Everything Can Be Trained
In 2023 I put myself on a list to see a specific doctor with traumatic brain injury expertise. His earliest availability was December 2024. I figured I’d get on the books but find another doctor in the meantime to address the reason I wanted to see one—depression and anxiety.
I found a different doctor; time passed; December 2024 arrived. I got a reminder email and debated cancelling. It’d been over a year, but I’d made the appointment—the right thing was to honor it.
I am glad I did, and made a follow-up six months out. It was a profoundly positive experience. I knew right away I wanted to write about the prevailing takeaway: Everything can be trained.
I hadn’t really known what to expect. We did balance drills, strength, reflexes, vision, vestibular tests, saw if I could move in certain ways without having symptoms.
We tested how precise and quick I could be with my affected right hand. He had me use my right pointer finger to go from touching the tip of my nose to his fingertip as he moved it around. Nose, fingertip, nose, fingertip, repeat.
I have brain damage but we didn’t have to do any work on the cognition front. We talked about my mental health, the reason I initially made the appointment.
At the end, we reviewed how I’d done. Nothing stood out as bad enough to create obstacles to living, but there were things I’m definitely not as able to do. Going between my nose and the doctor’s fingertip I was slow and imprecise. A few times I touched his finger but missed the fingertip. I wasn’t as able to close my eyes and stand on one leg; walking heel to toe wasn’t mindless.
He asked if I had any questions.
Is doing exercises this far into TBI recovery, almost three years, a waste of time? If I spend time walking heel to toe or standing on a leg at a time with my eyes closed, would that be worth it? Would I even improve?
Yes, it would be worth it; yes, I would improve. Everything is trainable.
That has always been my belief—particularly since TBI, since reading Norman Doidge on neuroplasticity.1 In order to promote neuroplasticity the brain needs to be exposed to new experiences.
My TBI2 isn’t typical. Cognition, a common source of symptoms for survivors, somehow poses no issues. The symptoms of my injured brain manifest physically. Could’ve been my executive function, word finding, ability to drive, a myriad of things.
An experience may not be purely “new” to me, but might be new to my brain. I’ve cast a fly rod thousands of times. Since my accident, my brain “remembers” the mental cues for how to control my right arm to cast a fly rod but isn’t as able to enact them. It needs “new” experiences to relearn from.
It doesn’t make immediate sense. My brain injury seems to affect my body more than anything. Memory and cognition are fine. If you tell me something I might remember it verbatim months later—what you were wearing when you told me, where we were. I can still tell you what I wore for my drum solo in the sixth grade talent show and where I heard one rather vocal Northern Parula in 2020. Despite my cognition and memory, my brain still needs to relearn things through new experiences that might not be truly “new” to me.
Norman Doidge writes, in The Brain That Changes Itself:
We must be learning if we are to feel fully alive, and when life, or love, becomes too predictable and it seems like there is little left to learn, we become restless—a protest, perhaps, of the plastic brain when it can no longer perform its essential task.
A traumatic brain injury is not a gift, but reading that I can’t help but think of it that way—a reason to keep learning. I have always been something of a nerd; now I get to employ my plastic brain to perform its essential task: learning—relearning what I knew or still “know.”
“Everything can be trained” is where my head has always been. My instinct when something doesn’t go as planned or how I’d like is to find ways I can make the requisite improvements to facilitate the result I want.
That was difficult? But you did it; it will get easier.
You failed? Make it so you don’t next time. Learn and grow from failure.
A post-TBI realization: It’s okay to ask for help. Part of learning and growing from failure is seeking and accepting help that doesn’t purely originate within. That doesn’t mean there isn’t anything to be done for yourself from within, but if something didn’t go how you wanted an action you can take might be to find and ask for help.
The doctor said still doing recovery work will help me regain abilities, but that if something doesn’t matter to me there’s no reason to work on it. No need to regain something just because it can be regained.
He asked what I like to do. I bird, read, write, edit, and exercise—miss being able to fly fish as I did and can’t swing a hammer as well. I used to bang nails into scrap wood as self-administered PT/OT—as I did with postholes. Everything can be trained.
The doctor said I’ve outgrown typical PT, but for specific activities I want to regain ability with I should find a coach and rebuild muscle memory. I was almost 29 when I was injured, so I have decades of muscle memory to rebuild.
He told me it was refreshing I had a positive attitude about my injury. Compared to what it could be, it is—but positivity isn’t the word that comes to mind for me. Maybe refusal. I don’t want to be passive. If there’s something I can do, I want to find out and do it. Nothing benefits from passivity.
This is a personal essay. In personal essays writers talk about themselves. I don’t want this to just be about me. My aim is to provide insight into what I learn from brain injury so readers can understand without having brain injuries of their own.
Everything can be trained. It’s easy to understand that in terms of the body. Want to get faster? Run. It also applies to less tangible forms of self-improvement. Want to be kinder? Listen, learn, practice empathy, don’t see everything strictly as it relates to you. Want to be patient? It’s okay if something doesn’t happen the instant you want—good things can take time. The more you have to wait or work for something, the sweeter it is when working and waiting is done. Easy to say, worth living by.
Kindness, patience, compassion, listening: everything can be trained.
Last time I wrote a personal essay, I said I’d paywall them in the future. For this, I didn’t. ’s note made me see personal writing has a place at Rock & Hawk—not always behind a paywall. In 2022 I said “I don’t want to profit off of what happened to me.” I still don’t; birds and nature are sources of hope for many as they endure difficulties. Even if the details of my relationship to birds and nature are specific to me, looking to them for hope is relatable to many people.
For a long time I didn’t call it “my TBI.” I believed: “words I precede with my…feel different than traumatic brain injury…My gets used with what I love. My TBI? No, no, no…The traumatic brain injury I sustained. Demote it.”
I don’t “love” my TBI, but it’s part of me. I used to see it as an enemy but it’s just something to live with.
Inspiring words and images James. I've never had a TBI, but as I approach the age of 50, I think about how my brain works now compared to my 20s or 30s. It's less nimble and spongelike, but more willing to take its time learning. Maybe the birdsongs will sink in eventually. Maybe I can learn a musical instrument as a middle aged person. Everything can be trained is a wonderful mantra. Thanks
Well done, James. Incredible photos and inspiring words. I needed to read this yesterday. I was already loving it before getting to the bottom. I learned about neuroplasticity several years ago and it was a revelation. The human body and brain can heal so much more than we sometimes believe capable. I needed this reminder.
Oh, and I understand your hesitation to go autobiographical. There's a time and place, and you are doing it well. I look forward to hearing more about your training!