12

IT’S SEVEN MONTHS post-stroke: February 2010. I’m anxious to get on with my recovery, and the more I read, the more it seems like a computer-based cognitive training program is what I need.

I ask Doctor Small about such programs, but he knows nothing about them. Then I ask Doctor Mercer, the ophthalmologist, if computer-based training would improve my visual deficit, but she’s not heard of this approach either. She recommends gentle exercise, such as walking along the beach, and tells me that I’ll see improvement with the passage of time.

Doctor Small has recommended a neuropsychological assessment, so I decide to put off ordering a program until I speak with the neuropsychologist. A standard assessment includes a clinical interview and a series of tests that aim to measure a person’s cognitive functioning, including short- and long-term memory (both verbal and visual), processing speed, spatial skills, conceptual thinking, decision-making ability, and learning capability. I am keen to know the extent of my cognitive capacities, like a high jumper wanting to know how high the bar can be set.

I call the neuropsychologist to let him know that I am a clinical psychologist and I have experience in neuropsychological testing. I’m aware that my prior knowledge of some of the tests might influence the results. He asks me what tests I’ve used in the past; he’ll find alternatives, he says, and thanks me for making contact.

On the day of my appointment, I meet him in his city office, which is quiet and comfortable. The assessment, including the interview, takes almost three hours, with a break in the middle. In one test, he recites a list of eight pairs of unrelated words and asks me to repeat them back to him. After the first trial, I correctly remember two of the eight word pairs. He repeats the list three more times, and after each trial, I repeat back the word pairs I can remember. By the end of the fourth trial, I have only learnt one extra pair — three all up. I’m trying really hard, but the words just don’t stick in my mind. This is the type of test I’ve given many times before, and I know that mine is a poor result: I should’ve learnt most of the pairs by now.

The neuropsychologist reads out two short stories. Then he asks questions about the content of the stories, and, some time later, asks me to recall as much as I can. Once again, my performance is poor, even though I think I’ve administered one of the stories myself in testing clients.

My memory for faces and my working memory (working memory typically lasts twenty to thirty seconds) are poor. My visual memory is good, and my vocabulary and speed of processing on visual tracking tests is in the superior range.

My uneven results across the different tests points to an organic cause for my cognitive deficits that’s consistent with a brain injury. The neuropsychologist says that the high level of chronic stress and my post-traumatic stress disorder could also have caused the cognitive deterioration. He tells me that he went to a professional-development seminar where the presenter showed the test results of four cases: two with post-traumatic stress and two with brain injury. The participants in the seminar were unable to distinguish the non-brain-injured from the brain-injured by the test results alone.

In his opinion, there’s no way I could return to clinical work: my poor memory, difficulties with auditory processing, and mental fatigue would preclude it. Also, my past exposure to trauma puts me at risk of being re-triggered.

I ask the neuropsychologist about computer-based cognitive training. His only knowledge is of the training games available for the Nintendo DS, a small handheld gaming gadget I’ve seen children using.

On my way home I look at these brain games in a store, and they’re simplistic compared with the sophistication of the Posit Science programs. I reach a conclusion: I’m going to have to design my own rehabilitation program. And the first step in that will be brain training.

But what program do I choose?

An internet search reveals there are few commercially available programs, and what little scientific research I can find on computer-based cognitive training points to Posit Science having the most backing for its claims. I locate the Australian distributor, Alzheimer’s Australia, and call them. Their adviser, Matthew, tells me that they decided on Posit Science’s programs based upon an exhaustive review of existing cognitive-training programs they undertook in 2008.

I will only manage one of Posit Science’s two programs with my limited mental energy. I’ve lost a quarter of my visual field, and the InSight program, which trains visual processing, could help with that. But what hampers me most in daily life? I’m driving okay, and my visual memory is good. All in all, my visual deficit does not restrict me greatly. By comparison, I think of how tiring it is to understand others’ speech, and how I need to think out each word before I say it, as though English is now a second language.

Matthew says that studies with older people have shown that those using the Brain Fitness program double their processing speed and gain more than ten years on their scores in standardised measures of memory and attention, leading to improved comprehension. Yes, this is what I need most. According to Matthew, I’m not the usual type of person who enquires about the programs, but he can’t think of a reason why I shouldn’t give it a go.

