Until she was 26 years old, Cole Cohen had no idea why she couldn’t tell time, learn how to drive, cross a street on her own, or know how long to hug someone.

Finally, an occupational therapist in her native Portland, Ore., suggested Cohen get an MRI, and on the morning of June 17, 2007, she and her parents met with her neurologist, Dr. Volt, for the results.

In her new memoir, “Head Case: My Brain and Other Wonders,” she describes receiving her diagnosis.

“Dr. Volt is behind his desk; his computer monitor is turned toward us. I don’t understand the image in front of me. It’s a black-and-white splice of a brain, I assume mine, with an inky black spot on it in the shape of a lopsided heart.

“I tell myself that this is a spot on the film, which it’s way too large to actually be. It’s something not to worry about, something I don’t understand that the doctor will explain away.

“We are all staring dumbly at the image on the screen until Dr. Volt begins to speak. ‘So, this is your brain . . . and this’ — he points with a pencil to the black spot — ‘is a hole.’ The image comes into focus. It is not debatable.

“A hole.”
“There is a hole in my brain.”

Cohen asked the next obvious question: How big is it?

Dr. Volt took his pencil and pointed to the image of her eyeballs on the scan. He tapped from one eyeball to the hole, back and forth, until he filled the void.

“About 20 eyeballs,” he said. “About the size of a lemon. Or, say, a small fist? Like the fist of a 10-year-old?”

As far as Cohen knows, there has never been another recorded case like hers. After her appointment with Dr. Volt, she and her parents went to lunch at a Chinese restaurant, where they largely sat in silence.

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