4. Morning of the Stroke
It was 7:00 am on December 10, 1996. I awoke to the familiar tick-tick-tick of my compact disc player as it began winding up to play. Sleepily, I hit the snooze button just in time to catch the next mental wave back into dreamland. Here, in this magic land I call "Thetaville" a surreal place of altered consciousness somewhere between dreams and stark reality - my spirit beamed beautiful, fluid, and free from the confines of normal reality.
Six minutes later, as the tick-tick-tick of the CD alerted my memory that I was a land mammal, I sluggishly awoke to a sharp pain piercing my brain directly behind my left eye. Squinting into the early morning light, I clicked off the impending alarm with my right hand and instinctively pressed the palm of my left hand firmly against the side of my face. Rarely ill, I thought how queer it was for me to awaken to such a striking pain. As my left eye pulsed with a slow and deliberate rhythm, I felt bewildered and irritated. The throbbing pain behind my eye was sharp, like the caustic sensation that sometimes accompanies biting into ice cream.
As I rolled out of my warm waterbed, I stumbled into the world with the ambivalence of a wounded soldier. I closed the bedroom window blind to block the incoming stream of light from stinging my eyes. I decided that exercise might get my blood flowing and perhaps help dissipate the pain. Within moments, I hopped on to my "cardioglider" (a full body exercise machine) and began jamming away to
Shania Twain singing the lyrics, "Whose bed have your boots been under?". Immediately, I felt a powerful and unusual sense of dissociation roll over me. I felt so peculiar that I questioned my wellbeing. Even though my thoughts seemed lucid, my body felt irregular. As I watched my hands and arms rocking forward and back, forward and back, in opposing synchrony with my torso, I felt strangely detached from my normal cognitive functions. It was as if the integrity of my mind/body connection had somehow become compromised.
Jill's hemorrhage began deep inside here!: Xuất huyết của Jill bắt đầu sâu bên trong đây! (Mũi tên chỉ vào một vùng sâu bên trong bộ não, ám chỉ vị trí xuất huyết).
Feeling detached from normal reality, I seemed to be witnessing my activity as opposed to feeling like the active participant performing the action. I felt as though I was observing myself in motion, as in the playback of a memory. My fingers, as they grasped onto the handrail, looked like primitive claws. For a few seconds I rocked and watched, with riveting wonder, as my body oscillated rhythmically and mechanically. My torso moved up and down in perfect cadence with the music and my head continued to ache.
I felt bizarre, as if my conscious mind was suspended somewhere between my normal reality and some esoteric space. Although this experience was somewhat reminiscent of my morning time in Thetaville, I was sure that this time I was awake. Yet, I felt as if I was trapped inside the perception of a meditation that I could neither stop nor escape. Feeling dazed, the frequency of shooting pangs escalated inside my brain, and I realized that this exercise regime was probably not a good idea.
Feeling a little nervous about my physical condition, I climbed off the machine and bumbled through my living room on the way to the bath. As I walked, I noticed that my movements were no longer fluid. Instead they felt deliberate and almost jerky. In the absence of my normal muscular coordination, there was no grace to my pace and my balance was so impaired that my mind seemed completely preoccupied with just keeping me upright.
As I lifted my leg to step into the tub, I held on to the wall for support. It seemed odd that I could sense the inner activities of my brain as it adjusted and readjusted all of the opposing muscle groups in my lower extremities to prevent me from falling over. My perception of these automatic body responses was no longer an exercise in intellectual conceptualization. Instead, I was momentarily privy to a precise and experiential understanding of how hard the fifty trillion cells in my brain and body were working in perfect unison to maintain the flexibility and integrity of my physical form. Through the eyes of an avid enthusiast of the magnificence of the human design, I witnessed with awe the autonomic functioning of my nervous system as it calculated and recalculated every joint angle.
Ignorant to the degree of danger my body was in, I balanced my weight against the shower wall. As I leaned forward to turn on the faucet, I was startled by an abrupt and exaggerated clamor as water surged into the tub. This unexpected amplification of sound was both enlightening and disturbing. It brought me to the realization that, in addition to having problems with coordination and equilibrium, my ability to process incoming sound (auditory information) was erratic.
I understood neuroanatomically that coordination, equilibrium, audition and the action of inspirational breathing were processed through the pons of my brainstem. For the first time, I considered the possibility that I was perhaps having a major neurological malfunction that was life threatening.
Fibers Passing Through the Pons of the Brainstem
normal hearing: thính giác bình thường. Pons: Cầu não (equilibrium, coordination, sound, and breath inspiration): (thăng bằng, phối hợp, âm thanh và hít thở)
As my cognitive mind searched for an explanation about what was happening anatomically inside my brain, I reeled backward in response to the augmented roar of the water as the unexpected noise pierced my delicate and aching brain. In that instant, I suddenly felt vulnerable, and I noticed that the constant brain chatter that routinely familiarized me with my surroundings was no longer a predictable and constant flow of conversation. Instead, my verbal thoughts were now inconsistent, fragmented, and interrupted by an intermittent silence.
