Readers, I’ve read many memoirs, and it’s easy for me to get a little jaded about them, so when I tell you that Where Is the Mango Princess? made me laugh, cry and laugh till I cried, you’ll know this is powerful story. Cathy Crimmins’ husband Alan suffered a massive brain injury while they were on holiday in Canada with their young daughter Kelly and some friends. Alan was helicoptered to a hospital in Kingston, while having seizures, where he spent several days in a coma, and he received wonderful care that saved his life. Eventually he was flown back to his home town of Philadelphia, where he received more hospital treatment, rehabilitation, and help going back to his old job. Crimmins details the struggles and agonies of this journey swiftly, with occasional meditations on what all these changes have meant for her and their daughter.

Crimmins has a dry sense of humor and can take down her opponents with a cutting one-liner. But what is so amazing is how she allows the reader to laugh at the excruciatingly embarrassing episodes she goes through. A common result of traumatic brain injury is that the recovering person loses inhibitions and experiences powerful emotions. During his slow recovery, Alan frequently curses, rages, smashes things, and masturbates in public. As he gets better, he is also able to be extremely warm and loving, and in some ways more open and spontaneous than he was before his injury. Crimmins is also struck how much she has to become a mother to her husband, practically nurturing him as a baby and on through the stages of an accelerated childhood development. On several occasions as he re-learns toilet training, he pees all over him and her as she struggles to find the right receptacle. On other occasions he craps in his bed.

Of course the toll on Crimmins herself is hard. She gets considerable help from her extended family and friends, but she also has to deal with their denial of the seriousness of Alan’s disability. Initially he was paralyzed on his right side and it was an achievement when he could get into a wheelchair. Eventually his physical symptoms become much more subtle; he is easily tired and is often clumsy, and people assume on meeting him that he is doing much better than he really is, because that is what people naturally want to believe. It is depressing for Crimmins to explain to others all the problems Alan still has.

One of the main villains in this story is their HMO, which acts disgracefully. It tries to deny payment at almost every stage. It does not reimburse the cost of much of the rehabilitation treatment. It makes the life of Crimmins and many of Alan’s caregivers a living hell, because they have to spend so much time fighting it. Most of us don’t need reminding about the pernicious effect of HMOs on modern health care in the US, but if you are in any doubt, Crimmins’ book will make you want to emigrate to a more civilized country.

The features of the story I’ve mentioned so far probably apply to most cases of traumatic brain injury. But maybe why the book is especially moving is the particular losses that Crimmins experiences. She and Alan met as graduate students in English at the University of Pennsylvania. He is a lawyer and she is a writer; they are smart people with interests in, nature, literature, the arts, humanities, and politics. Alan used to like obscure Japanese movies. Alan used to be acerbic in his wit, and prone to depression. Now, several years after the accident, he is basically a different person, with worse practical judgment and more like a party animal. It is remarkable that he has recovered as much of his former self as he has – he is able to enjoy going to the theater, for example. But it is not surprising that 95% of marriages of people with severe brain injuries fail, and it is clear that Crimmins herself is still adjusting to the change in her life and wondering what to make of it.

Few people could be as articulate and open as Crimmins in describing her experience. It is hard to imagine her husband and daughter reading her book, because she says things that people normally keep to themselves, about sex, for example, but also about how she feels about her marriage now. She describes Alan as a survivor of traumatic brain injury, but she is also a survivor. I hope that she will write another memoir in ten years, so she can tell in her unique way how her story unfolds in the long term, and how this first memoir changes her life.

© 2001 Christian Perring

Categories: Memoirs, General

Tags: Neuroscience and Neuropsychology