This novel is a fictionalized true story of two sisters. It unfolds through letters they wrote between 1977 to 1999. Book One: Title In Mind furnishes the background of the story. In it the reader learns both sisters sustained traumatic injuries from a near deadly accident that changes their lives. Breta Gale sustains traumatic brain injury with loss of her short-term memory while her older sister, Meta, suffers from multiple physical injuries. At first, the two sisters and their family lack insight into dealing with memory impairment and pain. Writing becomes a key avenue for their therapy. After being comatose, Breta awakes and struggles with living only in the present time. She organizes her world with sticky notes for labelling. Living in the world of NOW, her horse pulls her through mind turmoils while her sister Meta struggles with pain by writing, studying and mentally escaping her tortured physical body. Pain and curiosity steer Meta on an alternative career path out of her sheltered library. She finds unexpected romances as she challenges her mind in medical school. Meantime Breta toils away hours of each day by labeling and then organizing to help her function. Her mind struggles to organize the letters, which lay the ground for the story, while Meta struggles with pain that moves her along as one of thousands of foreign medical student graduates. Those who cannot gain admission to U.S. medical schools or cannot afford them might opt for overseas education. Even for US citizens who graduate from any of the accredited foreign medical schools, the path of returning to train in the US is far from easy. First, during the years of this story, one had to graduate from an accredited World Health Organization medical school and then pass the ECFMG. The ECFMG (Exam Certification for Foreign Medical Graduates) certifies (FMGs) foreign medical graduates' competency to enter a United States residency teaching program. The ECFMG is an opening step to be eligible for the more difficult and longer 3 day exam, the FLEX (Foreign License Exam). Second, to become a licensed physician, each state controls who sits and who passes the FLEX. At the time of this story in the early 1980s, Meta never expected to be one of some 400,000 foreign medical students. When asked how she went to medical school, Meta answers, a truck hit me. Breta and Meta were in the same vehicle accident through no fault of their own. Their life-threatening injuries happened when a drunk driver lost control of his truck. Breta and Meta endure through subsequent ordeals. What drives Meta is pain and curiosity about memory. Pain occupies her life. Pain pushes her. Meta turns to study to pull her mind away from torture. She finds romance when she is not looking for it. She elects a career path over a romance that tears her heart to pieces. Breta, in the meantime, battles with her memory to do activities of daily living. Meta wants to know more about helping her sister, and others with brain injury, as well as those tormented by pain. This is the journey of how two sisters struggle to function after trauma. Pain reins Meta while Breta Gale is stuck in the world of "NOW."
