When Stroke Strikes

There's a patient in the Neurosurgery ward who died last Friday. From stroke. The only problem is that she didn't die fully. I saw her today. She smiled at me. I asked her how old she was. She smiled at me. I asked her when she was brought into hospital. She smiled at me. I realize she couldn't talk. "Ok, each of my fingers stands for 1 day, nod when i have the correct number of fingers held up." I stuck out 1 finger. She nodded vigorously, still smiling. 2 fingers. She nodded. 3 fingers, she nodded. I realized that she was there, but she was gone.

How does one not die fully? Well, the smart alec answer would be: the same way in which one can have type one-point-five Diabetes Mellitus - they both boil down to a matter of classification. Type 1.5 Diabetes, otherwise known as LADA (Late autoimmune diabetes in adults) is a Type 1 diabetes which presents in adults instead of children. The 0.5 stands for the fact that it is neither a true type I or II diabetes, but somewhere inbetween; in limbo. Just like my patient.

She was alive well one morning but by afternoon collapsed with a massive stroke involving both the anterior and middle cerebral arteries of the left brain, causing her speech centres as well as her motor and sensory centres for the right side of her body to shut down. Her right arm and leg were completely paralyzed, so was her right face, turning her smile into somewhat of a grimace. Like the look you give when someone has played a bad joke on you. Only that you aren't really you anymore. Whatever other people say about that, its pretty much as good as being dead really.

She appeared happy though. Eerily happy. Oblivious to her newly acquired disability. My clinical skills tutor says its because her comprehension centre in the brain had been knock off. So ignorance is indeed bliss.

The tutor then embarked on a tirade against the British and Australian governments for their abysmal efforts in public stroke prevention by endorsing health campaigns and screening tests for the number one risk factor for stroke: Hypertension. Stroke is the 2nd most common cause of death and disability in Australia. Wouldn't it make perfect sense (if not cents) to increase public awareness of the lifestyle changes needed to circumvent this tragedy?

I've glad that I've managed to cook without buying any salt this year and I've since sworn not to buy any more light sauce (liquid salt) for the rest of the year. I'm not sure how, but the 2.5 bottles in my cabinet is gonna have to last me that long =)