Again I Formed Whole

Shortly after midnight on October 27, 2010, Patrick Mahoney was cycling home from the Stone Church, a bar and live music venue in Newmarket, New Hampshire. He’d been out with some friends after an evening poetry workshop led by David Rivard, a former instructor of his at Tufts and the director of the M.F.A. program in writing at the University of New Hampshire.

The weather was brisk, and there was a light evening mist, but the twelve-mile distance home—an hour’s ride—was nothing for a guy who’d biked across the country a few years earlier. Mahoney was well versed in bike safety: He was sober and wearing a helmet, as well as reflector stripes on his legs. His bike had a rear light and Ortlieb panniers with built-in reflective patches.

He was pedaling along a flat two-lane stretch of Route 33 in Stratham when a young woman in a Honda Accord struck him from behind as she was sending a text. He hit the windshield, then flew forward ninety-four feet before landing on a grassy patch of roadside, his head severely injured. He was taken to nearby Portsmouth Regional Hospital, then transported by medevac to Massachusetts General Hospital, where surgeons performed a craniotomy, removing and preserving part of his skull while the right frontal lobe of his brain healed.

The surgery went well, but doctors were still grim. They told his family that given the extent of the damage to Mahoney’s brain, his quality of life, if he pulled through, would be extremely compromised. “One neurologist told my parents to face reality, go home, and move on with their lives,” he said in a recent interview. “They were pretty offended.”

The third of five siblings in a close-knit Irish-American family—his mother, a nurse, emigrated from Ireland in the 1970s—Mahoney was intellectually curious and driven to achieve. At Tufts he majored in Spanish and in international letters and visual studies (“basically, comparative art and literature,” he explained) and delved into the work of writers like Jorge Luis Borges and Gabriel García Márquez. He ran cross-country, won division titles in track, and graduated summa cum laude in 2006.

To Rivard, his poetry teacher, Mahoney seemed “extremely disciplined and ambitious,” yet at the same time “affable and super friendly.” “He appeared very laid back,” Rivard said in a recent phone conversation.

Mahoney played the guitar and wrote song lyrics but was officially seduced by verse in Rivard’s Introduction to Poetry course at Tufts, where he distinguished himself as one of the best in the class. “He wrote about what a lot of undergrads write about—family, childhood, love relationships—but he had this very intense, quirky sense of image,” said Rivard. “There was also a kind of soulfulness to his work, which you can’t really teach. His poems had these two opposing qualities—melancholy and wildness—that created an interesting tension.”

Mahoney completed a senior honors thesis that combined a general analysis of American poetry with thirty-three of his own poems, and after graduation, he used poetry to help him process his day job as a mental health counselor. “You’re listening to people’s stories all the time,” he said. “Writing gave me an outlet for all the experiences I was having at work.”

In 2007, he moved to San Francisco and volunteered for the Berkeley-based nonprofit Small Press Distribution, which exposed him to a wide selection of contemporary poetry. “He was sending me his work, and it was really strong,” said Rivard. “It was clear he’d been reading a lot and was serious about writing.”

In September 2010, Mahoney enrolled in the M.F.A. program at UNH, where he received a teaching assistantship and had the opportunity to work with Rivard, who had recently taken a tenured position there, and Charles Simic, a former poet laureate.

Then came the accident, and Mahoney’s promising future was put on hold.

Rivard recalled visiting the ICU at Mass. General a few days after Mahoney’s surgery. “It was heartbreaking and horrifying. It didn’t seem like he was going to live, and if he did, his physical ability and entire character would be forever changed.”

Sustained by a deep Catholic faith, Mahoney’s large family rallied around him, never doubting that he would pull through. Two weeks after the accident, he opened his eyes for the first time and gave his mother a reassuring wink. By the time he moved to Spaulding Rehabilitation Hospital, at the end of November, he was breathing with the help of a tracheostomy tube, smiling, and trying to write notes. His girlfriend, Anne, was another constant presence, and one of his first jottings was a shakily scrawled “Dear Anne,” accompanied by a wobbly heart.

