Lev Zasetsky: The Struggle of a Traumatic Brain Injury

Lev Zasetsky's journey illustrates the profound struggle of reclaiming identity after a devastating brain injury.

### The Struggles of Lev Zasetsky: A Journey Through Brain Injury and Recovery
* 🧠 Lev Zasetsky, who was severely injured in World War II, wrote in his diary about his experience of being "**killed**" on March 2, 1943, despite surviving, highlighting the **complexities of his brain injury**.
* 📖 Over 25 years, he compiled a remarkable **3,000-page diary**, detailing his life, although he could write but could not read his own words, illustrating the **paradox of his condition**.
* 🎖 A gifted student with a passion for science, Lev was mobilized at 20 to fight in the war, where he distinguished himself as a **commander of a flamethrower platoon** before sustaining a **traumatic brain injury**.
* 💔 His injury left him with significant cognitive challenges, including the **inability to process language** and **severe visual disturbances**, leading to a **fragmented perception of reality**.
* 🔍 Neuropsychologist Alexander Luria studied Lev's case, which revealed the **complexities of aphasia and the brain's functioning**, as Lev struggled to **navigate everyday tasks and communicate effectively**.
* ✍ Despite his limitations, Lev made significant progress in writing, learning to **express himself again through persistent practice**, which he described as a means to **reclaim his lost abilities**.
* 😢 However, Lev remained acutely aware of his struggles, often expressing **despair over his condition** and the limitations it imposed on his life, culminating in a **deep sense of loss and isolation**.
* 📚 His autobiographical work, initially titled "The Story of a Terrible Brain Injury," ultimately became "**I'll Fight On**," reflecting his **enduring spirit and relentless pursuit of recovery** until his death in 1993.

Lev Zasetsky said that he was killed on March 2, 1943 – a line which he wrote in the past tense. Because he was probably right. Which… is confusing. He wrote it again and again during 25 years of observation by one of the Soviet Union’s most accomplished neuropsychologists, eventually compiling a 3,000 page diary recollecting his life story… He could write by hand, but he himself was unable to read it. Which… is strange.

It became one of the most valuable, insightful texts on the study of the human brain in the history of biological science – but Lev Zasetsky, whose horrific shrapnel wound to the brain in World War II that ended up destroying his life, was not a researcher or scholar.

He was the one being studied. And his story won’t just make you re-think what reading and writing are, or how your own brain works – but it’ll make you question whether a spoon can really be separated from the soup it sits in.

Lev Zasetsky was just 20 years old when Germany enacted Operation Barbarossa, a surprise invasion of the Soviet Union. As a child, Lev had been fascinated by science – which he only vaguely remembered. He’d graduated with honors from middle school and went on to complete three years at a polytechnic institute in Tula where he did advanced work in chemistry. “Early one morning I was heading for the institute, thinking about my future, when suddenly I heard… there was a war on with Germany!... they had already invaded and we had 

to defend our country. The Komsomol mobilization
had sent to the front fourth-year students who, for the time being, had to forgo their work
at the institute until the war was over. " At 20, Lev the Scientist was already
gone, and Lev the Soldier was born.

That mobilization took him
directly to the frontlines, where he eventually gained command of
flamethrower platoon 33A and served with distinction. A document of the Central Archive
of the Ministry of Defense shows that he was a:

“Military technician of the 1st rank,
a participant in the Patriotic War from January 1942 in the position of platoon
commander of a separate flamethrower company, attached to the 222nd rifle division
of the 33rd army. With his platoon,

he destroyed five German pillboxes,
personally killing five Germans.” By March of 1943, the German 6th Army had
surrendered at Stalingrad – but the Wehrmacht was in the middle of defeating the Soviets
at the Third Battle of Kharkov. Nearly 1,500

kilometers south, Lev Zasetsky was leading his
unit across a river in Smolensk when he was hit in the head by shell fragments that “penetrated
the left parieto-occipital area of the cranium”

and left him in “a prolonged coma.” He had an
opening in his skull of 16 square centimeters and he’d lost a quarter of his brain matter – the
Red Army wasn’t able to perform a cranioplasty

with tantalum plates as some Western Allies could. He was just kept alive in a field hospital as his body attempted to heal and scar tissue made permanent alterations to his brain. Lev Zaletsky had been taken out of a war against

man and thrust into a fight to the death against nature. Nearly 70 years before neuropsychologist Alexander Luria first met Lev Zasetsky, science already had only a rudimentary understanding of aphasia – the loss of the ability to process and formulate

language. Why did some people seem to understand the world around them, but had lost the ability to talk about it? Why did some people develop aphasia from unexpected, unseen internal injuries like strokes, and others from physical trauma? Why didn’t EVERYONE who experienced physical

trauma develop aphasia? And how did Phineas Gage survive an iron rod being driven directly through his skull and brain and out the other side and not lose any of his communicative faculties?! In 1873, an article in Popular Science called “On Acquired Physical Habits” described the state of

pathological research as showing that aphasia comes from “malnutrition of a certain part of the Cerebrum; and the tracing of this malnutrition back to an interruption in the supply of Blood.” That same year, a paragraph in the Miscellany section of Popular Science claimed that “aphasia

is produced by an incapacity to execute the coordinate movements requisite for pronunciation, and that it has nothing to do with loss of memory as to the meaning of words.” Oh brother. I mean c’mon, it was like 150 years ago.

