JOE PALCA, host:
Now we're going to look at stroke in a more personal way. Jill Bolte Taylor had a stroke 12 years ago when she was just 37 years old. Now, it's a bit unusual for someone that young to have a stroke in the first place, but what makes Jill Bolte Taylor's experience extremely unusual, is that she's a Ph.D neuroscientist with a very thorough understanding of brain anatomy, and unlike most people who suffer strokes, she knew almost precisely what was happening to her, as it was happening. She writes about her experience and it's a remarkable story, and her recovery and her new mindful approach to life in a new book. She joins me today.
Jill Bolte Taylor is the author of "My Stroke of Insight: A Brain Scientist's Personal Journey." Just out from Vank - Viking Penguin, she's a national spokesperson for psychiatric disorders for the Harvard Brain Tissue Resource Center, and an adjunct professor at Indiana University School of Medicine in Bloomington, and she joins me from the studios of WFIU in Bloomington. Welcome to the program, Dr. Taylor.
Dr. JILL BOLTE TAYLOR (Neuroanatomist, Indiana University School of Medicine): Hi, Joe. Thanks. It's great to be here.
PALCA: If you'd like to join our discussion, give us a call. You can talk to Dr. Taylor about her experience, or maybe you had a brain injury, and you can tell us a little bit about the effect it had on how your brain works. If you can explain that, because I think most people have a hard time in even encapsulating or explaining how their brains have differed. Anyway, our number is 800-989-8255. That's 800-989-TALK.
So, Jill Bolte Taylor, in your book, which I thought was quite a remarkable story, but the specificity of the events, on the morning in December when you started having this stroke, I just can't get over the fact that you remember all that so clearly.
Dr. TAYLOR. You know, when on the morning the hemorrhage happened in the left hemisphere of my brain, and that's - it happened right near the language centers. And so language started to go offline, but also it began as a very small bleed. It was an arterial venous malformation, very comparable to, I'm sure, the one that happened in your earlier caller...
PALCA: That's right.
Dr. TAYLOR: Who had a stroke at - yeah, because she was 23...
PALCA: Right. Right.
Dr. TAYLOR: And this happens to young people.
PALCA: Can you explain - OK, maybe before you go too far, maybe you can explain...
Dr. TAYLOR: Yeah.
PALCA: You know, what a stroke is and why an arterial venous malformation could cause one.
Dr. TAYLOR: Sure. In a - well, a stroke happens, when for some reason, the blood supply to certain cells - any cells inside of the brain - gets cut off. And, the typical type of stroke is the ischemic stroke, where a blood clot gets thrown somewhere in the body, and it will travel in the arteries into the brain until the artery has tapered so small, that it would - blocks that artery. And what then happens to the cells beyond that is that they can no longer get their oxygen, which they need in order to survive. So, in an ischemic stroke and a blood clot, you will have a territory of cells start to die, because they're not getting their oxygen.
In the case of the other type of major stroke is the hemorrhagic stoke, where there's actually a break in the blood vessel, and blood is seeping out into where the neurons, the cells of the brain, are positioned. And one of the things about blood and neurons, is that blood is toxic, essentially poisonous to neurons, and it kills them. So, it's very important we have blood-brain barriers. There are different kinds of blood-brain barriers, and one of the purposes of that is to protect the neurons from the blood. So in...
PALCA: So, you want what's in the blood, but you don't want the blood itself.
Dr. TAYLOR: Exactly.
Dr. TAYLOR: Exactly. So, what happens with an arterial venous malformation is, it's a congenital malformation in the blood vessels that I was born with. And normally, you have a high-pressure artery system that tapers down to a capillary bed, which is a zero essentially pressure system, and then hooked on to the other end of that, is a negative pressure system, the vein. And so, in my case, there was an artery directly connected to the vein, without the capillary network in between to act as a buffer. And these are essentially bombs that are inside of our heads, and they commonly break between the ages of 25 and 45. And I was 37 when mine blew.
PALCA: Yeah, yeah. And so, you were saying, you didn't obviously - or I presume you didn't know, oh, I have an arterial venous malformation...
Dr. TAYLOR: Right.
PALCA: But you knew that you were having something happening in the left side of your brain.
Dr. TAYLOR: Right. And so when the hemorrhage originally occurred, it started out very small, and so the cells that were immediately impacted by that were affected, but as time went on, the blood was seeping more and more out. The hemorrhage was getting larger and larger.