On December 1, using a speaking valve on his trach tube, he managed to count from one to five and back and recite the middle names of each of his family members. His memories of this period are understandably muddled, but certain impressions stand out. “I was hyperconscious of having that one-sided form of interaction where you’re taking everything in, but you don’t have anything going out,” he remembered.

Speech therapy and reading simple texts—Roald Dahl and the free Boston Metro were favorites—helped his language recovery, which he recalled as “simultaneously frustrating and a huge relief.” Remastering the nuances of inflection, body language, and facial expressions remained difficult, and therapists worked with him to overcome the “flat affect” common in people with brain injuries.

Mahoney’s left side was partially paralyzed for almost a year following the accident, so regaining his mobility was an even bigger challenge. With an athlete’s discipline and intensive physical and occupational therapy, however, he was walking with minimal assistance by mid-January.

Then, after three months of solid progress, Mahoney was admitted to Mass. General’s ICU with seizures—not uncommon in people who’ve had traumatic brain injuries. He remained unresponsive for several days, and his family was told it could take weeks for him to recover. By mid-February, he took a few tentative steps aided by his physical therapist, and by the end of the month was steadily improving.

He left Spaulding in April for Crotched Mountain Rehabilitation Center, in Greenfield, New Hampshire, where, at “maybe thirty percent better,” his focus turned to cognitive rehabilitation. “At Crotched Mountain, they believe that in order to get someone rehabilitated, you have to embrace what they were doing before the brain injury and use that as a guide,” said Mahoney. “For me, that was writing.”

His first assignment was to read a book and prepare a presentation for his therapy group. He chose Rats, by Robert Sullivan, a natural and social history of the relationship between rats and humans. “The exercise was so refreshing, because it was the exact opposite of that one-sided taking-everything-in that I’d been experiencing. I felt like ‘the camera’s on me now,’ and it was really tempting to go on and on. I had to really work to stay relevant and communicate clearly.”

Crotched Mountain also had a strong arts emphasis that appealed to him. He learned how to read music and play the piano, and was encouraged to take up juggling. “It’s good to relearn the things you did before, but learning new things is even better for rehabilitating your brain,” he explained. “A big part of recovery is creating those new connections between brain cells.”

By June, when Mahoney left Crotched Mountain, he was walking unaided, conversing, and feeling much more confident. But despite the therapeutic writing he had done in the past few months, his poetic ambitions had been overshadowed by the tasks of daily living.

After spending a few months in New Jersey with his parents, he moved to Cambridge with Anne in January 2012, and the idea of writing slowly crept back into his life. He attended Community Rehab Care in Newton four days a week and was eventually asked to moderate a writing therapy group there. When the spring semester started, he drove up to UNH with David Rivard and sat in on back-to-back poetry workshops. But speaking still required all his concentration, and he wasn’t writing much. “He really used the workshop as a way to exercise his speech,” said Rivard.

Mahoney reenrolled at UNH in the fall of 2012, but his struggles were not over. After the relative silence of his ordeal, he found himself overcompensating. “Poetry is often about what you don’t say, or saying the most you can in the fewest words,” he said. “I kind of had the opposite approach at first because I had so much I’d been wanting to say that my poems just sounded like ranting.”

Rivard noticed the same thing. “His poems were filled with wonderful, wonderful stuff, and he was all over the place trying lots of different things—from narrative scenes to gnarly, intense lyrics. The struggle was to control and structure all of it, which was really what Patrick was having to do in other areas of his life, too.”

Mahoney waited patiently for nature to take its course. “Gradually I went from sitting down with a pile of books, and sort of piecing things together, to being led by sound and composing more slowly in fewer words,” he said.

Seizures were another major obstacle. He’d been diagnosed with post-traumatic epilepsy, and suffered a grand mal episode in the spring of 2013. He bounced back, even despite the heavy side effects of his antiseizure medication (“I could always tell when he had to go on more meds,” Rivard said).

