We often think of ourselves as our personalities, as personality is often the one thing we feel we can control. We cannot change the color of the skin we are born into, nor can we change the genetic dice that was rolled onto us. However, we can work on cultivating good character and choose how we express ourselves. But meeting John in the neurology clinic made me realize how vulnerable and uncontrollable our personalities can become sometimes.
John was once the manager of a construction company, and was the man to go to get things done. He supervised numerous employees, and had great organizational abilities. At home, he was a family man with good values. However, five years ago, John suffered an aneurysm rupture in his anterior cerebral artery in his brain. It led to bleeding and subsequent damage to the frontal lobe, the part of the brain known to control our ability to judge what’s good and bad, to reason, and to control our impulses. Ever since then, nothing was the same for John nor his family. John didn’t become paralyzed or lose the ability to speak like many stroke patients do. In fact, he was quite active and spoke fluently and quite a lot. John, however, was a different person, and the man his wife and family knew is no longer there.
Ever since the incident, John became very uninhibited as if he no longer cared about what he said anymore or how people perceived him. During our encounter, John was restless, excited, and happy, but he often blurted out very inappropriate comments, sometimes offensive or politically incorrect. Despite being at a medical office for his condition, he often spoke off-topic and joked around a lot. His attention was short, and his memory was spotty. According to his wife, he no longer feels the need to brush his teeth, shower, and do other daily routine activities unless he’s told to do so, and his wife finds herself managing him as if he were a child needing to be told everything that needs to be done. This is quite unexpected from a man who was once managing a large company and raising a family with children. Today, he no longer works, and is being taken care of by his loving wife who never forgot the man who he was.
I’ve seen many patients who had strokes during my rotation in Neurology. Of those who survive, some people may lose their ability to walk, while others may lose their sight. But my encounter with John made me realize that the most heart-breaking for me to see are those who lose their personalities, which makes us who we are.