Blood vessels

"My Stroke of Insight" book club and review

Dr. Jill Bolte Taylor: Neuroscientist, stroke survivor, and author.

This rare combination of traits makes Dr. Taylor unquestionably qualified to write about ischemia, the medical word for what is commonly known as a stroke. And she does so compellingly in this nonfiction first hand account of her experience with this highly devastating brain injury.

It is 1996 in the middle of December, 13 years before the book would eventually be published in 2009. The 37-year old Harvard neuroscientist Dr. Jill Bolte Taylor experiences a massive brain hemorrhage in the left hemisphere of her brain. Little did she know that inside the blood vessels of her brain was an arteriovenous malformation, or AVM, a very rare defect in the brain’s circulatory system that results in increased pressure against the blood vessels that separate the brain from the blood. When her AVM ruptured, blood began to leak into her brain. Her body, correspondingly, began to weaken in several ways. She uses her extensive knowledge of neuroanatomy to explain to us her rationale at the moment: She explains her deficits and she knew that she must call for help.

jill bolte taylor stroke book

Her autobiographical account of her stroke wastes no time. She spends just a few chapters going through the basics of the what you need to know about the brain before describing in amazing detail her first hand experience of a stroke. These chapters move along quickly, and the sense is urgency is sensed immediately in her writing. She knew that the longer that she goes without help, the worse her prognosis becomes. The most vivid and outstanding description is her recollection of what it was like when she made that life saving phone call to a colleague and friend of hers, who immediately recognized Dr. Taylor’s voice and knew to send help. She describes her inability to remember phone numbers, even the emergency hotline number 9-1-1. She forgets the entire concept of numbers! Since the left hemisphere of the brain, where Jill’s stroke happened, is largely responsible for the production of speech, her cries for help came out stilted and ineffectual.

The two hemispheres of our brain serve different purposes. Whereas the left hemisphere is highly proficient at functions such as math and logic, the right hemisphere is very skilled for emotions and artistic expression. In a normal person, each hemisphere of the brain communicates with the other using a large white matter tract of myelinated projections called the corpus callosum. And in these people, both hemispheres of the brain are functioning, processing, and transmitting information. But in the case of Jill Taylor, after the rupture of the arteriovenous malformation that sent blood throughout her brain cells uncontrollably, the left hemisphere was taken largely out of the picture. In these moments where her right hemisphere was in charge, she describes wonderfully how much her world had been altered.

One of the most interesting tidbits in her book is how her outlook on the world changed as a result of the stroke that damaged wide swaths of her left hemisphere. She describes how she experienced things on a more emphatic level using her right hemisphere, letting feelings and emotions guide her daily interactions. This was in sharp contrast to her left hemisphere, which was more heavily centered on mathematical equations, as it often performs calculus-type evaluations on a regular basis. With the logic-centered left hemisphere put to the side, the feeling right hemisphere became dominant over her interactions. This first hand account is an amazing look into what our interactions might be like if decision making was performed by the right hemisphere of our brains. These end chapters really stress the idea of lateralization of brain function, and Taylor’s writing is compelling and honest.

After receiving the life saving treatment of stereotaxic surgery to relieve the pressure on her brain resulting from the spilling of blood from her stroke and to repair the arteriovenous malformation, we get to see her on the road to recovery. A slow process, but undoubtedly an incredible journey demonstrating that sheer willpower and a strong support network are essential steps to healing. We certainly take many of our basic functions for granted - eating, walking, talking, thinking, for example. All of these functions were radically disrupted as a result of Dr. Taylor’s stroke. We are next to her the entire way, as she takes us through her struggles to repair what was damaged.

It took Jill a full eight years to recover, although she says that the process is continual: There really is no end to the process of recovery.

Even though the stroke was very damaging and kept her from the life she had been on course to live, she still believes that her stroke was the most beneficial event of her life. She speaks fondly of that time when she did the entirety of her neural processing with the right hemisphere, the hemisphere that functions as the emotional responder to the outside world.

The first half of the book is a very interesting account of her experience of the stroke and the recovery. But the inertia generated by the first part of her memoir fizzles near the latter quarter of the book, when her science and experience-driven writing changes in tone suddenly to that of a self-help book. I didn’t find this section of the book engaging. Instead, I found the prose to be out of place, less in line with the Harvard-educated neuroscientist that she is, and more in line with a pseudoscientist blogger.

Jill Bolte Taylor is a wonderful science and medical communicator. She writes at the level for anyone to understand. But this is not to say that a neuroscientist won’t learn from this!