Does the old conundrum (“Which came first, the chicken or the egg?”) really have an answer? One can argue sequentially that to have an egg there must first be a chicken to lay the egg. However, from where did that chicken come? All of today’s chickens come from eggs that were laid by other chickens. The most recent announcement (October 2009) from the U.S. Food and Drug Administration claims that no chickens have been cloned. Thus, we can still ask, “Which came first, chicken or egg?”
I’m asking this question because I have noticed that there is a one-to-one correspondence between my struggles with words and my thinking in terms of pictures. On the other hand, when I am operating in a verbal thinking mode, I have much more facility with and memory of words.
In my sequential thinking mode, I find myself asking the question,”Which comes first: visual thinking or aphasia?” In this sequential thinking mode, I am really asking the question: “Does one condition cause the other?” In my visual thinking mode, I am trying to construct a story board. So which picture panel do I include first in my story?
I realize that my case is very unusual. My brain tumor was in the meninges in the right frontal lobe area. The small hole in my brain and the scar tissue caused by the removal of the benign tumor are in that right frontal lobe area. Although it is known as the executive brain, it is not the normal area associated with language.
Immediately after my surgery I noticed a decreased facility with words. I generally understood what people were saying. Almost all of the time, I knew what I wanted to say, but I couldn’t find the right words to use. This deficiency was much more pronounced in oral exchanges. When I was writing, I had more time to come up with the right word.
When I would mention the battle that was going on in my mind, many people would remark that they could not see that difficulty in my responses. However, I knew it was there. I also knew that I was answering questions by using a preconstructed story board and a previously prepared script. Ad lib responses were slow and not always on point.
For six months following the surgery, I went through extensive speech therapy for the aphasia. Month by month, I noticed slight but continual improvement until I finally reached the point that therapist’s evaluations showed that I was in the above normal range for my age group. This meant that the insurance company would no longer pay for therapy.
However, three months after the speech therapy stopped, I had a serious setback. I experienced four tonic-clonic seizures within a 30-minute time span. I lost consciousness the moment of the first seizure, and I did not wake up until four days later in the hospital. When I did regain consciousness, I immediately knew several things were different. I had lost many of the gains in the use of words that I had achieved through the speech therapy. I also realized that I was vacillating between two modes of thinking. The first mode was a verbal, analytic, quantitative, sequential mode, which had been my normal mode prior to the surgery. The second mode was a visual, metaphoric mode which was brand new to me.
It was immediately back to speech therapy. This time my progress was spotty. Some days were much better than others. It all depended upon which thinking mode I found myself in. When I was in the verbal mode, my performance on the therapist’s assessments was good enough, so that five months after the seizures my insurance company again said that therapy was no longer necessary.
Shortly after the therapy stopped for this second time, the tremors and hallucinations started. One year after the first tremors and hallucinations, the dysesthesia started. I realize that my aphasia is far from the usual forms of aphasia. For more than one year, I have been battling the aphasia, tremors, hallucinations, dysesthesia, and visual thinking. These conditions are not universally present. However, when they are present, I have noticed that verbal, analytic, quantitative, and sequential thinking is much more difficult. Complicating things is that the tremors occur almost at random. They are not associated with either thinking mode, or the aphasia, hallucinations or dysesthesia.
Again, the question: “Which came first: visual thinking or aphasia, hallucinations and dysesthesia?” However, in reverting to analytic thinking for a moment, are these factors occurring simultaneously because there is a third factor that is causing these two observable factors?
In the meantime, I know that if I am fighting hallucinations and dysesthesia, the visual thinking is not too far behind, and vice verse. Although I know that I can write in either mode, verbal or visual thinking, it is easier when I’m in verbal mode. Sometimes I can’t wait for the verbal mode to show up, so I plow ahead writing in the visual mode.
