replay

I tape-recorded last night a longish conversation with a good friend. Regretfully, I spoke with such fluency and smooth facility that it can gave give little to the knowledge of false starts and grammatical stumbles the purpose of which this blog has its invention. There will be in the merit of comprehensiveness yet brevity in this post, that what few slips I can render, I can render completely in a handful. I am afraid that I am recovered, or so nearly, as to have lost any interest in myself as a subject of science, for the sake of deft facility. Even this writing recalls pre-stroke manners. So here’s the sad litany, if so few as these merit a litany:

1. Not only do I find syncopation of words, but frequent jumping ahead with too many words of a clause that lead nowhere. In describe a discription of the EMS trying to wrest me from my home shirtless on the coldest night of the winter, I retold last night, “I was in my shirtless…” stopping at the adjective at a loss, not because I couldn’t retrieve a word, but because I had added too much structure for my meaning. I should simply have said, “I was shirtless.”

I have noticed this kind of excessive structure leading to an exhausted and completed meaning before the grammar was unfinished, demanding a something more to satisfy, like among copulating dogs when one (here the grammatical structure) holds on tightly while the dumb male (the simple-minded content), instantly finished, waits stuck useless (forgive the image — I’m in a funk, piquant, but a funk).

It’s not just occasional, it’s frequent in my aphasic patterns. Or it was. It occurred only once last night. Still, there’s a question here: why should the sentence structure should set up too much for necessary necessity? Is it just a fear of aphasia — an overcompensation?

But I think it may be related to my frequent reduplication of verbs. Part of grammar is the nifty fit between meaning and structure. In aphasia, this fit is loosed. The result seems too much structure, structure on holiday, structure for the sake of structure — not unlike the old classic Wernicke’s, prolixity for the sake of grammar, regardless of any fit to meaning.

2. Often I mangle adages or platitudes or colloquialisms. Last night I tried a colorful phrase for ‘toss up a drink’ and said instead, somewhat amusingly, “throw up a cup.” Another example, a day prior, I could not immediately find the phrase “made a killing” meaning ‘gained a lot of money’. Yet again that previous night, instead of “better easier done said than done” I had to run a rambling explanation of “it is better to say something easier than what you do” or some such awkward effort, reminiscent of the derisively gleeful renditions of the last president’s mistakes, with the difference that by the time I’d finished with the explanation, the old adage appeared to me, and I stated it clearly at last.  Again, I have noticed these mangled platitudes many times.

3. A slip I scarcely include, since I might have done or anyone might have, I misspoke, “[the stroke]…from the back of your frontal cortex all the way to the frontal cortex.” I meant, “…the back of the cortex…” but I am so accustomed to linking the phrase “frontal cortex” that I threw it in where it didn’t belong. I mention this only to be exhaustive.

4. Metathesis, often, but again, last night only once, albeit a recurrent one that has pop popped up twice over the past two days: “a second…call” when I meant, “a close second.” This is instructive. The night before I worked on the phrase until I got it right, “a second [I’m still jumping it ahead, even in writing!] close second” (which recalls “a close call,” which may be the interference — and that is instructive too, since it implies that this is not a failed link, but, as an interference, rather a misled link), and “a distant third.” Nevertheless, I tripped over it last night again, exactly the same way, “a second…?”

Instructive, to be plain, because the mistake is or has become, recalcitrant. It seems to me that there is a lot of interest in this fact. The meaning of the phrase is itself “a second that is close” and the most important part of the meaning is the ‘second.’ I speculate that the meaning has taken priority over the expression. Meaning jumps to “a second” and then is left trying to figure out how to incorporate the remaining meaning, the ‘closeness.’ In the effort to find the schematic phrase, the most common, and the phonetically closest, is “a second call,” and this phrase has tripped up the mental search, very much like a tip-of-the-tongue. The mind occupies itself with finding the right replacement for “call” never guessing that the problem is, in the first place, the priority of “second,” which, after all, has already been said, and so requires a backtrack and self correction. The mind is hanging out on a limb.

