Jill Bolte Taylor: Communication After Brain Stroke

Communication After Brain Stroke

Allow me, to introduce to you, Jill Bolte Taylor. She is a Neuro scientist with a Ph. D. She is a research specialist at the Harvard University School of Medicine where she also teaches. She teaches: gross anatomy, human neuroanatomy, and histology. She is an accomplished, published professional that serves on the board of directors of the National Alliance on Mental Health. She is skilled at communication in all forms: teaching, writing, and speaking. She understands verbal and non-verbal communication. Then one day Jill had a cerebral vascular accident (CVA) commonly termed “a stroke”. Jill transitioned from being a master at communication to being completely disabled. In Jill’s words ““I could not walk,

Jill proceeded with her morning exercise routine thinking it would help her feel better. Instead, Jill’s condition worsened. Jill describes having strange feelings of detachment from normal cognitive function (p. 38). Jill noticed that her movements were jerky, she had loss of muscle coordination and her sense of balance was gone. During an attempt to get into the shower, hearing running water, Jill recognized that in addition to having difficulty with coordination and equilibrium, her ability to process incoming sound was erratic. Jill describes not being able to clearly distinguish the physical boundaries of where she began and where she ended. Jill was not able to tell the difference between herself and the space around her (p. 41). When Jill lost control of her right arm, it finally occurred to her that she was having a stroke (p. 44). Jill knew she needed help but could not stay focused on how to get it. Battling confusion and pain, Jill managed to dial her work. One of her colleagues answered the phone and Jill could not understand his words. To her, he sounded like a barking dog (p. 56). Jill was unable to speak and tell him that she needed help. She thought she was saying “this is Jill and I need help.” In reality, Jill was not even speaking only grunting (p. 57). Jill had aphasia meaning, she was unable to form words and speak them. Lucky for Jill, her colleague was able to

The key to improving communication in healthcare is education. I have worked as a medical imaging specialist for over 20 years and I have provided care for hundreds of CVA patients. I never knew that lights could cause a stroke patient pain, or that a loud voice was painful. I learned these things on my own when one day just by chance I picked up Jill Bolte Taylor’s book and decided to read it. I now use a soft voice and speak slower for my CVA patients. I give them plenty of time to respond to me. I have the lights dimmed before the stroke patient arrives in my department. I know these patients need these things now only because of the book. I often wonder why and how it is that this type of clinical care was never discussed when I learned to be a radiologic technologist. I further wonder how it is that the place where I work does not provide in-services about special needs of CVA patients. I think about the difference that educating clinical staff about these needs could make for patients. It is obvious that a stroke patient is in a situational crisis and most likely will not be able to vocalize needs. I believe that continuing education should be taken more seriously and be of more practical use. I also would like to see the implementation of a peer to peer discussion forum where providers could learn from the experience of other providers. This practice is utilized for trauma patients and there is an established tumor board