HIGH PLACE PHENOMENON

The day before yesterday, Noa was hit by a car and lost consciousness. She had a type of seizure called a concussive convulsion which caused her arms to go rigid and her body and face to shake. She quickly came to. Many bystanders helped us until an ambulance took her to a nearby private hospital. She was seen quickly and a CT scan showed no skull fractures or internal bleeding. It seems most likely that the car knocked her over and she hit the back of her head on the asphalt. I didn’t see it happen; by the time I turned my head, she was already on the ground.

Concussive convulsions are a fairly uncommon but benign symptom of a blow to the head. According to researchers, “In one in about seventy concussions, concussive convulsions occur, but seizures that take place during or immediately after a concussion are…thought to result from temporary loss or inhibition of motor function and are not associated either with epilepsy or with more serious structural damage. [They] have the same high rate of favorable outcomes as concussions without convulsions[1].” Reports of concussive convulsions are most common among rugby and football players, MMA fighters, skateboarders, and BMX riders - groups which generally have higher rates of traumatic brain injuries captured on video.

A few days earlier, in Rio de Janeiro, we were biking through a state forest near the old Santa Teresa neighborhood. Our guide, Stefano, was a local Italian expat and avid cyclist who built a small business taking tourists on cycling excursions on a forest road that had been converted to a bike path during the pandemic. The path offers several excellent views of Christ the Redeemer, the statue that overlooks the city. His tour had been written up by a journalist for Conde Nast Traveler and was very popular and well-reviewed. After it was published, he was inundated with bookings, some by people who did not know how to ride bicycles. He told us stories of people falling, scraping knees, giving him bad reviews. He asked us twice if we knew how to ride bicycles and we told him we did.

Stefano explained that the forest was mostly non-native trees introduced by the Portuguese, though a few native trees remained, taller and silver. Tiny monkeys scrambled along power lines, peering at us from the rooftops of old buildings. He told us about the gangs that control the favela down the hill from his house, and how, on some nights, he can hear them in shootouts with the police. He recommended we watch “Elite Squad,” a Brazilian blockbuster action movie about the war between the gangs and police (we watched it that night - it’s actually really good and even includes a scene where university students, one of whom is also a rookie cop, analyze Foucault’s Discipline and Punish in the context of Brazil’s dysfunctional justice system of the late 1990s.)

During our ride, Stefano would stop us at particularly scenic viewpoints to take photos, always first with his phone, then with his DSLR. At one of these points, he had us stand at the edge of the road, which seemed to just end there – it seemed like a cliff. He told us that there had been a path and a small clearing there before which had disappeared in a mudslide. All I could see was asphalt and sky.

Ever since I was a child I’ve struggled with heights. That’s not actually true - I’ve struggled with edges. I actually like being high up, seeing how things look like a tiny diorama from above. I only have a problem when I get close to the edge. It’s not a fear of falling as much as a fear of jumping - there’s a sort of magnetic pull that I can feel in my body, drawing me toward the edge. I sometimes dream I’m in a different place, where I see myself falling through the sky and hitting water - I immediately wake up and inhale, as if I’ve been holding my breath during the fall.

Researchers call this intrusive thought pattern “high-place phenomenon.” The French call it “l’appel du vide,” the call of the void. I try to keep a general rule of not Googling medical questions, but I break it often. According to an article I found online, “HPP was named as such by a group of psychologists at Florida State University in 2012. They theorized that these thoughts or urges might be our brains’ way of responding to a primal instinct—such as stepping away from the edge of a cliff to keep ourselves safe.” To me this is just professionalized confirmation of something that is intuitive and obvious, though it’s still reassuring to have a hyphenated proper noun for a private compulsion that can feel strange, even shameful.

As I’ve gotten older, my experience of high-place phenomenon has expanded to include people close to me. At the cliff on the bike path I saw Noa in a different place. I watched her fall off the cliff, her body struck by branches and protruding rocks, tossed like a rag doll or a 3D model, perpetually falling, never hitting the ground. I’ve often thought about what it would be like to fall, what I’d do. In my mind I imagine rotating my body so my head is facing downward to increase my chances of a fast and painless death. In theory this would eliminate the possibility that I would survive, conscious and lying on the forest floor with a completely shattered spine, ribs protruding from the front of my body, drowning in my own blood or something. In more clear-headed moments I’ve considered how it might not be possible to reorient my body in free fall - that there is nothing to push against, no leverage to use, but I think it’s understandable that actual physics is not relevant in the context of intrusive thinking. I put my arm around Noa, pulled her one step away from the cliff’s edge, and smiled at Stefano. He took a few photos with his phone. “Ok” he said in a Portuguese-inflected Italian accent, “now weez my good ca-ma-ra”. Later he pointed out a place on the path where, a few weeks prior, a young Israeli biker had been forced off the road by an oncoming car and fell 60 feet to her death.

