How cerebral hypoxia affects Agent Washington (David)
CANON - what we see in canon during season 17 ( pretending zero and reconstruction arenr there)
Memory consolidation issues and short-term memory loss- Wash displays short-term memory loss, and is shown to repeatedly tell the same stories without remembering that he had recently done so. This is shown when he repeatedly asks questions like “Have I told you about my cat Loki?”
Retrograde amnesia- Possibly linked to Traumatic events, Wash is shown to have difficulty remembering Temple's layer or the room where he was locked in his armor a year after he was shot in the throat when with Carolina.
Migraines - Wash mentions his headaches several times throughout the season, a notable example is “speaking of closed loops, my migraine has a migraine.”
Confusion + slowing processing - His confusion when the time travel was being explained, and he confuses current events with memories. For example, when he asks the team, “What does this have to do with Church’s distress call?”, he genuinely forgets that this happened a year ago.
Lower impulse control - First seen with Carolina on the training course, when he decides to challenge Carolina to complete the course. While Wash has always had a competitive streak, he previously had been more naturally reserved and cautious, especially with things related to safety. The fact that he starts doing the obstacle course suddenly points to a thinner threshold between thought and action for him. His subsequent embarrassment upon falling and forgetting what he was doing exemplifies this as he immediately cites safety concerns, “I'm still recovering”.
Additionally, Wash seems to blurt out what he is thinking and feeling more often. He is quicker to take part in team banter, like when the Reds and Blues are introducing themselves to the gods. Wash expresses that he “spoil sport, I had a good one percolating” when Carolina introduces herself and him to try to cover his symptoms. Wash is also unusually expressive of his needs and vulnerabilities in situations he would never have encountered before. The most notable example is his repeated request for painkillers from strangers.
Emotional liability & reduced emotional regulation- involuntary emotional displays that may shift rapidly or appear disproportionately to the situation. Wash appears to be more expressive in emotions and likely experiences more intensely than previously.
For example, when he falls into the obstacle course, his mood quickly shifts from excited to noticeable embarrassment, then to irritation. Displays of emotions are also more expressive than previously, such as a more intense and less controlled explosion of Anger at Carolina and the Reds and Blues when his brain injury is revealed, followed by withdrawal into shame, “WAS I THE ONLY ONE WHO DIDN'T KNOW”
Anosognosia- “ a condition in which one is in denial--unconsciously--and unaware of an apparent disability or deficit”(Acharya, 2023 ). Wash has low insight into the extent of his symptoms and deficits. This is in part a result of the type of brain damage affecting certain structures in the brain, which contribute to metacognition, reasoning, and memory, but is also likely partly resulting from a defense mechanism of the ego/ avoid unbearable/painful reality. Wash’s identity is likely rooted in core competencies (like planning, organisation, and problem solving) and his ability to perform his duty, especially related to his found family. The loss of his ability to perform this social role or take concrete steps that allow him to return to it would likely shatter his self-esteem and sense of place in the world. It would also likely cause psychological flooding related to his traumatic involuntary hospitalization with the failed Epislon implantation during Project Freelancer.
Wash’s denial and subconscious awareness are evident in the way he talks about his projected recovery or ability to “bounce back”. These repeated stories about the cat Loki are unconscious attempts at self-soothing the unprocessed grief and anxiety that things will never be the same. Wash states that he knows he isn't “100% yet,” pointing to the fact that he has some insight into persistent symptoms.
While Carolina's concealment and lying to him about his symptoms contributed significantly to his lack of insight, Dr Grey and other medical staff have likely informed Wash about his diagnosis more than once, especially while he was getting treatment throughout the year on Chrous. Her decision to lie likely enabled his denial; however, to be fair to her, we do see him get defensive and agitated the only time she does point out a memory lapse to him when he falls on the obstacle course. Wash would likely become outright dismissive, become agitated with, shut down around (dissociate and forget), or withdraw away from anyone honest with him about his diagnosis and symptoms before he was ready to process it.
Figure 1 (MEDIAmaker. (n.d)
Deficits in executive functions - likely has difficulty planning, initiating, and completing tasks related to damage and temporal in the frontal lobes.
Ex: doing laundry becomes a difficult task.
He may get distracted while collecting dirty clothes (attention deficits), struggle with sorting which clothes go where while folding (organization and problem solving), or may forget he started the task and find wet clothes in the washer hours later (memory). Will likely need to write out a detailed checklist to keep track of what's been done and to outline clear next steps.
