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“Aging is a process which we know will go from bad to worse, until it comes to the worst of all.”
— Arthur Schopenhauer

In Schopenhauer’s world, you’re not allowed to die quickly, the way people die in movies. You’re much more likely to go out slowly, in agony and terror. It can happen in hundreds of thousands of ways, because one of Nature’s little jokes is that everything you have can and will be used against you. Your skin — any cell of it could decide to become a melanoma franchise at your expense. Your bones, your muscles, every organ in that squishy torso can fail for hundreds of different reasons, or for no comprehensible reason at all.

But the most underrated nightmare fate of all is to suffer a stroke. What this harmless-sounding word means is that a blood vessel in your brain bursts, destroying the brain tissue around it.

Everything you have can and will be used against you — including that big brain you’re so proud of. That brain requires a great deal of blood. So it’s served by a vast network of vessels. Every time your heart slams in your chest, blood is pushed through those thousands of vessels, creating pressure. If there’s a little weak spot in one of the vessels serving the brain, this pressure will make it swell, then burst. The effect is like having a tiny hand grenade explode inside your brain.

The effect of the stroke depends on where in the brain the little blood-grenade goes off. If you’re lucky, it might blast the part of your brain controlling heartbeat, killing you on the spot. But if you’re unlucky enough to survive, as most Westerners are the first time around, there’s a whole smorgasbord of disabilities available. Your first choice (not that you get a choice) is between left-hemisphere and right-hemisphere strokes. If the blood-bubble bursts on the left side of your brain, which controls speech and language, you might get lucky and merely be paralyzed, or you may develop one of hundreds of different kinds of language-centered brain damage. You may be unable to speak at all, ever. You may be able to write but not read, read but not speak, or spend the rest of your life with “tip of the tongue phenomenon,” always feeling you’re just about to remember the word you want, but never managing to do so. This wonderful disability is called “aphasia,” but that won’t matter to you because you won’t be able to pronounce it whatever it’s called. Hell, you won’t be able to say “cat.” You may also become terrified or passive, unable to act at all and needing constant prodding to eat, wash, or walk. You may forget the right side of your body entirely, banging it into walls and doorways without even noticing.

If your stroke hit the right side of your brain, a whole different torture-menu awaits you. Since the right side of the brain handles spatial perception, you won’t be able to dress yourself, pick up objects, or navigate through a room. Yet you’ll keep trying, because another of the effects of right-side strokes is to change the personality, often making the victim wildly impulsive, overconfident or manic. You’ll crash through the rest of your life like one of Romero’s living dead, stumbling around growling and thrashing, terrifying all those around you. Unless your next-of-kin is Mother Theresa, you’ll find that you have a lot of time to yourself.

Once you’ve had that first stroke, you’re likely to have another. And the second stroke will give you new damage, sometimes reversing the effects of the first one. Maybe your first stroke was on the left side, leaving you timid and passive. If your second stroke hits the right hemisphere, you could be transformed into a screaming, violent monster. And you’ll be watching yourself do all these horrible things without being able to stop yourself, as you drive away any remaining friends and family.

And all this is not just possible but probable! Strokes are as common as dirt! You stand an excellent chance of dying in this slow, nightmarish way! And you’ll be in excellent company: celebrities who’ve had strokes include six US presidents as well as Mary Kay Ash, Charles Dickens, Ken Kesey, Patricia Nixon and Thelonius Monk. Mrs. Nixon and Mr. Monk were not together at the time of their strokes, of course.

And then of course there’s Kirk Douglas. At this year’s Academy Awards, millions of Americans were forced to watch his damaged brain struggle to transmit four large simple teleprompter words to an unreponsive mouth while his son winced beside him. Douglas is the author of the stroke memoir Stroke of Luck. He wrote it after his failed suicide attempt in February of last year, brought on by the stroke and his inability to talk. “What’s an actor who can’t talk?” he asked. But the stroke wasn’t going to let Douglas go so easily: he loaded the gun and put it in his mouth, but because of his damaged motor skills, he knocked out a tooth, causing so much immediate pain that he couldn’t steady himself long enough to pull the trigger. The humiliation was so great that he has not had the nerve to try again.

If you live in the “Stroke Belt,” you’re even more likely to have a crippling stroke. This belt includes all states of the former Confederacy (suggesting that there is some form of celestial justice after all), as well as Indiana (further confirming the celestial justice theory).

For many lucky stroke victims, the torment ends relatively soon; most die within a year. But not all. Many of you will spend years locked inside a short-circuited body. The scariest comment we found in researching strokes was the “inspirational” message at the end of a website: “Life [after a stroke] can and does go on for a long time!”

This article was first published in issue #164 of The eXile in April, 2003.

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