My Dear Abigail:
A humdinger this time!! I love the science, the details. No way you put us (me) to sleep. My mind was making associations as I read. The last bit I found most fascinating, and informative: It was the nature of PR's brain injury that allowed neuroplasticity to kick in as well as it did. The pace at which damage occurred gave the brain time to adjust. Sudden, traumatic injuries, like stroke, do not give the brain that luxury usually.

We all know someone, don't we, who has in some way suffered an injury to the brain?
My brother suffered the more sudden, traumatic sort. He had a devastating attack of autoimmune encephalitis when he was in early 70s. Because of a delay in diagnosis, he lost specific functions--short-term memory and spatial orientation chief among them. Vocabulary and thought processing remain intact--he does very well on intelligence tests. Your explanation for why his brain has not compensated as we hoped it might (his loss occurred over a very short span of time) helps me to understand the persisting difficulty.

Reference to metacognition also sent me down a sort of rabbit hole looking up studies on autism--theory of mind, self-awareness, etc. An area of speculation not exactly related to your subject...but then tangents are inevitable when the material is rich. Such an open field. So much research to be done. So many people, families affected. To start with, there seems to be a need for a better understanding of metacognition and self-awareness.

Thank you for this informative and stimulating piece.

With respect and appreciation,
Love from New York,
AG