There are those in academia who claim that knowledge of Latin gives a student a major leg up when it comes to understanding other foreign tongues. I am a great dissenter from that viewpoint. Latin is of no value in deciphering some of the world’s major languages, such as English or German, or any of the languages of Eastern European groups or of the Asiatics, such as the Japanese or the Chinese. It seems to me that Greek counts most when dealing with non-English words. Take Aphasia. The Greeks say it is the loss or impairment of the power to use words usually resulting from a brain lesion. As far as can be determined now in the 21st Century, the Latin speaking academicians had no word for it. Only the Greeks. So stay with the Greeks.
I have no claim to academic credentials. The Clayton Missouri Public Schools had me as its student through all 12 grades in their system. John Bracken was Clayton’s long time superintendent of schools. They taught Latin, but as far as anyone can remember, they taught no Greek at all. At Clayton, Latin was a subject of great disinterest to me as I avoided study of that dead language. I had no interest in being a priest. On the other hand, after I left school and began to work in filling stations, it was my lot for Tallis Liacoupoulus, a Greek who worked in a small nearby restaurant, to become one of my best friends. He worked for an uncle, Leon Antonapolus. His family spoke Greek among themselves and with my being curious, they would sometimes explain Greek words or sayings to me. So when it was time to join the United States Army, I knew a little about Greek speech and virtually nothing about Latin and I wound up in Italy.
The definition that the Greeks used to describe aphasia is quite accurate insofar as it goes. Clearly, those who experience aphasia will find their ability to use words impaired, and they will have their pride tested. Sometimes the impairment is greater and there are times when the brain simply refuses to function. And there are occasions when an aphasia impaired person has a thought in his or her mind, but it is delivered in a garbled fashion. On other occasions, the aphasia affected person will not enter a conversation to express a thought because it may be forgotten by the time he or she wishes to speak. And there is more which I will try to describe in this little exploration into the effects of aphasia. That is what this essay will attempt to describe.
Since late November, 1997 when I had a major stroke, aphasia has been my constant companion. Fortunately, the stroke did not impair any of my limbs. It seems that the main result of the stroke was the brain lesion which caused, in the beginning, a severe dose of aphasia. So I have wrestled with aphasia for the past five years and I expect it will be with me the rest of my life. So those are my bona fides to comment on the effects of aphasia. I did not plan on becoming a commentator on what causes aphasia. I am not qualified to do that. In my case, it just happened. Now it is my continuing intent to defeat and subdue aphasia rather than having it the other way around. In the main, after five years of trying, I think my efforts have been fairly successful.
When it becomes apparent that the stroke sufferer has lost the power to recall words, there is a chance – or perhaps I should say a danger – that he or she may simply remain silent. This is a matter of pride. There is the embarrassment factor at work here. Forgetting words and concepts is an embarrassment. An even greater embarrassment is to have the stroke sufferer deliver his comment in a garbled fashion. The mind may have a strong idea of what needs to be said, but the tongue mixes up the subject and the predicate so that the comment is very difficult to understand.
For example, at Overlook Hospital in Summit, New Jersey, while the staff had me in intensive care, there were six or eight other bodies in this small room. It became very warm there so the obvious solution was to turn down the thermostat. I knew what the problem was, but it was impossible for me to express that thought about being hot – or cold for that matter – in any fashion. And thermostat never entered my mind. Finally, a nurse came by and I drew her what looked like a thermostat facing and I showed her how if I moved the imaginary needle to the right, sweat would appear on my brow. Moving it to the left caused me to shiver. She got the idea, but in that whole episode, I couldn’t think of the words “thermostat” or “warm” or “cold.” Having to use a crude drawing might possibly be an embarrassment, but I waded in and let any embarrassment take a back seat.
There is another factor at work here having to do with the intrusion of a word or words that make no sense whatsoever. Let’s say that “carnival” weighs on your mind, as some of these nonsense words often do. And let us say that today, a waiter asks you about your order for lunch only to be told that, “I would like a hamburger and a carnival.” There are dozens of nonsense words that I had to purge before I spoke. In any case, this is another reason to remain silent rather than to risk embarrassment. Pride again.
The dictionary definition of aphasia as we said earlier, is the loss or impairment of the power to use words. Man, that’s only the half of it. What do you do when your brain completely shuts down or goes on strike? In some cases, the better off aphasia sufferer will search for a synonym. Let’s say he can’t think of the word “watch.” If his brain is at work, he may say “timepiece” or “Timex” or “Movado.” But when your brain simply shuts down completely, there is a period of silence which is a major embarrassment. In my case, there is a background of labor negotiations, lobbying and speechmaking where it was necessary to have a quick response to everything. When my brain occasionally shuts down, even at this late date and even at my age, I feel embarrassment. I understand embarrassment. And I comprehend pride.