By,
Fascinating conundrum. What I wonder is what is it like when you write. When you sit down to write a blog entry, do words form in your mind and it just takes a while to get them out and onto paper? Or do words sort-of-form in your mind, perhaps just out of reach? As you know, my mom had the catastrophic stroke and has chronic aphasia. I’ve always wondered what goes on in her mind. She can speak a little. She can’t write. But she is smart. It must be horrific to have words and thoughts in your mind and the complete inability or the impaired ability to communicate them.
When you write visual, what do you mean? Do you see pictures of words or scenes or thoughts and these help you write or speak what you are thinking? Are these visuals in the form of hallucinations or clear mental images? When I think of visual, I think of using pictures to communicate — either by me to my mom or perhaps mom drawing something in an effort to communicate to me.
Are you in one mode (verbal) or the other (visual) at any time, switching between the two during the day? Do you have to write in both modes at any time, never sure when one will show up and the other will recede?
It’s just amazing what you go through just to write a blog entry or an email. You’re an inspiration fighting, learning, writing, teaching. I look forward to more Musings.
Dan,
Thank you for your comments and very pertinent (Aphasia attack) questions. The word “0ertinent” was my third choice. “Perceptive” was my second choice. The word that came to my mind first was “good.” However, “good” didn’t say anything. As I fought to find a workable word. Perceptive came to mine. This word carries with it the connotation of being thoughtful, and indeed your questions were obviously full of thoughts. However, I wanted to say something more positive. My next choice, “pertinent” carries with it the idea of being on point. I suppose I could have used all three words (which by writing this paragraph, I guess I have). Yet all of the writers’ guides tell us to be concise and precise in our writing. I find that to be a problem. The old saw says that “Pictures are worth a thousand words.” Sometimes it takes a thousand words to describe my ideas. I have always been accused of having the Russian novel syndrome in my writing style.
When I am in a visual mode, I see scenes and sometimes the dialogue that goes along with the scene. It’s like how Templin Grandin, author of “Thinking in Pictures: My LIfe with Autism,” was able to design her famous cattle chutes. Sometimes she physically crawled through existing cattle chutes to physically see what the cattle were seeing as they went through the chutes. By doing that enough times, she was able to get inside the minds of cattle and anticipate what would startle and unsettle them and what would be soothing and calming.
I am fighting other types of hallucinations. I balked at even calling these events hallucinations because I knew they went real. I wanted to reserve the word hallucination for those events that even though they weren’t real, seemed to be real. The image of the imaginary oasis in the desert is a hallucination. When I “feel” bugs crawling on my arms, I know there are no bugs there. But my sense of touch is telling me they are there. In fact today, I had a new one. I was riding in our car. I had my arm on the passenger side window sill with the window was completely shutted since it was raining. I could see rain drops hitting the passenger side window. However, I started feeling the rain drops hitting my arm and my arm getting wet. I knew it wasn’t. But I still reached up with my right hand to feel my left arm, which was perfectly dry.
I am not an artist in the usual sense of the word. The closest thing to visual artistic ability is that I am a very good “mechanical” drawer. I can draw house or building plans. I think I would have been a decent architect from a design point of view. However, I couldn’t produce life-like visual sketches of my buildings. I could see them in my head but not put those images on paper. I could describe them verbally.
My current battle with words seem to be one of almost having the word, but not quite. As I describe in the first paragraph of this reply. I had the idea or concept of what I wanted to say but didn’t have completely satisfactory words in mind. In earlier posts, I described the process of trying on my hands and knees to dig coal or diamonds out of the hard-packed rock wall of a mine with a pick and a shovel. The second analogy that I used was trying to put together a jig saw puzzle together with a piece missing.
Another metaphor that I used was the dog and cat analogy. Words act more like cats than dogs. Dogs come to you when you call them. Cats come to you when they want to come to you. If you check out Aphasia Corner, there is a retelling of my story in an “aphasia friendly mode.” Look at it and maybe try showing it your mother. See if she understands it.
Peace brother. My best to your mother and the rest of your family
By