and to anyone at all who would benefit from hearing about my experience. It’s extremely meaningful to me, so I’ve gotten beyond this sense of privacy that I used to have.”

While taking part in a “beta test” seminar given by the Brain Injury Association of Utah run by a Covey training expert and a TBI patient, Greg and Laura requested that the group break out into two separate subgroups: survivors and their caregivers. Laura said this was really informative especially for the caregivers, who found they had never previously had a forum where they could support each other and share. “There are therapists and psychologists available, but our support groups aren’t built around caregivers,” Greg says. He intends to change that for the Salt Lake TBI community. Greg has applied to join IHC’s neuro rehab group. He is hopeful they will accept him, and highly motivated to train as a volunteer mentor.

“I want to help people get through their roadblocks. I want to know for myself what it feels like to watch someone recover, and to help them learn to read and write and speak again from scratch, like my therapists did for me. I would love to feel that.”

Greg and his family have been through an extraordinarily difficult experience, but their adversity may be the Salt Lake TBI community’s blessing. TBI survivors and their caregivers have gained an extremely intelligent, compassionate, driven, and ambitious advocate who draws daily strength from the arduousness of his ordeal and who isn’t afraid to talk about it.

Greg first connected with CATALYST after reading Lori Mertz’s account of her own traumatic brain injury in the March 2012 issue, and he found he identified strongly with Lori’s sentiment: that in spite of her injuries, she is now the best iteration of herself that has ever been.

Greg has spent the last year and a half contemplating his experience and trying to write down his story. It began as an attempt to recreate the month of memory he lost, but has evolved into what he hopes will become an actual book. He’s titled it Warmth and a Bad Fish—a toxic trout being the food that poisoned him, beginning this ordeal. He hopes to eventually share it with the TBI community.

Greg’s journey into the hinterlands of the mind and back is ineffable. He struggles to wrap his experience in words, but it isn’t his aphasia that cripples him in his attempts at expression; it is, rather, the fundamentally inexpressible nature of this expanded awareness itself. “It’s natural for me to express gratitude for these gifts that were given to me through this experience, without having to define it. There are no boundaries in what I experienced, no spiritual or theological words that can contain it. I would never put it in those realms. But I would hope that at some point, I would be able to be with another TBI survivor and be able to relate to them because of this, and to be able to help them.”

The poet Rumi said, “The wound is the place where the light enters you.” We all sustain damage during our time on Earth, both physical and psychological. The best we can do is to, like Greg, draw strength and empathy from these experiences and to support our fellow humans and all the life that shares this planet with us. Even in the darkest moments, beauty unfolds.

 

The brain’s role in our capacity for self-reflection

The human brain is an amazingly complex organ, and the only one that strives to understand itself in addition to taking care of the physical business of running a human body like other organs do. Historically, its function was poorly understood—Aristotle famously hypothesized that the brain was merely a kind of radiator for cooling the blood. There is, however, evidence that humans going back to neolithic times did somehow grasp the need to alleviate pressure on the brain after a traumatic brain injury: Many skulls have been found all around the world and from all ages of history with trephination holes drilled in them—and the edges of the holes often show evidence of healing, indicating that the patient survived this primitive surgery and successfully went on with his or her life for some time afterward.

During the Middle Ages and the Renaissance, trephination was practiced as a cure for skull fractures, seizures and madness, though it wasn’t until the 19th century that we began to understand the relationship between specific parts of the brain and human personality. An unfortunate man named Phineas Gage presented a famous case, where a railroad blasting accident shot an iron tamping rod straight through his head. Gage somehow survived this incident, and his availability for medical study afterward helped jump-start our comprehension of the brain’s role in creating our experience of ourselves as human.

This article was originally published on March 1, 2013.