Elisabeth Grace, an almost-retired Clinical Social Worker, a writer, birder and gardener, has lived in the United States since 1972 but has deep roots in England and Scotland. She now shares her Columbia County home with Cole, a retired therapy dog, and Molly, a polite blue-eyed cat.
The initials TIA stand for transient ischemic attack, a medical diagnosis, an indication that something is not right, that it may be time for a visit to the doctor. What about TGA, three letters which I had never heard in conjunction until a few years ago? What do they mean?
At the time, I was caring for my partner of 33 years who had suffered from cancer for fifteen years. It wasn't an easy time. We had the support of home-based Hospice and several wonderful friends. A visiting group of Scottish folk-singers gave an impromptu concert on our front porch, a friend gave a session of body-work, another brought her nine-month old son to visit and yet another came to demonstrate her newest skill, belly-dancing. Quakers brought meals and Kate's family members called frequently from Illinois, Indiana and Michigan.
Attention was diverted and stress alleviated by these measures, but sometimes I just wanted to get out of the house for a while. I fiercely rejected offers from well-meaning friends to go to the store for me; those little outings were my therapy. Sometimes a friend would come to visit with Kate while I was gone. At other times we agreed that she would be fine until I returned. She had the phone beside her bed, and knew that I would hurry back.
It was a day like many others during those long months. I went off to nearby Chatham with a list of errands, including a stop at the printers to pick up a completed order.
I don't know how long I was gone. I shopped, paid my bill at the print-shop and drove home. I used my credit card at each store I visited; later, the receipts were proof of those transactions.
And that's when those three unfamiliar initials entered our lives. I entered the house and looked at Kate lying in a hospital bed beside the picture window through which she could see flower-beds and an expanse of sky. What followed is hearsay, a story pieced together over the next couple of days. Puzzled, I asked Kate, “What are you doing? Why are you lying there? Why are you in that strange bed?” She explained that she had cancer, could not move her legs or get out of bed. I don't know if I believed her, and she quickly realized that something had happened to my consciousness. Fortunately, she had the telephone and the use of her hands, and within a short time three large, orange-clad emergency personnel were at the house and insisting that I, not Kate this time, should accompany them in the waiting ambulance.
Questioning and protesting, I was lifted onto a gurney and driven to the hospital. I have no recall of the journey: it was several hours until I became aware of my surroundings, when I was surprised to find a former colleague standing beside my bed. Kate had called her after the rescue squad had whisked me away, so that a familiar face would welcome me back from wherever I had gone. At some point I had been examined by the neurologist on call. There was enough information to diagnose that I had had an episode of transient global amnesia-- a TGA.
So what is that? There is a lot of information about it on the internet, little of it conclusive. An attack results in a complete loss of recent memories, never to be retrieved, with no loss of the ability to function. I had shopped, gone to the printers and driven the eight miles home without difficulty and apparently without any oddities of behavior. In my case, no physical cause could be determined, but a relatively common antecedent to such attacks is stress, either sudden or prolonged, such as long-term problems at work or caring for someone during a terminal illness. The neurologist told me on my follow-up visit some weeks later than an attack can happen to anyone, is unlikely to recur and is not predictive of future problems. He told me that I would never retrieve those lost hours, and that has proved to be true. It is as if the brain decides to take a time-out, and starts to work normally again after a few hours' rest. It resembles an alcoholic blackout, without the alcohol.
I do not know exactly how long my brain took to recover from this strange experience. A friend drove me home from hospital on the evening of the same day, and I resumed my care-giving role without a hitch. My ability to remember events as they occurred returned. I have had no further attacks. There was one sequel which, on balance, I do not regret. A few years after the attack, I applied for long-term health insurance. After filling in many forms and enduring a long interview, I was turned down. Why? Despite the relatively benign diagnosis and the excellent prognosis for a full recovery, my brain's brief vacation was apparently judged a good enough reason to reject my application. In the long run, my TGA saved me a lot of money: no insurance, so no premiums. I can live with that.