It was her seventh birthday, Ellie’s father is telling me; a clear morning in April. They had stopped to chat to one of the neighbours. Ellie was losing patience. She had her new bicycle to ride. He can see it now, blue and silver chrome, dazzling in the sunlight. And then, “She was lying in the middle of the road, dead still. It was like the world had stopped, except for me. When I got close, the rest caught up; the screech of tyres, the bicycle scraping across the road. Someone said, ‘Oh my good Lord.'”
His mind held a contradiction as he looked down on his daughter’s body: she’s not badly injured and, at the same time, she’s dead. Neither was the case. Not the latter because, of course, she is here, a young woman now, squeezing her father’s arm; and not the former. Her arms were grazed, nothing serious, and her face was unblemished. But what he could not see was the fractured parietal bone and the slow seepage of blood into the right hemisphere of Ellie’s brain. It would be a week before she opened her eyes. And through the tunnel of intensive care-she in coma, he consciousness flayed-he found the strength not to pray. His prayerless vigil was rewarded. Ellie recovered and, months later, returned to school. He dropped her off and says he blubbered so much on the drive to work he had to stop the car. Joy can be so profound it borders on grief.
Ellie never quite regained the full strength of her left arm and leg, but it didn’t stop her joining in with the other kids. She struggled to concentrate and keep up in some lessons, but that was to be expected. No one pushed her; she pushed herself. She found a talent for languages and is preparing to go to university. So what’s the problem? “Parallel parking,” Ellie says. “And overtaking.” She has difficulty judging speeds and distances. She’s twice failed the driving test. Is it to do with her brain injury and, if so, can I help?
I finish my assessments at the next appointment. Ellie has worked hard at tests of spatial awareness, motor co-ordination, concentration and reaction time. They show problems consistent with the brain injury. She senses this and, with a kind of desperation, offers to take me for a drive. I accept. “Do you want me to come?” her father asks. “No,” I tell him, “Go and get a cup of tea.”
At first she seems unsure where her car is parked. It’s an old Citro?n, the colour of tomato soup. “Where shall I go?” she says. “Anywhere,” I say. “Just drive around. Go left here, then next right.” And so we go, me giving directions, she taking them. I have to admit she’s pretty good. Ten minutes into the drive nothing untoward has happened and I am beginning to doubt the predictive utility of my tests. There’s no doubt she had problems, but here we are in the real world and she’s doing fine.
Ellie has steered the car into the middle of the road ready to turn across the oncoming traffic back into the hospital car park. The indicator clicks as we wait. It’s a comforting sound. Tick, tick, tick. Almost hypnotic. There is a steady flow of traffic. Ellie waits. Tick, tick, tick. Then, a gap; nothing for 50 yards, space enough to get across. But we don’t budge. Tick, tick, tick. Another line of traffic draws towards us, headed by a white removals van with “Your Move!” splashed across the front, and a picture of a smiley chess piece. Tick, tick, tick. Your Move! The image of the van now filling my retina takes the quick and dirty route, via the thalamus and straight to the belly of the amygdala. Action stations. No need to trouble the higher cortical centres just yet, because something has impelled Ellie to turn across the traffic and we are going to hit the van. Conscious deliberation would be a hindrance. This is basic survival. My arms fly up and my head jerks sideways. The amygdala screams instructions to the brain stem, signalling the release of chemicals into the blood stream, and, through a clatter of synaptic activity, galvanising the autonomic nervous system. This is red alert. Then I become aware of the pig squeal of tyres: the van’s tyres, not ours. The cortex is coming back on line, reflective consciousness restores itself. We roll serenely on. I glance back and see the van pulling away. Ellie is unperturbed.
We are back in my office. “It was a close call,” I say. “Oh?” she says. “I thought the van was going to hit us.” “What van?” she says.
I tell her that we could arrange for a more advanced assessment of her driving skills, and that she is obliged to inform the driving licence authority of her condition. “I already have,” she says. But I feel I can’t encourage her to drive. I see a damaged brain encased in a tonne of metal cruising down the motorway, through rush hour traffic, through residential areas where children play on their birthday bicycles. The damage is beyond repair. They have a different view. “I came to you for help,” Ellie says. Her father gives me an empty “Thank you” as they leave.
A few months later I get a call from Ellie. She has taken her driving test for a third time and she has passed. “I thought you’d like to know,” she says. I picture her father standing beside her. What’s that on his face? Absolution?