I pay for the two-person version of Brain Fitness, thinking that Anna might like to do it too.

BEFORE I CAN get started on the Brain Fitness program, there is something else I need to deal with. In late March, I walk out of a lift and taste the dry, air-conditioned air. I’m in a shining chamber of marble — almost too shiny to look at.

I haven’t been looking forward to today.

Over to my left, a receptionist with perfect hair and a pinched look of concentration sits behind a highly polished counter. She wears a telephone headset: the type that looks like a hairband, where the incoming call goes into only one ear, leaving the other ear free to hear external sounds. It is to this ear that I direct my enquiry. ‘I’m here for a meeting with Mr Tsanov?’

‘He’s in conference,’ she says. Gesturing behind me with a flick of her head, she adds, ‘Take a seat.’

In the seating area, there is a long coffee table with an etched-glass surface. Set upon this are two tall, fluted vases holding long-stemmed gladioli with pink and red blooms: one at each end of the table. Placed precisely in the centre is a stainless-steel tray, upon which sits a plump glass jug, filled with water to its throat, where blocks of ice congregate. The ice and the beads of condensation suggest that the water is nicely chilled, untouched by anyone this morning. Circling the jug, like a small band of kindergarten children — upright and attentive, as if waiting for their teacher’s instructions — are eight clean glasses. I have a dry mouth after the walk from the bus terminal, but I don’t want to disturb this perfect arrangement, perhaps put together by the woman with the perfect hair. And I don’t want to drink their water and feel myself coming under their sway. Instead I sit on one of the heavy leather sofas with fleshy armrests, the two facing off like bull-mastiffs.

I reflect on what’s happened over the past few months. A property we’d purchased off the plan, which was going to be a retirement apartment for Anna’s parents, was due for settlement late last year, but of course we couldn’t pay for it. A property investor had recommended Donald Trump’s book Trump Never Give Up. When Trump faced bankruptcy, he acted on faith that he would work his way through it. He stressed that it was important not to ever give up. I followed Trump’s advice to make personal contact with creditors: I phoned the developer and told him, before settlement was due, of our financial position. He sounded accommodating, saying, ‘Get your lawyer to write to us and state your case.’ I wasn’t keen on this approach: lawyers meant that negotiations would become adversarial and expensive. But we couldn’t dictate the process, so what else could we do? Doom and Gloom wrote to the developer with supporting financial and medical documentation, and all we got for our trouble was a legal letter of demand from the developer’s lawyers — settle the purchase or we’d be up for damages. I tried making contact with the developer again, but never got a return call.

Then, a few weeks ago, the developer called us out of the blue. He apologised, saying that he hadn’t intended things to get adversarial: his hands had been tied by his overseas bank after he had defaulted on his development loan. But now he had the bank’s authority to offer us a substantial reduction in price. Many purchasers were defaulting, and the dreadful market conditions were making it impossible for them to get finance. I told him that we might’ve been able to accept his offer when I spoke with him last year, but our cash reserves had since been swallowed by legal fees, loan repayments, and living costs. He said he couldn’t help us any further, and, giving his lawyers a blast, complained that the fees they were charging him were outrageous. He added that he was madly trying to sell his own properties to maintain the payments on his development loan.

We were at a stalemate. I could only conclude that we would be sued by the developer for damages.

I am here, in the offices of this major law firm, because I am fighting over money, which Anna and I will need even more acutely if the developer does sue us. I had asked my income-protection insurer to backdate my claim from the date I had actually stopped work: two years before I lodged the claim. With legal costs, and large ongoing loan repayments to make each month, Anna and I needed more funds. But the insurer didn’t accept my request, saying that I had not sought the advice of a medical practitioner in my treatment prior to making the claim.

This was true, in a sense. I had ‘referred’ myself to a clinical psychologist, Wayne. If I had asked my GP to write a referral letter for Wayne, I would have been following the advice of a medical practitioner, but I hadn’t thought it necessary to do so. Although I had sought the advice of my former colleague, Ian, the insurer saw this as an ‘informal arrangement’ that did not meet their definition of ‘under the direction of a medical practitioner’.

