In reminiscing some cases over the years, I remember one that involved a stripper and sex worker who suffered a traumatic brain injury in a car accident. She’d been thrown from the back seat of the car, reportedly while on the job. Until that day, she’d always used her beauty to help ease her way in life, and with the flash of a smile or some other beguiling segment of her anatomy, she had always been able to get anything she needed. She was still beautiful when I met her, with an air of vulnerability. Her injury had left one side of her body weak, and she walked with a cane, but she was able to carry out the all-important activities of daily living—self-care, eating, driving. Soon after her accident, she had her breast implants removed because they threw her off balance and made her back hurt, and she was suddenly freed of her old identity. She seemed poised for a new start. But as we worked together and she began to trust me, I learned that she was still holding onto an old sense of shame and insecurity about her past. It wasn’t about the sex work—she was open about that. The secret she’d kept from everyone was that she never learned to read. I coached and encouraged her as she worked on her literacy skills, and day-by-day, she broke through her old beliefs that she was “dumb” and gave herself a path out of a life that she had outgrown long ago but was too afraid to leave until she was forced to. That’s what transformed her: having to confront the fears and weaknesses that were so visible when her old “strengths” and coping strategies were taken away. She was reading, and confident. Hopeful.

I knew she’d be okay!