Case History Alison Head Injury Essay Topics

Ursula Fanthorpe was a highly qualified, Oxford graduate teacher before leaving her job at a leading English Girl’s Independent school to work at a hospital in Bristol that specialised in brain and spinal injuries. She became interested in the medical case-histories and how hospitals reduce patients' complex lives and personalities to technical notes — essential for their care but in a sense de-humanising.

The poem is a dramatic monologue about Alison, a young woman suffering the after-effects of a head injury. Her present-day self looks at a photograph of her former self and describes how she feels about the person she was and how the injury changed her. It is almost an elegy, a lament spoken by the present Alison who is mourning her former self.

Structure Nine three-line stanzas known as tercets, in this case unrhymed. The middle line in each tercet is longer than the two adjacent lines, giving a choppy, uneven flow that may reflect Alison’s disrupted and now broken life.

Voice Alison speaks in short sentences and broken phrases, maybe because of her condition.

Themes
Loss
Life’s fragility and dangers
The universality of looking back at our former selves and coping with the change

Fanthorpe shows how integral memory is to our sense of self through a patient suffering a serious head injury.

‘Case History: Alison (Head Injury)’ by UA Fanthorpe

(She looks at her photograph)

I would like to have known
My husband’s wife, my mother’s only daughter.
A bright girl she was.

Enmeshed in comforting
Fat, I wonder at her delicate angles.
Her autocratic knee

Like a Degas dancer’s
Adjusts to the observer with an airy poise
That now lugs me upstairs

Hardly. Her face, broken
By nothing sharper than smiles, holds in its smiles
What I have forgotten.

She knows my father’s dead
And grieves for it, and smiles. She has digested
Mourning. Her smile shows it.

I, who need reminding
Every morning, shall never get over what
I do not remember.

Consistency matters.
I should like to keep faith with her lack of faith,
But forget her reasons.

Proud of this younger self,
I assert her achievements, her A levels,
Her job with a future.

Poor clever girl! I know,
For all my damaged brain , something she doesn’t:
I am her future.

A bright girl she was.

After a head injury affects her memory, Alison, the poem’s speaker, looks at an old photograph of herself.

Throughout the poem, Alison makes an important distinction between her present and past selves. She identifies the woman in the old photograph as ‘my husband’s wife, my mother’s only daughter’ – rather than as herself. She uses the third person ‘her’ and ‘she’ throughout, as if the Alison before the accident is literally another person.

Alison wants to ‘keep faith’ with her past self’s ‘lack of faith’ but she ‘forget[s] her reasons’. In other words, Alison struggles to maintain the values and beliefs she had before her accident. Our beliefs are key to defining who we are, yet we are not born with them: they are built up over a lifetime of learning and experience. Without memory, Alison can’t remember why she believed in her particular value system. And without this value system, she is another step further from being the person she once was.

The absence of memory also has a profound emotional effect. Although she was ‘griev[ing]’ for her father’s death, the past self was still able to ‘smile’ in the photograph. After the accident, however, Alison ‘need[s] reminding / Every morning’ that her father has died. Her fractured memory erodes continuity between one day and the next, as if she is repeating the same day forever. The loss of her father, then, is experienced anew daily, meaning that she ‘shall never get over what / [she does] not remember’.

The present self is stranded, unable to access the past. However, the past self is also frozen in time in the photograph, unaware of the future.

The past self may have achievements, relationships and a stable identity but the present Alison has one striking advantage. ‘For all [her] damaged brain’, she knows something her past self doesn’t: ‘I am her future’. This is both poignant and unsettling, highlighting the fragility of our own identities which seem so stable and innate but in fact could disappear any time.

‘Consistency matters’, Alison recognises. But without memory, consistency is lost; Alison becomes disassociated from her past as the world is repeatedly experienced anew. Fanthorpe suggests that it’s the memories of how we were in the past – what we achieved, what we have felt or believed, the relationships we have made – that makes us who we are in the present.

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