Book Review
Brain Insight
Neuroanatomist Jill Bolte Taylor unevenly shares her experience as a stroke patient.
Book review by Charles R. Meyer, M.D.
During medical school, one of my mentors was a nephrologist who had survived a nephrectomy for a renal cell carcinoma. I often thought about the almost spooky irony of a specialist developing a disease in his specialty’s organ. Since then, I have met a neurologist with Huntington’s disease, cardiologists with coronary disease, and a hematologist with leukemia. Although likely the result of the roll of the dice, such occurrences seem targeted, picking a special victim with special knowledge of his malady. I have often wondered whether these victims of diseases from their own textbook would approach their illnesses differently than “regular” patients, weather the inconveniences more smoothly, follow their treatment program more faithfully, or accept their disability more calmly. Yet, as I’ve observed doctor-patients over the years, most were more patient than doctor during their illness.
In her memoir about her cerebral hemorrhage, My Stroke of Insight: A Brain Scientist’s Personal Journey, neuroanatomist Jill Bolte Taylor, Ph.D., frequently seems more scientist than patient. At the age of 38, Taylor was struck with a left cerebral hemorrhage from a ruptured arterio-venous malformation, leaving her with aphasia and partial right-side paralysis. She required eight years of rehabilitation to recover her verbal and physical capabilities.
Taylor’s account starts with her first inklings of something amiss. All of her recollections of the acute stroke are overlaid with the analysis of a neuroanatomist who specialized in the anatomical correlates of behavior and thought. In the early minutes of her hemorrhage she recalls, “I understood neuroanatomically that coordination, equilibrium, audition, and the action of inspirational breathing were processed through the pons of my brainstem. For the first time, I considered the possibility that I was perhaps having a major neurological malfunction that was life-threatening.”
As the severity of her situation dawned on her, she sifted through the mental calculations needed to call for help. Her description of grappling with her damaged communication centers is truly nightmarish as everything turned nonsensical. She thought about calling 911, but “The neurons that called 911 were now swimming in a pool of blood, so the concept simply didn’t exist for me anymore.” She located the business card of her physician, but “the card looked like an abstract tapestry of pixels.” She finally speed-dialed a colleague at work, who was able to divine that she was the person calling and that she was in trouble even though she couldn’t utter a word.
Unfortunately, this riveting account is marred by distracting shifts in tone. Shortly after losing the movement in her right arm, Taylor says she thought “Wow, how many scientists have the opportunity to study their own brain function and mental deterioration from the inside out?”—an expression of emotion more in keeping with a surprise on Christmas morning than the shock of having a stroke.
As Taylor’s rehab progressed, she focused on her newfound awareness of her right brain. Moving from the intellectual ambience of a Harvard neuroanatomy lab, where left-brain reason was in daily overdrive, to a therapy facility, where she was forced to navigate with a severely damaged left brain, Taylor discovered her right brain: “It wasn’t that I could not think anymore, I just didn’t think in the same way. Communication with the external world was out. Language with linear processing was out. But thinking in pictures was in.” She repeatedly—too repeatedly for my taste—rhapsodizes about the revelations of right-brain awareness. “In the absence of my left hemisphere’s analytical judgment, I was completely entranced by the feelings of tranquility, safety, blessedness, euphoria, and omniscience.” Many of her comments take on an almost New-Agey tinge: “Everything, including the life force you are, radiates your energy. With childlike curiosity your heart soars in peace and your mind explores new ways of swimming in a sea of euphoria.”
Jill Bolte Taylor’s is a truly remarkable saga, and My Stroke of Insight tells the tale from the unique, at times moving, perspective of a neuroanatomist describing her damaged neuroanatomy, wrestling with her mortality, and struggling to regain her cognitive skills. As a scientist unfolding her illness narrative, she is superb. As a patient trying to make sense of her disease, she has lapses that interfere with her message. MM
Charles Meyer is editor in chief of Minnesota Medicine.