And as the hemorrhage got larger, more tissue became nonfunctional. So, on the morning of the hemorrhage - so - and so the left hemisphere also thinks in language, and the right hemisphere though, thinks in pictures. So, for example, if I say dog, dog, a picture of a dog probably flashes into your mind, and that's what's going on in your right hemisphere, and left hemisphere is thinking of a specific kind of a dog, or a specific dog that you know. So that both hemispheres are actively involved in the process of language, they just think about it differently.
So, on the morning of my hemorrhage, the left hemisphere, parts of the cells were becoming nonfunctional, but my right hemisphere was fine. So, I essentially was running a video tape of the morning of the hemorrhage. And, another thing about the right hemisphere from my experience was it shifted me into the present moment, because when I didn't have the language center giving me words, words attach me to the external world.
In the external world is my relationship with my job, and my relationship with people, and my relationship with time, and linear thinking. And all of that - as that was bouncing on and of, on and of, based on my ability to be what I would have waves of clarity, that would bring me back into normal reality, when normal reality...
PALCA: Dr. Taylor.
Dr. TAYLOR: Yeah.
PALCA: Hang on one second. I need to remind people that we're talking to Jill Bolte Taylor about "My Stroke of Insight: A Brain Scientist's Personal Journey." I'm Joe Palca and this is Talk of the Nation from NPR News. Sorry, it was bringing you in and out of a kind...
Dr. TAYLOR: Yeah.
PALCA: A different kind of - a reality that - see, that's what I was interested. You recognized that this reality shift was occurring, although nobody in normally would ever experiencing - experience it this way. Right? Because...
Dr. TAYLOR: Well, yeah. Oh, I think...
PALCA: I mean, you would have your right brain, and your left brain, and associations with them...
Dr. TAYLOR: Right.
PALCA: But suddenly...
Dr. TAYLOR: Right.
PALCA: You were having them disassociated in a way that you could actually say, oh, that's what it's like not to have your left brain doing very much at the moment.
Dr. TAYLOR: Well, I don't think at the time I was saying that. I think at the time I was drifting off into the right hemisphere experience, being in the present having that experience, and then the left hemisphere would come back online, and say, you've got to get help...
Dr. TAYLOR: You've got to pay attention, you have a problem and it's serious. So, there was this bouncing back and forth between different circuits inside of my mind that were working or are not working. But by the end of that morning, by the end of that four hours, the left hemisphere was completely silent. I crawled up into a little fetal ball, and essentially said goodbye to my life.
Dr. TAYLOR: Once I awoke later that day, I was starting essentially as an infant in a woman's body. The left hemisphere circuit was totally silent, and I was beginning new, like a newborn with new stimulation coming in, that really didn't make any sense at all.
PALCA: Mm. And, from the moment that the symptoms first started to appear, and how long was it before you said, ah, I'm having a stroke?
Dr. TAYLOR: It was - well, it was long enough for me to jump on my cardiac glider, get into the shower, dress for work. So, we're looking at at least 45 minutes to an hour, before my right arm went totally paralyzed.
PALCA: Mm, mm. Well, we have lot of....
Dr. TAYLOR: And that was the warning sign for me, that when I figured it out.
PALCA: Yeah, yeah. OK. And the other question I have is, in terms of maintaining this - it seems as if from reading your book, the first day was fairly clear, but things got a little fuzzy after the first day.
Dr. TAYLOR: Well, on the first day on the morning of the stroke, I still had a left hemisphere that was semi-functional on the morning. After that, I didn't have much of a right - left hemisphere to work with, and I was completely dependent at that point on the right hemisphere.
PALCA: OK. We're talking with Jill Bolte Taylor about her new book, "My Stroke of Insight: A Brain Scientist's Personal Journey," just out from Viking Penguin. We have to take a short break. We'll be taking more of your calls at 800-989-8255. So, stick around. We'll be back in just a minute.
(Soundbite of music)
JOE PALCA, host:
From NPR News, this is Talk of the Nation: Science Friday. I'm Joe Palca. A brief program note on Wednesday, Talk of the Nation host, Neal Conan, will be back at the museum in Washington, DC. That's the new museum dedicated to news and journalism.
