Insight and strength

It's like this, March 2011

Mary had a stroke in January. I met her in February when she was still quite sick and now we're working together in the rehab hospital. She will never be the way she was before.

There are three main cerebral arteries on each side of our brains, creatively named anterior, middle, and posterior. Mary had blockage in the anterior and middle and this starved much of the left side of her brain of oxygen. We can't really tell where the clots came from, but likely her heart, which isn't working well, sent the blood boogers up to do the damage.

The left side of the brain is where most of us have our communication centers. Our ideas and memories combine in the front: "I want to say something." Another area, further back, contains the structural rules of our language: words and grammar. Once the message is assembled, it is sent to the motor areas that control our speaking muscles. The message is programmed (maybe like computer programming) and is sent out to the muscles which are monitored by another area to make sure everything is coordinated. At the same time another part of our brain listens to what we are saying, making sure it all makes sense. Somehow this all works together, at lightning speed, and we talk to each other (or read and write).

That's how the bits and pieces work, but what is it like to have a aphasia (loss of language due to brain injury)? I always ask my clients and most of them can express something of what it's like. The words may not be so good, but you can see in their eyes, their tone of speech, and their gestures what it's really like.

Mary describes it this way:

"Like this." She holds up her index finger and thumb and makes me look at the space between them.

"Like that," she says, "gone. GONE!"

I know what she's talking about. She's referring to the connection we share when we communicate (talk, read, write). This connection is language and without it we are mostly cut off. It may only be an inch, but it might as well be a mile. Rehabilitation helps, as does time, but very often that gap is never fully repaired.

Stroke prevention is a complex story, much like life, but here's a keen fact: 80-90% of all strokes are preventable. That is, if we have the insight to see the harm we are doing to ourselves and then the strength to change, we can avoid having a stroke. Learn more here.

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