The LIGHT Center, T-90, College of the Redwoods (476-4290) - March 27, 2000

I am a retired health professional (Ph.D. in Speech-Language Pathology and Learning Theory). Since 1982 I have had to deal not only with the physical aftermath of a right hemisphere stroke but also with my own associated grief
and grieving process as discussed by Dr. Blair. Prior to 1982 my professional history was that of a highly successful professor, researcher, and clinician. My success was not fully due to an extraordinary amount of innate intellect but rather to a highly extraordinary long and short-term memory. While a student, getting all "A's" was an easy achievement because I could retain and repeat information after only one reading. Later, as a professional, I could attend lengthy meetings and retain content without taking notes. I did not need a "Day-Timer" because I was able to remember appointments and other commitments. I was also blessed with good analytical skills and was able to problem solve in a divergent manner (look at many possibilities, not just one approach).

Then came the stroke. This was a right hemisphere stroke leaving my main language skills intact (those brain centers being mainly in the left hemisphere). Also, I suffered no paralysis of limbs but did have some left sided sensation problems, visual field problems and auditory processing problems. I "awoke" seeing, hearing and feeling a very strange world. None of it was "terrible" but I noted right from the very first day that "I" simply wasn't "me" any longer. Every morning when I awoke and swung my feet to the floor I expected to be the "old me" in feelings and perceptions, but it was not to be. I began some rather intense grieving or mourning (and felt extraordinarily sorry for myself). This grieving went on daily for almost 2 years. After a few months I felt well enough to go back to work and I learned that my perceptual problems were child's play compared to what lay ahead. I very quickly learned that my self cherished memory and thought organization skills were just short of nonexistent. My long-term memory was still excellent (and still is; I can recite neurology information I learned 35 years ago) but I could not remember the content of conversations with colleagues even an hour earlier. I often didn't even recall having the conversation at all! I tried keeping a calendar and making notes of things requiring action. Most of the time I forgot to take the notes OR when I did, I'd forget to look at them. When I did look at them, I couldn't figure out what they were referring to because they weren't detailed enough. I was failing to attend meetings that I had called and/or I was showing up and not knowing why I had called them. This was the most painful time of my entire life! What was the worst of it all was the fact that I was fully aware of these deficiencies, and I was constantly comparing myself to my "old" self! I was experiencing a level of grief that was not only constant but much more severe than even the grieving I had over my own father's death. I ended up relying on colleagues and loved ones to be my memory, reminding me of dates, deadlines and appointments. I also began to realize that I no longer was a divergent problem solver. I now tended to home in on one solution only, becoming rigid and unyielding to anyone's suggested alternatives. All of these problems continued for well over two years before beginning to abate.

As my problems began to abate in earnest, my grieving did not. Now, almost 20 years later and while I'm not in a position where I have to make professional decisions, I still yearn for the old me. Once or twice a week I swing my feet out of bed, put them on the floor and think a very old thought "when is all this going to stop?" I guess it never will. There is something else that contributes to grieving. It's called "Secondary Gain." Secondary Gain is a concept that refers to the perpetuation of unpleasant things because they have certain pleasant or rewarding consequences. It's "nice", in a way, to rely on others to do your thinking for you because it's less work. I'm certain my recovery was slower than it needed to be because I selfishly allowed it to be -- it was easier. How does this feed into grieving? It does so because the "old" me didn't need secondary gain - I had an abundance of Primary Gain! Did all this affect my clinical practice in a positive way? Yes, indeed it did! Especially when I was working with stroke survivors. I was able to counsel patients and their loved ones about what to expect during recovery, especially that part of recovery that is above and beyond mere physical rehabilitation. Critical is the part dealing with the old "you" and the new "you", for loved ones too, I have learned, do a good deal of grieving for what their lives could have been.

Dr. M. Webster, SLP (retired)
Carlsbad, California

Comments? mailto:trish-blair@redwoods.edu