Yes, of course, it’s hokey and old-fashioned to say this, but Ernest Hemingway changed my life. And I know exactly when it started. Exhausted and beat up after a high school football game, I lay awake the rest of the night, starting and finishing The Old Man and the Sea. Which led me in the following weeks of my senior year to all the other novels, even that enormous tome about deep sea fishing Islands in the Stream, which I hauled around for a month. And then the terse beauty of the Nick Adams short stories, which hit me harder than anything I’d ever read before, and probably, more than anything else, got me dreaming of writing myself.

Setting out to write, like so many other newbies, I took Hemingway’s gnomic commandments to heart. Go to work at dawn, when your head is clear and there are no distractions. Write when you’ve learned something you know to be true. Start when you can with “one true sentence” and go on from there. Stop when you know what will happen next, then go have some fun for the rest of the day. I’ve always been a part-time writer, making my living another way, but I’ve kept to that schedule, though instead of going out to have fun at the end of my writing time, like most writers I’ve had to clock in somewhere else. 

A visit to Key West and Hemingway’s home there a couple years ago led me to biographies, notably Paul Hendrickson’s Hemingway’s Boat that centers on the prolific Pilar years in Key West and Cuba, and A.E. Hotchner’s rollicking memoir Papa Hemingway, that drops you into the circle of pals who marveled at the writer’s joie de vivre. Their swash-buckling anecdotes put to shame the hotel smashing silliness of latter-day rock’n’roll celebrities:  Things like shooting himself in the leg when aiming for a shark, punching out the poet Wallace Stevens, wooing Ava Gardner and Marlene Dietrich, and the bull fights, the big game hunts, the U-boat chases.  Most especially, the battlefront in three great wars.

None of the biographies ends happily, of course. They all run up against Hemingway’s dark slide into psychosis, disorganized writing, and that shotgun in a cabin in Idaho.  Burns, like other biographers, blames a family history of depression, what Hemingway himself called the “black ass”, that he battled much of his life.  There is mention of post-traumatic stress disorder, driven by all the death he witnessed and so chillingly depicted from those wars.  The thing that interests me, and that seems to be neglected in the biographies and in Burns’ film, too, is Hemingway’s history of repeated head injuries.

I’m an occupational therapist who specializes in brain injury.  I founded and ran a community reentry program for people with brain injury in Charlottesville and served as board president of the Brain Injury Association of Virginia. I’ve treated a lot of people emerging from coma, concussed from a car crash, lobotomized by a gunshot to the head.  And I’ve seen how brain injuries can scramble thinking, erase memory, torture sleep, ruin judgment, and lead to impulsivity, emotional disregulation and depression. This is the constellation of problems a brain injury clinician expects and works to resolve.

So when I read about Hemingway’s famous initial injury, the artillery blast in World War I that led him to write his magnificent war romance A Farewell to Arms, about the bizarre incident in Paris of a chandelier falling on his head that knocked him out and left a C-shaped scar on his forehead, about the pair of head injuries suffered in World War II, about the plane crash in Africa that put him in a coma for a week, and about all his many bare-fisted boxing matches in Key West, I couldn’t help but think of what we have been learning about the effects of cumulative brain trauma from professional boxers, and NFL and NHL players. Biographers can appear stymied by Hemingway’s collapse. His fall seems precipitous, this super-humanly robust genius reduced to chronic headaches, paranoid rants, alcoholism, delusion, confabulation, the inability to work, and finally suicide. To me, speaking as a brain injury clinician, it’s quite familiar.

I don’t see how anyone can overlook what happened to Hemingway in Africa in 1954, suffering two small plane crashes in as many days that might have killed him. Newspapers reported that cerebral fluid leaked from his nose in the hospital. He endured the final seven years of his life in pain and bewilderment, anger and despair.  In seven years in Key West during the 1930s, Hemingway wrote his classic novels A Farewell to Arms and To Have and Have Not, the ground-breaking bull-fighting chronicle A Death in the Afternoon, and his story collection The Green Hills of Africa.  In seven years in Idaho, at the end, he fumbled with what was left, fragments shaped into books only after he died (among them Islands in the Stream and the autobiographical A Moveable Feast, from which so much of his writerly guidance has been gleaned).

Ernest Hemingway suffered repeated severe brain injuries. His behavior changed after each of them, and it seems he was never treated as a brain injury survivor, only towards the end seen briefly as a psychiatric patient (and given shock treatment, about the worst thing you can do to a damaged brain).  Maybe someone with experience in treating the manifold challenges of brain injury could have helped.  We’ll never know.

I have been working for pay since fourth grade. In one month, I retire from my long career as an occupational therapist, and for the first time I’ll be free to write as I wish, as Hemingway counseled, with some fun when you’re done in the afternoon.  If my idea of fun is a walk in the woods with my pup, a bike ride with a son, sketching a seashell, or grabbing a beer with a friend, all the better.  Few can live like Hemingway and no one would want the scars that came with such a life. And no one can write like him either, though we all labor under his influence.  What we can do is get up in the morning and strive to write a true sentence. In that endeavor, wish me well.