Normal from Afar, a Doctor Reveals His Own Traumatic Brain Injury: An Amusing and Unorthodox Tale of Concussion, Pain, Loss, PTSD, Homelessness, Suicide, Hope, and a Service Dog

By Dr. Daniel Herlihy and Dr. Stephan Arndt

Dr. Daniel Herlihy has a bachelor's degree in liberal arts, a master's in microbiology (the human gut bacteria), graduated from medical school, survived residency in family practice, and is homeless.
After a serious car accident, his neurologist prescribed daily journaling to regain his ability to talk, write, read, and remember his life before the accident. After twelve years, his first book was coauthored with a service dog who saved him from suicide: Chewy: A Doctor's Tail.
Dr. Herlihy continues to heal by sharing his difficulties so those with a compromised brain will have a path back to neurotypical.
In this book, Normal from Afar, he shares the harrowing journey from competent, caring family doctor to disoriented homeless person, and back again, to a place of hope and a new version of normal.
A Dozen Homeless Voices, to be released in early 2023, contains the stories of the most interesting, unheard friends Dr. Dan grew to love while on the streets himself.
A fourth book, to be released at the end of 2023, describes twenty modalities that best helped the doctor's broken brain and body, including: Neurofeedback, oxygen therapy, microcurrent, Pulsed electromagnetic therapy, vagal nerve stimulation, medications, and supplements.
Dr. Dan understands that a catastrophe can take anyone to a place of complete defeat. Losing his mind, being in chronic pain and unable to do the activities of daily living (Dressing, eating, and bathing) he slowly fell into despair, disability, and a private purgatory. From there it was a short hop into homelessness.
Yet, in the darkest places there is hope.
Dr. Herlihy found the unsheltered to be resilient, unique, thoughtful and the absolute best story tellers. They are a caring community of outsiders who understood and supported him when others turned their backs.
While living on the streets as he recovered from his brain injury, Dr. Dan found unique ways to help his unsheltered community. He taught some to read, guided others to get needed medical attention, and helped several earn money.

One more thing, the author bores easily so Normal is not just a read for social workers, psychologists, and medical professionals. This book is a medical thriller with the really exciting parts of his journey included. Here's a few places where the fun begins: A nerve-racking car accident, a gruesome mugging, a romantic relationship of complete horror, a bad trip with LSD.

Two more things, a recovered memory is a fun fact. In the eighties, Dr. Dan worked as a medical missionary in Iturbide, Mexico, a small village of indigenous people high in the Sangre' de Cristo mountains. Working closely with a curandera (shaman) he learned to use herbs and psychedelics to aid patients. He can still do the trance dance (not a disco style) to good and healthy effect.

Now that Dr. Herlihy can write, he would love to hear from his readers, and anyone interested in brain health and recovery.

• Language: English
• Publisher: BookBaby
• Release date: Feb 27, 2023
• ISBN: 9780997833805

Book preview

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Normal From Afar

Print ISBN: 978-1-66787-611-5

eBook ISBN: 978-0-99783-380-5

Copyright © 2022 by Daniel Herlihy

All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the publisher, except in the case of brief quotations embodied in critical reviews and certain other noncommercial uses permitted by copyright law. For permission requests, write to the publisher, addressed Attention: Permissions Coordinator, at the address below.

[e-mail]

Medical Editor-in-Chief — John Capobianco DO, FAAO

Normal from Afar, Dr. Daniel Herlihy. —1st ed.