We saw a lot of guns in Brazil. Sometimes, when I see an officer with a gun in a holster, I have an experience of high place phenomenon, and I see myself shot by them. It’s not only guns – I imagine what it would be like to get sucked out of a plane’s emergency exit mid-flight, or accidentally drink something toxic. It’s a reflex. When a portal to death is so visible, I start visualizing what it would be like to pass through.

The first gun we saw in Brazil was an automatic rifle that looked like it was welded together by someone in a garage. It had huge holes along the side and looked like a child’s drawing of a gun, something from a video game. It was partway through a tour of Vidigal, a favela in Rio which, due to its proximity to wealthy parts of the city, had become safer and more well-serviced over the past several decades. The Rio Olympics accelerated this shift; following the rumored purchase of a $1 million property by David Beckham, home prices quadrupled, foreigners started buying up lots and building Airbnbs and bars, and it quickly became known as the “tourist favela.” Our guide Rodrigo grew up in the neighborhood and had a tattoo of a moth on his throat, with a skull on the moth’s back covering his Adams apple. He was small, optimistic, and charming. He took us through a park which residents had built by clearing an area that had been formerly used as a dump. He explained that they’d planted trees to halt erosion, and that before the park had been built, some sections of the hillside dump had collapsed in mudslides, burying the homes below in soil and trash. He took photos of us on a small deck that had been built into the hillside which provided an excellent view of the ocean. I didn’t experience high place phenomenon, though in the photos I look terrible, a forced smile, Noa’s arm around my hips drawing my shirt taut against the soft parts of my torso.

We hiked a steep path out of the park, where Rodrigo paused our group near the top to tell us not to take photos past that point - the area beyond, he said, was where the drug dealers hung out, and the gangsters did not like to have their photos taken. Sufficiently warned, we turned a corner and were immediately confronted by what looked like a typical taco stand in Los Angeles, where I’m from – a small shade structure, a folding table, some chairs. A vinyl sign hung at the back of the tent, listing menu items and prices over a lush jungle background - maconha, coca, hashish by the gram. Next to the sign, a skinny young man wearing red held an AR-15 style gun, the one with the holes, on a sling over his right shoulder. He smiled at our group and graciously pivoted, positioning the gun between himself and the wall. Rodrigo greeted him warmly - I stared at the gun, then directly past it, and we walked through the alley to the street.

Rodrigo explained that the favela was controlled by Comando Vermelho, the Red Command, a gang dominant in Rio which had formed in the 1970s when the military government made the mistake of incarcerating leftist political prisoners with hard core gangsters, who found they had a common enemy in the government and a shared interest in class struggle. Later in our tour I saw a man wearing red with a plastic earpiece and the second gun, a pistol strapped to his waist with two extra clips, one long, one short. He passed behind our group and said hello to Rodrigo as he took photos of us at another viewpoint. Nearby, a few boys wearing red were preparing to roll a joint. One boy used an empty coconut shell and a pair of tiny scissors to cut up the flower.

The third and fourth guns we saw in Brazil were outside the Jewish Museum in São Paulo. We visited on the morning of the 5th. The museum is fairly new, inaugurated in 2021, and occupies a former synagogue building near the downtown area. It has been beautifully converted, a new wing integrated into the historic structure, glass and steel meeting the old concrete. The site of the former main sanctuary houses a large exhibit meant to educate non-Jewish people about Judaism. The museum also contains several exhibits on the history of Jews in Brazil and a space for shows by contemporary Jewish Brazilian artists. After circumnavigating the old sanctuary space we were intercepted by a volunteer docent, a Brazilian Jewish man in his 70s who proceeded to tell us, with unparalleled vigor and enthusiasm, in strong but definitely not fluent English, his own version of all the things we’d just read in the museum’s expertly-translated exhibits. His passion was infectious, familial, he gesticulated wildly, no one mentioned Gaza. We politely evaded an invitation for him to give us a tour of his own synagogue and meet his wife later that afternoon when his volunteer shift was over. We were leaving on Thursday and unfortunately couldn’t join them for Shabbat.