LANGUAGE CENTERS: Trung tâm ngôn ngữ Broca's Area: Vùng Broca (ability to create speech): (khả năng sản xuất lời nói) Wernicke's Area: Vùng Wernicke (ability to understand speech): (khả năng hiểu lời nói)
When I realized that the sensations outside of me, including the remote sounds of a bustling city beyond my apartment window, had faded away, I could tell that the broad range of my natural observation had become constricted. As my brain chatter began to disintegrate, I felt an odd sense of isolation. My blood pressure must have been dropping as a result of the bleeding in my brain because I felt as if all of my systems, including my mind's ability to instigate movement, were moving into a slow mode of operation. Yet, even though my thoughts were no longer a constant stream of chatter about the external world and my relationship to it, I was conscious and constantly present within my mind.
Confused, I searched the memory banks of both my body and brain, questioning and analyzing anything I could remember having experienced in the past that was remotely similar to this situation. Whatis going on? I wondered. Have I ever experienced anything like thisbefore? Have I ever felt like this before? This feels like a migraine. Whatis happening in my brain?
The harder I tried to concentrate, the more fleeting my ideas seemed to be. Instead of finding answers and information, I met a growing sense of peace. In place of that constant chatter that had attached me to the details of my life, I felt enfolded by a blanket of tranquil euphoria. How fortunate I was that the portion of my brain that registered fear, my amygdala, had not reacted with alarm to these unusual circumstances and shifted me into a state of panic. As the language centers in my left hemisphere grew increasingly silent and I became detached from the memories of my life, I was comforted by an expanding sense of grace. In this void of higher cognition and details pertaining to my normal life, my consciousness soared into an all one knowingness, a "being at " with the universe, if you will. In a compelling sort of way, it felt like the good road home and I liked it.
By this point I had lost touch with much of the physical three-dimensional reality that surrounded me. My body was propped up against the shower wall and I found it odd that I was aware that I could no longer clearly discern the physical boundaries of where I began and where I ended. I sensed the composition of my being as that of a fluid rather than that of a solid. I no longer perceived myself as a whole object separate from everything. Instead, I now blended in with the space and flow around me. Beholding a growing sense of detachment between my cognitive mind and my ability to control and finely manipulate my fingers, the mass of my body felt heavy and my energy waned.
When the shower droplets beat into my chest like little bullets, I was harshly startled back into this reality. As I held my hands up in front of my face and wiggled my fingers, I was simultaneously perplexed and intrigued. Wow, what a strange andamazing thing I am. What a bizarre living being I am. Life! I amlife! I am a sea of water bound inside this membranous pouch.Here, in this form, I am a conscious mind and this body is thevehicle through which I am ALIVE! I am trillions of cells sharinga common mind. I am here, now, thriving as life. Wow! What anunfathomable concept! I am cellular life, no - I am molecular lifewith manual dexterity and a cognitive mind!
In this altered state of being, my mind was no longer preoccupied with the billions of details that my brain routinely used to define and conduct my life in the external world. Those little voices, that brain chatter that customarily kept me abreast of myself in relation to the world outside of me, were delightfully silent. And in their absence, my memories of the past and my dreams of the future evaporated. I was alone. In the moment, I was alone with nothing but the rhythmic pulse of my beating heart.
I must admit that the growing void in my traumatized brain was entirely seductive. I welcomed the reprieve that the silence brought from the constant chatter that related me to what I now perceived as the insignificant affairs of society. I eagerly turned my focus inward to the steadfast drumming of the trillions of brilliant cells that worked diligently and synchronously to maintain my body's steady state of homeostasis. As the blood poured in over my brain, my consciousness slowed to a soothing and satisfying awareness that embraced the vast and wondrous world within. I was both fascinated and humbled by how hard my little cells worked, moment by moment, just to maintain the integrity of my existence in this physical form.
For the first time, I felt truly at one with my body as a complex construction of living, thriving organisms. I was proud to see that I was this swarming conglomeration of cellular life that had stemmed from the intelligence of a single molecular genius! I welcomed the opportunity to pass beyond my normal perceptions, away from the persevering pain that relentlessly pulsed in my head. As my consciousness slipped into a state of peaceful grace, I felt ethereal. Although the pulse of pain in my brain was inescapable, it was not debilitating.
Standing there with the water pounding onto my breasts, a tingling sensation surged through my chest and forcefully radiated upward into my throat. Startled, I became instantly aware that I was in grave danger. Shocked back into this external reality, I immediately reassessed the abnormalities of my physical systems. Determined to understand what was going on, I actively scanned my reservoir of education in demand of a self-diagnosis. What is going on with my body? What is wrong with mybrain?
