Aphasia – a’fazh(e)a n – the loss or impairment of the power to use words as symbols of ideas that results from a brain lesion –Merriam-Webster
Partners in the Aftermath of Aphasia By Jane Penland Hoover
We had just celebrated my husband Ron’s 34th birthday, our seventh wedding anniversary and the good news that we were to have a second child, when we learned that Ron’s aortic heart valve, damaged in childhood by rheumatic fever,was failing. “We must schedule surgery right away,” said Dr. Logue, his doctor. In 1973 a new open-heart procedure made it possible to replace a weakened valve with an artificial one. Then three months after the surgery had returned Ron’s heart to its normal size, he suffered a massive stroke. The doctors, who hoped to avoid putting such a young man on anticoagulants and a lifetime of complicated blood testing, had to do so.
After the stroke our doctor’s evaluations regarding Ron’s recover were distinguished only by degrees of hopelessness. Some expected Ron to have another stroke. One even told me Ron would likely die. The speech therapist said that with expressive aphasia Ron might learn to copy spoken and written material, but would not speak normally again. The physical therapist thought Ron would though he would not regain the use of his right arm. All assured us that any changes would be slow.
“Medically there is nothing more we can do,” said Dr. Logue as he walked with me the length of hospital corridor one afternoon. Like Ron’s, the doctor’s eyes held bewilderment, pain, and kindness. Seeing his compassion strengthened my resolve for Ron to live, work, raise his children, talk again, and enjoy his life.
The speech therapist taught me how to encourage Ron’s speaking by showing him word and picture cards and letting him try to say what he saw. “Point to the window and ask him to name what you are pointing at,” she instructed. “Anything in the room — get him to name everything.” As she talked with me, Ron’s gaze followed us; frequently he flashed us a cheery smile. Seeing she expected this to work, I felt encouraged.
For Ron speaking was grueling work and uttering a specific word impossible. Gradually I learned to resist my urge to hurry. Ron shelved his anger and distress and managed to offer up patience. We settled into an awkward routine of pointing and naming. When I pointed to the window he would say door. When I pointed to a comb he said hair or do it. We grimaced and giggled at near misses. It was and six months before Ron said “jane”. The staccato delivery so alarmed me that I didn’t recognize my name in the sound of his voice.
After our efforts produced almost no useable language, fear, anger, and a silent sadness took up residence in the space between us. We moved along like flat tires. Shuttering and fretting, we continued to bump into each other whenever he tried to tell me something, and I tried to guess his meaning with his one-word clues.
On a crisp fall day eight months after Ron’s stroke, we waved to our first daughter Holly as she and her friends walked away from our house toward first grade. I located childcare for our new baby girl Rhonda and began searching for a job. Ron and I had worked together as auditors before we married so I imagined I could design arecovery plan. When offered an accounting job with a newly built senior housing facility, Inegotiated for a second desk and permission to bring Ron with me to work.
As I wrote the management plan, I developed a record keeping system Ron might understand. Slowly he learned to copy with his left hand. He prepared bank deposits and recording rent payments. To further his interactions and accounting skills, we started a newspaper route in the building. Pushing a two-tiered grocery cart my father had commandeered for him, Ron and our two girls delivered over a hundred papers seven days a week for five years. By then Ron was using a few words, calculating the payrolls, preparing monthly financial statements and insisting on driving his car again.
After two sessions the driving instructor told me, “Mr. Hoover is an excellent driver, likely better than you.” R winked my way and began driving himself to speech therapy, work, and back home – early enough to arrive before Holly returned from school in the afternoon.
By the time we retired 24 years later, Ron was entering the accounting data into a computer, reconciling 14 bank statements and producing the financial repots for the two facilites our corporation now owned. Although it me an entire year to teach him, neither of us ever regretted the time we gave to the endeavor.
Because our need for language, story and thought did not lessen after Ron’s stroke and aphasia, we each turned inward. Today he reads, and works 1000-piece jigsaw puzzles; I write. Sometimes he reads what I write, nodding his understanding. Each night we enjoy dinner with friends in our retirement community’s dinning room. Other times we treat ourselves to movies and popcorn. Our daughters and their four (soon to be five) children visit us and invite us to their homes. We eat and swim and go for long walks. The youngest granddaughter, Olivia, climbs up on Ron’s lap and says “Opa, read to me.” Ron points to the pictures and she calls out, “Chicken… cow…pigs.” Turning the pages, they both make farm animal noises and laugh. She says, “Do it again, do it again.”
Living with limited language is more challenge than either of us would have chosen. I often find it difficult to articulate the confusing emotions of emptiness, pain, and sometimes joy that success and failure deliver to us each day. However, we are gentler and less angry than we have been. Ron continues to support me with the grace of patience and bright smiles. Silence is more often sanctuary than isolation now. Our life is not easy, nor is it hard. It is as it is.
We have lived thirty-four years since the night of stroke,ten since we retired. Despite that length of time, I can still be startled as was recently when Ron called, “Jane!” I rushed to the sharp sound of his voice, relieved to find him standing at our lake-view window. As I stepped into the circle of his strong left arm, he whispered, “ahw – Ducks – ugh – ducks,” gesturing toward the geese flocked beneath our bird feeder. He straightened, stood taller. He was the one pointing now, pointing beyond the window, and calling me to enjoy the moment.
Published in Stroke Connect Magazine March/April 2008
American Heart Association
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