The point is, what’s happened here may not be something missed, but something awry. It could, of course, however, be something awry because something previously reliable, now missed or dead. But it’s also possible that nothing is dead, but only relocated, misled, frazzled. Lazy as I am, I haven’t found the studies that find the evidence which it is. This is only a diary, and merely suggestive. But if no one has tried to tease this issue out, someone should. I’d like to know what happens, after all, what happens to the so-called dead matter following the stroke. If the neurons are dead once starved of oxygen, presumably it doesn’t they don’t just turn into a mulch of jelly and liquifaction in the brain. I assume that the neurons remain in their structure as cells and potentials. Why cannot they revive?

The astonishing rapidity of my own recovery — two weeks ago I had zero comprehension of sentences, no knowledge of my own name, no ability to read a sentence for days, and, aside from fluent nonsense, minimal and incomplete ability to control a single name word coordinating between speech and meaning — so rapid that surely it is not merely accounted by compensation by the rest of the brain matter. Surely I have regained brain matter that had been … dead? dormant? temporarily vacant? waiting to reboot?

I was assured by the chief neurologist that the stroke was “large.” It was described as affected from Wernicke’s all the way through the frontal cortex. I even experienced, at the start, severely blurred vision in the right hemisphere. This doesn’t seem a small matter, and yet, sixteen days later I appear to be nearly unnoticeably changed from my pre-stroke self.

In any case, after over an hour of conversation last night, including long stretches of narrative, I slipped only these four times above. How I wish I had recorded myself the day of the stroke, or the day I got back from the hospital, or at least had begun blogging here as soon as I got back home. It seems like a greatly missed opportunity. Instead, I went off to the hospital where they gave me an aspirin and, after two days of tests, conclude[d] that I am perfectly healthy, and their disgnosis is cryptogenic, which is etymologically to say teasingly: a secret; or more honestly and accurate: unknown — they just plain don’t have a clue. All the while I might have [been] producing evidence. Now all I have for my stroke, and a linguist’s  opportunity of a life, is mood elevation. I can’t even claim attention and sympathy, since I seem better off now having the stroke than I was before.

Meanwhile, everyone tells me “you’re so lucky!” Well, even a week ago, when I wasn’t sure I’d ever read again, I didn’t think anything lucky of it. Now, I am thoroughly lucky, with no more failings than my own for not having been more diligent.

No mistake, however, my brain is not yet fully baked yet. I still have a few odd stumblings. For example, just this morning [I] left out “is” again (can’t recall the phrase, but just like “I have never [been] here” or “That’s what this [is].” I think it might be related to the reduplication of verbs and the setting up of excessive structure. It’s like there’s some loosed mapping between the innermost workings of grammatical agreement and meaning.

On the other hand, the verb “be” is kind of a useless verb in English. I used to point out that inner city English (ICE) doesn’t need it: “They covered with they blood” functions by syntactic word order, and “is” and the possessive “their” are unnecessary; these superfluous vestiges of a much older language are probably not the underlying real grammar of today’s natural English language. Maybe I’m just getting to the real optimal language.

3 Responses to “replay”

  1. Dorothy Ross Says:

    Hi Rob, You certainly are unique. This is the first time that I have ever heard a person with aphasia bemoan their rapid recovery! Although as you say, you do not have 100% recovery. Perhaps you have learned to cover up the errors better?

    What happened to those neurons that were not working two weeks ago. One theory is that they die, and other neurons compensate or learn new patterns to “work around” the dead area. Another theory is that they are injured and recover. I am not sure how long this would take. A third theory is that the initial stroke causes “shock” to many neurons that are not actually injured. When the precipitating event is over, the shocked neurons gradually return to normal.

    There has been a least one research article that showed if the area of the stroke was confined to the cortex, and did not penetrate deeply into the underlying white matter, then recovery was rapid and complete. I don’t remember how large the area of the stroke was, but I do remember that Broca’s area was involved.

    I wish you a continued speedy recovery. I hope that we in the aphasia community can interest you in taking a look at the neurolinguistics of aphasia. I don’t believe that any one has analyzed the language of a person with Wernicke’s. And we still need to know much more about Broca’s area. For example, how was is that initially you did not understand the grammar in sentence, but were able to produce grammatical, though meaningless, sentences?

