Stroke hits close to home

The summer before my final semester of college, my favorite professor suffered a severe stroke that wreaked havoc on large portions of the right hemisphere of her brain. Cruelly, and perhaps ironically, she was an instructor in the neuroscience department at Wellesley College. I am struck by how often I hear of neuroscientists suffering from a neurological disease or a stroke. But then, there is hardly a person or family in America who has not been touched or affected by stroke—it is the most-common cause of disability in the United States, and fourth most-common cause of death, according to the National Stroke Association.

There are two kinds of stroke: ischemic and hemorrhagic. Ischemic strokes are more common, occurring when a clot enters the bloodstream and becomes stuck in the narrowing canal of one of the arteries that provide oxygenated blood to the brain. The neurons that are serviced by that artery are starved of oxygen and begin to die. In a hemorrhagic stroke, there is a rupturing of part of the vasculature (the network of veins and arteries) that serves the brain, causing blood to spill into the surrounding cavity. It is a common misconception that the danger of a hemorrhagic stroke lies in the pressure created by the buildup of fluid (blood) around the brain. In reality, the major problem is that blood is a neurotoxin—it is deadly to neurons when it comes in contact with them. (See Dana Guide entries on ischemic stroke and hemorrhagic stroke for more details.)

Stroke, both ischemic and hemorrhagic, occurs four times as often in the left hemisphere as the right, interrupting left-hemisphere-localized language circuits and often leaving the person unable to speak. As a neuroscience major, I have heard a great deal about stroke, but it wasn’t until this past summer that I learned what a startling and isolating experience it is for both the survivor and her loved ones.

The first time I visited my professor in the hospital following her stroke, I was struck by her lack of “brightness.” It wasn’t that she was unable to express emotion—I could see the weariness and sadness in her eyes—it was that throughout my entire visit, not once did she smile. Here was a woman known for her vibrancy and energy, and as I left Massachusetts General Hospital, I realized that before that day I’d never seen her without a smile. In subsequent visits, it was difficult to know how to interact with her. I knew she could understand me and I was patient in communication, but I couldn’t begin to imagine her experience.

Very recently I read a book that I wished I’d known of ages ago called My Stroke of Insight. It is a memoir of sorts written by neuroanatomist Jill Taylor describing the onset and aftermath of a hemorrhagic stroke she had when she was 37. Her stroke was the result of a rare congenital disorder, ateriovenous malformation, which is when a malformed part of the brain’s vasculature causes the veins to weaken and rupture, often at a young age. As is common in stroke patients, she suffered severe damage to her left hemisphere, making verbal communication nearly impossible in the weeks following. The book chronicles the morning of her stroke: her four-hour journey from full functionality of her body to being unable to walk, talk, or speak. Using her neuroscience background, she clearly explains how circuits in her brain systematically shut down so readers like me can know, hypothetically, what it’s like to have a stroke.

More importantly, however, she describes her experiences with her recovery. Although she regained basic motor function within days, it took eight years for her to become what she considered “fully recovered.” Some of those around her—medical staff, family, hospital roommates—helped her recover faster, and some may have hindered her recovery. She offers a guide for caregivers and family on how to help best:

  • Understand that the survivor has not lost all brain function. Although she was unable to speak or process most language, Taylor was very sensitive to body language and others’ intentions. She compares a hurried medical student who spoke very loudly to her neurologist who spoke slowly and carefully and had endless patience.
  • Don’t do everything for the survivor. Taylor emphasized how important it was that her family, friends, and medical staff refrain from finishing her sentences or trying to feed her words. If she were ever going to recover her verbal functionality, she says, she needed to do it on her own.
  • Believe in the stroke survivor’s ability to fully recover. Taylor said that her friends’ and family’s belief that she would recover completely strengthened her own conviction and helped her continue to fight to restore her brain.

Although at times the memoir is a bit “new age” and I’m afraid that it will, like many neuroscience materials absorbed by non-scientists, establish new pop culture misconceptions about the brain (for example, the absurd claim that we only use 10 percent of our brains), Taylor provides valuable insight about the process of suffering a stroke and the progression of recovery. If I’d read this book a year ago, I would have known how to interact with my professor a little more comfortably and confidently, and perhaps made the journey easier for both of us.

To hear more about Jill Taylor’s experience, watch her TED lecture here: http://www.ted.com/talks/lang/eng/jill_bolte_taylor_s_powerful_stroke_of_insight.html

–Caitlin Schneider

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