Mikazuki Augus's Brain Injuries
Mikazuki Augus through the course of the story in Iron-Blooded Orphans loses his sight in his right eye, the use of his right arm, and eventually use of his right side entirely. This paralysis comes as a direct result of his using the Alaya-Vijnana system, which allowed him to pilot the Gundam Barbatos. This system opened his connection to the Gundam to get more power and ability out of the machine.
We get an explanation of the Alaya-Vijnana system pretty early on in the series when Nadi explains how it works to Kudelia. He tells her: "It can only fuse with children who are still growing. It uses special nanomachines and is dangerous and inhumane. With those nanomachines, it creates a pseudo-brain lobe that governs spatial awareness. Through that, it connects to an external device, making a system where the brain can directly process Mobile Suit data."
Later in the series, in Episode 24, Mcgillis talks a little about how the Alaya-Vijnana system works and we get the following diagram:
It shows where the ports attach to the spine, and then where the main system connects directly to the medulla oblongata, where the brain and spinal cord connect.
It is unclear, from what I recall, if children get surgeries for connections on both the spinal cord and on the base of the brain. It seems like they don't. From what we see in various flashbacks and the lack of visible scarring on the children's necks, it seems like they only undergo one surgery on the spinal cord. It's also said they don't have the full Alaya-Vijnana system installed, so I think that means they lack the main system input area. What that means for the kids in the series is that they cannot access the full power of the suits without risking injury, as we see happen to Mikazuki twice.
Mikazuki seems to be permanently injured from opening himself up to the full power, or even just more power in the suit (it's difficult to say if Barbatos is operating at full power in either instance Mikazuki is injured or if he would have had access to even more power if he'd had access to the full Alaya-Vijnana system). While he regains functionality whenever he plugs himself back into Barbatos, he is otherwise injured or paralyzed when not plugged in.
In the show, these injuries seem to be treated entirely as physical injuries rather than mental ones. Mikazuki wears a sling for his dead arm and later is carted around by Hush, and presumably others, when his right leg doesn't work anymore. Mikazuki himself seems mostly unfazed by his new reality, determining he's only really good for being a weapon. He says to Kudelia in season two, "Unlike the other guys, it's about all I can do." Even when he is further injured, he mentions to Orga how it makes things easier because he could not imagine himself in the world that Kudelia is trying to build, one where the violence he is accustomed to is unnecessary. I've seen some people talk about this, about his attitude toward himself, especially in season two, how he's resigning himself to be a weapon, a tool for Orga's dream, and other similar lines of thought. I'm not going to say they are wrong; everyone can interpret a story differently.
I would, however, like to offer another perspective: Mikazuki has brain damage. He sustains a traumatic brain injury when he fights Ein at the end of season one, and then injures his brain again when he fights the mobile armour in season two. Perhaps one could even argue that since he continues to use Barbatos after the first injury — and Barbatos is essentially building new pseudo-brain lobe pathways with nanomachines that allow him to use otherwise inaccessible body parts — that doing so is potentially re-injuring him every single time. I'm not sure I believe that, but it could be argued without much difficulty.
Having had a stroke, it seems to me like Barbatos forced Mikazuki to have a stroke by suffocating the part of his brain that controlled his right arm and eye the first time, and then further suffocated that same area of the brain to paralyze the entire right side later. I say stroke, because honestly, due to how much he bleeds from his face whenever he injures himself like this, it seems like there's a problem with the blood flow in his head at these times. Due to this, it seems likely that what happened to kill that part of his brain is the same thing that causes him to bleed from his face. The blood is hindered from going where it is supposed to go, i.e. to the areas controlling his limb use and eye, and instead goes through the pseudo-brain lobe the Alaya-Vijnana system created within him, with the excess draining out.
We aren't shown any medical care he receives after either injury, but given the way people treat him and act around him, it doesn't seem like there would have been any treatment given to him or examination that would lead to anyone understanding that he had brain damage. It really does seem like he's just treated as having these physical injuries and that's it. But given that these injuries happen due to the system that is attached to his spinal cord and fed into his brain, it seems very reasonable to conclude he has had several traumatic brain injuries.
Once I thought about it that way, things about his attitude, his motivation, and the way he thinks about himself made a bit more sense to me. For example, after I had my stroke, I found it very difficult to read for a while, understand what I was reading, and to follow along with things that were simple to me before. I could still read, but it was much, much harder than before. Mikazuki was only just learning how to read in the months leading up to the fight in Edmonton, but after, when we hear Atra talk about him being lazy about keeping up with his reading lessons, if he'd had a stroke/traumatic brain injury, this attitude towards reading makes a lot more sense. This is especially true for someone like Mikazuki, who had just started learning, only to find it suddenly even more confusing and difficult than it had been before, and not understand why. I can see him giving up on it for a while or being lazy about it. Now, my stroke was different from what Mikazuki would have experienced given his paralysis, but mine wasn't in the part of the brain that controls your ability to read either. In my experience, when you have a brain injury, some other parts of the brain that are uninjured may struggle as well. In studies done on strokes in the young, issues with cognition are a common complaint and struggle – it's something I struggled with myself. All to say, I think Mikazuki's lack of engagement with his previous interests makes a lot of sense for someone who is struggling with cognition, especially when he doesn't even have the knowledge that he's dealing with a brain injury the whole time.
