A New Take on Stroke Rehabilitation

Excerpted from the book: The Brain That Changes Itself

Stories of Personal Triumph from the Frontiers of Brain Science

By Norman Doidge, MD, Penguin Publishing, December, 2007

In 1959 Paul Bach-y-Rita’s father Pedro Bach-y-Rita, then a sixty-five-year-old widower, had a terrible stroke that paralyzed his face and half of his body and left him unable to speak.

Paul and his brother George, then a medical student in Mexico, were told that their father had no hope of recovery and would have to go into an institution. Instead, George moved his paralyzed father from New York back to Mexico to live with him.

George knew nothing about rehabilitation, but he had good intuition. "I decided that instead of teaching my father to walk, I was going to teach him first to crawl. I said, 'You started off crawling, you are going to have to crawl again for a while.' We got kneepads for him.

"The only model I had was how babies learn. So, we played games on the floor, with me rolling marbles, and him having to catch them. Or we'd throw coins on the floor, and he'd have to try and pick them up with his weak right hand. Everything we tried involved turning normal life experiences into exercises." p.21

Gradually Pedro went from crawling, to moving on his knees, to standing, to walking. Eventually he even began talking. After a number of months he wanted to resume his writing. He would sit in front of the typewriter, his middle finger over the desired key, then drop his whole arm to strike it.

At the end of a year his recovery was complete enough for Pedro, now sixty-eight, to start full-time teaching again at City College in New York. He worked there until he retired at seventy and then got another teaching job at San Francisco State, remarried and took up hiking, and traveling. On a visit to friends in Bogota, Colombia, he went climbing high in the mountains. At nine thousand feet he had a heart attack and died shortly thereafter. He was seventy-two. p.22

When an autopsy was performed on his father's brain, Paul saw that the stroke causing lesion was mainly in the brain stem — the part of the brain closest to the spinal cord — and that other major brain centers in the cortex that control movement had been destroyed. Ninety-seven percent of the nerves that run from the cerebral cortex to the spine were demolished — catastrophic damage that had caused his paralysis. p.23

"I knew that meant that somehow his brain had totally reorganized itself with the work he did with George. We didn't know how remarkable his recovery was until that moment, because we had no idea of the extent of his lesion, since there were no brain scans in those days." p.23

To Paul, his father's story was firsthand evidence that a "late" recovery could occur even with a massive lesion in an elderly person. He dedicated his life and work from that point on to rehabilitating other patients who suffered from sensorimotor impairments.

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If this post strikes a chord with you, we take brain plasticity possibilities a step further in Impossible Dream, the extraordinary story of triumph over disability told from the first-person perspective of a young woman living with autism.