For a while now I have wanted to write a post about Nicole. Specifically about aphasia. Nicole had a devastating stroke on December 3, 1999. I was with her when it happened, and I remained with her every step of the way, watching, learning and trying to help. I learned more about the human brain and how they work than I could have imagined during the first weeks afterwards, and the ensuing years.
This is written from memory and without consulting any references other than for spelling and such. I want my lack of sophistication regarding brain anatomy and functions to be obvious. This is how it was. The whole story will be long so I'll break it up into a few posts.
On the fateful evening we were downstairs. We wanted a bit of privacy. My mother had been with us for about a year and things between Nicole and I were strained. Neither of us were particularly happy. It wasn't about my mom. We were questioning and yearning, but not together. We were growing apart and doing all the wrong things to fix the situation. We were arguing the moment it happened, about what I do not remember.There was no lightning bolt strikes moment. Strokes don't always happen like that. The first thing I noticed wrong was that she was now speaking french to me. Not so odd. French is her first language, but we did not speak french to each other very much at that time, a word or two here and there, generally for clarification purposes. This time she stayed in french. When I questioned her about it she replied that she was speaking french. Odd, I thought. This was about 9:00 PM. Physically she seemed fine. I was barely noticing something was wrong. So, we talked in french. It was no big deal. I speak french. About an hour in all of a sudden she refers to me as her brother Jacques. She now is calling me Jacques. This got my attention alright. WTF?
Why is she doing this? She is pissed off at me. Had enough. This is some mean spirited game she is playing. Rising confusion in me but I am still not thinking something has happened to her, not yet. She is lucid other than calling me by the wrong name and speaking only french. She brushes aside any suggestion that her behaviour is out of the ordinary. She is aggressive about this and I am still deflected and distracted by her protestations. It is now about 11:00 PM and I am instantly on high alert. Something is drastically wrong. She is no longer speaking french or english. She is speaking an alien tongue. For real. She will not stop. I start to get nervous, then afraid, then terrified. I yell at her to stop. Stop this minute! Stop this right now! We are still downstairs. She does not know me anymore. She moves upstairs, physically fine. My mother has heard all the commotion now, she is up in bed. She wants to know what the hell is going on. I describe what has been happening to her. Nicole is beside me. Nicole tells my mom that I am crazy, nothing is wrong. In french. My mom is confused. It is now about 11:30 PM. I am in panic mode by now, although I am still hoping that she is fucking around with me, but that seems less and less likely to be the case. That theory is taking a big nosedive, headed for a crash. What the hell is happening to Nicole?
I pick up the phone and show it to Nicole. I tell her that if she does not stop behaving this way I am going to call 911. She is screaming at me about how I am out of my mind and to leave her alone. I am her brother again. I dial 9 and tell her that she better stop right now. Nothing changes. She is outraged. I am blue in the face screaming back. I dial 91 and tell her that the game is up. She better get her shit together right fucking now. She does not. I dial 911 at 11:57 PM.
First Tangent
11:57 PM not after 12:00. Those three minutes kept us in the middle class, for real. It took a lawyer but the insurance company agreed to pay out her disability insurance. Insurance she had paid for. She had quit her job that same day, December 3, 1999. She was starting a new job on Monday December 6, 1999. Our lawyer argued that the insurance was in force until midnight of that day. Jurisprudence was not clear in this regard in Canada. I was running a business from home. Nicole was the main money maker. We came close to having No income with years of therapy ahead of us. Three minutes.
Back to main story
The paramedics arrive quickly. I greet them at the door and let them in. Nicole is sitting on the couch calmly, looking great. I explain events to the paramedics. They ask Nicole a few questions. She answers brilliantly while denying I am her husband. She explains that I am her brother Jacques. This goes on for a few minutes, maybe three. The paramedics are trying to decide who to believe. I bring out my mom. Mom tells the paramedics that I am indeed her husband and not her brother. A paramedic asks Nicole what date it is. Nicole is somewhere lost in 1976. The paramedics start to check her out, make measurements, make some phone calls. A protesting Nicole is taken to the ambulance which heads for the Lakeshore General Hospital. I follow in my car after talking to my mom and making sure she is going to be ok.
When I get to the hospital she is better. Speaks english again. Gets a bed in emergency. Friend from bowling in the bed next to hers, with her husband nearby. Little reunion happening, neither of the ladies are particularly ill. Our friend had been spitting up blood but it seems to have been innocuous, from a bad bout of coughing. Nicole is speaking french again and seems to be falling into a daze. Nothing happens for two hours. I finally freak out totally and grab a nurse and read the riot act. Woman here, middle aged, healthy as a horse, good living 100%, possible brain thing, do something fucking now or I shall haunt your fucking ass forever! Stat! NOW. it works. Doctor arrives, testing starts. I am such a beginner I go home for some sleep. It is about 4:00 AM.
Phone rings, 7:00 AM. Nicole has been transferred to the Montreal General Hospital. She had a stroke. I talk to my mom, pack some stuff and drive calmly to the hospital. I think I drove calmly. I did not understand. I had no idea how much our lives had changed, forever.
She is in emergency at the MGH. Parts of what happens here during the next three hours or so are not clear, other parts are. I am not sure exactly how Nicole was behaving, but she was alert. She was also confused. There had been diagnostic imaging done during the night at one or both of the hospitals. What happened while I was not present I never learned. A short while after I arrived one of the neurologists came to bedside and spoke with us. He conducted various reflex tests and administered other tests that investigate various neurological functions. He informed us that Nicole had a stroke. She could move all of her limbs but there was an obvious deficit on her right side. She was not paralysed. The right side just did not seem to work as well. I was still not overly alarmed. I had no idea.
Another neurologist came to see her and administer more tests of the same flavour. I asked him what had happened. He told me left side stroke, significant broca center damage. Somewhere during this time language and words left Nicole. She smiled and smiled and faded away, blissfully.
Next Episode: Welcome to the ICU, meet the stroke trauma team!
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