To force the insurer’s hand, I sought the assistance of two lawyers, Simon and Andrew. They were confident of achieving a positive outcome, and we filed a statement of claim in the Supreme Court. We are here today, nine months after filing, at the invitation of the insurer’s lawyer, to try to reach a negotiated settlement. If we don’t settle today, we will do battle at a court hearing in two months’ time, but Anna and I will not hold out financially for another two months.

My lawyers arrive. Simon is the solicitor. He has a hale and hearty manner, ginger hair, and a stocky build. Then there’s Andrew: tall and lean, with a conservative coiffure and the intellectual manner of a barrister. He makes an effort to be friendly, in a self-conscious way. He’s dressed in an impeccable black suit and emits measured assurance.

Andrew gives me a rundown of what he’s expecting for the morning, and he sounds confident. He’s like a sports coach giving final instructions before the game. ‘I’ll do the talking. You don’t need to say anything. If it gets too uncomfortable during the conference, you can excuse yourself and leave the room.’

‘I’d like to be present,’ I tell him.

He thinks that today will be procedural, and we’ll have a settlement by the day’s end. ‘We’re here to support you. We’re on your side,’ he reassures me.

Off either side of the waiting area are two conference rooms. Andrew talks to the woman with the perfect hair, comes back, and directs us into the conference room to the receptionist’s right. There is a jug of chilled water here too — this time set unceremoniously on the kitchenette sink — and now I am too thirsty for mental games of defiance, so I help myself to a glass. As we stand by the kitchenette, marking time, I can see through the open door into the reception area. I hear the sound of the lift doors open, and out walks the man I suspect is my support person, Craig, although I haven’t met him yet — we’ve only spoken over the phone.

Craig has worked in the life-insurance business and knows my policy inside out. I wanted him to come today and explain, in non-legal terms, what is happening and to help me with the decisions I will need to make. Since the stroke, complex decision-making has become terrifying; and, although I have no particular reason to distrust Simon and Andrew, over the last year I’ve developed a dislike for lawyers. Craig is dressed in a suit, and has a few curious features: a small stud in his left ear that shines like a diamond, rakish hair, and a pink tie that doesn’t coordinate with anything else he is wearing. The other noticeable feature is his physicality: he’s big, with the chest of a bull. I’d say he is in his fifties, both fit and strong.

Andrew has been looking at his watch off and on, and, once Craig has introduced himself, says, ‘What’s going on? We were meant to start the meeting at ten o’clock. It’s now ten twenty-five. They’ve had weeks to prepare for today. What are they playing at?’

We wait another five minutes or so, and then Simon gets a call. I think it’s about the case, so my ears prick up when his voice gets noticeably louder. But instead I hear him say, ‘Well, when I put the washing on the line this morning, it wasn’t raining. I can’t predict when it’s going to rain. What do you expect me to do about it? I’m in Sydney … Look, I’ll see you tonight.’ He snaps his phone shut and says to none of us in particular, ‘She expects me to be a weather forecaster!’

Finally, there is movement from the conference room opposite. The door opens and out comes a thin man with a beaked nose and heavy, square glasses. He says he is Mr Tsanov, the barrister engaged by the insurer. Simon introduces each of us in turn, and we shake hands. Tsanov gives me a second’s worth of eye-gaze — no smile — and a short hello in a plummy, resonant voice. Following in his wake is a woman who almost curtsies in deference behind him, and who is introduced as the insurer’s in-house lawyer. Her expression when introduced to me is sympathetic; I wish we were dealing directly with her instead.

All six of us sit at the long conference table. I am at the head, with Tsanov to my left, and his assistant lawyer in the next chair along. Andrew is off to my right, with Simon the furthest away. My large support person sits in the wedge of space between Andrew and me. Tsanov has insisted that if Craig is to be present during the conference, he is not allowed to speak. We have no choice but to accept this condition.

The barristers square off with each other, and although it is an informal conference, I can see them mentally putting on their wigs and gowns, adjusting themselves to sit taller in their chairs. Tsanov searches silently, unhurriedly — all eyes on him — through a folder of documents resting on the table. Then he leans forward, as if seeking intimacy (his tie bent by the edge of the table, eye contact only with Andrew), and, without any preliminaries, asks, ‘What is your client’s position … what is he seeking?’

Henceforth, I become invisible.

