Encephalopathy is disease affecting the brain, from the Greek ‘enkephalos’ (about the brain) and ‘pathos’ (disease). Depending on severity encephalopathy can show up as symptoms from headaches to coma. Hepatic encephalopathy (HE) is caused by liver problems and accumulated toxins in the blood.
In March of 2021 I was at Stanford hospital in the M5 Liver and Kidney clinic dealing with serious malnutrition and other medical issues. I couldn't really eat, had difficulties taking oral medications, and my veins were so collapsed that it was hard to draw blood from them. M5 rooms are pretty nice though, and after a long day of tests I was returned to my room. All that remained was a final blood draw of the day.
That blood draw took a long time. More than an hour to get a specialist to try to find my tiny veins and even longer to try to get a needle in it. I don't remember whether it was successful: I passed out a bit before midnight either way.
The next day of 'my' life is where 'DAIR' kicks off "There is a surfboard on the door in front of me.…" I was now in a much less pleasant room and wired up to many different devices. It is several days later and I am now in the ICU.
Between falling asleep in M5 and waking up in ICU, I was an 'encaphalopod' (my own terminology, AFAIK). The doctors and my family can tell me how I behaved but I was not me. I was something else. When the liver fails to process and remove toxins (e.g. ammonia) from the blood stream, they can build up to a level that they make it to your brain. There are all kinds of effects from Encephalopathy, but in my case, I simply lost my mind. Or had it replaced with some other creature's mind.
Examples apparently included pulling out catheters, leaving my room, and having completely nonsensical conversations. Ultimately I entered a stupor and coma, eleviating the 'leaving my room' symptom. I have memories of none of this time. I fell asleep in M5 and woke up to the Surfboard in ICU. I can't access any perception of anything that occurred in between, even when I was apparently mobile or able to talk.
After waking up from the coma, I was not back to my state when I fell asleep in M5: I was both very confused and severely cognitively impaired. I had no idea where I was or how I got there. I describe the experiences waking up and dealing with my new world in DAIR, but in summary it is the intersection of trying to regain my mind, medically recover my body, and dealing with the hospital staff that are trying to help me.
Because the state of encephalopathy causes the patient lose control of their mind and body, the hospital staff do tests of your mind and body to see how well you have recovered. These tests include:
As you recover from the encephalopathy, you do better and better at these tests. I never remembered the period I was in a stupor or worse, but I did feel like I was present in the moment and remembered my life before the incident. Several days are simply missing from my conscious life.
Even years later, I may still be mentally and physcially impacted from the episode. I have clearly made monumental progress from when I first returned to consciousness. Most people wouldn't know I am impaired unless they knew me well before all this happened.
An interesting aspect of becoming an encephalopod is you never want to become one again. It is now a serious worry of mine where before I had no particular worry about falling into a coma. And because you can't tell when you turn into an encephalopod, you have to solicit someone (who knows you well) to look out for it. It feels like paranoia for 'Body Snatching'... except it isn't paranoia if it can really happen (again).
