This is Your Brain After a Stroke

My Stroke of Insight: A Brain Scientist's Personal Journey, by Jill Bolte Taylor, Ph.D., Viking, May, 2008

What are the limits of the human brain?  Popular belief has it that we use only 10% of our brain's capacity every day, which is a woeful misrepresentation of the great organ's function.  Jill Bolte Taylor has written about a journey of discovery into the abilities of one human brain:  her own.  Part lay medical handbook, part personal narrative, and part new-age self-actualization manual, My Stroke of Insight attempts to unite both hard science and metaphysics, and very nearly succeeds.

In 1996, Taylor, an academic neuroscientist at Harvard, suffered a hemorrhagic stroke caused by an arteriovenous malformation.  The stroke affected the left hemisphere of the brain, in a distribution that effected her ability to speak and comprehend language, move normally, and process information linearly.  As a result of the injury to the left hemisphere, Taylor experienced a dominance of right hemisphere activity.  She discovered a sense of profound well-being, characterized by heightened sensory impressions and euphoric mood.  Once the AVM was diagnosed, Taylor underwent a stereotactic craniotomy and a prolonged period of recovery.  She credits her mother with teaching her how to speak, walk, and resume normal everyday functions.  After recovering, she moved to Indiana to live near her family, resumed teaching at the university level, and continued her advocacy for the National Alliance on Mental Illness, specifically soliciting donations to the organizations "brain bank" which collects specimens for neuroscience research.

As a neuroscientist, Taylor was uniquely positioned to observe and draw conclusions from her experience of the stroke.  The most engrossing portions of My Stroke of Insight describe Taylor's impressions during the first few days after the stroke.  During this time, she was unable to comprehend words without a struggle, and similarly unable to communicate to the doctors who were taking care of her.  As the right hemisphere processed her experience without the top-down logic of the left hemisphere to balance it out, Taylor experienced a profound joy and compassion that she compares to spiritual enlightenment--the "stroke of insight" stated in the title.  Although Taylor tries to ground her experiential account in neuroanatomical fact (chapters 2 and 3), her personal narrative of the days following the stroke are written in an impressionistic, purely subjective manner.

Indeed, the book suffers from the widely-ranging subject matter (neuroanatomy, personal narrative, spiritual enlightenment) and the equally erratic writing styles Taylor uses for different subjects.  She writes best when discussing scientific matters, and one can see the accomplished academic rising through the reconstructed prose of her post-stroke mind.  When it comes to personal narrative, however, Taylor slips into an unfortunately elaborate prose style, marked by excessive modifiers and awkward sentence structure:

Feeling defeated and tired, I hung up the phone.  Rising from my seat, I wrapped a scarf around my head to block the streaming light from my eyes.  Picturing the deadbolt on my front door, I slowly navigated my body, step by step, down the front flight of stairs by sliding on my butt.  Ready for company and no longer preoccupied with what I felt compelled to do, I crawled back up the stairs to my living room, where I crouched on my couch to quiet my weary mind.

On the one hand, such prose captures a sense of the agonizing reconstruction of linear thought Taylor had to go through merely in order to call for help on the day of her stroke.  I also wondered if one of the consequences of the stroke on the language centers of her brain might have been the development of such a style.  On the other hand, such purple prose tends to distance the reader from entering the experience of the writer:  "My soul," wrote Taylor, "was as big as the universe and frolicked with glee in a boundless sea," and I found I had to put the book down for a few hours before I could pick it up again.  Surely this was not her intention when she decided to reveal the extent of her brain injury to the world.

Once Taylor's recovery was well under way, she began to understand the original joy and euphoria she experienced initially after the stroke as an emotional state accessible to anyone who could develop an attentiveness to internal stimuli and thought patterns.  The concluding chapters of My Stroke of Insightdescribe, rather superficially, a number of techniques to achieve this degree of attentiveness.  Taylor's description of this state of awareness alludes to Buddhism, and indeed the parallels between Buddhist enlightenment and Taylor's right-brain awareness are striking.

Perhaps it is her enthusiasm to convey the message of self-awareness to others that leads Taylor to violate what must have been a central tenet of her neuroanatomical education.  As she describes, in increasingly ecstatic language, her "stroke of insight," she begins to slip into a teleological argument in which "...99.999 percent of the cells in my brain and body want me to be happy, healthy, and successful." Moments like this in My Stroke of Insight made me cringe.  The great beauty of the natural world is that the lack of intention or specific design does not prevent truly elegant adaptations from evolving--including the plasticity of the human brain.  I suspect the majority of scientists would agree with this statement, so it makes it all the more painful to see Taylor--formerly a scientist, now apparently a new-age insight guru--succumb to a version of intelligent design theory.

In the end, My Stroke of Insight was a book I liked more for its idea than for its execution.  True, Jill Bolte Taylor has written a book that takes us deep into the mind and brain of a profoundly injured stroke patient, and I am grateful to be given a glimpse into that experience.  But by trying to be too many things to too many people (scientist, patient advocate, spiritual guide), Taylor succeeds in being none of these.  I encourage everyone to read My Stroke of Insight if they would like to understand a patient's experience of a massive stroke, but not if they are expecting a tour-de-force of humanistic medical narrative.

Comments

[sudden stroke]

* a stroke is a BRAIN attack and is the 3rd leading cause of death in the U.S. following cardiovascular disease and cancer.
* 75-80% of all STROKES are associated with blockages in the carotid arteries – and are preventable!
* Almost 50% of the people who are going to have a STROKE have no symptoms prior to the time of stroke.
* Up to 43% of the Medicare budget is expended annually for the medical care of stroke patients.(1)

[Theresa]

Stacy, I actually admire her greatly for having recovered from the event and for investigating her experience so minutely. However I thought she lost credibility over the teleological slip. My attitude towards human health and illness is that natural processes are unpredictable, and I respect them for that. For that reason I tend to be a bit skeptical about arguments that the human mind can completely overcome physical phenomena.

[Stacy]

I first saw her speech on "Ted" and admittedly, I fell for it too. Her speech was both funny and heartwarming. Before I examined it all further, I went and posted it (video of the speech) on my blog. I guess I was wrapped up in offering some feel good stories since my blog tends to be very serious and controversial. After a few days I watched it again and cringed during a few parts of her speech.

And, like a friend of mine posted in my comments... I wonder what her experience would have been like had her stroke been on the other side of her brain.

[Vijay]

Great comprehensive objective review.
It's a good thing you're not in academia. You would have been what students would term a 'tough examiner.'