If you'll be in Washington and want tickets to join the audience for a live broadcast of Talk of the Nation, send an email to firstname.lastname@example.org. We're talking this hour with Jill Bolte Taylor, author of ""My Stroke of Insight: A Brain Scientist's Personal Journey," a brain scientist personal journey.
She's also the national spokesperson for psychiatric disorders for the Harvard brain tissue resource center and an adjunct professor at Indiana University School of Medicine in Bloomington.
And we have quite a number of callers. I'd like to go to the phones now, and take a call from David in Lexington, Massachusetts. David, welcome to Science Friday.
DAVID (Caller): Thank you very much. Well Dr. Taylor, reason I'm calling is because I too had a stroke at age 30, where I had a major problem with aphasia. Although yours was much more exciting than mine, now I'm 56 years old, and in the last year - I had a TIA last September.
And then an actual stroke last January, and finally this summer, we're trying - we (unintelligible) find out some things that are wrong with me, that they're going to try to correct. So, I don't have the (unintelligible) with that bullet anymore.
PALCA: Huh. But David, it just doesn't sound - it sounds if you're talking about aphasia, I never talked with you before, but you don't sound like you're having trouble with language at all.
DAVID: Well, it took months for me to get back to full communication. But as it occurred, it was - I did not understand that I was having a stroke, but obviously I knew I had a problem because I couldn't communicate properly. I couldn't find the words.
Dr. TAYLOR: So we went to - we happened in Chicago, and I went to the emergency room and when they finally - I had me try to read out loud a newspaper. The neurologist finally decided that I better be looked into as having some type of a stroke at my age 30.
PALCA: Wow. Yeah.
DAVID: And in fact, they eventually found in a CAT scan, that what they call the communication center on the left side of brain, that that was damaged. And that actually is - you - when you speak out loud, essentially we you used three times.
You know, you have to interpret what you see, you have to form the word, and then you listen to what you're saying, and self correct. And all of that was really failing for me. And I couldn't even find words or very common things.
PALCA: David, very interesting Very interesting. And I want to turn to Jill Bolte Taylor then and ask, if you also had damage to the left side of your brain and language was lost, but...
Dr. TAYLOR: Yeah.
PALCA: You know, if - again, I haven't talked with you before, but I would not have identified you as somebody who had aphasia. You seem as if you've completely recovered.
Dr TAYLOR: Right. Well, you know, from my perspective, the brain is filled with, you know, these billions of beautiful cells, and they're all communicating with one another in circuits, and, you know, whatever his stroke happened and my stroke happened, it happened to those cells, and those cells then become no longer capable of communicating inside of their networks.
But again, the beauty of the human brain is its ability for neural plasticity and its ability to create new connections and regain function. So, I think, David - I think you sound fabulous as well. But again, I'm a firm believer in the ability of the brain to get better and to increase its function. I think it wants to heal itself and, you know, it sounds like you had great rehab and helping you identify the different pieces of the circuit along the way, so that you could do it from the inside out.
PALCA: So, how, long Jill Bolte Taylor - how long did your - I mean, when did your speech start to return, so that people like me would not be able to identify you as having a problem.
Dr. TAYLOR: For that actually, you'd have to ask the people around me...
Dr. TAYLOR: Because again, you know once perception of oneself isn't always the perception that everyone else did. But, I had lost so much of my ability to walk and talk and read and write, and all recollection of my life, that, I decided that I was going to focus my energy on getting the ability to speak back, because we communicate in this society and it didn't matter if I couldn't do math, or had no recollection of science, or didn't have any recollection of my life. I was going to need to be able to speak.
And so, I actually did my rehabilitation, working with a speech therapist for the first four months after my stroke - five months after my stroke. And, I would watch myself, old video tapes of myself giving presentations. And that's how I would retrain myself to mimic the woman in that video talking. I regained my terminology, my inflection of my voice, how to hold a microphone, how to communicate with an audience and that's - so that's was my number one priority. So, if you ask me I think I was doing very well in the first six months, but that was that, you know, and so I got speech back long before I got many other things back.
PALCA: So, I guess we should make the point that not all strokes are the same. I mean some...
Dr. TAYLOR: Oh, exactly.
PALCA: Yeah, and...
Dr. TAYLOR: Well, the brain is a very, very big place, and it's got lots of tiny little arteries and branch lids of arteries. And if so, one of - depending on which little branch lid has a problem those are the cells either going to be influenced. So, I would bare to say no two strokes are the same from the inside perspective.
