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Fri

14

May

2010

My Stroke of Insight - A brain scientist's personal journey - Book Review by Kéllia Ramares
Friday, 14 May 2010 05:56
by Kéllia Ramares

    I have heard doctors say, “If you don't have your abilities back by six months after your stroke, then you won't get them back!” Believe me, this is not true. I noticed significant improvement in my brain's ability to learn and function for eight full years post-stroke, at which point I decided my mind and body were totally recovered.

    - Dr. Jill Bolte Taylor, My Stroke of Insight, p. 116.

This short book is the amazing first person account of Dr. Taylor's stroke and eight-year path of recovery. In December of 1996, the then-37-year-old neuroanatomist suffered a hemorrhagic stroke from an arteriovenous malformation, a congenital disorder. The hemorrhage flooded the left hemisphere of her brain with blood and created a golfball-sized clot that had to be removed surgically. The stroke left her without the faculties of language, calculation and memory, basically returning her to an infantile state.

The book begins with a short description of her early years, including her brother's diagnosis of schizophrenia, which first got her interested in the workings of the brain. She goes on to describe her education and her associations with NAMI (National Alliance on Mental Illness) and Harvard University's Brain Bank, a facility that dispenses donated brain tissue to researchers. It was the combination of Dr. Taylor's background in brain science and the fact that the stroke did not render her unconscious that she was able to later record both her brain trauma and its immediate aftermath.

Just before the chapters describing her ordeal, Dr. Taylor presents two chapters of basic brain anatomy to help people understand the various functions of the brain and how they were impaired by her stroke. These chapters are easy and interesting for a layperson to read and although they may be skipped, they shouldn't be. She then describes what happened the morning of the stroke, when she realized what was happening and tried to get help as her cognitive functions were deteriorating.

I learned from reading those chapters two big things: the first was how important it is to be able to reach other people in an emergency. (Dr. Taylor was single and the circumstances of her illness had deprived her of the awareness that her landlady was home, or that 911 could be called for an ambulance). The second was what a shameful excuse for a health care system we have in the United States. As she struggled to get help during this life threatening emergency, Dr. Taylor also worried about where she would get care and how much it would cost:

    [E]ven in this discombobulated state, I felt a nagging obligation to contact my doctor. It was obvious that I would need emergency treatment that would probably be very expensive, and what a sad commentary that even in this disjointed mentality, I knew enough to be worried that my HMO might not cover my costs in the event that I went to the wrong health center for care. (her emphasis) p. 58.

Unfortunately, after having raised this important issue, Dr. Taylor does not resolve it. We never find out to what extent her HMO covered her.
 

The later chapters of the book, in which Dr. Taylor described what she learned from the stroke, were at times a bit confusing to me, in light of her stated purpose in writing the book: to help others who faced stroke or other brain trauma. Clearly she learned many things about herself from the stroke, but as I wrote in one of my margin notes: “If we are too left brained or right brained, how do we experience more of the other side without having a stroke?” She does give some suggestions for how to be more present in the here and now, and how to practice disconnecting from negative neural feedback loops (the programmed way we respond to things emotionally). But I was still left with the feeling that it would take most people having a Near-Death-Experience to make these major life changes. I know that some people feel they can do it with meditation, which is never mentioned in the book, although Dr. Taylor several times describes the feeling of being in her right brain with the Buddhist term Nirvana.

I was left with an unclear and unsatisfactory picture of what Dr. Taylor thinks spirituality is or what part of us is spiritual. She writes of praying to the Great Spirit, and also of speaking to her own mind, yet she also clearly believes that our emotions are the products of our biology. She writes in very clinical terms of what the physiological responses of our bodies are, and at one point states, “We are ultimately the product of our biology and environment.” Does she really believe that, and if so, why does she believe that her body can respond to what she tells it?

Also, Dr. Taylor writes of the left brain and the right brain as being very different. While there is certainly plenty of evidence of that, experiments have revealed that the brain is not so rigidly divided into areas having specific functionalities as we have traditionally believed. For example, experiments in which parts of salamanders' brains were burned away showed that the salamanders were still able to carry out the functions believed to have been located in the part of the brain that was burned away. This is part of the plasticity of the brain which Dr. Taylor believes in, relied on in her recovery, and wants others to believe in so as to keep doctors and other caregivers of brain traumatized patients in an encouraging mode. Yet her descriptions of left brain and right brain functions seem very rigid.

Throughout the book I wondered how much the quality of care she received, from doctors affiliated with the Harvard Medical School, to a loving mother with a gift for teaching, to support from thousands of people who had heard of her from her work with NAMI and the Brain Bank impacted her recovery. In recent years, two other stroke recovery cases have made the news: Sen. Tim Johnson (D. SD) who also had a congenital arteriovenous malformation, recovered sufficiently to win re-election two years later. Tedy Bruschi, a New England Patriots linebacker, had a stroke at age 31, due to a blood clot, but returned to professional football 8 months later. Is the kind of medical care and public support that a U.S. Senator, pro football player or national spokesperson for a Harvard-affiliated organization can get qualitatively different enough to affect the degree of recovery compared to what is available to a poor, anonymous, uninsured person dependent on the county hospital? Every brain is different, every stroke is different. But I wonder.

Despite my lingering questions, I recommend this book to anyone who is or knows someone who is recovering from brain trauma, as well as anyone who is interested in learning more about the brain without taking heavy science courses. The book contains useful information including how to recognize symptoms of a stroke, what Dr. Taylor needed in terms of attitudes and interactions from her caregivers, which may be useful to other patients, as well as information on the Harvard Brain Bank.

Dr. Taylor is now teaching neuroanatomy in her home state of Indiana as well as continuing her advocacy for the Brain Bank.

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