Think how difficult it was to understand what
was happening: you need to have a clearly defined map of all parts of the brain. You need
to understand what those parts do and DON'T do,
and how they work in tandem. You need to
know what affects their operation in the

short-term and long-term, what damage does to
each part, what can be healed and what can't. And all of that needs to be placed in the
contexts of both the state of medicine and the actual lives of the patients, all without any
imaging or non-invasive examinations of any kind.

Studying the long-term effects of traumatic
brain injuries was particularly difficult
in the 1800s because so many of those
who suffered those injuries just… died. But we were making progress on understanding the
innerworkings of the brain – and fast. In
the August 1875 issue of Popular Science,

“Infirmities of Speech” described a “rare form
of aphasia in which the intellect is unaltered,
memory is good, the patient writes easily, and
expresses his thoughts correctly in writing as
educated deaf-mutes do. The recovery of the art
of writing (where it is recovered) is gradual.”

In an 1885 edition of Popular Science, W.R.
Benedict defined aphasia as simply “a disturbance
of the power of speech.” He broke it down into two
categories – “amnesic aphasia,” in which a patient

forgets “substantives and names,” misuses words,
or forgets the language they knew altogether,
and “ataxic aphasia,” in which “the power of
articulation is completely lost” despite the
patient fully understanding a word, although not
being able to use it despite “vigorous effort.”

Through the 1880s and 1890s, articles
about or mentioning aphasia were common
in Popular Science, like “Centers of Ideation
in the Brain” and “Word-Blindness” –
and then the progress just… stopped.

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The final appearance of the word “aphasia” in all of Popular Science came in May of 1913 in an article about William Harvey, the 17th century physician who unraveled the circulation of blood. The next great leap in understanding the physical mechanisms of the brain and its

related traumas came with the imaging revolution of the 1970s – the CT scanner finally allowed us to look inside. But in that interim period, something happened that generated more observable cases of brain injury than in the whole of human history before it: two world wars.

The Great War and World War II affected every populated continent on the globe, and in a sort of twisted silver lining for medical progress, the tens of millions of casualties provided doctors with opportunities to develop more effective treatment for acute brain injuries and to improve rehabilitation after.

Alexander Luria was assigned to care for over 800 patients hospitalized by traumatic brain injury – one was Lev Zasetsky. Luria “first met [Zasetsky] toward the end of May 1943,

almost three months after he had been wounded” and found that he “simply could not write and realized he had suddenly become illiterate.” It was a case so nuanced, so tragic, and so powerful that Luria spent decades

trying to understand it, culminating in “The Man with a Shattered World: The History of a Brain Wound,” which Oliver Sacks said ‘turned science into poetry.’ Lev Zasetsky had lost virtually all ability to use words, with all words seeming “vaguely

familiar” with meanings that were “incomplete
and unformed.” For Lev, choosing the right word wasn’t just like finding a needle in a haystack
– it was finding a needle in a stack of needles. The result was essentially paralysis.
When he ran an errand to a government

office back home in Tula, he was so “afraid
[he] wouldn’t remember the few words [he] needed to carry on a conversation” that
he simply waited in the hallway outside, working up the nerve to give even
a simple conversation a shot.

It was just as bad as he thought it would be. “... the few words I needed to use seemed
deliberately to have slipped my mind–all of them. Something felt very wrong in my
head, I just couldn’t remember a thing.”

He could see, though. Sort of. His vision was
equal parts disorienting and fascinating. His entire right side of his field of vision was
completely gone, which forced him to turn his head to view anything that wasn’t on
his left. What he could see was a maelstrom:

“Through and beyond the objects I
see are endless numbers… of tiny, shifting swarms of midges that make
it hard for me to look at objects themselves.” This “swarm” affected
his ability to understand what he

was seeing so much that he wasn’t able to
distinguish the first letter of any word. But closing his eyes was even worse: “...there were two days and nights
I didn’t dare close my eyes. I seemed to be having hallucinations” of “some
ugly thing, something weird – a human

face but with enormous ears… and eyes that
were just as peculiar.” And if it wasn’t	a Picassoan rendering of some unknown
person, he’d see other “faces, objects,
and rooms of different sorts,” leading him
to “open [his] eyes as fast as [he] could.”

