Normal is just a word away
DETROIT -- Jim Osborn remembers waking up in a hospital bed, unable to speak.
"It was the most horrible thing when the doctors asked, 'Who's this?' and 'Who's that?'" recounted Osborn, a Livonia, Mich., father of two. "And I almost cried because I couldn't say my kids' names or my wife's name."
From those first few moments after his October 2010 stroke, Osborn, 60, has contended with aphasia -- a condition that affects the ability to speak, read and write after a traumatic brain injury.
It's a disorder that impacts 1 million Americans, among them U.S. Rep. Gabrielle Giffords, whose first public interview since being shot point-blank in the head outside a Tucson grocery store was held last month with ABC newscaster Diane Sawyer. Giffords spoke in short phrases, sang a bit, and said she wants to get back to work.
After his stroke, Osborn also wondered whether he'd be able to return to his 20-year career as a telecommunications support manager at Detroit Metro Airport. But he has regained his communication skills through speech therapy and an intensive regimen offered by the University of Michigan Aphasia Program.
About 60 people a year enroll in the program, some coming from as far as Australia and Europe for four weeks of individual speech therapy, group therapy and counseling.
Stroke is the primary cause of aphasia, but brain tumors, head injuries and brain infections such as meningitis also can trigger the disorder. The University of Michigan program gets about five or six people a year -- often military members -- who, like Giffords, have sustained gunshots to the brain.
ABC newscaster Bob Woodruff, a Michigan native and Cranbrook school graduate, also suffered a brain injury that brought on aphasia when he was nearly killed by a roadside bomb in Iraq in January 2006. Woodruff returned to the air in 13 months, but he says he still deals with the aftermath of aphasia.
Aphasia doesn't affect a person's intelligence. People with aphasia can form thoughts and words in their minds, but they cannot always get the words out.
"It can affect your ability to listen, to write, to read, to do gestures, to do math," says Mimi Block, clinical services manager of the University of Michigan program. "Anything that's language-based. And you don't realize how much is language-based until you lose it."
The left side of the brain is generally considered where the ability to read, write and speak resides. An injury can impact the ability to form words and phrases. Aphasia may manifest itself as what experts call word-salad -- gibberish.
Snapshots of Giffords' struggle emerged earlier this year in an Associated Press story about her new memoir, "Gabby: A Story of Courage and Hope," (Scribner, $26.99), which was co written by her husband, former astronaut Mark Kelly. The memoir recounts that when former President George H.W. Bush visited her in the hospital, Giffords greeted him by uttering two unrelated words -- "wow" and "chicken." In another instance, she recognized a photo of actor and former California Gov. Arnold Schwarzenegger, who'd admitted to having a child out of wedlock with his maid, by saying: "Messin' around. Babies."
Singing over speaking
Because it's sometimes easier for the brain to recall words drilled into it through repetition, "we have some clients who can't say many words, but can really sing beautifully," says Block.
Besides individual one-on-one therapy, the U-Michigan program offers patients book clubs, music clubs and dining clubs as a way to practice interacting with others conversationally.
Losing the ability to speak clearly can be devastating and the path to recovery arduous and demoralizing, Osborn can tell you now.
On Oct. 4, 2010, as he was getting ready to leave for work, he suddenly felt weak and out-of-sorts. He was in the basement dumping a load of laundry when he told his wife he wasn't feeling well, and then "felt a bump or a hit."
He banged his head on a door as he fell to the basement floor. When his wife asked if he was OK, he could only respond in a garbled mumble. His wife called an ambulance. Within 10 minutes, he was in the emergency room at St. Mary Mercy Hospital in Livonia; a helicopter then took him to St. Joseph Mercy Oakland in Pontiac.
In the days and weeks that followed, Osborn's speaking, reading and language skills were an unintelligible scramble.
Still, says Osborn, "I was lucky." He displays no paralysis or outward signs of a stroke. "Mine just caused all speech problems."
Says his wife, Carolyn Osborn, 57, a paralegal: "It was a month later when he could say my name. He knew who I was, and he would try and write it. But he couldn't read. And he couldn't write, either."
She thinks he struggled with her name and the names of their daughters, Emily, 21, and Alison, 25, because they're three syllables. At first, his brain could only handle one-syllable words.
"It was like a disconnect. My name was in his head, but he couldn't verbalize it," recalls Carolyn Osborn. "He was very quiet for a long time. And when he did say something, it was the wrong thing. It was very frustrating for him."
Osborn was in outpatient speech therapy for several months. He relearned how to write and spell. Friends brought him magazines and newspapers, but initially they were a jumble of nothing to him. He first made progress, he remembers, by reading newspaper headlines.
He struggled to make sense of the comics, but he couldn't grasp the punch lines that used to make him laugh out loud every day. To improve his reading, his daughters hauled out the seven-volume "Harry Potter" series, which he eventually read cover to cover, but didn't always understand.
When Osborn's health insurance for speech therapy ran out, Carolyn Osborn knew her husband still needed specialized, intensive treatment, much like Giffords is receiving. That's when an Internet search brought her to the university's Aphasia Program.
"That's why I came here," says Jim Osborn. "I wanted to get the best chance to succeed when I got the chance to go back to work."