What It’s Like to Have a Stroke

An acclaimed writer describes the harrowing experience that left him partially paralyzed and struggling to speak, swallow, or stand.

Between Heaven and Hell: The Story of My Stroke, by David Talbot, Chronicle Books, 176 pages, $22.95
Between Heaven and Hell: The Story of My Stroke, by David Talbot.

This is what it feels like to have a stroke. Or rather this is what my stroke felt like. Like Tolstoy’s unhappy families, I’ve learned that each stroke is unhappy—or terrifying and hallucinatory—in its own way. Different strokes for different folks.

I was dining one fall evening with friends at an unassuming neighborhood French bistro. Nothing fancy, just a good roast chicken, green salad, and chilled chablis. The restaurant was mostly empty—ours was the most boisterous party, though we were few in number.

We were celebrating what seemed like an important step in the never-ending odyssey to turn my history books into Hollywood dramas. I think we were closing in on a top screenwriter, something like that. There’ve been so many twists and turns in this labyrinthine journey that I can’t remember all the little happy endings, and unhappy setbacks, along the way.

Anyway, toasts were drunk to our ephemeral success, and as the meal concluded, I rose to my feet and instantly felt my life change. My mild sense of euphoria from the pleasure of the company and the smooth flow of wine…it all evaporated in a moment. I felt like the lights had dimmed, that I suddenly was dispatched to another dimension. And then I felt a curious sensation in the back of my head, like warm liquid rushing inside my skull. It was all very brief, and soon it seemed like the lights were fully turned back on. But I knew I’d just been transported somewhere I’d never been before, and I felt deeply unsettled.

My friends immediately noticed that something was wrong with me. “Are you OK?” asked one with a look of concern. But I assured them I felt fine—I had just stood up too quickly after the wine, I explained. In fact, I convinced them I was well enough to drive myself home. “Don’t expire on us, we need you,” joked one as I left to find my car. It somehow felt more ominous than funny.

Of course I should have stayed and admitted that I needed help. But as puzzling as it might sound, the truth is, I wanted to be alone. I didn’t realize I was having a stroke; it felt instead as if something strange and special had just happened to me. Something more than just a wine-induced haze, something too intimate to share, even with close friends. I wanted to be inside myself; I wanted to figure out what was happening to me.

On the way home, I drove past Davies hospital on Castro Street, where I would be rushed in an ambulance 36 hours later. Yes, I should’ve pulled into the hospital driveway right then and checked myself into the intensive care unit. You can imagine how many times I dwelled on that missed turn later, when I lay in my hospital bed, hour after hour. What if, what if, what if…until I realized that mental fixation was a dead-end alley and if I kept going down it, I’d never find a way out.

But I include this information for all of you who might be fated to have strokes, or know and love someone who will. When I drove past Davies that night, I was still in the first hour of what would later be diagnosed as an ischemic stroke (a blocked blood vessel) that cut off the oxygen flow to my pons, a small area buried within the brain stem that controls such rather essential functions as breathing and heartbeat, as well as swallowing, speech, vision, and coordination. Without a constant flow of oxygen, brain cells start dying at an alarmingly brisk speed—1.9 million per minute—so speedy treatment is essential.

If I had checked myself into the hospital within three hours of my first stroke symptoms, I might have been treated with a clot-dissolving drug known as tPA (tissue plasminogen activator). The clot-busting drug has its own hazards—it causes a fatal brain hemorrhage in about 1 in 15 people. But I’ll never know if my family and I would’ve played those odds because I didn’t realize I was having a stroke until long after the three-hour window had closed.

I somehow drove home safely that night, enjoyed a sound sleep, and woke up the next morning full of my usual energy. I drove to the nearby Black Jet Bakery on Bernal Hill to buy almond croissants for my still slumbering family, then cooked for my brood the usual Saturday morning banquet of scrambled eggs, green onions, and Jarlsberg cheese, accompanied by the platter of pastries. It was not until early evening, as I lay in bed reading, that my stroke clearly announced itself—nearly one full day after I had felt the lights flicker in my brain.

As I was reading, my vision suddenly blurred and my head felt like it was spinning. Just then my wife, Camille, arrived home after walking our dog, Brando, on the hill. I told her I couldn’t see straight. I was gripped by the strong sensation that I was disappearing as we spoke, as those millions of brain cells went dark.

Camille immediately called my doctor’s office and was told by the after-hours physician on call that I should go to a nearby walk-in clinic, those medical pop-ups you drop in on weekends when your doctor’s office is closed. Wrong. At my age and with my medical history, I should’ve been told to rush to the nearest emergency room.

Fortunately, or forebodingly, I began feeling so dire—dizzy, nauseated—in the car on the way to the weekend clinic that I told Camille I wouldn’t make it there. So she quickly headed to the ER at St. Luke’s, our neighborhood hospital, just a block away.

The medical tragicomedy continued at the St. Luke’s emergency room, a grim holding pen in the bowels of the building. Because I was able to walk in, barely, the emergency staff didn’t think I presented much of an emergency. While leisurely checking my vitals, the doctor examining me suggested I had a bad, if rather sudden and mysterious, case of the flu. Then, as he was about to release me, I began violently, explosively throwing up and the doctor changed his diagnosis.

“Let’s get him upstairs,” he said with a frown.

As I lay in the hospital room upstairs, my head swirling, I began to feel parts of my right side go numb. My head, neck, arm, hand, leg, foot, toes. A great heaviness was taking over that side of my body. I told my wife, who urgently relayed this news to the medical staff.

“It’s probably just the potassium we’re pumping in him,” said a new, much younger doctor on weekend duty, airily dismissing my growing paralysis.

I was hauled onto a gurney and whisked down a long, bare hallway with dim lights to a remote tech room for a CT scan, to determine if bleeding was the cause of my crisis. It wasn’t—the culprit was a clot. I should have also been given an MRI exam, which would have pinpointed the location and damage caused by my ischemic stroke. But the hospital staff informed Camille that it only had use of the MRI during weekdays. Do they rent out the machine to other hospitals on Saturdays and Sundays? she wondered.

By now, I felt my spirit beginning to waft from my body. As I was being wheeled down the shadowy hallway to the CT scan room, it seemed like a final passage of sorts. In fact, it felt oddly familiar—and then I recalled a similar image that I had used in my final Facebook post that afternoon. I used the photo of a murky hallway to illustrate a post about the dark times we live in. But, I wrote, we should take heart, quoting folk singer Jemima James’s bittersweet song “Nothing New”: “Long walk, dark hall, there’s a door where there’s a wall.” Clearly, when I posted that message, my brain was already launched on some ineffable journey. I just didn’t know it yet.

Excerpted from Between Heaven and Hell: The Story of My Stroke by David Talbot. Copyright © 2020. Reprinted with permission of Chronicle Prism, an imprint of Chronicle Books.

Alta and Book Passage will host a free conversation with Talbot on January 28, 2020 at 7 p.m. in Corte Madera. RSVP here.

David Talbot's latest book is Between Heaven and Hell.
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