On Sunday 31st January, 2010, I rose early, and went for a run. Then Mel and I drove up North to have lunch with an elderly relative of hers, and pick up Mel’s new spinning wheel. We had a very pleasant, crafty time. I was dealing with a disagreeable situation at work, and it was good to have a few hours in which I wasn’t preoccupied with such things. I came home, had supper with Tom, uploaded a few photos, wrote a short blog post, and went to bed.
On February 1st, I got up at 5.30, as I normally did on a Monday morning. I felt nothing peculiar, except that I was, in myself, considerably more edgy than usual, because of two difficult meetings that I had to face that day. At 6.20, I put on my coat, slung two bags across my shoulders (one full of work, the other full of knitting) and set off on the two-mile journey to Waverley station. Outside, it was dark and bitterly cold. I quickened my pace. As I walked along the cycle path, I reflected on the day ahead. My first meeting was going to be particularly problematic because of the presence of an unpleasant individual. I reflected on previous meetings involving this individual; I rehearsed, in my mind, our forthcoming exchanges. As Tom or Mel or my parents will attest, over previous weeks, this person had pretty much made my working life a misery. I repeatedly went over the situation, the meeting, its difficulties, its possible outcomes. Useless, pointless, thoughts went round and round and round in my mind. I was extremely tense and agitated.
Then, suddenly, I felt as if a gun had gone off in my head. This is not to say that I heard a noise, rather that I felt a severe jolt from behind, a massive physical kaboom. My legs collapsed underneath me, and I fell to the ground. I immediately became aware of a peculiar and very powerful sensation, as if the whole world was fizzing or buzzing, but, at the same time, I felt incredibly distant from my body. Indeed, everything seemed weirdly detached, and the peculiar buzzing simply added to the detachment, blocking out the world like the white noise of a radio. I did not panic. I did not think: holy shit, what on earth has happened here? I felt very strange indeed, but I also felt strangely calm. I had landed rather awkwardly on the frosty ground. I tried to move, but I couldn’t. Ah, no worries, I thought. Someone will come along soon enough and give me a hand. In front of me I could see a lamp-post. and behind it, a bend in the path. I waited. I started to feel rather cold. Then, after a few moments, a man in hi-vis running gear, and a black spaniel with a flashing collar, appeared around the bend. I tried to call out, I tried to say, I can’t get up, can you help me? But my tongue seemed too big for my mouth and I just burbled uselessly. No problem, I thought to myself, I’m obviously just getting really cold. The man stopped, and bent down to help me. I reached up toward him with my right hand, and he reached down and pulled. It was at that point that I realised that there was something terribly amiss, and that, just like my mouth, my body appeared to have stopped working. The man gently helped me to lie down. There was the lamp-post in front of me again. And there was the dog with its flashing collar. It investigated me in the lollopy, snuffly way that spaniels do. It burrowed its head under the crook of my arm. It licked my face. Its collar flashed off and on. Off and on. It was a nice dog. Everything was all right. I don’t think I lost consciousness, but my recollection of things from this point on is rather hazy. I felt extremely cold, and this seemed to be all that I could think about. The weird fizzing and buzzing was now incredibly intense, and was accompanied by a violent, physical shaking. The man said “Don’t worry. I’m a GP. They are going to take you to the Western General.” I could hear fear in his voice, but I did not feel afraid. Some other people arrived, and covered me with their coats. A woman’s voice said “I’ll get off now that the ambulance is coming, is that alright?” The dog was there. Its collar flashed off and on. Everything was fine.
I had suffered two serious strokes, but I didn’t know that yet. For why on earth should I, a healthy thirty-six year old woman have a stroke? I walked everywhere, and was fit and active; I had never suffered any sort of serious physical illness, and my blood pressure had always been on the low side of normal. But I was unaware that I had an atrial septal defect — a hole in my heart — that had failed to close up after I was born. While I slept on Sunday night, my blood generated a couple of perfectly ordinary clots in my legs. Then, as I began to walk briskly to the station that Monday morning, my heart began to pump away. Meanwhile, I was reflecting on an extremely stressful situation, and winding myself up with anxious thoughts. As a consequence of this, my blood pressure, from its usual low point, rose very swiftly. The clots in my legs became dislodged, and, because of the dramatic rise in blood pressure, were diverted from their usual journey around the venous system (where they would have been broken up by my lungs). Instead, the clots pumped through the hole in my heart into my arteries, and were then carried up toward my brain. One clot ended up in my right temporal lobe, messing with my ability to apprehend and process sound. The other blocked off the blood supply to my right frontal lobe, severely damaging that part of my brain. The memory map of the left side of my body had been erased, and I was now half-paralysed.
Sudden rises in blood pressure present a very serious stroke risk. In fact, recent studies have shown that dramatic fluctuations in blood pressure from low to high are just as pertinent a stroke risk as persistent hypertension. There is also some evidence to suggest that, just like heart attacks, in people of working age disproportionate numbers of ischemic strokes occur on Monday mornings. I was a young woman with low blood pressure and apparently excellent physical health. But I was also unlucky enough to have a leaky hole in my heart about which I knew nothing. On that Monday morning, my blood pressure spiked dramatically because of stressful thoughts about a work-related situation that seems, with hindsight, completely inconsequential. But this inconsequential situation had devastating consequences. I had a serious stroke because of two random blood clots, some annoying stressful thoughts, and a congenital heart condition.
