Where Is the Mango Princess? – Review – book review

Claudia Osborn

Where Is the Mango Princess? Cathy Crimmins (Knopf, 2000)

“We thought we had experienced crummy vacations before the disaster on the lake in Canada.” So begins Cathy Crimmins’ story about the lakeside holiday that ended when her husband, Alan, was hit by a runaway speedboat. That accident severely damaged Alan’s brain and divided their lives into “the great before and after.” Before the accident, Alan was bright, witty, intense, and life was normal. But after the accident, everything changed.

In Where Is the Mango Princess?, Crimmins describes the frightening aftermath of traumatic brain injury and the agony of living with the desperate question, “Will he live?” and then moves on to Alan’s rehabilitation and the more mundane yet horrific question, “Live for what?”

As is common in head injury, Alan suffers speech and motor difficulties. But more alarming than these are the behavioral changes. He tires quickly, quarrels childishly and competes with his 7-year-old daughter Kelly, and is markedly uninhibited–he swears in public, makes gauche remarks, and laughs and angers quickly. (In the first few weeks after the injury, he openly masturbated.)

Yet Alan is one of the luckier victims of serious head injury. His education, motivation, family support, and intelligence are in his favor, and in the brief time frame of the book, he exhibits a remarkable degree of recovery. With the use of a paid assistant, he returns part-time to his work as a trust officer at a bank within months of his injury. But he is unquestionably changed. The complicated Alan has been replaced by a simple, impulsive guy who yells at his daughter.

The book is filled with telling anecdotes about Alan’s inappropriate behavior and poor judgment. These are the stories shared in caregivers’ support groups, the gritty day-in, day-out incidents that can erode the most resilient of family relationships, and that lead to divorce in 95% of cases.

The early months following head injury are a painful, emotionally and physically exhausting period for the victim’s family. Crimmins takes us into this stress-filled arena. She ably captures the kaleidoscope of intense emotions felt by a spouse confronted with a beloved person who looks the same but who is now someone else. We share her fear for their future, her anger at the interloper (who now calls himself Al), her grief at the loss of her absent husband, her fragile hope that the missing Alan will return, and the grim despair during those moments when she is sure he won’t.

Crimmins (author of When Parents Were My Age, They Were Old and Newt Gingrich’s Bedtime Stories for Orphans) is a skillful storyteller. Her book is a compelling chronicle of her struggles immediately following the accident, throughout the acute recovery phase, and into the early stages of rehabilitation. Readers will gain an appreciation of the devastating effects brain injury has on the victim and the victim’s loved ones. They will also feel the frustration and anger of a woman who must now add spousal caretaker to her role as a mother with a successful career.

Regrettably, Crimmins’ book tells us only about the first several months of recovery, and inevitably leaves us with the impression that there is little basis for hope. Brain injury rehabilitation is a slow, repetitive, boring process that plays out over many years of dedicated effort. Yet there is reason to hope: The injured can continue to improve for years; there are programs that can teach strategies to manage impulsive behavior; there are support groups for families; and there are methods to improve family dynamics. If this story had been written after Alan had had more time to progress, readers overwhelmed by the burden of chronic caretaking might feel more encouraged.

Even so, the book has much to recommend it. Crimmins highlights two important problems facing the brain injured: First, most insurance plans and HMOs do not provide full rehabilitation coverage, so victims do not progress as rapidly as they could. Second, the brain-injured have great difficulty in returning to employment. Most need to be trained for new work, and others need special accommodations at their old jobs. Although Alan made an enormous effort to return to work part-time at his bank, he ultimately lost the job because he could not work full-time. Ironically, he could have received disability income for staying home and not trying so hard.

Where Is the Mango Princess? is an intimate view of a family struggling through the aftermath of a serious brain injury. This story is not only well told, but also compelling and memorable.

Claudia Osborn, D.O., is the author of Over My Head: A Doctor’s Own Story of Head Injury from the Inside Out (Peripatetic, 1998), and is an associate clinical professor of medicine at Michigan State University.

COPYRIGHT 2001 Sussex Publishers, Inc.

COPYRIGHT 2001 Gale Group

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