Contents

in the beginning

1 the beginning of the end

2 the initiating incident

3 brain trauma

4 storytelling

5 the road to perdition

6 mindful

7 hospital rounds

8 holy holy holy

9 theresa

10 disruptions

11 hangmen’s fracture

12 faded father

13 books and bravery

14 erasure

15 anatomy of chaos

16 car talk

17 no practice

18 post-partum depression

19 what crazy feels like: hearing voices

20 love in the time of dementia

21 a perfumed fire

22 she snatches from the sun

23 the loss of my daughter

24 public storage

25 the tale of a toenail

26 a study of the homeless

27 audubon society

28 divisions

29 a guardian archetype

30 eccentric orbits

31 pages of pathology

32 metrocare

33 karen

34 schizophrenia

35 sharing

36 family statute of limitations

37 enormous smallness

38 conversion

39 osteopathic medical manipulation

40 try living for a living

41 john gets me a job

42 a clinical lab rat

43 the transformative power of vulnerability

44 adjacent realities

45 mind field

46 debriefing time

47 a coming to Jesus moment

48 monster

49 aftermath

50 the sound of the elixir

epilogue

0 chapter zero

chapter zero

acknowledgments

suffering and bliss

Dedication

Chewy Napoleon Bone-Aparte Herlihy

Service dog: canine hero, antidepressant, and suicide preventative. This creature walked me out of suicide and inspired my first book – Chewy: A Doctor’s Tail. Amazing lessons from a service dog as transcribed by a medical doctor.

What Working Dogs do on the job: Seizure alert, reset circadian rhythms, socialization, recovery from P.T.S.D., danger alert, disability advocate, and coauthor of my books.

Sadly, I have not been able to teach him how to do the math for a tax return nor how to prepare eggs benedict properly.

Happily, this small terrier provides eternal, nonjudgmental friendship and is the executive adviser in our small pack of two.

This book is dedicated to my daughter Riley. I hope this makes up for my absence during my lost years. Some of your questions can now be answered. If we could not be together in the past, perhaps this book will join us, at least literarily, into the far future.

A special thanks to Dr. John Capobianco, D.O., F.A.A.O., who treated my physical, emotional, and spiritual injuries. He pulled me from the darkness of despair and set me on a path of writing this book as a prescription to recover my speech, reading, and writing abilities. His abilities in physical medicine are beyond compare.

I am incredibly thankful for John’s hundreds of hours editing and directing this book.

Dr. John Capobianco

[e-mail]

(516)-353-7814

The Rough Writers group was superbly supportive. We are bibliotherapy book writers. We scribble to find our new identities. Professor Captain Lee Sneath is at the helm. Find us on Facebook and join us to re-story the world.

Tank Gunner’s stories rival the Old Testament. He was invaluable in guiding me along the writer’s path. Find him on — https://tankgunnersix.blogspot.com/

My Two Selves

The first drawing for rehabilitation

Evaluation by Dr. Capobianco: Basic spatial ability as realized by a malfunctioning cerebellum. This Patient cannot understand object positions in space. No shading and poor lines depict only the most straightforward features. The content is childish. This is a sketch of the Patient as Frankenstein.

A general trend is slowly advancing motor control. Another more accessible ruler of improvement is to number the age of the skill. For example, Daniel, at the beginning of rehab, shows the abilities of a 6-year-old, as this pic demonstrates. The end of the book shows work on the High School level.

Author: I was disabled in my motor cortex enough that bringing a fork to my mouth was a high-wire act. I was eating without a net. Not many friends could watch without losing their appetites. My neurologist suggested I take a drawing class to increase my coordination. Here are the drawings which indicate my recovery status. They are not in chronological order, but more fit the contest of a chapter’s theme.

Three medical and psychological doctors evaluated this series of drawings. The best insights are spread throughout the book. This drawing indicates brain development and motor cortex ability (ability to move in a coordinated manner).

The therapeutic suggestions of John Capobianco, D.O., Soni Helmicki, Ph.D. and Stephen Wentworth Arndt, M.A., Ph.D.; M.S., LPC-S, were of utmost value, as were their written contributions to the medical and psychological portions of this book.

Their advice will serve any brain-injured patient:

Write a memoir, regenerate your grey matter, relearn the language, and understand what you can no longer remember.

You must WORD your lost life to regain it and shape it into a hero’s journey.

