My Year Off by Robert McCrum Read Free Book Online Page A

occur.’
    We talked about the brain’s resilience to stroke. ‘The brain,’ said Frackowiak, ‘is uniquely adaptable, but it’s not like the liver. You can cut out seven-eighths of the liver and it’ll regenerate. So it’s not as resilient as the heart or the liver, and that’s why it’s stuck in a rigid box [the skull] and covered with fluid to absorb shock. It is beautifully designed. It is extraordinary. It weighs only1.4 kilograms and yet it defines our whole personality, and our interaction with the world.’
    The brain and the spinal cord, or central nervous system, is located at the core of our very being; this is the epicentre of the earthquake in the life of a man or a woman that is constituted by a stroke.
    In the West, about three-quarters of acute stroke cases occur, as we have seen, in people aged sixty-five or more. But this means that 25 per cent of all strokes will occur in people under that age; another estimate says that a fifth of all strokes occur in people under the age of forty. So, while stroke is
perceived
as an old person’s illness, the statistical reality is that large numbers of younger people today are having to come to terms with a sudden and devastating affliction of which they know little or nothing. In Britain, about two hundred young, ‘socio-economically active people’ (as the jargon has it) are affected by stroke
every week
. The general public is almost completely unaware of this staggering statistic.
    The remoteness of the affliction perhaps explains our general ignorance of it, except, perhaps as the mysteriously devastating illness that fells our elderly relatives. I suppose the first time I must have become conscious of ‘stroke’ was when, as a child, I read
Treasure Island
. The opening chapters of Robert Louis Stevenson’s masterpiece are among the most compellingly urgent ever written, and the moment when the mysterious sea captain (‘the brown old seaman, with the sabre cut’) fights Black Dog and collapses on the floor of the Admiral Benbow always seemed to me especially gripping:
    I heard a loud fall in the parlour and, running in, beheld the captain lying full length upon the floor. At the same instant my mother … came running downstairs to helpme. Between us we raised his head. He was breathing very loud and hard; but his eyes were closed, and his face was a horrible colour … It was a happy relief for us when the door opened as Doctor Livesey came in.
    ‘Oh doctor,’ we cried, ‘what shall we do? Where is he wounded?’
    ‘Wounded? A fiddle-stick’s end!’ said the doctor. ‘No more wounded than you or I. The man has had a stroke, as I warned him … I must do my best to save this fellow’s trebly worthless life; and Jim here will get me a basin.’
    A great deal of blood was taken before the captain opened his eyes and looked mistily about him.
    Such was the treatment for stroke in the fiction of my childhood, and I suspect that memories of this passage, and others like it, formed the bulk of my adult knowledge of stroke, too.
    Regardless of age, the physical and psychological damage is the same. The cost to society in economic terms is staggering: in the USA and Britain, respectively, $30 billion and £2. 8 billion each year. About one third of those afflicted by stroke between the ages of thirty-five and sixty-five are disqualified from work by disability. The majority of stroke-survivors will have a paralysed arm, and many will be unable to walk normally. Between 50 and 75 per cent will have some form of permanent disability.
    The heartbreaking nature of such disability is vividly evoked by Sheila Hale who, writing in the
London Review of Books
in March 1998, poignantly evoked the post-stroke experience of her brilliant historian husband John: ‘The sociable stranger with the donnish manner would like to know who you are and what interests you. Hewill listen attentively and respond enthusiastically. Whether you speak English, Italian,