Perhaps what is more embarrassing is to forget the subject under discussion. This may not happen much anymore, but when there are allied subjects to the main subject, it is a real problem to remember what points B, C and D are when they are ready to be broached. Losing a train of thought can happen very easily and it has not much to do with the impairment of the power to use words. It has to do with forgetting and losing the train of thought. Again, it is an embarrassment even if it happens in private.
This happens often in writing. My handwriting is about like other peoples, I suppose. Sometimes, I will have a thought and it is urgent to write it down before it is forgotten. This results in words that are misspelled or words that make no sense at all. Before the stroke well into my 75th year, I could easily retain those thoughts until they could be written and recorded. After the onset of aphasia, it is important that the thoughts be recorded quickly before being forgotten. As I said earlier, not being able to recall a word is only the half of it when it comes to aphasia. Forgetting is a major problem.
Now we come to the issue of concentration. Since aphasia became a major factor in my life, I find that it is urgent that all my powers of concentration be applied to the subject at hand. When it comes to reading stock tables, it is often difficult for me to remember which letter follows what other letter. “M’s” and “N’s” are good examples. Locating Comcast, for example, is a bit of a problem because it is necessary for me to sound out the word and to realize that it is “Comcast,” not “Concast.” Before aphasia, I never had that trouble. This same problem applies to looking up words in the dictionary or names in the telephone directory.
If I had trouble with the alphabet in reading stock tables, looking up words in the dictionary or dealing with the telephone directory, it all pales in comparison with my bank statements. I never claimed great expertise with numbers, but aphasia really threw a monkey wrench into the gears. All I am talking about is a simple checking account. In a month, perhaps I would write 25 or 30 checks. But when Chase sent me a monthly statement, I knew that a major battle was about to be joined. I am doing much better now, but I still look forward to the arrival of the monthly statement with a degree of distaste and I blame the lingering effects of aphasia for this outlook.
Now a little more about concentration. When driving my car, I never use the radio because it would impact my concentration. As a flyer for the U. S. Army Air corps – later the Air Force – we were trained to listen for noises that might presage engine trouble or for the sound of bullets hitting the plane’s skin. Those factors do not apply anymore, but I am not casual about driving a car. It is important that concentration be applied so that I don’t forget what I am doing. It goes without saying, that cell phone usage does not ever occur in my car. Another long term effect of aphasia.
I find also that words spoken by other people during a TV newscast, for example, are distracting. My concentration on the newscast is broken by the distraction which all goes to show that with the after effects of aphasia, it is largely possible to do one thing at a time – but not two or three things at a time.
Related to concentration is this thought. In a complex sentence where two or more people are involved, it is often difficult for me to determine who did what to whom if the account goes on in great detail. In my letters and essays, I usually deal with only one subject at a time. When I attempt to bring in other characters in an effort to make the account more concise or to save space, even I am unable to tell you who the “he” or “she” is in the concluding lines in the sentence structure. For example, in the attached story by Sam Dillon in the New York Times, I read only a part of the story before I was lost between Father Anderson of the Archdiocese of St. Louis and the man who claimed he had been sexually abused, Mr. Andreas. Perhaps if I subscribed to the Catholic faith, I might be able to distinguish between the litigants, but the lingering aspects of aphasia makes it not worth my while to figure out who did what to whom and who is the litigant and who is the defendant. For not understanding Sam Dillon’s story, I am prepared to spend the centuries after my demise in Purgatory. Serves me right for getting aphasia, which was invented by Satan himself.
In the foregoing paragraphs, I have told you some of the reasons for doing nothing about treatment for aphasia. Embarrassment and discomfort with the effects of aphasia are significant factors. Pride is sometimes the major factor. I know that from first hand experience. But those factors are of no consequence when the cost of doing nothing is considered. The overwhelming factor is that doing nothing is not an option. It is not an option to say that overcoming aphasia is too much work or can’t be done. Simply put, it has to be done. Certainly, it is hard, hard work and no one else can do it for you. Early in my aphasia experience, Shirley Morganstein, the Director of Speech Therapy at Kessler Institute for Rehabilitation, gave me a homework exercise that she thought would take ½ an hour or even one hour. I spent eight hours on that little project. I’m glad I did, but that homework assignment tired me greatly.
As soon as Overlook Hospital released me, Judy and I made a beeline for Kessler. During my two weeks in Overlook, some women who claimed to be speech therapists came to my room and gave me exercises. For example, name 12 vegetables or 10 automobiles makes. They took advantage of my being a prisoner of the hospital and attempted to sign me up for longer term work once I had gained release. Judy and I – mostly me – were put off by their high pressure tactics. So a day or so after leaving Overlook, we were in Shirley Morganstein’s office and she agreed to take me on as her student.
Shirley is a no-nonsense director and teacher who has no patience with people who show no sign of trying to help themselves. Failure to bring homework to the session would result in an imposing demonstration. I made sure to do what I was told even if it took eight hours to do what others would consider a half hour task.