PALCA: Interesting. Let's take another call now and go to David in Tucson, Arizona. David, welcome to Science Friday.
DAVID (Caller): Oh yeah. Hello, there. How are you today?
DAVID: Well, I'm calling because when I was - I'm 37 now when I was probably about 17 or 18 I was using a bit of illegal substances recreationally. Most commonly LSD. And I had an experience that, you know, now I understand to have been rather stroke-like in nature. You know, it was actually an episode of like - the doctor described of - where the language center just didn't seemed to be working. I would - I was aware of it - I was trying to formulate words and then the words that would come out would be not the words at all that I was trying to speak.
And I've talked to a couple of different people since then and I have asked about that. And I've kind of gotten some mixed answers on it and I'm just curious if the doctors had any experience or study or knowledge about the potential for LSD or something like that to cause either a stroke or some kind of stroke-like reactions.
PALCA: Interesting, David. Jill Bolte Taylor, what about that? I mean this is another - the LSD is a drug that's affecting the way neurons communicate with one another, so I presume it's doing something to make the brain behave abnormally.
Dr. TAYLOR: Well, you know I'm going to right back to the brain is filed with cells and circuits and drugs impact the brain by stimulating circuitry and so some circuitry they may activate it or they may inhibit it. And so, I've actually have lots of people bring this to my attention of either LSD or some of the other drug systems. But again you know the brain is a place of circuitry and so you put something in there and it's going to cause some kind of a response. But the response that you experienced is circuitry again. And so, you know it's - I do think it's comparable that when I lost my left hemisphere and my right hemisphere came more online and I had this experience of nirvana or euphoria that is often described by individuals who have used LSD. You know, the big difference being - mine was a situation that ended up being eight years process in order for me to recover from, step by step, and rebuilding my brain, and consciously choosing to do that, is supposed to having an experienced that that is drug induced in may last 12 hours.
PALCA: Yeah. So, you've really - I mean, you count your recovery as having taking eight years. I wonder how do you - I mean how did you decide one day eight years after the event I'm better now?
Dr. TAYLOR: You know it happened because the first thing that I lost on the morning of the stroke was my perception of the boundaries of where I began and where I ended. And when I lost - you know, there's a group of cells in the left hemisphere's parietal region that receives input from our sensory systems and our - those cells then define the boundary of where we begin and where I end. You look at your hand and you know what is you and what is not you, even though there's just atoms and molecules in you and atoms and molecules around you. It's that portion of your brain that defines that boundary that of course this is me what is she talking about, my boundaries are obvious. Well, I lost that perception of that boundary and once I lost that I felt that I was a fluid instead of a solid and that's sounds very peculiar but we are in - it does, but we are in a fluid environment.
PALCA: Right and we're a bag of fluids.
Dr. TAYLOR: And we are a bag of fluids. And atoms and molecules are in fluid movement around us and that became my perception and it wasn't until the eighth year when I was - actually had learned how to - relearned how to water ski and water skiing had been my number one sport when I was a child. And I just - I just, you know, what it took for me to be able to get to that point to me that was total success. And I realized that after a season of water skiing I felt like a solid again, and it was at that point that I just realized you know I am complete. Everything that I had lost I have regained. And you know this is the new beginning, this is a new life.
PALCA: Wow, it's - I'm thinking it's, you underwent a phase change.
Dr. TAYLOR: I did.
PALCA: In the sense of a physical term. Well, how interesting.
Dr. TAYLOR: I really did.
PALCA: All right, let's take another call now from Vicky (ph) in Carthopolis, Michigan. Did I say that properly? Carthopolis, Michigan?
VICKY (Caller): Cassopolis, Michigan.
PALCA: Cassopolis, OK. Welcome to the program.
VICKY: Thank you, thank you. Yes. I was - I'm a survivor of a traumatic brain injury and received that in a car accident. And it was very, very odd because I don't recall losing consciousness, but I'm told that I did and it was like somebody slipped a switch in my head and everything seemed very fuzzy around me. I couldn't place where I was. My communication skills were very different. I was miscalling a lot of things, you know, massive headaches obviously from this injury. But, when they took me to the hospital and the doctor, they said no, they didn't think they'd seen any problem in CAT scan. But as months went on and I continued to see the neurosurgeons and so on, they were able to pick out more and more deficits. And I finally ended up in a brain injury program, and had a battery of tests and there were a lot of cognitive losses.