Rivard was confident that Mahoney would get his writing chops back. “When he was at Crotched Mountain, he wrote this strange little piece about chickens as part of some therapy exercise,” he said. “There were these quirky perceptions in it that made me think, ‘Oh, yeah, he’s going to be writing poetry again. Whatever that thing is that drives him to write is still intact.’ ”

Rivard thinks the accident helped loosen Mahoney’s creativity in beneficial ways. “Poets start with language, with rhythms and sounds floating inside of them, and they’re able to let go and let the sounds tell them what to put on the page,” he explained. “When Patrick started writing again, it was like everything that was there before was amplified. It became easier for him to let go.”

The need to pay conscious attention to almost everything he did—not to mention sheer gratitude for the gift of life—also sharpened Mahoney’s poetic gifts. “You have to relearn everything you learned as a child, but you have the gift of consciousness and gain more appreciation for seemingly little things, like the amount of work it takes to walk or count,” Mahoney said.

Mahoney completed his master’s degree last May. He and Anne are married and back in the Bay Area, and he is embarking on a career as a writing and art therapist. He has just published a book of poems, Towards Being Infinite (Piscataqua Press), under his Irish nom de plume, Padraig Mahou, a nod to his transformation of late. The book’s title shares its initials with “traumatic brain injury.” Fittingly, the proceeds from its sale will go to a treatment facility where Mahoney taught creative writing, the Krempels Center in Portsmouth, New Hampshire.

Poems like “Plasticina,” in which he compares his brain to Play-Doh being molded anew until “again I formed whole,” and “Flat Affect” take the reader inside the frustrations and epiphanies of his recovery. “Ar Gach Aon Taohb” (Irish Gaelic for “On Each Side”) and “Heaven” convey Mahoney’s heightened sense of gratitude, while other poems look confidently toward a bright future. All are bursting with sharp observations, revelatory metaphors, and a clear sense of what it means to be alive.

The idea of infinity resonates with Patrick, because, he explained, “my recovery seemed so unlikely, and now, even today, seems limitless. Regardless of what happens, your words, your thoughts, your poems, your sound may echo on.”

Heaven

Where I want to be

until I find out

I’m already there.

This world beyond

is inside the wool

sweater my mother knit,

behind these eyes

my fingertips touch

each morning. I live outside

lands long settled and embrace

minutia—I smell the coffee

ground, then taste it brewed.

I feel the dirt road with my feet

through my black faded Chucks.

The end of the road

goes well beyond sight.

So I turn on tips of toes

and I am breathing deeply—

the air, tasting of oak-moss,

my eyes—still closed.

Flat Affect

The room I have always carried inside of me

looks and feels the same in my mind—

my wool socks on the wood floor

slide and spin, and I’m still

the heir to this creaking stool—

each hand rests on the opposite hip.

I sit up straight and arch

cat to cow at rest.

I speak to myself the poems I remember—

words with an inherent rhythm, wandering songs

about clay pipes, lost birds, and America.

There is tone

to these words that echo

in this near empty room, in this space

in my head. I speak and hear

some type of music.

Perhaps we all send words,

develop connections as the brain

touches the tongue. Like a needle to a record

spinning, speaking away the mystery of vinyl.

Candor and confidence are the album cover.

Even with scratches, the record inside will play on,

sound the same. In a way. I see clearly my own reflection

in the glass as I look straight out these windows.

I still know how I look

but how do I sound?

Ar Gach Aon Taohb

So I’m after a walk in

the woods—

on a path alongside

an icebound

riverbed, left

by some arborist—

this past blue-green hot

summer, the trees

were felled so morning

snow’d soften on ice caps.

Sounds going soft

on step into step now,

with sun-faded fog

to unearth an accent,

to stretch this bit of sleep

on me still.

Nurtured by time

      my words speak themselves

tongue feels the shapes—

feel pliant, placid—

I return to that higher plane,

having learned to speak again—

to know, to be, to get

awake or asleep,

into then or now

and how you speak

says where you are:

from which bank

of the river you stare—

the river’s current

runs the same way

but each look downstream

is in wholeness unique.

KARA PETERS is a freelance writer and editor in Georgetown, Massachusetts. She writes Tufts Magazine’s “Mixed Media” department.