Not long into the three days a week therapy sessions with Shirley, she suggested that I write essays. Our next meeting was on December 8, 1997. That day is of some significance to me because in Italy in 1943, I was shot down. In 1953, my wife at the time and I adopted a little girl. And, our second daughter was born on December 8 in 1956. So that date has some significance to me. In my first essay, I wrote about what that day has meant to me.
Because I had sessions with Shirley on Monday, Wednesday and Friday, it kept me hopping to deliver three new essays a week. I am not sure that Shirley demanded three new essays a week, but that’s what I gave her. Shirley traces her ancestry to Poland and Rumania. I had no idea of that fact as I began to write of my travels in Europe. When we got into the essays and I showed her my many souvenirs and my multiple passports, I suspect that Shirley became interested in what I was describing. After she told me about her ethnic background, I took her an ancient Polish flag in a small frame as well as a doll from Rumania.
In the five years since I finished at Kessler, my guess is that about 350 pieces of prose, including dozens of essays and countless letters and e-mails, have been written at this desk. Some are better than others, but there is a hidden ingredient in the written word as opposed to the spoken word. When an aphasia afflicted person is writing, he can take his time about the right word or the right phrase. Perhaps he may consult dictionaries or other reference works to find the right word or phrase. Or he may ask his wife. There is no immediacy to getting the word right and hence, no embarrassment. If my brain locks up while writing, which happens less often these days, I simply wait awhile and after some time passes, the words come back to me.
Writing is the most valuable contribution to speaking orally for me. If I have written about a subject, when I speak it poses much less of a problem. Perhaps the rule ought to be that writing should precede speaking. Obviously, that is not always possible, but writing helps immensely when speaking.
Shirley of Kessler is nobody’s fool. She had no idea whatsoever that I could write an essay. I knew I could but Shirley was completely in the dark on that subject. But in the end, writing is what brought me back from the jaws of aphasia and Shirley Morganstein is a proper heroine.
As you can see, recovery from the effects of aphasia is a long term investment that takes a lot of work. Having people like Shirley Morganstein – a tough teacher – around was a great help. And mostly, having my wife Judy to look after me and to give me thoughts of how I might improve was nothing less than crucial.
Aphasia it not the end of the world. From time to time, it frustrates me particularly when I know a word that I have used 10,000 times, will not come to my mind or to my tongue. Ah, but there are certainly worse things, so to the extent it can be done, I am inclined to laugh about it. The saving grace is that the word which won’t come to my mind or tongue this afternoon, will roll out of my mouth this evening without my even being aware of it.
Now to all those people out there who cluck their tongues and diagnose alzheimers for every word forgotten by older people, I would recommend that they be introduced to aphasia. Or perhaps they ought to talk to me or to Shirley Morganstein or to Judy Chicka. Nobody can claim that he or she is as quick as they were 40 years ago, but when I forget a word, it doesn’t mean that the alzheimers caretakers should ready a bed for me. It is a long struggle, but with the help of my friends and my wife Judy, old Ezra will do pretty well indeed. When I worked for Uncle Sam, nobody in the Army ever heard of anyone having alzheimers or aphasia. Now at this late date, this old soldier does not intend to succumb to ailments that nobody ever heard of – except for the Greeks.
All things considered, it is my hope that after reading this essay on the effects of aphasia, that you found it instructive or that you enjoyed it. On the other hand, if none of those positive factors apply, remember that when I began to deal with aphasia, I was unable to say “warm” or “cold” or “thermostat.” Those words were light years beyond my reach. The point is that with my background and with the help of professionals, I can now say pretty much what I think. A few years ago, this stroke victim was largely mute. If I can do it, if I can come back, surely other people can do it as well. Stay strong and get to work on your exercises and, in my case, on my essays.
This essay is being written for those currently suffering from the effects of aphasia, be that now or in the future. It is not written as a means of attracting sympathy for myself. I need no sympathy. In my case, I have wrestled with the aphasia tiger and I believe he has been largely subdued. So don’t waste any tears or hand-wringing for me. Save that for those who are dealing with the aphasia concern right now or somewhere down the road in the future. If those aphasia afflicted people work hard and stay strong, I am certain that they too can dispatch the aphasia tiger.
E. E. CARR
November 27, 2002
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The revelation here for me was that writing about a given topic “cleared” that topic in his mind, and made it easier to access going forward. That actually seems like it might explain why he went on to double the count from 350 essays to the final count of 700+. (Fun fact, this is the 701st essay to be published to this site!) The way it’s presented, writing about these memories cleared out some mental cobwebs and let him speak more confidently about those topics going forward. I think in a more literal sense that means that these essays were re-wiring the neurons in his brain. New, alternate paths were created to access knowledge that was closed off by the brain damage caused by stroke, which is amazing. I’d imagine that raw persistence and laughing off the hard moments probably helped tremendously.