After parting ways with Ruben, we were tired and wanted to leave the museum. We sped through the next two galleries and returned to the mezzanine level to exit. Peering out of the elevator, we could see Ruben standing in the main sanctuary, arms flailing, engaging a young woman holding a paper shopping bag. We power-walked past the sanctuary entrance, through the metal detector, and onto the street. Outside, two military police wearing T-shirts and shorts turned the corner. One had his handgun drawn. He held it with both hands, firmly pointed downward, the way they do in movies before kicking in a door and shouting “CLEAR”. The other had his hand on his gun, which was still holstered. We had started to call an Uber but quickly began walking away, unsure whether something weird was happening. I looked back and saw a police SUV pull up onto the curb. We turned the corner and didn’t hear anything else.

From the Jewish Museum, we took a car to a trendy restaurant in the Pinheiros neighborhood that a fashion designer had recommended to us when we had wandered into her boutique the day before, where Noa bought a bright orange shirt. Noa was starting to feel unwell, tired. She was on her period and had an upset stomach, I suspected she was dehydrated, and hoped some food and water would help her feel better. We ordered a tempeh sandwich, a bowl with grilled chicken and pesto, two small bottles of filtered water, and a frozen limeade with coconut water and cinnamon. There was a fire pit and the smell of smoke bothered me, but the restaurant had us order food by table number using our phones, our waiter didn’t speak English, and it wasn’t bad enough to move and make things more complicated. We ordered two more waters, drank them, paid, and left. We walked to a store that sold crafts made by Brazilian artisans and found a bunch of wooden bananas we’d seen in another shop and thought were fun but had decided not to buy. They were 99 reals, about $20. We discussed whether they would be too kitschy, too problematically exotic, and whether the context of the shop, filled with other jungle tzotchkes, made our judgment difficult to trust. We left the shop without them. Later I would wonder whether we made the wrong choice about the bananas.

It was Wednesday, about 1:00pm. We walked past a corner restaurant where people sat at tables on the sidewalk eating typical Brazilian food, chicken parmesan, a black bean and pork bean stew called feijoada, steak, french fries. The afternoon felt hazy - we had eaten and drank and felt revived but still tired, and were intending to have a slow day. We walked toward a bakery the designer had mentioned - our lunch had been light and we wanted to try their pastries. We arrived at an intersection we’d crossed the previous day. Across the street, the designer’s shop. There was traffic in a normal way; Brazilians crossed the street around us. We looked both ways. I held Noa’s right hand in my left. We started crossing, and there was a white car. I looked down, Noa was lying on her back on the asphalt. Her eyes were open and empty. Her arms were both bent at the elbow, rigid against her upper torso, quivering. Her left hand pointed outward with her fingers splayed in a strange and inhuman gesture. Her whole body shook and her eyes were open. I could see her tongue, and she made a sound like a moan, steady with no affect, the way “om” is said in meditation. I screamed and kept screaming.

People, cones, trees. There was a man with a beard, a woman with tattoos. People stood in the street to block traffic. I touched Noa’s face and her legs. I screamed no, no, no, no, no. I screamed please no. I screamed her name. She was not there. Two men wearing the same shirt knelt next to me. One spoke English, he asked me questions. A year passed, a day, a few seconds. Noa stopped shaking and then she came back. She asked where we were, what happened. She asked if we were in Brazil. I told her we were, and that she’d been hit by a car. She started shaking again and asked me if she was going to die. I told her she would be ok. She said we were supposed to have a whole life and she didn’t want to die. I touched her face and told her she would be ok. She said she was scared and her body shook from fear. I touched her legs and her arms and she told me she could feel my touch. People were around us. A man handed me her glasses. Police arrived, then firefighters, then an ambulance. One of the two men wearing the same shirt translated for me. Another man pointed to a yellow house and told me he lived there. The police asked for our IDs and seemed annoyed when I handed them two California driver’s licenses. My phone buzzed, I looked at it, a text in Portuguese read “reply YES to approve a 2,299 real purchase at ZARA”, but we hadn’t been to Zara. A woman slid off Noa’s bag and handed it to me. A man in an EMT uniform held her head, slowly moved it side to side, then forward, asking if she felt any pain. She said no. Two men and a woman arrived and lifted Noa onto a stretcher, then into an ambulance. A Japanese-Brazilian woman pushed a man with gray hair toward me and said, “He can go with you to translate”. He told me he spoke English, in English. His accent was strong. We got into the ambulance. We waited a few minutes and it felt like a long time. I wrote something on my phone, then copied and pasted it into a translation app and showed the medics in Portuguese: “She was struck on the back right of her head. either the car hit her there or she fell to the ground and hit her head there. after she was struck she had what seemed like a seizure for a few seconds. her arms went up and shook and her face looked strange”. The EMTs nodded and told me it was ok. They called dispatch, one told me to take her to a public hospital, that it would be expensive otherwise. I told her the cost didn’t matter. There was confusion about insurance. The man in the matching shirt and the man with gray hair told me to take her to a private hospital, that she would be seen more quickly and they were more likely to speak English. We waited while the EMTs finished their call with their dispatcher. I became impatient, I asked if I should call an Uber. Noa was shaking from fear. I held her hand, and touched her face, and told her she would be ok. The EMTs put a foil blanket over her, and the ambulance started to move.