PALCA: And have you been able to return to normal functioning?
VICKY: And I have. And it's funny that your speaker is calling eight years and that was my experience as well, was eight years.
PALCA: Very interesting.
VICKY: Because, at first I could not, for instance, if I would look at piece of fruit and it was a piece of red fruit and I knew it was round, eventually I would come to the recognition that it was an apple, but it was a process to get there.
VICKY: And my mathematic skills were very, very slow to come and difficult in a lot of emotional ability and severe depression.
PALCA: Vicky, thanks very much for sharing that with us. We're talking this hour with Jill Bolte Taylor, she's the author of "My Stroke of Insight: A Brain Scientist's Personal Journey. I'm Joe Palca and this is Talk of the Nation from NPR News. What did you make of that description of trying, you know, of getting your function back, Dr. Taylor?
Dr. TAYLOR: You know it's - I do think, that when you think about the brain and whenever it experiences any kind of trauma, so many of our abilities are really subtle abilities that we don't think about because they just happen naturally for us. But if all of a sudden you couldn't see three dimension and you had to relearn three dimension, are we - how are we testing people for what is actually going on inside of the brain. As in her case the symptoms started becoming worse and worse over time. You know, we know a lot in medicine where we have wonderful, wonderful tools to be able to go in and look at the brain and see what's going on. At the same in many ways we're still very naive in our ability to judge what that experience is like for that person who has a - some kind of a trauma in a certain region of the brain.
So, you know, I'm very excited about what this means for the future because as people are more aware of what's going on inside of their own brain, and they started getting a language for how to talk about things more neurologically. And they start having a better way of understanding how their brain pieces together information and organizing it. I think that raises us to a new level of people looking at themselves and saying you know, I've got a problem, I know I've got a problem, this doctor and this doctor haven't recognized that I have problem, they can't identify it. So, keep looking. Look for the doctor who says oh yeah I understand what's going on, because they're looking at you as an individual with a brain trauma through a different filter.
Dr. TAYLOR: I think it's a really an exciting time in brain research.
PALCA: Well, absolutely. I just want to ask you on a personal sense, you know I described this experience and when I was introducing you, it was something that sort of had a fundamental change on your life. How would you describe it?
Dr. TAYLOR: For the fundamental change in my world?
Dr. TAYLOR: You know when I was - I was a brain scientist at Harvard. I was very analytical. I was very - experimental design was one of my areas of specialty, linear thinking, I was climbing the Harvard ladder, I was an advocate for NAMI, the National Alliance on Mental Illness. You know, I was very ambitious very driven and when I lost the left hemisphere I shifted into more of the right hemisphere consciousness which is that fuzzier picture that our - that Vicky was talking about. It's - you know, you step back and things aren't so clearly defined and it shifts you into a different perception of the world and in what's important. And so and when you spend that many years kind of isolated with yourself, identifying what's going on inside of your brain and what do you need to do, what action do you need to take an order to recover it?
It's a very introspective experience and I found that once I had recovered, I just wanted to move forward back into the world, but I didn't want to move back into being the person who might I had been before. In the shift into right hemisphere experience I became much more compassionate. When I was a fluid experiencing the world I recognized that we are all atoms and molecules, we're all connected, we're all brothers and sisters, we're all one. Which makes me look at you and understand you didn't come in with a manual on how to get it all right. So...
PALCA: Absolutely not.
Dr. TAYLOR: So, yeah, I'm much more compassionate with people. Most of my friends will tell you I'm friendlier and more available now.
PALCA: Well, I'm glad to hear that and I'm sorry to cut you off, but I'm afraid we've run of time for this hour. So, I'll end by saying thank you very much for joining us.
Dr. TAYLOR: Thank you, Joe. I appreciate it.
PALCA: Jill Bolte Taylor is author of "My Stroke of Insight: A Brain Scientist's Personal Journey." She's also a national spokesperson for psychiatric disorders for the Harvard Brain Tissue Resource Center and an adjunct professor at Indiana University School of Medicine in Bloomington.
PALCA: If you have comments or questions write to us at Science Friday, Four West 43rd Street, room 306, New York, New York 10036. Or you can e-mail us, the address is email@example.com. For NPR News in New York, I'm Joe Palca.