Andrew refers to a sheet of paper, naming each item in my claim, like an old-fashioned greengrocer with a list on a notepad, written with a pencil grabbed from behind his ear. Unpaid monthly benefits from this date to that date, interest, costs, refund of paid premiums, and interest on interest. He cites the dollar amount of each item, and finally, looking to Mr Tsanov as if expecting immediate payment, announces the grand total. Tsanov gives this summation a moment’s disdainful consideration, bows his head to look at his documents again, and the real tussle begins.

I have already decided that I will tune out during most of the conference and maintain a look of equanimity. I think I know how this game is played, based on stories from past clients and from television shows: the other side’s lawyer tries to agitate you, needle you, and catch you out in some way.

‘Your client’s claim has a number of flaws, I’m afraid,’ Mr Tsanov begins. His tone sounds reasonable, even considerate, but the import of what he is saying has a growing malevolence about it.

‘To suggest that Doctor Somerville, a clinical psychologist, is a medical doctor is absurd. I’ve looked at the registration requirements for medical practitioners in this state …’ he intones. He’s referring to Wayne. I reassure myself that Andrew will deal with all this. As Tsanov continues, I notice the thinness of his long neck, with its protruding Adam’s apple that moves skittishly as he speaks. Along with his small head and the thick glasses that magnify his eyes, I can’t help but imagine a turkey. As I mentally withdraw from attending to the meaning of his words, his speech begins to sound like the gobble, gobble of a turkey.

I build a life story for Turkey Neck. I imagine that he attended a private boys school, spending his lunchtimes in the library looking up reference or special-interest books. He was probably a member of the chess club, and no doubt excelled on the debating team. Now I’m receiving the brunt of his debating skills. With his slight frame, average height, and glasses, I imagine he avoided the parts of the school playground where the sporty boys hung out. I envision that basketballs, thrown ‘accidentally’, would some-times hit him on the side of the head, knocking off and breaking his glasses, and they would need to be patched up with tape until he made it home and got his spare pair, his parents resigned to ongoing optometry bills.

Now, Turkey Neck is looking and sounding like an old-time headmaster chastising his pupils: so confident, so superior. He is taking my legal team to task. ‘Of course, the logic of your argument is ridiculous. Doctor Roland has clearly managed his own affairs and has not relied on a medical practitioner’s directions at all. He didn’t even mention his condition to his GP for at least a year and a half, and yet consulted him on a number of occasions for other ailments.’ As he says this, I see him, out of the corner of my eye, glance towards me, as though to determine if his remark has provoked a reaction from me. I remain impassive.

‘I don’t want to insult Doctor Roland’s intelligence,’ he says, and then goes on to detail — in that tone of reasonableness — how unintelligent I have been.

What’s going on? This is supposed to be a negotiation. Andrew had told me that we were invited to a settlement conference; he didn’t say it was going to be adversarial. But Turkey Neck is having a good old poke at my claim, and is barbecuing my legal team in the process. He rummages around in our box of arguments, picks up each one, and holds it at arm’s length with pinched fingers, as if saying, You mean this is an argument, this fragment? and then drops it back into the box. I feel like squeezing his turkey neck.

My team looks off-colour. Andrew spits out short retaliations now and then, and occasionally rises to launch a salvo. But I can see that he is rattled, and his retorts are smothered by Turkey Neck’s words. He is leaning back in his chair, like someone facing a barking dog. Simon, although not directly in the line of Turkey Neck’s assault, exhibits similar body language.

Turkey Neck refers to a letter that apparently says something that disadvantages my case. Simon says, ‘Oh, I’m not sure I’ve seen that.’ He flaps through his folder of documents, the size of the city telephone directory, as if somehow the offending page will float out — magically, as in Harry Potter — into his hands. After a few minutes of flapping, he says, ‘I can’t seem to find it. I’m not sure that we’ve received that.’

At this, Turkey Neck’s expression seems to say, I thought as much … total incompetence.

As my confidence in my legal team wanes, I let go of the idea of strangling Turkey Neck — it’s stirring up a disconcerting feeling of anguish. I tune out again. As far as Turkey Neck is aware, I remain unmoved, staring out the window at the end of the room. Fortunately, I can see a large patch of perfect blue sky. In my mind, it becomes the blue of the ocean. I am swimming in the bay near home. I can see turtles and fish, and feel the sand, gritty in my bathers, as I stand up in the surf after being tossed around by breakers while coming into shore. My friends are there, the sun is out, and I feel all right.