In my experience, it really did feel like I had lost a part of myself for a few years as I recovered from my stroke. I could not read like I used to; I found conversations harder; I found thinking more difficult. I had completed a master's the year before, but knew I would have a very difficult time following my own work after my stroke. It was very difficult to get people to understand what I was experiencing because I could still communicate fine, I could still do my job the same as before, I was still capable of living alone and being okay – I was competent enough to an outside observer that no one could see the loss the way I felt it. This meant that the inconvenience of losing a part of myself was just that, inconvenient and not life-ruining. I had to keep on going because what else was there to do? It took four months to learn I had the stroke anyway, so I just thought I felt weird and off the whole time until the MRI came back and we knew it was much more serious.
I bring that up to speak to how I can see Mikazuki, who is a very pragmatic deal-with-what-is-in-front-of-me person, dealing with the hand he is given to the best of his ability while not fully understanding what it is and why it happened. He resigns himself to the reality he sees before him: he is no longer useful outside of Barbatos, and as it seems they've only had to fight more after the battle of Edmonton, his abilities as a pilot would be even more in demand than before. He can still fulfill a role that only he is able to do; no one else can pilot Barbatos like him, no one else can be the beast of the battle that earned him the name the Devil of Tekkaden. He has resigned himself to this role inasmuch as he can see nothing else available for him to do with his abilities. Much, much later in the season, Kudelia comes upon him reading again, and he says he's reading about vegetables. Here we see him, after the second brain-injuring event, moving forward in a very small way. He's engaging again with his interests, despite speaking to Kudelia in a way that suggests he does not see a life for himself outside the battlefields they cannot escape from.
As far as I remember, we don't actually know how much time passes between the mobile armour fight and the end of the show. I'm not even sure if within the show itself we learn it has been two years since Edmonton when season two begins, but I know from secondary material that the intent was for that amount of time to have passed. It wasn't a few years between Hashmal and Mika's death; I am pretty sure of that at least. So when looking at his progress from the point of view of brain injury recovery, two years of being rather down on himself reads as true to me, as does him trying to grasp a little of who he was before later in the show. This makes sense to me, perhaps even more so after he has been injured the second time. It could have accelerated his internal perspective on his recovery, where he accepts this further loss while trying to claw some measure of himself out of the wreckage of his body.
Also, to go back to my thought earlier about him possibly re-injuring himself every time he uses Barbatos, even if he didn't re-injure himself and, just opened the pseudo-brain-lobe connection to compensate for the dead parts of his brain, to me, using that kind of continuous crutch of sorts would only hinder his ability to actually recover from the injury. He sees no improvement in the arm paralysis or the eye blindness because he continues to use the machine that is forcing a false brain inside him. By doing so, it is hindering his own brain's ability to learn how to compensate for what was lost and now will remain, dead forever in his head until he dies himself. Given how young Mikazuki is when he sustained this injury, his brain could very well have learned how to compensate in other areas to an extent that he could have seen some capability return to his arm and eye. With how extensive the injury was, based on my readings of studies done with stroke patients who had motor function loss, if there is no rehabilitation done soon after, it is unlikely they will regain any use of those motor functions. Granted, I could not find any studies like this done specifically with younger stroke patients who had motor function loss, but younger patients have a much better outlook for recovery because the brain is so elastic in our youth. And again, Mikazuki is young. With physio exercising the limb to an extent, and making himself use these parts of him that are injured to the best of his ability, he could push himself into regaining some functionality. Perhaps he would never regain all of it, but his outlook would have likely been better than not doing anything at all and allowing Barbatos to mask the injuries for him.
If say, there was an AU where after Edmonton he did have that opportunity to be seen by a real doctor, to have his brain looked at, to get the care he needed, well… it would be an entirely different story. But it can be fun to play with the possibilities. It doesn't mean that if he did get that care and did that work, he wouldn't be disabled. One thing I liked a lot about what Iron-Blooded Orphans did was not shy away from disabling one of its protagonists and leaving him disabled without finding a magical cure. Stroke recovery isn't a magical cure; it takes a lot of work, it is absolutely not a linear upward trajectory to full capability, and it can be very frustrating, but it is also possible. Especially for someone his age. And, honestly, given that we already had an illiterate protagonist, it would have been pretty neat if they'd actually been explicit about him having a traumatic brain injury whilst also still being very capable.
Brain damage isn't the same for anyone who has it. And thinking of Mikazuki living with it, however unknowingly, adds quite a bit to understanding his character in season two.
Thanks for reading! And thank you extra to @lanaserra who gave me a read through and some great edits!