Only halfway through this composition did I fully realize this was not an academic exercise to aid my Broca’s and Wernicke’s speech centers.

Without a remembered backstory, where is my character?

As Dr. John explained, each memory inspires a sentence that leads to another and then is grouped as a paragraph to build into a chapter. Just as each memory slowly brings me forward. Each day adds new neurons. I found this an excruciatingly long process, and seven years passed until I penned two humbling words.

The End.

Dr. Capobianco also recommended that I draw to renew my crushed cerebellum, without which I do not know where my corpus existed in space. My feet and brain were strangers. I often fell, damaging my mind more. Over the years, my hands gradually gained competence while the rest of my body followed.

The sketches here show my different stages of motor skills, my moods, and my madness. These are visible psychiatric tests the reader might enjoy for armchair speculation. These are visual shortcuts through my central nervous system (brain) and peripheral nerve supply (arms, legs, and organs).

Further, the drawings were interpreted by various medical professionals with varying degrees of psychiatric training. Nevertheless, I found the words of these art critics accurate, amusing, and insightful. The reader might want to play therapist and compare notes.

The reader is notified this work was composed over seven years and multiple states of brain dysfunction. And is not in chronological order but more a psychological order.

Dr. Stephen Arndt wrote an enthusiastic review of this work filed as the last word. His experiences as a Philosopher, Theologian, and Psychologist are all on display. I highly recommend reading this section. It has put my experiences into perspective and those with similar traumas.

in the beginning

I am a reluctant memoirist.

Why?

I am disinclined because I want to write protection into every sentence. I desire to use letters to barricade myself from scrutiny. I need sound to keep others away, not draw them closer. I want to look good; I like to hide. I have a safe public persona and my private world.

I lack the boldness to run naked through the streets and down the pages.

Fuck you! It’s none of your business! I often think.

Protecting the characters (me mostly) cheats the truth and is a failure of courage.

I saw enough of this in exam rooms, this avoidance of the hard facts. Hemophobia (blood averse) patients fear seeing their blood pouring out. In my own family, we avoided diagnosing my father until his dementia became severe.

This is not the path to a good life. That path should be Compassion, not self-protection! One must be able to look at life’s dark and ugly side to live it fully with balance and wisdom.

So, it is these reasons I came to write this book. There are other reasons as well.

After my accident and brain injury, my loss of identity was complete. Having to sneak a peek at my driver’s license to remember who I was when asked was such a total loss of identity that putting pen to paper became a visible way to prove my existence.

It is impossible to hide when writing about yourself. I see my face in the loops and lines of ink. Moreover, bleeding on every page helped me see my minor and mortal wounds. Viewing the carnage is a catalyst for change.

I needed to explain where I had been. Everyone has asked. They do not mean my geographical location.

Any healer who glances at a medication list knows the patient more intimately than his spouse. Why do you think houseguests open the bathroom cabinet? A lurid factor is at play here, but you get my point. Thus, I dragged out a dozen or so medications to answer the location inquiry.

These medical vignettes only confused people as they did not speak medicine. I felt obligated to satisfy their ongoing questions as a father, brother, lover, and friend who was physically present below the neck but above, not so much.

So, this work is my answer to their many questions.

In the middle of my path to normal, I woke up to understand I was on the hero’s journey. Further, every reader is the hero of their own life. It must be this way; Life is too difficult for it not to be.

It was a confusing expedition, as my understanding of time was distorted. In fact, each chapter was written during different times of my rehabilitation, revealing evolving (revolving may be a better word) pathology. Some events are out of order.

Here my descent into abandonment and homelessness is chronicled. Lastly, the unsheltered community and my eventual involvement as a street doctor are described. And doesn’t everyone have secret questions about the panhandlers who are increasingly on every street corner?

The finale of my recovery occurs while still on the street. The protagonist excepts the new reality of loss and heals himself. Finally, the hero returns from the strange, wild world of soul and psyche to open the map to all who must navigate their own lands of disaster.

