The Curious Afterlife of a Brain Trauma Survivor

Sophie Papp and her family had a ritual for the recently deceased. When a relative died, she and her brother and cousins ​​got into a car and drove to Koksilah River, an hour north of their homes in Victoria, British Columbia. There they spent the day swimming in the glassy jade water, letting the current drag across the squishy riverbed and gazing at the native arbutus trees, whose red bark peeled off like wrinkly snakeskin. After her grandmother passed away, Sophie – a sweet, reserved 19-year-old with gray-blue eyes and freckles – went to the island with her younger brother, cousin Emily and a close friend. It was Sept 1, 2014.

Along the way, the group made a short stop at a Tim Hortons for coffee and breakfast. That’s the last memory Sophie has of that day. About 45 minutes after the stop, Emily, who was driving, spilled her iced coffee. Her attention drifted off the highway and she lost control of the Volkswagen Golf. The car skidded across multiple lanes in both directions before crashing into a ravine on the other side of the road.

Of the four, Sophie was the most seriously injured in the crash. At the scene of the crash, EMTs gave her a score of six on the Glasgow Coma Scale, indicating severe brain trauma. She was rushed, unconscious, to the trauma center at Victoria General Hospital, where doctors and nurses worked to save her life. After a week she came out of the coma.

In her second week in the hospital, Sophie’s recovery began to take on astounding qualities. Just days after regaining her rudimentary communication skills, she had extensive, in-depth conversations with everyone around her. “One day she spoke a sentence, and not long after, she was talking endlessly, about everything,” recalls her mother Jane. Sophie asked the staff how old they were, if they had children, what their most interesting cases had been. She slipped effortlessly into heartfelt, sincere conversations with the nurses’ assistants.

One morning she had an appointment with a radiologist to discuss the MRI scans she had taken a few days earlier. With her mother by her side, Sophie intervened with one question after another. “Are there lesions in the cerebellum?” she asked. “Has an fMRI been done? What about the thalamus, fornix, and pons? Are they affected?” The radiologist paused, his furrowed brow and sharp eyes flicking to Jane, before turning back to Sophie. “How do you know those things, Sophie?” he asked. In the days before the appointment, Sophie had persuaded her father to borrow some books on neurology from the library. After he handed over the texts on neuroscience and brain anatomy, she would read “until late at night,” she recalled.

Sophie had been a “quite introverted, cautious girl” all her life, Jane recalled. However, as her time in the hospital progressed, that young woman increasingly disappeared from view. When a nurse went through the neurology department and marked each room with colored tape, Sophie sneaked around and mischievously peeled off all the tape. One night, after most of the patients had gone to sleep, she turned on the floor and changed the dates on all their whiteboards to December 24. When a technician explained that he was going to do something called “propeller rotation” while using the MRI machine, she told him, “It’s not a helicopter, so fuck you.” She thought one of the neurosurgeons who circled her wing was handsome and asked him out on the spot. With intense sincerity, she asked one of the doctors on her healthcare team where the source of consciousness was in the brain. “She was very, very social, and she wasn’t the Sophie we knew before,” Jane recalled.

Sophie’s doctors believed her traumatic brain injury (TBI) was affecting her executive functioning, including her inhibition control. The result was a more uninhibited person—one who acted freely, spoke eloquently, and approached others with an immediacy that bordered on daring her old self had never dreamed of. The metamorphosis was also not limited to the way she communicated with others. During her month-long stay at VGH, Sophie became more emotional than ever before. For most of her adolescence she was an even-keeled girl, but in September she quickly boiled over, tumbled into the undercurrent of powerful mood swings and burst into cramping fits of crying.