On that Monday morning, a bulldozer rudely and abruptly ploughed through the middle of my life. I was transformed from an able-bodied, energetic, active woman into a wonky, exhausted, brain-damaged one. One moment I was a lecturer, walking to work, and worrying about the day that lay ahead. The next, I was a paralysed lump in a wheelchair, having her own shit wiped off her hands. At about 6.30am on the morning of February 1st, 2010, I became a person who was recovering from a stroke.
In English, the word “stroke” is a strange one, doubly suggesting (as it does) a gentle gesture and a catastrophic blow. I can assure you that only the latter sense of the word prevails when a couple of blood clots end up in your brain. A stroke casually smashes up your sense of self. Most people who’ve written about the experience say something similar, and I think that because it is so damned sudden; because its effects are so evil and disabling; and most of all because it involves the brain, it messes with the basic concept of who you think you are. It draws a line across the sand of your identity. That was who you were then, it says. So, who are you now?
One year later, I am still a person who is recovering from a stroke. For the foreseeable future, I will continue to be a person who is recovering from a stroke. Believe me, there is nothing histrionic in the statement that my life has changed forever. I feel a little peculiar all of the time. If I didn’t constantly ‘manage’ my energy, I would be in a state of permanent exhaustion. I still lose two days out of every ten to post-stroke fatigue. I have a droopy left shoulder, a weak left arm, and a left leg that, despite what I regard as its pretty much miraculous abilities, refuses to move when it is cold, and spasms uncontrollably when I am standing still. I find it difficult to filter out foreground from background noise, and simply cannot concentrate in situations where lots of people are talking. An evening in a noisy pub, or among a group of chatty knitters, has become a form of minor torture. My relationship with sound and music has altered radically, perhaps forever. Though Tom no longer has to turn me over in bed, get me in and out of the bath, or plait my hair (badly), I am still far more dependent on him than any ‘normal’ partner would be. Looking at me now, you would see someone who seems more or less the ‘old’ me, with a limp and a wonky leg. But you might not see the new me, the one who is totally knackered all the time, who can’t really hear what you are saying, and who is still dealing with a serious brain injury.
But the ‘new’ me is a newly appreciative person, too. To be frank, I am more proud of myself for getting through this crappy time than I am about anything else I have ‘achieved,’ academically or otherwise. I would rather not have discovered in quite this way that I am a stupidly determined individual, but I am still very glad that I am one. There is certainly something in the cliché that being close to death makes you appreciate life much more intensely. Personally, I have found that there is nothing Pollyana-ish about this: rather, it is the stubborn clinging to existence of a character in a Beckett play. One must just keep clinging, keep on going. And one must cling to those who are close to one as well.
I could not have clung to anyone better than Tom. He is a wonderful, truly lovely man. There is a terror in the prospect of permanent disability and brain injury, but if you love and are loved by someone unquestioningly, then you feel much less afraid. This fearfulness is seriously one of the worst things I’ve had to deal with in the past twelve months (trust me, the effects of neurological damage are very frightening indeed), but the only way to fight it is to draw strength and encouragement from those around you, and put everything you’ve got into getting well. Because I was so utterly desperate to knit and walk and read and be me again, I found recovery to be largely a positive process, (albeit an uneven and incredibly difficult one) and it has felt like a genuine privilege to see the way that the brain adapts and works from the inside, as it were. Seeing a dead limb – a limb that has completely lost its brain-map – flicker into life again for the first time, and knowing that some neurons have fired in your head in a way they never have before to make that movement happen, is a quite miraculous thing. Gaining insight into the basic operations of my grey matter made me reflective and philosophical in a completely new way. Now, I really do think that there is only the brain.
I can’t tell you how much I wish I hadn’t had a stroke. But, in many ways, the experience has been both salutary and instructive. Unless we have the great good fortune to go suddenly, while at the crease (like the father of a friend of mine), every single one of us is going to have to deal with the effects of a stroke, or serious disease, or disability, at some point in our lives. We are going to struggle, and see those we are close to struggle alongside us. We will need help from others, and we will have to draw on what reserves of strength we have to help ourselves. Tom and I have often reflected on how very like bereavement dealing with my stroke has been: being bereaved doesn’t make a subsequent death any easier necessarily, but at least you sort of know what to expect. Having been through this shit once, I think we can probably deal with it when life throws it at us, as it inevitably will, again.
I’ll conclude with some lines from Adrienne Rich’s brave, spare, poem, Shooting Script which have often been in my mind over the past year.
“Whatever it was, the image that stopped you, the one on which you
came to grief, projecting it over & over on empty walls.
Now to give up the temptations of the projector; to see instead the
web of cracks filtering across the plaster.
To read there the map of the future, the roads radiating from the
initial split, the filaments thrown out from that impasse.
To reread the instructions on your palm; to find there how the
lifeline, broken, keeps its direction.
To read the etched rays of the bullet-hole left years ago in the
glass; to know in every distortion of the light what fracture is.
To put the prism in your pocket, the thin glass lens, the map
of the inner city, the little book with gridded pages.
To pull yourself up by your own roots; to eat the last meal in
your old neighborhood.”