Just as Seabiscuit, with his unconventional physique and stubborn early disposition, was dismissed by seasoned trainers and faced daunting odds, Matt's TBI presented an equally formidable "race." Both were considered underdogs—Seabiscuit due to his physical traits and temperament, Matt due to the invisible and devastating impact of his injury. Yet, just as owner Charles S. Howard and trainer Tom Smith saw beyond Seabiscuit's perceived limitations and ignited his competitive spirit, Matt’s cause was championed by our tireless advocacy and belief in his potential. The series of arduous, hard-won gains in Matt’s recovery mirrors Seabiscuit's improbable victories over more favored rivals, culminating in his status as an American hero. Matt's journey, like Seabiscuit's, showcases the power of unwavering support, fierce determination, and the extraordinary triumph of spirit against all odds. Their stories resonate with others facing their own seemingly insurmountable challenges, offering a vital message of hope.

Learning three-syllable words like "stethoscope" and "octopus" on Constant Therapy was almost Matt’s undoing—and Megan's! His sister diligently worked with him for twenty minutes, but he kept saying "octapush" or "octopiss," or some other variant until he finally got it right. Matt celebrated by giving two thumbs up and excitedly shouting, "Booyah, Baby!" A loud groan immediately followed this—as his bubble burst—when he realized there was still another word to do before his session was completed.

This ability to say "Booyah, Baby!" with no issue after struggling so long to say "octopus" is a classic example of speech apraxia. The irony was not lost on us when, the very next day, he used the word 'theoretically' in a sentence without batting an eye. Then one day, as if it was no big deal, we learned that Matt had set his watch alarm and changed his desktop alarm to daylight saving time. Equally startling was the time when Aunt Sue was taking care of Matt. Before she was awake, Matt had gotten out of bed, dressed himself, and was comfortably watching TV. Go figure! Sue recalls how difficult it was to comprehend this stark contrast between Matt’s ability and inability to perform comparable tasks or articulate simple words. This was even more mind-boggling given his former well-spoken and educated self.

In general, though, Matt couldn't identify his mistakes or "shortcomings." This lack of insight and awareness into his deficits, combined with limited carryover from day to day, were traits associated with his brain injury, not a stubborn nature. But that knowledge didn't make it any less frustrating for caregivers. These attributes, along with his limited short-term memory, often impeded progress—as if riding the car brakes while hurrying to reach one's destination.

We sought to expand Matt’s opportunities for self-expression, moving beyond the constraints of face-to-face conversations. Our goal was to enable him to communicate concepts, thoughts, needs, and emotions through diverse methods. These included phone calls, writing, typing, texting, voice recognition/dictation, journaling, reading aloud, lecturing, and even singing. Computer coding was also considered an additional language skill for Matt, but that was put on the back burner for now.

Matt began by talking with family and friends on the phone. That immediately raised the bar. Matt needed to speak clearly since people couldn’t read his lips or see his expression, and his words often came out garbled. On one such occasion, while talking to his Aunt Debbie, he realized she couldn’t make heads or tails of what he had said. Shaking his head, he laughed and admitted, “I screwed that up pretty good.” It was quite unusual that he was aware of and able to describe his mistake. Matt's social engagement soon ratcheted up, evidenced by his calls to his siblings and the "pretty awesome voice message" he had left his sister.

Matt received a letter from a friend in Oregon, and it meant the world to him! Full of news, he read it several times, growing very protective. I spread the word that Matt would appreciate hearing from more friends—to reconnect and share their lives, even if he couldn't say much in response. I predicted he would soon be able to have short phone conversations with them as well. I wish I could say that all his acquaintances jumped on the bandwagon, but they didn't. The perceived barrier was formidable: not knowing what to expect, how to conduct a conversation, or not wanting to face the reality that Matt was no longer the person they remembered. This fear of the “what-if” in life, like lockjaw, often immobilizes people into inaction.

The Constant Therapy app was used for speech and cognitive training, focusing on following instructions, sound recognition, voice clarity, and volume.  Speech volume was an issue, especially in a noisy car. As we drove to and from appointments, recalling names of his family and random topics, he constantly needed reminders to talk loudly and turn his head towards me so I wouldn’t have to lean halfway across the center console to hear his voice. It was a rare occasion when he did so without prompting. The app provided progress updates, indicating a 64-point increase in Word Retrieval score (from 19 to 83) and a 78-point increase in Attention (from 9 to 87). Disappointingly, his ability to recall spoken information was generally noted as challenging.

Matt engaged in cognitive activities and games. He completed worksheets (addition, dot-to-dot, and word searches) and used flashcards for numbers and letters. We played games like Yahtzee (keeping and adding scores) and worked on puzzles. He was using several computer apps to help with math and following instructions. He even began reading an Agatha Christie book himself. Matt was relearning to type, and just like with the piano, his right fingers moved slowly and tentatively, and were held in an awkward position.  Inadequate letter recognition impeded his progress.

Matt's ability to play the piano was improving. This was evidenced by his right fingers now curving slightly rather than lying flat, and a reduced influence of rogue fingers that refused to release a key. He was now playing arpeggios and easy melodies with his right hand, progressing to do so in concert with left-hand chords. Besides the apparent benefits of regaining this prior source of pride and joy, it actively engaged his left-brain function, the area affected by his injury.

Dance lessons felt more pressing as we got ready for Megan and Ben’s fall wedding. Matt and I practiced the Waltz and Foxtrot, and we recently began the Cha-Cha. His steps grew longer, and his balance visibly improved. We focused on rising onto his toes during the Waltz and turning his partner. Last fall, there was no vibrancy or bounce in his step and no natural effort to lead different moves, which matched his flat affect and limited visible expression of emotions. This began to shift, and although his lead began to improve, it remained too tentative and late for me to finish a turn.

In the swing dance, Matt could generally lead Meg through underarm passes and side-by-side steps without needing prompting. During a recent lesson, Megan threw a curveball by suggesting they try the "pretzel move." Even after reviewing and practicing the steps, they immediately ran into a snag or miscommunication when trying to execute them within the dance. They shared a few good laughs and finger-pointing before analyzing what went wrong. The mishap was blamed on Matt’s limited right shoulder elevation, which had clipped Megan in the head as she tried to duck underneath. In celebration of his upcoming first anniversary, Matt had been gifted a certificate for dance lessons at Arthur Murray. We hoped that might be the key to unlocking greater potential and elegance. Well, perhaps not just yet.

Matt began to reveal poignant glimpses of self-awareness and a profound desire for normalcy. He found genuine joy participating in familiar family activities, commenting, "How nice it was to participate more normally in activities such as Megan’s birthday celebration and bowling," even though bowling was a significant team effort. Two of us helped him approach the lane with his walker, and collectively lined him up, stabilized him, and helped push the bowling ball down the metal shoot. Our aim was questionable at best, which earned us a drawn-out, “Nooooooo!”

His wit and sarcasm, hallmarks of his former self, also began to resurface with startling clarity. During one medical evaluation, when the doctor commented on his injury having occurred a year prior, Matt responded by raising his arms and air-quoting, "Yeah, that's when all of the fun started." The doctor was remarkably deadpan and didn't recognize Matt's sarcastic humor, but we certainly did. These instances confirmed what we were increasingly seeing: Matt was "getting wittier and is sometimes a 'character.'"