    All the best, Dorothy

  2. rob Says:

    Always grateful thanks for your comments and interest!

    About recovery and regeneration: there was a moment within an hour of the stroke when recovery returned rapidly, much too rapidly for new neuron creation or rerouting, unless rerouting is virtually instant. Other aspects of language didn’t recover for weeks, so, presumably, neurons don’t reroute instantly, even though I worked on those areas persistently.

    So I’d hypothesize that many neurons were simply waiting for blood flow to return immediately to normal function. Still, the MRI apparently showed that these areas were affected. I haven’t seen all the MRI details yet.

    Other linguistic functions were slower, over hours, some days and some weeks. Some have not fully recovered. So there may have been a gradient of damage, unless neurons reroute or rework within hours, days or weeks. This may seem obvious, but I assume that part of area affected of the stroke was undamaged, part was damaged, but recoverable in time, and part may have been completely lost, although I can look only at eighteen days so far.

    It’s true that scripts and music scores and terrain can be memorized quickly and can cement permanently into the mind over night. But language is not exactly mere memorization of repetition, but a machine that can generate unbounded new sentences from a variety of relations. Similarly, memory retrieval also seems to have a machine structure (I think in Chomsky-Fodor rules and representations, partly because I don’t know parallel processes as well). Memory retrieval and grammar are both recalcitrant to recovery. It seems likely that more is required to structure language and memory retrieval than mere memory or rote.

    So, I conclude that while neurons can make all sorts of new memories, language structure and retrieval require something more, some quantitatively or qualitiatively different kind of work. That endorses the view that the neurons that improved at the first hour had not died or damaged, but were simply waiting for circulation. Likewise, the linguistic deficits that improved more slowly must have been damaged or died.

    Here’s a thought: when we memorized a speech or a melody, we have before us the sensual evidence, the sound, the words. But grammar is not a sensual presence. Neither is retrieval. Both are methods, and more cryptic than, say, method of bike riding. Watching the route of a bicycle rider may be simpler than memorizing how to ride oneself, but at least learning how to ride is feet and wheels and handlebars. With grammar, most people don’t have a clue what the parts of grammar that would correspond to wheels and handlebars and legs and peddles and arms. In fact, linguists themselves do not entirely understand all the relations of grammar.

    I mean that maybe there isn’t anything qualitatively different about grammar and retrieval at all. Maybe they’re just obscure to the senses.

    Back to evidence. Within the first hour, I was aware of rapid improvement. Blurry vision lasted only a few minutes, less than a half hour. I was able to construct a sentence shortly after I’d taken a shower, within, I’d guess, forty minutes, at most, after the stroke. Improvement seem at an asymptote, rapid improvement at first and increasingly slower improvement at an almost even decline, although I still notice marked renewal every day.

    It may be that I have compensated cognitively, but, on the whole, I am so stubborn that I have not been focused on compensation. That is, I stubbornly want to regain old methods of sentence structure and vocabulary at the expense of skirting around or pushing through and not stumbling. So I’m inclined to believe that nearly all the renewed fluency is brain recovery, not cognitive compensation.

    Regarding the grammatical sentences that were apparently meaningless, that I uttered at the beginning at the stroke: I know that I let loose with a fluent sentence, or part of a fluent sentence, but I couldn’t understand what I heard. It is possible that I said exactly what I intend to say, I just couldn’t hear what I had said. I was, however, quite shocked at the sentence because, whatever I had said, I didn’t understand it hearing.

    So, here’s another Wernicke’s idea from an insider: it’s possible that a sentence begins appropriately to the speaker’s intention, but, not hearing the expectation, things derail quickly. I don’t imagine this is a thorough explanation for Wernicke’s grammatical-yet-meaningless fluency. But this may play into the problem. Lack of comprehension is not merely a problem of listening to others. Lack of comprehension includes one’s own heard speech.

  3. Siggy Says:

    I’m a friend of someone you know, Rob (who shall remain nameless!), who directed me to your interesting blog. I read Dorothy’s comment and your reply as well. I’d say it might help for you to stick to short, simple sentences, like Hemingway. That will gear things better. Also try more music, good for connecting things and for the soul!

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