Anomic aphasia- Wash may say one word when he means another and may have difficulty finding the word he is looking for, or “Hey, where is the thing? The stuff that comes out of the gun. The things...” he means ammunition.
Deficits in Attention and Concentration - Wash may have difficulty doing tasks that require sustained attention and concentration, such as reading, planning, or even following a complex or long conversation. He probably struggles to read or watch long movies. In long conversations, Wash may miss chunks of what is said if he has an intense internal sensory or emotional experience, as he is less able to notice and direct his focus, especially with salient stimuli. Alternatively, his brain may just kind of go “TV static” when overloaded with information.
Limb weakness - Wash has massive changes in his physical capability, especially in early recovery, and experiences significant fatigue even after short bursts of activity. This gradually improves with time and PT/OT. During the first months of recovery, Wash becomes exhausted after walks or after PT or OT, may crash on the couch, or take an afternoon nap.
Balance and coordination- Wash has difficulty with gross and fine motor control very early on his recovery, although he makes significant progress with treatment. When he first stays in his apartment on Choris, he struggles with dizzy spells and balance issues and needs a shower chair. He is probably prescribed a mobility aid for getting around, though he probably struggles between wanting to do things right and following the doctor's instructions, and feelings of shame/avoidance around using the mobility aid, especially in public, and if he can ambulate effectively most of the time.
“Frontal lobe injury may produce changes in personality, including irritability, poor tolerance of frustration, impulsiveness, and impairments in social perception and conduct. There may be apathy and lack of insight, as well as intermittent agitation and mood swings, or more sustained periods of depression. “(MEDIAmaker. (n.d.)
Myers-Briggs personality type: ISTJ
Wash’s personality and cognitive functions would remain the same before and after his brain injury; however, the damage to the prefrontal cortex and the associated symptoms would impact the presentation of those functions, especially when he is under stress.
Dominant (Si) Introverted sensing -
-Means Wash is constantly interpreting his environment through a lens of his past experiences, and he derives comfort from the familiar. Memory lapses make it more difficult for Wash to rely on previous experiences to guide his decision-making process. Additionally, routines become disrupted when there is less impulse control, a lower threshold for emotional overwhelm, slower processing, and a higher incidence of migraines. This may mean Wash is more likely to unintentionally break old habits, for example, do something like sleep in late /wake up at inconsistent times during the week, which is something he would have rarely, if ever, done. If he has a migraine or wakes up from a bad dream, he may cling to familiar comforts like the texture of the sheets or the person lying beside him that morning.
As he tries to rely on his dominant function to navigate the world, it doesn't work as well as it used to, and this is deeply distressing for him. As a result, Wash may become more rigid about sticking to certain routines, such as having the exact same thing for breakfast, eating in the same spot at the same time, etc., as ways to ground himself when he can’t trust his recollection of recent events. Additionally, there is an increase in revisiting specific comforting memories, especially those related to identity and relationships with others.
Auxiliary (Te) Extraverted thinking
Changes in the prefrontal cortex significantly impact Wash’s reasoning. Deficits in attention and slower processing mean he is less able to strategize and think through complex chains of reasoning. The impaired Si additionally means he is less able to recalculate what has made sense and been logical in the past. So, Wash is more likely to accept the logic or reasoning of someone or something he trusts, and more likely to get stuck when he is without that support system. He might ask more questions like “What do you think?” “does this make sense to you?” “I'll just wait to see what X says.”
Changes in impulse control and risk assessment mean that wash is more likely to try to resolve problems with the first solution that comes to mind rather than pausing and thinking through what is applicable in the current situation.
Tertiary (Fi) Introverted feeling-
Wash works through uncomfortable or intense emotions as if they were a problem that can be thought through, and this process tends to be internal. Normally, Wash will try to compartmentalize when there are things in his immediate environment that need attention. This may mean grounding exercises (deep breathing) during stressful situations, or just shoving that shit down for later. In an ideal situation, when things are safe and calm, that's when he unpacks stuff and tends to his feelings.