He would also ‘lose’ parts
of his body because he would	forget that he couldn’t see his own right side: “Often I fall into a kind of stupor and I
don’t understand what’s going on around me;	

I have no sense of objects. One minute
I stand there thinking about something,	the next I lapse into forgetfulness. But suddenly,	I’ll come to, look to the right of me, and be
horrified to discover half of my body is gone.”

Zasetsky called these kinds of incidents
“spatial peculiarities.” He couldn’t	remember how to navigate the town he grew up
in, and Luria described his relationship with	space as being “broken into thousands of
separate parts.” He said that the “problem	

was not that he failed to see an object. He
would recognize it, know what it was for,	and how to use it. But it was altogether different
when he tried to orient himself in space,	distinguish right from left, or gauge the
distance and relationship between two objects.”

Lev didn’t really understand… anything
anymore. He’d wake up with pressure in	his stomach but not realize it meant he had
to go to the bathroom. He was afraid to reach	out and touch objects on a table. And he
was unable “to see a single object as a	

whole,” causing him to “get frightened when 
a spoon” would get “lost in [his] soup.” A simple comprehension test 
illustrates exactly what it was like to live with Lev’s brain. He was 
asked to listen to the following paragraph:

“On both sides of the house were large trees of 
a rare variety that had big berries resembling fir cones on the underside of the leaves. In the 
pond, across which four white swans were gliding, one could see the reflections of the Chinese 
lanterns, made out of brightly colored paper, 

that were hung everywhere and 
depicted grotesque, grinning faces.” Then he was asked to decipher 
it. This was his answer: “No… I can’t make anything out 
of it… They’re talking about… about… it’s hard to say… about lantern lights, and 
about swans in a pond… and something like woods on 

both sides… swans… and lantern lights. There 
are these trees… on both sides… and berries… and some more lantern lights… and swans floating. 
There’s a house… and alongside it… fruit trees… They look like fir trees. Then there are also 
lanterns… and a pond… swans floating… near them… 

horns. And so… lantern lights… colored 
paper… No, I just don’t understand it!” How do you live in a world that makes no sense 
at all? How do you exist when every second of your life is an unsolvable puzzle, and the tiny 
bits you do manage to recognize can’t come out?

The real question is: why would you go on? Luria pinpointed Lev’s injury 
to “the second major block of the brain located in the posterior 
sections of the large hemispheres.” This portion of the brain’s entire job 
is to “act as a block for receiving, 

processing, and retaining information a person derives from the external world. Luria posited that within that area is another “tertiary” sector, whose function “is to combine the visual (occipital), tactile-motor (parietal),

and auditory-vestibular (temporal) sections of the brain” which are “the most complex formations” in this second block, and “the last part of the brain to develop” in human evolution. That’s in line with the 1875 Popular Science “Infirmities of Speech” article,

which highlights discoveries made by neuroscience pioneer Paul Broca that pins aphasia to the left, anterior part of the brain, and more specifically to the “third cerebral convolution” – the same region that Luria refers to as the “tertiary” sector. Even as

far back as 1873, after performing a series of electro-shock tests on various animal brains, a Professor Ferrier was able to link aphasia to “the left side of the brain, in the posterior part of the inferior frontal convolution,” also associating it with “paralysis of the right hand.”

The precise location of Lev’s shrapnel injury meant that “a very important function [had] been seriously impaired: he [could] not immediately combine his impressions into a coherent whole; his world [became] fragmented.”

But his frontal cortex was entirely undamaged. Luria wrote that the frontal cortex allows for a person’s “capacity to recognize his defects and wish to overcome them,” and that Lev Zasetsky “was acutely aware of what it means to be human,

and to the extent his strength permitted, 
worked feverishly to overcome his problems. Lev’s human spirit was intact – he 
just needed to find a way to channel it. He’d lost the ability to read or write 
immediately following his injury, 

but he still tried. He’d forgotten how to 
use a pencil – he couldn’t control it or even hold it. And when he tried to read, he 
found that he had to go one letter at a time, 
reciting the alphabet until 
he got to the letter he saw. 

Which… he actually could do. He couldn’t remember 
a word he just heard, and he couldn’t remember anything about his time on the front lines, or 
how to get home from across the street… but he could remember parts of his childhood and the 
things he learned then. He knew the alphabet. 

Luria called these sorts of memories 
“kinetic melodies,” or a “series of 
built-in movements” that once mastered at a young 
age become second nature in adulthood. That 
meant Lev still possessed the ability to 
write somewhere in his brain. He just 
needed to figure out how to access it. 

The letter-by-letter approach had gotten 
Lev absolutely nowhere. But then a doctor 
told him to stop trying – he asked Lev 
to write a whole word without thinking 
about it or lifting his hand from the 
paper. He repeated the word “krov,” or 

blood, out loud a few times – 
and then he actually wrote it. Lev couldn’t read, he couldn’t 
understand what he saw, 
and couldn’t navigate the world around 
him – but he suddenly could write. His previously meaningless days now had 
meaning – he could do something again. 

