Aphasia: The disorder that makes you lose your words
It’s hard to imagine being unable to turn thoughts into words. But, if the delicate web of language networks in your brain became disrupted by stroke, illness or trauma, you could find yourself truly at a loss for words. This disorder, called “aphasia,” can impair all aspects of communication. Approximately 1 million people in the U.S. alone suffer from aphasia, with an estimated 80,000 new cases per year. About one-third of stroke survivors suffer from aphasia, making it more prevalent than Parkinson’s disease or multiple sclerosis, yet less widely known.
There are several types of aphasia, grouped into two categories: fluent (or “receptive”) aphasia and non-fluent (or “expressive”) aphasia.
People with fluent aphasia may have normal vocal inflection, but use words that lack meaning. They have difficulty comprehending the speech of others and are frequently unable to recognize their own speech errors.
People with non-fluent aphasia, on the other hand, may have good comprehension, but will experience long hesitations between words and make grammatical errors. We all have that “tip-of-the-tongue” feeling from time to time when we can’t think of a word. But having aphasia can make it hard to name simple everyday objects. Even reading and writing can be difficult and frustrating.
It’s important to remember that aphasia does not signify a loss in intelligence. People who have aphasia know what they want to say, but can’t always get their words to come out correctly. They may unintentionally use substitutions, called “paraphasias” – switching related words, like saying dog for cat, or words that sound similar, such as house for horse. Sometimes their words may even be unrecognizable.
So, how does this language-loss happen? The human brain has two hemispheres. In most people, the left hemisphere governs language. We know this because in 1861, the physician Paul Broca studied a patient who lost the ability to use all but a single word: “tan.” During a postmortem study of that patient’s brain, Broca discovered a large lesion in the left hemisphere, now known as “Broca’s area.” Scientists today believe that Broca’s area is responsible in part for naming objects and coordinating the muscles involved in speech. Behind Broca’s area is Wernicke’s area, near the auditory cortex. That’s where the brain attaches meaning to speech sounds. Damage to Wernicke’s area impairs the brain’s ability to comprehend language. Aphasia is caused by injury to one or both of these specialized language areas.
Fortunately, there are other areas of the brain which support these language centers and can assist with communication. Even brain areas that control movement are connected to language. Our other hemisphere contributes to language too, enhancing the rhythm and intonation of our speech. These non-language areas sometimes assist people with aphasia when communication is difficult.
However, when aphasia is acquired from a stroke or brain trauma, language improvement may be achieved through speech therapy. Our brain’s ability to repair itself, known as “brain plasticity,” permits areas surrounding a brain lesion to take over some functions during the recovery process. Scientists have been conducting experiments using new forms of technology, which they believe may encourage brain plasticity in people with aphasia.
Meanwhile, many people with aphasia remain isolated, afraid that others won’t understand them or give them extra time to speak. By offering them the time and flexibility to communicate in whatever way they can, you can help open the door to language again, moving beyond the limitations of aphasia.
there is a Starbucks on campus. you go there enough to have the employees’ names memorized, but there seems to be new people each time you go. this is your third venti latte of the day. you hand the cashier your punch card. they rip a new star-shaped hole with their nails. when you look at their name tag to thank them, all you see are chalk paint scribbles. it doesn’t matter. there’ll be someone new by the time you return in an hour.
you spend every night on the fourth floor of the library. there is only one room on that floor, full of windows. the rest of the floor is kept behind locked doors that claim to be “SPECIAL COLLECTIONS.” it is always just on the cusp of the sunset when you arrive to the fourth floor, and the sky darkens to pitch-black within minutes. you check your watch. it’s 3pm. the lights of the campus twinkle back at you. you drink your venti latte.
did you know you have an essay due tomorrow? you sit down to work on it. as you open your word document, a web browser video suddenly opens instead. you click it closed. it opens again. this time, it’s playing a new episode of House of Cards on Netflix. you’ve never seen this episode. you click it closed an hour later. did you know you have an essay due in an hour? you open your word document.
“The student center will be under renovation for a while,” the chancellor announced with a close-lipped smile. how long? you asked. “Oh, you know.” they offered a vague hand waggle. “Probably a few months. Maybe a year? We’ll just have to wait and see.” they direct you to the architectural firm that will be handling the project. when you hunt down the building, a trio of dogs growl at you from behind a 6 foot fence. barbed wire sparkles like frost. all of the lights in the building are off, and grass grows between the cracks in the parking lot. you make a u-turn and head back to campus.
your bio lecture has 143 students in it, your teacher announced on the first day of class. when she uses the iClickers to take roll, you always choose B. there are 70 students in the class, your teacher announced a week later. only 35 by midterms. now it’s finals week. you can only see one other student out of the corner of your eye. there is something hungry about him. you don’t know if you’ll be able to press B again, next week.
I fall for you
Like I felt thousand times before
And I can’t help it
My Love, My Sun, My Liquor,
You make me drunk all the time
When I think about you
And the next day
What will I do when I’m sober?