"[Wash]I don't really do emotional things" (Season 11)
This avoidant relationship with intense emotions means that there is a deficit in emotional intelligence (ability recognize and name emotions) and emotional regulation skills during times where stress overwhelms the capacity for compartmentalization. This is why we see that pitchy yelling and the sentimental behaviors and dialogue ex: "I just want you guy to know your some of the bravest soldiers I ever knew" (Season 12)
For example Hyper vigilance and anxiety pre-hypoxia can show up in trying to solve external problems by relying on comforting routines and logical problem-solving. Think after the crash in season 11, Wash initiates boot camp routines and starts working on practical survival strategies like fixing the radio tower and training drill to manage his anxiety, sense of impending doom, and fear of loss. Tucker calls him out on his feelings before wash names them.
Wash- "It's just a feeling.I can't explain it."
Tucker-"Really, 'cause I bet I can.You're a paranoid ex special ops guy"
Additionally Fi types are more understand their emotions as "immovable" (James, F, 2021) meaning emotions are a sensation to be experienced and accepted as they are. Fi types are less likely to consider what everyone else is feeling about the situation or what the right thing to be feeling is, in the context of processing their emotions.
Post Hypoxia brain damage means the reduced ability to tolerate intense emotions and stress is greatly reduced, and he hits that threshold where he can't compartmentalize anymore much sooner. Combine that with reduced impulse control, and the result is his feelings appear closer to the surface. Wash after hypoxia cries when he’s sad, is more outwardly affectionate, and is more easily irritable. He's still not super likely to imitate talking out his feelings, but it's more obvious to everyone around what he’s going through.
Taking the example of fear/hyper-vigilance/ paranoia, when wash goes to try and process that emotion he may have difficulty using his typical self soothing methods if he can't recalling specific details or certain routines. It would be like if in season 11 wash was trying to run bootcamp but couldn't actually remember the drills from basic training. As as result he may latch on to details he does remember, even if they don't really fit the situation or serve a purpose. Additionally the impaired reasoning and short term memory issues, may mean he start doing things that just make less sense overall. An example might be getting up several times in one night to check that the window is locked. Or he may want to wear full-body armor just while chilling around his apartment on chorus. He may also reach out for external support to help navigate planning for a crisis. Memory lapses may mean he repeats this action. If someone he loves or is attached to, he's going to insist on going over scenarios, such as what to do if an intruder breaks in or may ask to double-check that they have a gun on them. May also get kinda clingy and extra anxious about when the primary person he’s attached to leaves.
Inferior (Ne) extrovert intuition
Ne is that like classic what-if thinking and the inductive reasoning. When this function is serving at its best, it's spontaneous, creative imagination and connection-making. When Ne is inferior, there is a tendency for them to use this kind of thinking to justify why familiar structures should never change, because, after all, there are numerous ways it can go wrong (Love, W., 2022). Think season 11 when Wash wants everyone else to follow his structure because what if someone attacks?
Post-hypoxia, the impaired impulse control and difficulty with reasoning and processing mean that he is less likely to use his inferior function at all. Since Fi comes before Ne, Wash is going to get a feeling about what he wants to do, and do it before he gets the chance, even to think, “What if something goes wrong?”. However, since the capacity for stress management is more easily overwhelmed in circumstances where action cannot be taken, there may be an increased tendency to get stuck in cycles of catastrophic ruminations. I think that when sitting alone in his apartment, in chorus may get stuck thinking things like, what if I forgot to lock the door and someone breaks in? What if something happened to the people I care about? As Wash accepts that he has memory issues and cognitive impairments, this kind of thinking will likely increase, contributing to overall stress and cycles of denial to cope.
Acharya, A. B. (2023, April 24). Anosognosia. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK513361/
Brownlee NNM, Wilson FC, Curran DB, Lyttle N, McCann JP. Neurocognitive outcomes in adults following cerebral hypoxia: A systematic literature review. NeuroRehabilitation. 2020;47(2):83-97. doi:10.3233/NRE-203135
Caramel90popcorn. (2024). R/MBTI on reddit: Explanation of the si function (introverted sensing). https://www.reddit.com/r/mbti/comments/1er09ra/explanation_of_the_si_function_introverted_sensing/
James , F. (2021). How do the 16 Personalities Process Emotions?. YouTube. https://www.youtube.com/watch?v=oTQOkH0q8co
MEDIAmaker. (n.d.). Hypoxic and anoxic brain injury. Headway. https://www.headway.org.uk/about-brain-injury/individuals/types-of-brain-injury/hypoxic-and-anoxic-brain-injury/
Love, W. (2022). Cognitive Functions - Ne vs Ni. YouTube. https://www.youtube.com/watch?v=2zi89d-BhdA
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