Getting Knocked Out

You read it in novels and see it on the screen: A character gets knocked out, then “comes to” moments later and springs back into action. I can tell you from personal experience that it doesn’t work like that.

When a person loses consciousness after a head injury, it means they’ve been severely hurt. I have never been knocked unconscious, but I’ve had several concussions. (Easy to do when you fall off a horse.) And I know people who have sustained serious head injuries and, I’m glad to say, have largely recovered from them.

Concussions are a type of traumatic brain injury, or TBI. Such injuries can impair the brain and body for days, weeks, months – even the rest of your life. They can also kill you.

At the outset of my second mystery, Nighthawk’s Wing, my main character, the young sheriff Gideon Stoltz, is suffering from a concussion he got after falling off his mare Maude. Gideon is plagued by dizziness, headaches, an inability to concentrate, sensitivity to noises and light, a weird cobwebby thing floating in the corner of one eye – and a gap in his memory extending back from his accident for an indeterminate period of time. As he tries to investigate a murder, flashes of memory return, and he realizes he was with the victim the night before she died.

my icelandic horse naskur and i on a dirt road in vermont. photo by elise skalwold.

My latest concussion happened in August 2018. My gelding, Naskur, was moving along at a pretty good clip when he tripped and fell on his nose. I pitched forward over his head, and my own head slammed into the ground. I was wearing a helmet (I always do), which no doubt kept me from being hurt worse.

I didn’t lose consciousness, but I was stunned for a minute or two. I picked myself up and staggered home, leading Naskur by the reins. (I think he was stunned, too.) Some very unpleasant symptoms nagged me for over a month. I drew on that experience when writing about Gideon’s concussion and its aftereffects.

In doing research for Nighthawk’s Wing, I talked to friends who had suffered brain injuries. I attended a meeting of a TBI support group and listened to folks describe their lasting physical and mental problems, including recurring dizzy spells, exhaustion, and depression.

I also read these books: Head Cases: Stories of Brain Injury and Its Aftermath, by Michael Paul Mason (2008); The Ghost in My Brain: How a Concussion Stole My Life and How the New Science of Brain Plasticity Helped Me Get It Back, by Clark Elliott (2015); and The Traumatic Brain Injury Handbook: How a Near-Death Fall Led Me to Discover a New Consciousness, by Joseph Healy (2016).

Joe Healy is a friend of mine here in Vermont. After falling off a ladder, Joe was unconscious for three weeks. Which, as it happens, is roughly how far back Sheriff Gideon’s memory loss extends – with the details of his accident and involvement with the murdered woman, Rebecca Kreidler, gradually becoming clearer as Nighthawk’s Wing proceeds.

One thing I learned from my research is that both short- and long-term effects of a traumatic brain injury can vary widely from person to person and from accident to accident. Those effects can, and often do, debilitate a person for a substantial period of time.

So don’t believe that book or movie scene in which the hero gets bashed over the head with a pistol or a rock, crumples to the ground unconscious, and is back being heroic a couple of minutes – or an hour – or even a day later.

The Gideon Stoltz mysteries are fictional, but it’s important to me that they are grounded in truth. I found myself sobered by the real consequences of TBI as I spun out Gideon’s story of pain, memory loss, and a gradual return to normalcy in Nighthawk’s Wing.