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 "This is that state of man" (part 2)

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Tim of Aclea
Triumviratus Rei Publicae Constituendae
Tim of Aclea


Posts : 586
Join date : 2011-12-31

"This is that state of man" (part 2) Empty
20130509
Post"This is that state of man" (part 2)

I was taught to speak again by two Speech Therapists who were young, very tolerant and helpful. In early 1954 the Deputy Education Officer, Surrey County Council spent ninety minutes talking to me and he told me that as long as he is in his job I would be safe. Also the local Trade Union officer said that they would try to ensure that I would not lose my job. But the fact was that a long a long time I could not actually do my job properly and I was left with a weak right hand. I can now speak nearly as well as I used to be able to do.


I was not actually expected to regain the power of speech and one of the speech therapists produced a paper about my case.

“THE EMOTIONAL EFFECTS OF TRAUMATIC APHASIA”

Any speech therapist working with a patient suffering from traumatic aphasia must try to comprehend the emotional shock which has been experienced. It has therefore been decided to present the following extracts from an account written by such a patient. This account was written at my request and tells the story of the accident and subsequent feeling and behaviour.

As the material is of a very personal nature, the name of the patient and details as to his history will not be disclosed. He is an intelligent, educated man in his 30’s, who sustained head injuries as the result of a road accident. These resulted in an aphasia with accompanying dysgraphia and dyslexia. His speech has progressed steadily, and now, eighteen months after the accident, there is some degree of nominal dysphasia and dysgraphia, but the patient is happily rehabilitated enough to continue his job, a responsible one in the field of social welfare.

The extracts quoted show the terrible distress and humiliation suffered by a man suddenly deprived of communication, a husband, father and breadwinner suddenly reduced to a dependent, confused, isolated being.

It also shows how tremendously important it is for the speech therapist to see these patients as soon as the aphasia is recognised, so that reassurance and explanation can be given.

The first extract is from notes made by the patient’s wife, referring to her first visit to the patient some three or four days after the accident.

“He was sitting up in bed with his head covered with bandages. He seemed very pleased that I was there. He could not speak at all. I did not stay long because I felt that my presence worried him. I think that it would have been better if I hadn’t seen him for another few days.”

This last remark is supported by the patient’s own feelings. When he first saw her he felt pleased, but then almost immediately confused recollections started to upset him. “I ought to have been at _______. How are they getting on without me?”

The patient’s wife reports that on the next visit she found him “looking very well considering, but still no sign of speech at all although he tried very hard; by now I was definitely worried, as I knew how important speech, reading and writing were to his job.”

Extract from patient’s notes – four days after the accident –

“I found I was in a small ward…; it was light but it was also getting light so I thought it was about 7.30-8.00 a.m.

“The nurse spoke to ma as ‘Mr_______,’ and when she said ‘Mr_______,’ I felt she was either talking about me or to me.”

“I thought I must have a name as well as a person. But I did not want to say to the nurse ‘Who am I?’ because it would be silly. I wanted the nurse to tell me who I was and then I would say ‘I know that.’ Then, when she has gone I would be able to think about my position, on my own. I also thought that someone might telephone or write or come and see me then I would know who I am as I was rather interested. Anyway I could not worry any more and soon I was asleep.”

The first visit from his wife produced this reaction in addition to the one already mentioned.

“I wanted to speak to her but I could not. I tried again but I could not speak. I thought to myself ‘What has happened to me?” I tried again but I could not and then I panicked. ‘What has happened to me?’ I thought to myself, ‘Oh, it’s terrible, terrible!’

“I was crying, I was worse, I was terribly frightened. I do not know much more for a time. I was in a state.”

“Then I thought to myself, ‘Don’t be frightened, you will be alright. Don’t panic, you will be alright. Be careful. Find out who you are, find out what is wrong with you.’ After a bit I felt better and in any case I could not worry any more. I was very tired. It was the worst day in my life – I would think about it tomorrow.”

“I do not remember much during the next day; I was still very confused and though I tried to think sensibly about my position I was not able to think about one thing at a time for very long. I tried to think about many things at once and then I became tired. Then I would start again until I became very tired bit I never gave up trying.”

The patient in the next bed proved himself to be an extremely practical and kindly person.

“He wrote a letter to my wife… he then did a note for me to use when I want anything. It says –

I want a bottle
I want a bedpan
I want a cold drink
I want a hot drink
I have a pain
I want my earphones
I want my daily paper
I feel much better”

The next day –

“I thought I had a blow on my head. This had hurt some but not all of my brain. For instance, I could think quite well even if I couldn’t speak or write. I felt that I must appear intelligent even if I am not. I hoped that no-one would notice that I could not speak and it would help me if I could speak a little. Then I could say ‘I can speak but I don’t want to,’ or ‘I am very tired, when I am better I will be glad to speak to you or anyone else.’ The difficulty was that of all the many, many words which we normally say without thinking I could not say. I was dumb.”

“Then I thought ‘Perhaps the nurses haven’t noticed I cannot speak…’ Perhaps I ought to say ‘I realise that you haven’t noticed that I cannot speak and I am not surprised. But really I am in a terrible state I cannot speak or write, would you help me please?’ But I could not say what I wanted to say or write at all.”

“Then I thought ‘Perhaps I am not very bright.’ Or that I might still be intelligent but I would then be the only person who knew all about it. I felt that I was in a prison through my own fault.”

The patient goes on to think about his job – had he done his best up till now? – would he ever have a chance to try again?

“Never again did I think so deeply about my position. Never again did I speak to my God so deeply when I could not speak to anyone else. I prayed and I felt a sort of peace when one has though about things that matter.”

“This is that state of man; today he puts forth the tender leaves of hope; tomorrow blossoms, and bears his blushing honours thick upon him; the third day comes a frost, a killing frost and – when he thinks good easy man for surely his greatness is a ripening- nips his root, and then falls, as I do” (King Henry VIII).*

* The quotation is not exact but as the patient remembered it.
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