Now before you think this will be a chore — fear not. Between my delusions and hallucinations (amusing in themselves), I still retained the best defense mechanism — humor. That alone is worth the read. Death and illness will come to every reader; it might as well be funny.

There were other reasons I felt compelled to scribble and scratch on paper. A primary one would be to follow Dr. Capobianco’s orders to compose sentences to re-story my existence and thus grow nerve pathways. He said, Write till you have a headache, a sure sign new neurons and brain growth are forming.

This was excellent advice. After daily migraines and ten years, 2000 pages appeared, and I had enough to tell the tale.

The slow coal-to-diamond process is a daily mustering of chemical and electric impulses to translate into neurological activity, which pushes the cortex into action. Hence, the tongue moves to produce a sound. The note indicates a symbol that listeners can understand. This process is a scientific miracle and endlessly fascinating for me. And a central theme of my book.

Writing is a neurological prescription as powerful as any treatment!

A memoir is a restoration of life. It is the surest way to choke up and cry like a baby, wetting boxes of tissues before running away from the page. After the hysteric ebb, I felt less paralyzing fear, more in control, and more peaceful. This is the most potent therapy.

Not so apparent in my decision to write a memoir is this: In the beginning, was the Word, and the Word was with God, and the Word was God.

Hmmm…The persona of God is a giant almighty set of lungs, trachea, voice box, mouth, tongue, and teeth. The secondary significance is that the Word (literally) has power. My neurologist did not write that biblical sentence on a prescription pad, but I desperately needed to hear it.

There are side-effects of creating my story of cerebral injury. The more I write, the more the Brainers (those with neurological grey matter injuries) are called to me. And I to them.

We recognized each other more and more until we could not ignore each other. Our neurological passports were imprinted with the same stamps: lost places only visited by the damaged. Like me, they are lost travelers.

Due to my medical learnings and the charity of professional healers, my singular advantage has a sketchy map out of the foggy, boggy mental marsh. Sometimes the blessed, lucky writer says what we all can speak but cannot annunciate. Moreover, sharing this anatomical exit plan must be done if I am to be faithful to my calling as a healer.

Those who take up the self-story realize there is only one tale everyone says: A Darwinian drama and survival narrative.

Writers adrift, disoriented and wandering astray discover a transformational arc from everyday life that no longer exists. They devastatingly fall through a difficult and dangerous world where the self is challenged in unimaginable ways. Yet. Lessons are learned, talents developed, and skills honed. If lucky and persistent, they survive to become humble heroes.

The possibility of returning to the ordinary world is open to them, so they may bring back the treasures they found – wisdom, a code, and abilities. Not all return; Death is a natural consequence and the best teacher. A hero often must face annihilation. Indeed, I was playing for keeps.

The struggle is transcribed into our genes. Every one of us must tell our autobiography in some manner.

One treasure I have is this — I have returned to remind people life is firstly an adventure. And, inevitably, the hero will be broken.

There is a Japanese vase a wise friend owns. It has been broken and repaired with gold. The fractures stand apart as beautiful. No attempt is made to hide the damage, and the repair is illuminated.

The owner has embraced the flaws and imperfections as simply an event in the object’s life and not a reason to terminate its use by tossing it in the dustbin. Moreover, she says the breakage started the real life of the vase. She prizes it more for its broken story.

This compassion and sensitivity to our fractured self is the point of the memoir. Slainte’

(Health in the Irish language)

Dr. Daniel Herlihy

The ninth circle of Hell.

4/3/2022

Friend/Foe

Dr. Capobianco: This is at a medium ability with good shadow work. The work is anatomically accurate and symmetrical. The concept is simple but a realistic anatomical skull. All significant bones are represented. However, this does not seem to reference medicine or osteopathy but is a depressive symbol of self-harm.

