Sophie Papp and Her family had a ritual for the recently deceased. Whenever a relative died, she and her brother and cousins would squeeze into a car and drive to the Koksilah River, an hour north of their homes in Victoria, British Columbia. There they spent the day swimming in the glassy, jade-colored water, drifting with the current through the muddy riverbed, gazing at the native arbutus trees, their red bark peeling like wrinkled snakeskin. After her grandmother died, Sophie — a cute, reserved 19-year-old with gray-blue eyes and freckles — joined her younger brother, her cousin Emily, and a close friend for a drive to the island. It was September 1st, 2014.
En route, the group made a brief stop at Tim Hortons for coffee and breakfast. This is the last memory Sophie has of that day. About 45 minutes into the stop, Emily, who was driving, spilled her iced coffee. Her attention slipped off the Autobahn and she lost control of the Volkswagen Golf. The car spun across multiple lanes in both directions before overturning into a ravine on the opposite side of the road.
Of the four, Sophie was the most seriously injured in the accident. At the crash site, paramedics gave her a score of six on the Glasgow Coma Scale, indicating severe brain trauma. She was taken unconscious to the trauma center at Victoria General Hospital where doctors and nurses worked to save her life. After a week she woke up from the coma.
In her second week in the hospital, Sophie’s recovery began to take on confusing qualities. Just days after she regained rudimentary communication skills, she was engaging in extended, deep conversations with everyone around her. “One day she spoke a sentence and shortly afterwards she was talking endlessly about everything,” recalls her mother Jane. Sophie asked the staff how old they were, if they had children, what their most interesting cases were. She effortlessly slipped into a candid, heartfelt exchange with the nursing assistants on the floor.
One morning she had an appointment with a radiologist to discuss MRI scans she had taken a few days earlier. With her mother by her side, Sophie threw in question after question. “Are there any lesions in the cerebellum?” she asked. “Has an fMRI been done? What about the thalamus, fornix and pons? Are you affected?” The radiologist paused, and his frown and sharp gaze flicked briefly to Jane before turning back to Sophie. “How do you know that, Sophie?” he asked. In the days leading up to the appointment, Sophie had persuaded her father to borrow several books on neurology from the library. After he turned in the papers on neuroscience and brain anatomy, “read them into the night,” she recalled.
All her life, Sophie had been a “fairly introverted, cautious girl,” Jane recalled. However, as her time in the hospital progressed, this young woman gradually disappeared from view. As a nurse walked through the neurology wing marking each room with colored tape, Sophie snuck around and mischievously peeled off all the tape. One night, after most of the patients had gone to sleep, she rolled over on the floor and changed the dates on all her whiteboards to December 24th. When a technician explained that he was going to perform what he called a “propeller rotation” while she was on the MRI machine, she told him, “This isn’t a helicopter, so fuck you.” She found one of the neurosurgeons working on her wing Walking around, handsome, and she asked him out on the spot. With intense sincerity, she questioned one of the doctors on her nursing team about where the source of consciousness lay in the brain. “She was very, very sociable and this wasn’t the Sophie we used to know,” Jane recalled.
Sophie’s doctors believed her traumatic brain injury (TBI) was affecting her executive functions, including her inhibitory control. The result was more uninhibited Person – one who acted freely, spoke ebulliently, and approached others with a directness that bordered on boldness that her old self could not have dreamed of. Metamorphosis wasn’t limited to the way she communicated with others either. During her month-long stint at VGH, Sophie became more emotional than ever. An even-tempered girl for most of her adolescence, by September she was quick to anger, slipping into the maelstrom of powerful mood swings and bursting into spasms of crying.