I’m brought back when I hear the barristers declaring that they’ll take a break and have a private conference because ‘Doctor Roland is probably tired out’. I do welcome this, and the barristers and solicitors trundle off to the other conference room while I’m left alone with Craig.

Craig says that he is not in favour of adversarial tactics: it puts the insurer offside. Taking the insurer to court, as I have, makes them less willing to negotiate. But I did not have his advice before. He acknowledges that there’s no point in dwelling on it. He suggests a compromise, which sounds reasonable to me. I agree, and make a note to discuss it with Simon and Andrew.

But before they come back, I change the topic of conversation. I’m sick of talking about legal complexities, and I’d like to get to know a bit about Craig. Somehow, he gets onto telling me that he is a Remote Area Firefighting Team volunteer. I haven’t heard of this before. ‘It’s a specialist unit with the Rural Fire Service. We go where normal fire vehicles can’t get in. We’re dropped in by helicopter.’ He explains how they set up new fire fronts to fight the existing one.

‘What sort of training do you need for this?’ I ask.

He says that because they fly in helicopters, they need to be prepared to land in water. The fire service has a metal compartment the size of a helicopter cabin, and they drop this into the swimming pool used at the Sydney Olympics. When a helicopter lands in water, it can turn upside down, so to prepare for this, the volunteers are strapped into the compartment before it is dropped into the water upside down. They don’t have oxygen tanks, so they rely on holding their breath while they extricate themselves from the compartment and swim to the surface.

‘This isn’t easy,’ he says, ‘and it plays with your mind. Some can’t handle it. The key thing the instructor told us was that we have to know how to exit the compartment before we land in the water. We have to have our hand or arm on the exit lever before we crash, because under the water — in most conditions — you can’t see in front of your face.’

As he is describing this, I’m aware of a growing sense of discomfort. I’m being transported into my nightmare, where the family and I are driving in the failing daylight, and the van runs off a bridge and into a river. What he has just told me confirms that I would not be able to see the children in the back seat. I could not even know exactly where they were. I would have enough trouble trying to get out myself, without trying to help them. In my dream I could see them, and I would struggle to free them from their seatbelts, pushing them out the door to the surface. But with what Craig has just told me, they would surely drown.

I thought I had dealt with this nightmare in therapy, put it behind me. But here it is, stalking me again.

I’m shaking, and I don’t know if Craig notices. I have to get out of the room. I interrupt him and say that I have to go out for air. There’s no one in the waiting room. I grab a glass of water and stand by the window. We are sinking into the river, the water is pouring in through the windows and the gaps of the car, and now I can’t see the kids. This is bad. My chest is heaving. My breath is coming in waves. I try to jemmy the drowning images out of my head. I breathe and breathe and breathe, willing my breath to slow down; I press my face against the window, drinking the water slowly and hoping the chill of it will bring me back to the present. It’s not really happening. You’re in a lawyer’s office. You’re all right. It’s daytime.

After a while, the images and the physical sensations of the nightmare loosen their hold. It’s like being on a train that is slowing down as it comes into the station, and the snapshot view of the platform through the window lasts longer and longer. The view of the skyscrapers through the glass begins to last longer, becoming more solid, and finally fixed. At last, I really do feel I am in the waiting room of a high-rise building, in the office of a legal firm, with a turkey-necked barrister who wants to squash me. And the thought of returning to do battle with him isn’t as gruesome as the nightmare.

After my legal team has knocked heads in ‘secret lawyers’ business’ with Turkey Neck and his sidekick, they emerge from the second conference room. Andrew declares, ‘It’s useless. We didn’t come here to debate the case, but to settle. We’ve wasted our time. We may as well all go home.’

All this trouble for nothing.

TO MY RELIEF, the calls between Simon and Turkey Neck start the next business day. Turkey Neck is finally in the mood to settle. Simon rings me almost every day, telling me with excitement that Turkey Neck has raised his offer, and we discuss a counteroffer. I imagine Simon and Turkey Neck as two medieval knights jousting, their telephone receivers their lances.