Author: While practicing family medicine, I specialized in physical therapy and rehab. I had extensive training in osteopathic manipulative medicine, using a thorough exam with my hands to evaluate every aspect of the patient’s health. We palpate for normal healthy tissues and understand when an organ, joint, or head is not functioning correctly. Due to my training, I specialized in cranial-sacral medicine. I spent time in anatomy labs to treat malaise of the head and spine with the bones and soft tissue of these areas. The above drawing was of the bones of the skull. As I realized how serious my injuries were, the skull took a more morbid fascination for me. In book two, my depression was brought to fruition, and I began to fight suicidal ideation.

1

the beginning of the end

Reaching the iron gate at the end of my yard, I paused to open the lock. I invited John (Dr. Capobianco) to step into my magical, nocturnal park. The moon was full over the golf course. The pathway for the four, five, and six holes illuminated enough to stroll a couple of miles and catch up over our medical practices. I continued where I left off in the telephone conversation.

I must be getting smarter now. I would have never caught that stroke earlier in my career, I begin.

Yeah, you saw ptosis in the right eye. That’s it?

The lid sat at half-mast, so I did a neuro exam after writing his hypertension script. Poor guy, only fifty, didn’t know what a Polar Bear was, thought it was a ghost.

Left-sided stroke? Speech center?

Over the left ear. Wernicke’s and Broca’s areas. Thirty minutes into our conversation, he started slurring the words he remembered anyway.

Good catch, Herlihy. You might be doing osteopathic family practice doctors proud one day.

Thanks, a big compliment from the professor.

We ambled awhile, shorting the conversation with medical jargon. A couple of initials, TIA (transitory ischemic attack), and an entire neurological chapter was shared silently between us. These conversations can be more intimate than pillow talk with my wife.

The heat had receded on a perfect Dallas night, and the empty, manicured lawns were a visual utopia.

John, a gentle doctor, healer, and so far from a street thug, had to ask, Hey, do we have trouble ahead?

Four guys grouped around the sixth hole.

No. The men are here often. Nice guys. Waiting for 10 o’clock.

There’s nothing where they are standing. What could they be expecting? Pizza delivery?

It’s funny. They lived out by the Trinity River Basin in the forest somewhere.

Homeless and?

Gathered for the sprinklers to turn on for a half-hour.

For the grass?

See the towels? Give ‘em fifteen minutes, and you’ll see a clan of naked men clean off the dirt of the day.

Observing for a moment, I felt an embryonic emotion: one-part sympathy, two-part fear, and three-part revulsion.

A Fateful Drive

Dr. Arndt: The picture demonstrates basic outlines without shading and contours. A two-dimensional quality is present. Surprisingly, the driver is smiling. Could he not be aware of the tragedy awaiting? A possible manic or hypomanic state has gripped the driver — Patient. Age level represented: eight years old.

2

the initiating incident

The Santa Fe sky could not have been painted any bluer by one of the many famous artists geographically inspired to live there. I felt as I did when gazing into Van Gogh’s golden, sunny fields of wheat, undulating trees, and ethereal clouds.

The landscape unfettered my imagination, allowing me entrance to a fantasy world so much better than the harsh reality of medicine. The rolling mountain roads offered a retreat from the broken bones of beaten children, the suicidal mask of hopelessness on the faces of the aging, or the decaying smell of slicing into an abscess and seeing the bloody, green pus flow forth – unafraid of the light.

The mountain scenery shimmered hypnotically through the heat that seared off the two-lane road I was following. In the immenseness of the high desert, the car didn’t seem to move even when going the lawful top speed.

I was lulled into dreaming of my just completed honeymoon when the odd shape a half-mile down the road moved slowly, rattled me awake. I made out the back of a banged-up, older-model Ford pickup packed with a ridiculous amount of stacked hay. The bales extended ten feet into the air above the cab.

The bundles were tied together, creating a watchtower resembling a blurry Ogre reaching out to grab the innocent careless enough to venture too close in the fever of rippling heat waves.

