Aphasia and Communication After Stroke and Brain Injury

Communication After Stroke

By Vaughn Stone

 Word

Can I have a word with you?

For one or two words will have

to do, the place of words unspoken

in the quiet anguish of aphasia.

I try to fire on a target

only to discover it replaced by

multiple targets in the conversations of others.

People offer many alternatives,

because they can, and in their discomfort, must.

Silence is apparently too much to bear,

especially silence wasted on finding the

right word among painfully close,

but inappropriate choices.

Besides, who wants to talk to a 6-year-old

inhabiting the mind of a 60-year-old man?

To do so requires great courage,

thinking of yourself as vulnerable,

that it could be you instead.

If you have such courage,

can I have a word with you?

02/15/04 © Vaughn Stone 2004

 

Man of Few Words

I’m a man of few words.

Even Calvin Coolidge was generous

compared to me, but he was acting by choice,

not forced on him by an accident

over which he had no control.

I was a man of words before the accident –

a Speech major until my last year of college,

a Psychologist and a therapist for 33 years,

who continued to speak and lecture until

the year of my stroke and then was silenced.

It took six months of speech therapy

before I could be reached.

But under a list of special conditions –

one to one communication is essential,

if two or more people are speaking

I fade to the back of the conversation.

Any background noise can range from

distracting to painfully immobilizing.

My speech pathway must be cleared of

obstacles like overlapping conversations,

or no pauses between words to allow

me to collect my thoughts and say what I have to say.

And, if the conditions are met,

my aphasia limits me to a few words

and I can’t predict which ones are clear.

It’s like saying you want to go biking –

when the weather is perfect, you’re not too busy,

you feel in the mood, and the phone doesn’t ring.

Add to this, your bike is in perfect condition,

the course is all downhill – you get the drift.

No way you’re going biking. It’s a fantasy.

So, I’m writing this poem to communicate.

My hope is you will read it;

but my reality is: most poetry lies unread.

In this busy world who has time to sit

reading the words of an aphasic poet?

Still, I try my best to communicate.

The alternative is mute silence,

and considering that is unthinkable.

So, I’m a man of few words

with an uncertain audience;

but I reach out to you because I can,

I want to, and because I care.

07/17/04

© Vaughn Stone 2004

 

The Milwaukee Journal Sentinel Newspaper has given Lash and Associates permission to reprint an article by Jim Stingl about Vaughn Stone and his poetry. It was published Sunday, June 13, 2004. Read on…

Finding words again – through poetry

 By Jim Stingl Posted: June 12, 2004

Facing the dreaded blank screen, I’m sitting here struggling with how to best tell the story of Vaughn Stone.
Then I think about this man and how he manages to write poetry so insightful and beautifully honest, especially when you consider that last year he was lying in a hospital bed unable to communicate at all.

Even now, as far as he’s come since the accident and subsequent stroke, speech is a challenge. He often stares straight ahead, interrupting his own sentences with expressions like “No, wait,” and “What is it?” as he shapes the thoughts in his head into the words on his lips.

“By contrast, I used to be a psychologist, using verbal skills to report my findings, and scarcely acknowledging my right brain at all. The stroke has forced me to meet my artist within, because the important questions are not factual, but feeling-laden and spiritual. So I’m born-again as a poet and artist, and, at times, scarcely know myself.”

Vaughn wrote those lines in April, but not for himself. He has begun to craft poems for people who have overcome similar obstacles and then sending the words to them.

He doesn’t want to stop at simply being able to function. He needs his life to have purpose.

Let me stop here and properly introduce Vaughn Stone. He’s 60 years old. He lives near West Bend with Christy, a social worker. They’ve been married not quite two years, and they both have grown kids from previous marriages.

Vaughn earned his doctorate from the University of Minnesota, and he made a living as a psychologist among inmates at Wisconsin prisons. For fun and, some would say, because he was possessed, he ran marathons, skied in races, and rode tremendous distances on his bicycle.

“Before the accident, I was in charge – ask for 30 miles and I biked 50,” he wrote to begin a poem he titled, “Surrender.”

On July 18 last year, Vaughn crashed that bicycle into the side of a van that pulled out in front of him on a Washington County highway. Four days later, while hospitalized for broken bones and internal trauma, he suffered a stroke that left him partially paralyzed on the right side and damaged his brain with two “A” words: aphasia, meaning difficulty speaking and understanding words, and apraxia, meaning a loss of motor skills.

“Even yes and no were hard at first,” said his doctor, Jeff Cameron, at Sacred Heart Rehabilitation Institute in Milwaukee. Formerly a skilled woodworker, now Vaughn had to relearn to walk, shave, eat and become, at least for now, left-handed.

In those early days, he would point to words on a sheet to indicate his needs – “bathroom,” for example, or “drink.”

Christy was told at first that he might die and not to expect much if he didn’t die. But with lots of therapy and the determination he had brought to extreme sports, he began to improve, sometimes making dramatic surges forward.

“One doctor said, ‘I don’t know what you believe, but I have seen miracles happen,’ ” Christy said when she and Vaughn and I talked across their dining room table last week.

He battles anger and frustration and tries to stay positive.

“I want to do the best I can. The poetry helps me get a little more control. I can feel like I’m contributing something.”

Typing was difficult at first, but Vaughn developed one of the many detours he navigates through his damaged brain and figured it out.

Vaughn wrote some poetry before the accident, but it was mostly to mark special occasions. It was from the heart, but fueled by the intellectual side of his brain that he favored. After the stroke, his intuitive and emotional side has asserted itself. Writing allows him to take his time and collect his thoughts in a way that speaking does not.

One poem, “Word,” captures the frustration of his impaired speech.

“Can I have a word with you? For one or two words will have to do, the place of words unspoken, in the quiet anguish of aphasia. I try to fire on a target, only to discover it replaced by multiple targets in the conversations of others.”

The poem concludes: “Besides, who wants to talk to a 6-year-old inhabiting the mind of a 60-year-old man. To do so requires great courage, thinking of yourself as vulnerable, that it could be you instead. If you have such courage, can I have a word with you?”

He is now having that word with people he calls pioneers and heroes. His poetry has become a gift to certain people who come to his attention – a painter from Seattle and a quilter from Ohio who had strokes, a New York doctor who was in a bicycle accident similar to his, and Trisha Meili, the Central Park jogger who recovered from a sexual assault and brain injury.

He talks about their common struggle and offers them thanks and encouragement. Cheerleading, he calls it. Most have written back to him.

In a poem he wrote in March, Vaughn compares himself to an eagle chased away by urban development and a backpacker who is too old to continue, yet hopeful for the future.

“And maybe by fall you’ll find me, harvesting carrots, tomatoes, squash – transformed into a cardinal who sings over autumn hikers strolling hand-in-hand. Most importantly, I still have my soul and the freedom to let my soul take me, anywhere it chooses to go.”

Reprinted with permission. Copyright Milwaukee Journal Sentinel.

For more information, see:

Communicating with an Adult After Brain Injury

By Roberta DePompei, Ph.D. and Marilyn Lash, M.S.W.

Information with tips on communicating with an adult after acquired brain injury. Explains effects of head injury on speech, language, reading and writing with strategies for improving communication.