A reader writes:
Having had a stroke myself when I was 46 (I’m now 57), I can empathize with Mr. Dyer’s situation. After reading his description, he was quite fortunate. His impairments were quite limited and he never mentioned any need of rehabilitation services. But I was concerned about his driving, considering the visual deficits he described. The problem is that stroke survivors tend to develop a sense of overconfidence once they feel healed, but his visual impairments may be more involved than he notices. The brain needs closure. Stroke-induced visual deficits can be masked by the brain as it searches to fill in missing visual information with what it perceives should be there, and that perception is often a mismatch with reality.
An example: Patients with ischemias of the right cerebral cortex often develop a condition called visual neglect or visual field cut. The damaged brain may not see an obstacle in a hallway to the left but the brain has experienced that hallway before, so it plugs in that missing information as an obstacle. The patient walks into the object, insisting it is not there. Now imagine driving on a familiar street with an oncoming car on his left.
I forgot to mention I am a retired medical speech pathologist with 25 years of practice. The cognitive issues are a major pain in the ass. Reading for enjoyment is limited. In fact, if you have a blog entry over three paragraphs, I go into brain lock.
Another stroke survivor:
I read Geoff Dyer’s story with interest. When I reached the end I realized an obvious point. “Oh my God” I thought.
He’s writing about this year! He’s not even three months in. While his stroke was milder than mild, he’s barely had time to sort out it’s impact. I am also a survivor. I’ll have my fifth re-birthday over Memorial Day weekend. My two strokes happened within hours, and like Geoff’s, they were mild. I continue to play tennis, and I’m in the market for a ping pong table. It won’t fit in my apartment, and I don’t really have the money – I haven’t worked since – but I’m looking (I love the game so).
One of the mantras that survivors hear from their doctors is that six months is the golden window at which point you’ll know the extent of your recovery. What I, and many survivors will tell you, is that recovery continues beyond that point. Almost five years later, I’m still getting better. What’s more, is that as time passes, my awareness of the stroke’s impact has increased as well.
In Letters to a Young Poet, Rilke notes that “the point of life is to live everything.” What he didn’t say, is that while change can happen in an instant, we have to live into what follows. It will be interesting to see what Geoff has to say about his stroke in three more months, in a year, and again in two. In this piece it seems clear to me that he’s not sure what the lasting impact of his stroke is:
There had certainly been some cognitive impairment, but my wife insisted that this had occurred before the stroke. I used to pride myself on my sense of direction but that had long gone south, or maybe north or east. I had trouble concentrating but that too had been going on for ages; I put it down to the internet, not to my brain blowing a fuse or springing a leak. So no, nothing had gone permanently wrong in my head, or at least nothing had gone wrong that had not been in the process of going wrong for a while…” [italics are mine]
One of the experiences I had that is similar to what Dyer described in the quote, is that the people who knew me best were quick to locate impairments to pre-existing issues, or associate it with age-related issues. For me, this speaks to the way we really don’t know how to talk about strokes without relating it to experiences we have had, or our sense of pre-existing conditions. When it comes to ailments we cannot see, our imagination fails us. It takes seeing someone who is “sadly diminished” as Dyers describes Gilbert Adair – using Adair’s own words – before we admit it is real. A year after my strokes, I broke my wrist riding a bike. I received more care afterwards simply because people could see my cast.
Two months after my strokes, I could describe to folks what I was doing when I had the strokes. It’s a story I had to learn because I was having short-term memory issues. At the same time, I wasn’t aware of what I was living into. I pretty much lived in the present moment. I’m smart, and my ability to create coping mechanisms, allowed me to mask impacts I couldn’t see or put words to. As a result, I didn’t begin to become aware of what was happening to me, until fifteen months later.
Almost five years later I feel like myself again. Part of my brain is dead. I understand more of what the lasting impact of my strokes are. I’ve lived into this new life of mine. I know that I have gifts, what they are, and that they should be shared. I am very close to the person I was before (it’s glorious). Will Geoff experience something similar? Something different? Time will tell.
The Dish 