I automatically switched to the faster-moving left lane before getting closer. I noticed how the hay resembled an imposing barrier warning me away. Not fully understanding the danger, I saw the first stack hit the ground. And continued to watch another fall from the top, wondering if some magical pitchfork was pushing them outward into the air. As the bundles hit, they exploded.

Bindings ripped, and dry straw popped in all directions covering the entire road. Two slid together, intact, into the middle of the highway, forming large yellow boxes that deliberately blocked my passage. Nearer, I saw the truck had stopped; the driver had gotten out to look at his cargo. Even at a distance, I could tell he was upset.

Turning, I asked my wife, What’s all this about? I saw the farmer attempting to move hay, haphazardly strapped into large boxes, three to four feet across. He must have brought them from one pasture to another in these high mountain fields.

That’s crazy. This is a high pass. Dangerous as Hell. Slow down, Daniel! She had an edge to her voice that only registered distantly. I seemed lethargic and insensible from the high altitude of the Santa Fe Hills. I was already in the left lane, not sure where to go.

She added more with a panicked voice, Hey, slow down. Now!

In my bucolic inertia, I did not heed the warning fast enough and could not fully brake the car.

My brain, quickened by adrenaline, ordered my arms around spastically. I swerved impulsively, inexplicably afraid of the bundles. Still braking, I pulled too hard to the left, a maneuver that barely permitted the car to rush past the hay barriers. But they seemed angry for not being able to stop me, and the scratchy box-shapes vented by sounding a barking and scraping scream all down the car’s side.

I thought the vehicle had gotten past the danger until I saw yellow straw spread out before me like a golden oil slick. The tires spun on the slippery hay, squealing high-pitched, excited warnings before growing louder into full-throated screams from the car.

The present slides into eternity when confronted with an impending calamity; time becomes a slow, freeze-frame dance. In that eternal instant, I watched as my evasive turn transformed into a long, drawn-out fishtail. The vehicle continued to carve out a winding, snake-like pattern in the asphalt hardtop, slithering toward the edge of the elevated road.

I then realized we were going to go over the unguarded highway edge. The rims of the front wheels were grabbed by the soft, long grass reaching up from its intersection with the asphalt. It deliberately flipped the car down the steep embankment – over and over for about seventy feet.

The familiar soothing rhythm of the road I’d felt through the seat disappeared as we flew into the sky and roared into heaven. My body, instantly going into shock, served me a neurological cocktail (a shot of dopamine) that propelled me outside of time, giving a slight promise of paradise.

All that followed seemed an illusion, and as the seconds ticked by, there was no need to worry about what to do next. Looking over at my new wife, I enjoyed the pleasant, hormonally induced peacefulness of an unhurried day.

Theresa was so full of details. Her long, blond hair was still shining from the morning conditioning ritual. A few strands, still damp, stained the fibers of her pink linen shirt while orange gloss sat atop her lips, accenting their pillow fullness. They were slightly parted to show what I considered her best feature: dazzling white teeth. People often found her too-perfect smile off-putting until they noticed a slight chip on one of the lower incisors.

And now, her relaxed face was only marred by the minor wrinkles at the corners of her eyes. The pink softness of the blouse, draped around her delicate neck, was held by an actual pearl button. Yes, my bride was as beautiful as always.

Angelic, I thought.

Only one detail told me something was amiss. It was the smallest puzzle piece mislaid, so I had to look to figure out what was wrong with the portrait in front of me. Her eyes, the same blue of Santa Fe skies, were retracted to only a tiny rim surrounding marbles of black.

My ears flooded with noise. My skin prickled with maximum sensation. My entire body twisted and turned like a shaken ragdoll. Then nothing happened as I floated away, simply vanishing into blackness.

The light came back quietly and slowly. I could see it through my eyelids. My thoughts, confused and hesitant, tried to explain what was happening. My head hung