Aphasia - a Writer's Worst Nightmare

I once worked with a man who had suffered a severe stroke, leaving him with a medical condition called "Aphasia". He was relatively young, in his late forties, maybe early fifties. For the purposes of this article, I will refer to him as "Fred". Fred was extremely depressed and considered uncooperative. With the exception of a few single syllable words, most of his verbal communication was restricted to the word "corn". He was obviously intelligent and educated, which made his situation even harder for Fred to deal with.

So just what exactly is Aphasia, and why is it a writer's worst nightmare? Aphasia is a medical disorder that results from damage to the language center of the brain. Strokes are the most common cause of Aphasia, but it can also occur after any type of brain trauma that permanently damages the brain. In some cases, a brain tumor can cause the condition.

Damage to the brain's language center produces a wide variety of communication problems, depending on the severity of the damage. Aphasia usually manifests as either an expressive language deficit (the ability to speak), or a receptive language deficit (the ability to understand); in some cases a patient can suffer both. In addition to speech, the ability to read and write can be affected. In mild cases, Aphasia may result in a change in a patient's normal speech patterns, confusion between certain words, or problems with reading and writing. In the worst cases, a patient may completely lose the ability to communicate.

Aphasia left Fred able to comprehend what others were saying to him, but he was no longer able to read or write. When he spoke, he generally used the word "corn" in place of the appropriate words. His sentences had the rhythm and pace of a normal sentence, but "corn" was the primary word that came out. It was no wonder he was so depressed.

Another common symptom of Aphasia is referred to as "anomia", which occurs when a patient can't recall the word they are trying to use. Remembering words as simple as "cat" and "dog" can be difficult. Think of a time when you had a "word on the tip of your tongue" experience, and how frustrating that can be. Now multiply that difficulty several times over and you can see how debilitating this can be. As a writer, Aphasia is the worst medical condition I can think of.

How is Aphasia treated? The first step is an evaluation by a Speech-Language Pathologist, who will test the patient's communicative skills and design a rehabilitation program for the patient. This rehabilitative program generally consists of various drills and exercises, much like those used to teach young children how to communicate. It is estimated that over a million people in the U.S. have Aphasia, with the majority of these cases due to a stroke. As our population continues to age, it is estimated that approximately 80,000 new cases will occur each year.

So what can friends and family do for a patient with Aphasia? The number one thing is to be supportive and understanding. Don't laugh if they use an inappropriate word (like corn). Don't give up trying to communicate with them. Make it easier on the patient by speaking slower and using simple words. I discovered that if I listened closely and paid attention to body language, hand gestures, and the pattern of his speech, I could often figure out what Fred was trying to say. We often resorted to the equivalent of "20 questions", using yes and no answers, with Fred either nodding or shaking his head. I only worked with Fred for a few weeks, and never saw him again. I hope he is doing better. Fred left a huge impression with me, not just because of the extreme nature of his disability, but also because of the courage he exhibited, trying to exist in a world that he could barely communicate with.