‘My Stroke of Insight’ is a New York Times bestseller, written by neuroanatomist Dr. Jill Bolte Taylor. This powerful story has made a resounding impact across the world, through the medium of this book and Jill’s TED talk, which has received over 17 million views to date. I wasn’t quite sure what to expect when a friend handed me this book having determined it would be something I would enjoy from the title. I’m hugely interested in recovery from stroke and so the subject matter, a brain scientist’s own personal experience of having a stroke and their path of recovery, was certainly something that I was keen to read.
The book opens with a description of Jill’s past life, pre-stroke. She was a trained neuroanatomist who traveled the USA, encouraging clinical populations to donate their brains to science post-mortem. She enjoyed her work immensely and brought an air of creativity and uniqueness to it, as she was dubbed the “Singin’ Scientist” for the jaunty jingle she had created to relieve tension in these meetings. Following our introduction to Jill, she provides a good overview of the mechanisms of the brain. These are laid out in layman’s terms and are easily accessible to the general population. This brief tour of neuroanatomy allows readers to understand the source of the problem, which I believe is a vital component for comprehending the difficult subject matter. The core of the book details the events of her actual stroke and her steps to recovery. This candid account of her experience is novel; allocentrically, the reader watches as piece-by-piece her neural function shuts down and with it, her motor functions collapse, her speech becomes incomprehensible, her fixated attention becomes a distant memory. We learn of her struggle in the days and weeks after: the constant exhaustion, the incapability to communicate her wants and needs, her regression back to infancy. Yet Jill accounts for all of this in straight-forward manner: she facilitated her recovery by creating small, attainable goals and came out the other side of it as an ebullient and jovial woman. The book ends on a positive note, highlighting Jill’s renewed passion for life, deeply appreciative of many aspects of living that are easily taken for granted, like the feeling of raindrops running across your skin or the sound of your favourite music.
Throughout the book, Jill raises some excellent points with respect to the clinical treatment and examination of stroke patients. Personally I felt that these small suggestions and observations from a stroke survivor reflects the true seminality of this work. In a frankly honest tone, Jill illustrates the absolute necessity of feeling safe in the medical staffs’ care and the impact this holds over the recovery of the patient. She reminds us that these patients are not some stupid creatures to be cast aside thoughtlessly. They are human beings full of emotional turbulence and frantic need – they are wounded and frightened. Thus, good bedside manner is imperative and the strength and range of their remaining abilities needs to be taken into careful consideration for any and all interaction – even if that simply means lifting the lid off a plate of food in order for them to eat. Jill recounts how the staffs’ treatment of her played a role in her recovery: she would co-operate only with those who were kind and attentive towards her, and would choose to ignore those with whom she felt treated her in an inconsiderate and discourteous manner. She also describes her deep confusion and unhappiness with hospital policies, such as being asked to sign consent forms when her cognitive damage was so severe that she could not even understand language. Such aberrant treatment clearly bred an environment of dissonance for Jill during such a trying time, and may similarly be affecting many more suffering survivors. It is clear that there is a need to revise the guidelines for interacting with these types of patients, and garnering advice from stroke survivors may be a very good place to begin this process.
As I said earlier, this book also elucidated to some very thought-provoking opinions on assessment post-stroke. Although such examinations may appear simple and untaxing to the ordinary observer, to a stroke patient they are often exhausting and arduous. Jill speculates that the methods for assessment are simply concerned with matching performance to a criteria based on “normal behaviour” and fail to provide a comprehensive insight into what may actually be happening in patients’ brains. For example, the doctor may test if a patient’s recall is fast or slow, but will not take into account the time-consuming thought process that must be undertaken in order to grasp the mere understanding of the instructions, before even trying to carry out the task. Jill proposes that such practices would benefit immensely from a cohesion of information provided by stroke patients themselves based on their experiences.
Additionally, Jill draws some attention to reasons why patients may fail to make a good recovery (or certainly a remarkable recovery like hers!). She believes that patients often fail to recognize their smaller achievements, such as managing to grasp a pen again for the first time post-stroke, as real victories and so their path to recovery becomes elongated by their lack of belief in themselves. She also emphasizes the importance of wanting to try to relearn previous skills – without this, patients lack the foundation to propel themselves into recovery. One last casual observation made during the account of Jill’s rehabilitation also struck a chord of interest in me. She postulates that while we take many learned skills as abstract and irrelevant, it is surprising to find how much we really need them to conduct our day-to-day lives. The example she uses amused me, largely due to my ardent resilience to math during my school years: the importance of algebra in the calculation of where to put plates on a dish-rack when washing up.
While much of this book both intrigued and enlightened me, I did find the final few chapters more difficult to swallow – my time spent reading them felt like wading through quicksand that I couldn’t pull myself out of fast enough. Here, Jill reveals a very spiritual and mystical side of herself. Given her traumatic experience, this is a fully understandable paradigm to undertake, and her elation for life is deeply admirable. However, this is just not an area that encapsulates my attention. Furthermore, throughout the book Jill shows a penchant to lean heavily on the concept of hemispheric differentiation – the constant chatter of “right-brained” and “left-brained” failed to impress me. I felt that in this regard, she relied too much on the retired myth of the left and the right brain, rather than any of the more empirical evidence that have been demonstrated in studies of hemispheric specialization.
Regardless of my quandaries, I would recommend this book as a light and easy read. With less than 200 pages, it makes for an excellent companion on a long journey and provides a fascinating account of a brain scientist’s interpretation of the neural and cognitive events of her own stroke. Lastly, it is truly inspiring to read about such an exceptional recovery in the face of such extreme neurological catastrophe – and plants a seed of hope that such progress will become the norm in the future.
My Stroke of Insight is available to buy on Amazon here: http://www.amazon.co.uk/Stroke-Insight-Jill-Bolte-Taylor/dp/0340980508