Although the sporadically discontinuous flow of
normal cognition was virtually incapacitating, somehow I managed to keep my body on task. Stepping out of the shower, my brain felt inebriated. My body was unsteady, felt heavy, and exerted itself in very slow motion. What is it I'm trying to do ? Dress, dress for work. I'mdressing for work. I labored mechanically to choose my clothes and by 8:15 am, I was ready for my commute. Pacing my apartment, I thought, Okay, I'm going to work. I'm going to work. Do I know how to get towork? Can I drive? As I visualized the road to McLean Hospital, I was literally thrown off balance when my right arm dropped completely paralyzed against my side. In that moment I knew. Oh my gosh, I'mhaving a stroke! I'm having a stroke! And in the next instant, the thought flashed through my mind, Wow, this is so cool!
I felt as though I was suspended in a peculiar euphoric stupor, and I was strangely elated when I understood that this unexpected pilgrimage into the intricate functions of my brain actually had a physiological basis and explanation. I kept thinking, Wow, how manyscientists have the opportunity to study their own brain function andmental deterioration from the inside out? My entire life had been dedicated to my own understanding of how the human brain creates our perception of reality. And now I was experiencing this most remarkable stroke of insight!
When my right arm became paralyzed, I felt the life force inside the limb explode. When it dropped dead against my body, it clubbed my torso. It was the strangest sensation. I felt as if my arm had been guillotined off!
MOVEMENT AND SENSORY PERCEPTION: Vận động và Cảm nhận giác quan Motor Cortex: Vỏ não vận động (ability to move): (khả năng di chuyển) Sensory Cortex: Vỏ não cảm giác (ability to sense the world): (khả năng cảm nhận thế giới)
I understood neuroanatomically that my motor cortex had been affected and I was fortunate that within a few minutes, the deadness of my right arm subtly abated. As the limb began to reclaim its life, it throbbed with a formidable tingling pain. I felt weak and wounded. My arm felt completely depleted of its intrinsic strength, yet I could wield it like a stub. I wondered if it would ever be normal again. Catching sight of my warm and cradling waterbed, I seemed to be beckoned by it on this cold winter morning in New England. Oh, I am so tired. I feel sotired. I just want to rest. I just want to lie down and relax for a littlewhile. But resounding like thunder from deep within my being, a commanding voice spoke clearly to me: If you lie down now you willnever get up!
Startled by this ominous illumination, I fathomed the gravity of my immediate situation. Although I was compelled by a sense of urgency to orchestrate my rescue, another part of me delighted in the euphoria of my irrationality. I stepped across the threshold of my bedroom, and as I gazed into the eyes of my reflected image, I paused for a moment, in search of some guidance or profound insight. In the wisdom of my dementia, I understood that my body was, by the magnificence of its biological design, a precious and fragile gift. It was clear to me that this body functioned like a portal through which the energy of who I am can be beamed into a three-dimensional external space.
This cellular mass of my body had provided me with a marvelous temporary home. This amazing brain had been capable of integrating literally billions of trillions of bits of data, in every instant, to create for me a three-dimensional perception of this environment that actually appeared to be not only seamless and real, but also safe. Here in this delusion, I was mesmerized by the efficiency of this biological matrix as it created my form, and I was awed by the simplicity of its design. I saw myself as a complex composite of dynamic systems, a collection of interlacing cells capable of integrating a medley of sensory modalities streaming in from the external world. And when the systems functioned properly, they naturally manifested a consciousness capable of perceiving a normal reality. I wondered how I could have spent so many years in this body, in this form of life, and never really understood that I was just visiting here.
Even in this condition, the egotistical mind of my left hemisphere arrogantly retained the belief that although I was experiencing a dramatic mental incapacity, my life was invincible. Optimistically, I believed that I would recover completely from this morning's events. Feeling a little irritated by this impromptu disruption of my work schedule, I bantered, Okay, well, I'm having a stroke. Yep, I'm having a stroke...but I'ma very busy woman! All right, since I can't stop this stroke fromhappening, then, okay, I'll do this for a week! I'll learn what Ineed to know about how my brain creates my perception ofreality and then I'll meet my schedule, next week. Now, what amI doing? Getting help. I must stay focused and get help.
To my counterpart in the looking glass I pleaded,
Remember, please remember everything you are experiencing!Let this be my stroke of insight into the disintegration of my owncognitive mind.
Territory of Jill's hemorrhage: Vùng xuất huyết của Jill (shaded oval area): (vùng hình bầu dục được tô bóng) Motor Cortex: Vỏ não vận động (ability to move): (khả năng di chuyển) Sensory Cortex: Vỏ não cảm giác (ability to sense the world): (khả năng cảm nhận thế giới) Orientation Association Cortex: Vỏ não liên hợp định hướng (physical boundaries, time and space): (ranh giới vật lý, thời gian và không gian) Broca's Area: Vùng Broca (ability to create speech): (khả năng sản xuất lời nói) Wernicke's Area: Vùng Wernicke (ability to understand speech): (khả năng hiểu lời nói)