What if you were a fully independent person and then one day, out of nowhere, you had a stroke and then, all of a sudden, you could only say one word? You had been diagnosed with expressive aphasia and no matter what word you wanted to say, no matter how hard you tried or how much you focused, the only thing that came out was the word “door”? Even if someone showed you a picture of, say, a knife, and then told you it was a knife, and then asked you to say what it is, you would still say “door.” Picture of a table? “Door.” Picture of a cat? “Door.” Picture of a telephone? “Door.”
How would it make you feel? Confused? Frustrated? Angry? Helpless?
Though aphasia is something that I have learned about in an academic capacity both as a Psychology major in my undergraduate degree, and now in more detail in my master’s program for Occupational Therapy, I have never actually encountered a person who has had the unfortunate experience of having their life drastically altered by this brain-based disorder.
Never, that is, until this week.
This week I began my third Level I fieldwork (which means I’m still an OT student, but I’m out in the field for a short period of time doing supervised observation, treatment, and documentation, and this one I’m doing now is for a total of two weeks). This fieldwork is at a skilled nursing facility (aka- SNF…”sniff”) in Kapolei, Hawaii, a setting I have never really been exposed to except when I was a young child and my mom took me, my siblings, and my cousins to a local Sacramento nursing home so we could sing songs for the residents to brighten their day. During my four days here, I have had the chance to not only get great experience as an OT-in-training, but also as part of a multidisciplinary team. I have spent some time observing some sessions run by the speech therapist, who introduced me to her patient who can only say “door.”
Can you imagine how these sessions go?
Therapist: “Say table.”
Therapist: “Good try, let’s do it again. Say table.”
Patient: “Door. Door. Door!” Patient begins to cry out of frustration, because she knows what she needs to say, but she can’t say it. She can count to 10, say the days of the week, and sing the Happy Birthday song. But she can’t say “table.” The only thing she can say is “door.”
It’s “interesting”, but to call it that feels mean. To study the neurological component of the disorder is fascinating. To observe the human struggle is heartbreaking.
To take this a step further, can you even fathom how this profound communication disorder will affect this woman’s ability to function in everyday life? How will she talk on the phone? How will she order food at a restaurant? How will she communicate with her family and friends? She has been reduced to gestures and symbols. Even writing is difficult at this point.
And so, during my observation, I have sat on the edge of my seat, anticipating the moment when this woman’s injured brain will allow her to say just one new word. I imagine the excitement will be indescribable, and that it will open her up to a world of possibilities.
Any victory, no matter how small, should be celebrated. Because each victory, when added up with all the others, may just be enough to break down the “door.”