I wonder why we have to play this silly game. Why doesn’t the insurer just say what dollar amount they are prepared to go up to, and we can either accept it or not? In the end, it will cost the insurer much more to play this game than if they had been reasonable with me in the beginning, before the lawyers got involved; and I will get less out of the settlement because of the legal fees I’ll have to pay. The only winners are the lawyers.

Some days later, we get an offer. It is at the bottom end of the range of what Simon and Andrew thought we could achieve. I have to accept it. It is two-thirds of what we were claiming, and when I get my lawyer’s bill, I’m left with two-thirds of this amount again. The money will allow Anna and I to meet all our loan repayments and expenses for the next six months or so. After this, the battle for financial survival will start again.

AT THE START of April, some better news arrives — in the form of my Brain Fitness program, which turns up in the mail. I’m eager to get started. I need to get my brain working again; I’m not going to get out of this mess without it. Anna says she has no time to do the program, so I’m on my own.

For optimum results, Posit Science recommends the completion of forty hours of training over eight weeks — five days a week, one hour per session. On the first day, I only manage thirty minutes; after this, rubber brain threatens to overtake me. The next day is the same, as is the following. This shows me that I’m working to my limit. At this rate, it’s going to take me six months or more to complete it.

The program concentrates on building the basic auditory skills first (pitch and phonemes), and then the components of speech (syllables and sentences), and finally comprehension (narratives). It contains six different exercises, which I work through progressively. The first, ‘High or Low’, trains for pitch in speech, drawing on the frequencies found in spoken consonants and vowels. It does this by frequency sweeps: a computer-generated sound begins low and rises in pitch, or begins high and lowers. It’s a sound like a zipper being opened or closed quickly. I listen to the pairs of sweeps in my headphones. I have to decide if each sweep in a pair has gone upward or downward, and use my mouse to click on the correct sequence of up and down arrows on the screen. The program picks up on my progress, making the sweeps quicker and reducing the time gap between them. The brain needs to be pushed beyond its current limit to improve. I quickly reach my threshold, and it becomes difficult to tell whether the sweep is going up or down.

The second exercise, ‘Tell Us Apart’, uses phonemes — the individual sounds that make up words. In the word ‘dog’, for example, there are d, o, and g sounds. The program presents similar-sounding phonemes: for example, the sounds ‘dah’ and ‘gah’. The sounds are hard to tell apart. I perform very badly.

The program notes indicate that the voice saying the phonemes has been modified to alter the speed at which the phonemes are said and how much emphasis is put on the consonant. A faster speed and less emphasis makes it harder to tell them apart. Some phonemes are easier for me to work out than others. For some reason, my brain finds certain consonants harder to process than others. This shows me why I find the comprehension of others’ speech, such as that of the lawyers, so tiring: my brain is working overtime, trying to make sense out of fuzzy engrams.

There is one exercise I enjoy. ‘Match It’ is like the card game Memory. A matrix of cards is presented facedown on the screen. Each card has a syllable associated with it, and within the matrix there are pairs of syllables. Some of the syllables are dissimilar in sound: for example, ‘baa’, ‘fo’, and ‘pu’. Other syllables sound similar: for example, ‘sho’, ‘stu’, and ‘sa’. I am allowed to click on two cards, one after the other, and hear the sounds they represent being spoken. I work my way through the matrix, activating each card to find the pairs. This is training my working memory for spoken words, with a spatial-memory component. The matrices increase from eight to sixteen to twenty-four to thirty cards. I excel at ‘Match It’, compared with the other exercises; it’s encouraging to still be good at something. Perhaps it shows that when I can use my visual memory, it aids my overall memory.

As I progress onto the larger matrices, I notice that I can let go of mentally rehearsing the sequence of sounds I’ve just heard. Instead, when I click on a new card to hear a sound I’ve heard before, I let my mouse hand drift over to the card that ‘feels’ like the match and click on this. Most often, it is correct. Somehow, my subconscious processing has become faster and more accurate.

I’d love to spend more time doing the ‘Match It’ exercise, but the Brain Fitness program, like a good teacher, soon learns my weak areas and focuses on the exercises that most challenge my brain. One of these is ‘Sound Replay’. It presents syllables such as ‘baa’, ‘fo’, and ‘laa’ as a memory-span exercise, asking me to remember a series of such sounds, as if I am learning a list. The voice names a random sequence of syllables, starting with two and then moving on to three, four, five, and more. I need to indicate which syllables were said, and in what order. This is training my capacity to discriminate sounds and is building my auditory working memory. It reminds me of the paired-words test I did with the neuropsychologist. Like then, I do poorly on this exercise — the sounds quickly enter the fog. I can only remember two syllables, and occasionally three syllables, for a long time.