In the ambulance I thought about God. After a while we arrived at the hospital. It was clean, bright, small. Nurses lifted her out of the ambulance. I walked next to her and told her I was there. We went into an emergency room, they put her on a bed. The man with gray hair followed us. Two young male doctors came in. One spoke English and told her they would take a CT scan. He told her it seemed like she would be ok, that all the signs were positive, that they thought she would be back on her feet today. I leaned close to Noa and told her the young doctors seemed Jewish, or at least Jewish-looking, and we laughed. We waited. I asked the man with gray hair his name and he said it was Alex. He stayed with us and translated with the medical staff. Then he left the room to fill out paperwork for us. He brought back a clipboard and asked if she had health conditions, the names and dosages of medication she takes, if she’d had other surgeries, the name of her mother, if she might be pregnant. She said she had her period and couldn’t be. I couldn’t find the photos of our passports that I knew were saved somewhere on my phone. I found the photos and sent them to Alex, then realized I’d sent photos of our driver’s licenses and not our passports. I sent a message to our hotel owner, telling her what happened, asking her to go into our suitcases and send photos of our passports, which she quickly did. After a while, the nurses came to take Noa to the CT scan. Alex took me to a waiting room, and we sat, and he brought me water. I thought I might vomit and didn’t. I started to shake and sunk into my chair. Alex told me it was ok if I needed to cry and put his hand on my arm, and I cried. I told him I felt responsible. I told him I’d seen this happen in a dream. I looked him in the eyes and thanked him. I asked him about himself, about his work, whether he’d seen Elite Squad. He said he’d grown up in Rio, he was a supply chain consultant, he had seen it and thought it was really impressive, and said I should watch Elite Squad 2. He left to check if Noa was out, and came back because she wasn’t. A few minutes later a nurse came and told us the scan was finished.

An older, senior doctor arrived. He had a large body and light blue eyes. He read the scan results. His English was not excellent but he told us that there were no bone fractures and no internal bleeding. Noa was scared. He held her hand and said, “You are shake because you are afraid. If you are afraid and I am afraid, it’s problem. If you are afraid and I am not afraid, it’s ok! So it’s ok!” We all laughed. He spoke with the other doctors in Portuguese and then left. I gave Noa her glasses, and a nurse came to give her more medication. Then they helped her out of the bed and we walked with Alex to check out. The bill was 1,800 reals, or about $360. The Brazilians seemed uncomfortable with our celebratory reaction. I put it on our credit card. Alex called an Uber. There was traffic. We thanked him over and over for translating, for doing our paperwork, for staying with us. We asked him about his family. He said his wife had been really concerned and he texted her that Noa was ok. He said he had a 13-year-old daughter, that she really loves a popular singer who he can’t stand. When we were near the hotel, he pointed out a drug store, and we got out of the Uber and he helped us fill Noa’s prescription for a muscle relaxant and bought extra strength Tylenol. At the intersection of two streets called Angelica and Paulista, he said it was time for us to part. We hugged him and thanked him and cried again. As we walked away from the corner of Angélica and Paulista I realized that Paulista is the term for a resident of São Paulo, and the two street signs together can mean, “Angelic Resident of São Paulo”.

We returned to the hotel. We cried and kissed and laughed and drank water and watched the setting sun make the curtains glow red. We lay down to rest, slowly, carefully. After a while we walked to a restaurant a few blocks away that Alex had recommended. Crossing the street scared us, and we were cautious. We ate steak, we ate fish, we ate pasta with butter and cheese, fresh herbs and vegetables. We ordered two desserts and ate them too. Then we crossed the street, again and again.

[1] McCrory PR, Berkovic SF (February 1998). "Concussive convulsions. Incidence in sport and treatment recommendations". Sports Medicine. 25 (2): 131–136.

Asher Kaplan is an urban planner and community organizer from Los Angeles currently living in Boston. He graduated with a Master in Urban Planning from the Harvard Graduate School of Design in 2021 and a BA in English from Oberlin College in 2015. His writings has been published in Pelican Bomb, he served as an Editor in Chief of the Harvard Urban Review, and his works as an organizer have been featured by CBS News and LAist.