In just six months he learned to write
as well as he could before his injury. He still wasn’t exactly literate –
words still meant nothing to him, not in the automatic and nuanced
way they do for us. He had to break

each word down into its letters and
syllables to begin to decipher it: “When I look at a word like golovkruzheniye
[“dizziness”], I just can’t understand it… But soon something begins to stir in my mind.
I look at the first letter (“g”) and wait until

I remember how to pronounce it. Then I go on to
the letter “o” and pronounce the whole syllable.” But the further he got into a word,
the letters he’d figured out were gone: “While I’m looking at that letter,
the two letters to the left of it

escape my vision… at that point I
see only a gray mist in which spots, threads, and little bodies seem to
shift and flicker back and forth.” But still… it was progress. He could only write about ten lines a
day – sometimes a page – which would

take him all day. And the personal cost was
tremendous: “If I do spend a whole day at it, the next day (or two or three) my head aches
so badly, I often have to stay in bed.”

And each time he recovered, he went right
back to writing his autobiography – Luria wrote that Lev’s goal was “to write a journal
describing the terrible abyss into which his injury had hurled him and the struggle it
took for him to recover what he had lost.”

By the time Alexander Luria had completed what became a 25-year observation period of one of his most unique patients, Lev Zasetsky had written “a 3,000 page document which he could not read.” One of the most remarkable aspects of Lev’s book is that he “completed” his story multiple times.

When he finished one iteration, he would start from the beginning again to express himself more clearly as his writing improved, and to tell more of his own story as he remembered it over time. As he wrote, Lev found that he very slowly rehabilitated his ability to communicate:

“By doing it again and again (I don’t know how many times I’ve rewritten this over the years), my speaking ability has improved. I really do speak better now and can remember words that were scattered into bits and pieces by my head wound.

By training myself (through thinking and writing) I’ve gotten to the point where I can carry on a conversation – at least about simple, everyday matters.” The Disney version of this story ends right there – Lev Zasetsky the

author overcame tragedy and lived happily ever after! It’s great. But Lev Zasetsky never really lived happily at all. The problem wasn’t just that he couldn’t do most of the things that make up daily

life. It’s that he knew he couldn’t do them. His writing included a stark degree of self-awareness – he understood that “he was not fit for anything else.” “So it turns out that because my memory is so bad I’ll never understand anything about geometry,

grammar, physics, or any other science. What's
happened to my life is simply terrible. This strange illness I have is like living without
a brain. What I remember one minute is gone the next, so that I can't understand theorems
or even simple things in my surroundings.

What Luria called Lev's "shattered" existence invokes imagery of a whole so hopelessly
broken into so many pieces that it was impossible to even start putting them
back together in a meaningful way. To Lev, it was just living life without a brain.

Lev said that, "The point of my writing
is to show how I have been, and still am, struggling to recover my memory. It's an extremely
difficult fight… By working on that one story of mine every day… I hoped I'd be able to tell
people about this illness and overcome it."

Lev Zasetsky died on September
9, 1993 at the age of 73. When he started writing, he titled his book,
"The Story of a Terrible Brain Injury." By the time he was done, he'd changed
that title to "I'll Fight On."

The Man Who Lived with No Brain

Popular Science

Introduction to Lev Zasetsky and his unique case

Lev Zasetsky, despite brain damage, wrote a 3,000-page diary he couldn't read.

His diary became a valuable text on the human brain.

His story challenges understanding of reading, writing, and brain function.

Zasetsky's life before and during World War II

Zasetsky's early life and education in science.

His mobilization to the frontlines and service as a flamethrower platoon commander.

Limited understanding of aphasia in the 19th century.

Early theories on aphasia, including malnutrition and motor coordination.

Difficulties in studying brain injuries due to limited technology and high mortality rates.

Progress in understanding aphasia in the late 19th century.

The impact of World War II on brain injury research.

Luria's encounter with Zasetsky and his initial symptoms.

Zasetsky's severe communication difficulties and visual distortions.

Zasetsky's spatial disorientation and body image issues.

Neurological basis of Zasetsky's condition and recovery

Luria's analysis of the brain region affected by Zasetsky's injury.

The impact of the injury on Zasetsky's ability to integrate sensory information.

Zasetsky's determination to overcome his difficulties.

Zasetsky's retained motor memories and his approach to writing.

Zasetsky's breakthrough in writing and his gradual improvement.

Zasetsky's life after recovery and legacy

Zasetsky's continued struggles and self-awareness.

Zasetsky's motivation for writing his autobiography.

Zasetsky's death and the evolution of his book's title.