‘Sound Replay’ and ‘Tell Us Apart’ are the hardest of all the exercises, for me. After the first few weeks of training, I remain on the lower levels for these exercises, wondering how I’m ever going to progress beyond this.

In ‘Listen and Do’, I am presented with the visuals of a street scene that contains people, animals, and objects in the foreground, and buildings in the background. I hear a set of instructions: a sequence of people and objects that I am to click on. Once the instructions are given, I need to click on the objects in the same order. As the exercise advances to higher levels, I have to move a person or an animal to a new location. (For example, ‘Move the redheaded girl to the left of the brunette girl’, or ‘Move the black dog to the right of the hospital.’)

I’m okay with this exercise, once I develop a strategy for it. I draw imaginary lines between each named object, giving me a visual shape I can remember, which aids in recall. This resembles my real-life task of visualising a mental list of things to do and staying on track until they are all completed.

The final exercise, ‘Storyteller’, is the most enjoyable. The voice tells a story of everyday interactions and events happening between people. At its completion, I need to answer ten, fifteen, or twenty questions about the story I’ve just heard. The answers are in multiple-choice form. The stories, five in all, become progressively more complex. This is training short-term memory and comprehension — being able to remember and understand details in spoken conversation. I recall the short stories the neuropsychologist read to me and how poor my memory was; I can see already that I’ve definitely improved on this type of task since then.

Progress bars appear on the screen during each exercise, and I strain to get to the next level of difficulty. There’s a sense of achievement (a dopamine hit) when I reach a new level, and the program rewards me with animated fireworks and music. At the end of every session I can access a summary page, which lets me know how I’m going with each exercise. This is reassuring (even though it shows how poorly I’m performing in most exercises): it gives me a baseline from which I can see increments of improvement.

As I get into the rhythm of the program, most days I advance on an exercise or stay at the same level. But sometimes I have an off day. That’s when I see, in the form of the progress bar, how dramatically my performance drops off when I’m mentally or physically fatigued — the clearest indication so far that fatigue really does affect my day-to-day capacity to function.

After one month of doing thirty minutes most days of the week, I have progressed up the ladder to some degree in all exercises. But I haven’t noticed a great difference in my auditory processing outside these exercises. I’m a little discouraged by this. Yet the cheerful male voice that explains what each exercise does and why it is useful shows a picture of the brain with coloured lines connecting the areas that each exercise works on, reassuring me that I am making new neural connections. If it doesn’t work, I’ve only wasted some time and some dollars.

I’m consistent with the Brain Fitness training, even when I’m feeling off, or stressed and anxious. At first I do the session mid-afternoon, before I get rubber brain for the day, and after I’ve done a decent amount of wrangling with lawyers, real-estate agents, and creditors. But after a while, I realise that I make better progress if it is done earlier in the day. I change tack, doing the training session just before lunch. Yet on the mornings when I attend a medical or psychological appointment, I can’t do this: these sessions knock me around for most of the day.

By the six-week mark, I’ve noticed a real difference. My progress has been gradual, but all of a sudden the world is easier to comprehend, as if a door has opened. Other people’s speech seems clearer; it’s less of a strain to listen to them, and easier to understand what’s being said. Everyday social conversation with another person is simpler, and I’m less fatigued afterwards. I still lose track in longer, more involved conversations, and I get fatigued after group conversations, but I’m confident now that I’m showing real improvement. My brain is coming back online and is starting to work with me.

In time, I also notice that the individual notes in the music that Nick and I play, or the sounds that other musicians make, stand out more than they have since my stroke. Phone calls remain taxing, and I’m still easily distracted by noise or other disruptions. But I’m remembering the names of familiar acquaintances easily now, and I think that my sense of direction has improved a little too — although it’s nothing like it used to be.

I catch up with Wayne again and, after we’ve talked for a while, he says, ‘You’re looking brighter. Do you realise you haven’t asked me once to repeat a question?’ Gee, is the difference that obvious? I can’t help but smile.