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This programme contains some
strong language

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As many days of the year
as possible, I begin here.

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Other than constant chatter
in my head,

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it's a time that is
largely language-free.

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If, that is, it is ever possible
to be language-free.

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In 2011, my brother-in-law, Dennis,
had a stroke that significantly

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affected his ability to use
language -

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particularly cruel for a man whose
living had been as a journalist,

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a writer.

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Until Dennis had his stroke,

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I hadn't realised just
how common aphasia is.

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Dennis had joined the ranks of over
a third of a million people living

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in the UK whose language, to some
degree, has gone missing -

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the vast majority
the result of stroke.

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People like Barry.

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I...need...some...help.

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And Junior.

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I'm anxious about language.

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You're anxious? Yes.

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Two men who know what it is to live
in a world where a sudden storm in

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the brain has left them unable to
rely on what is the invisible

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mainstay of life - language.

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This is a film about
language and its loss,

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about aphasia and about
the organ that controls it all.

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Queen's Square in London and the
National Hospital for Neurology

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and Neurosurgery.

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Everything that goes on behind
these walls is about the brain.

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In February 2017, I meet Barry,

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an inpatient on the hospital's
neuro-rehab unit.

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Barry has been in hospital every
day since a devastating stroke

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four months earlier.

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Once a gym-loving fitness fanatic,

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he now finds himself in a wheelchair
barely able to use the right-hand

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side of his body,

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and barely able to speak.

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He's now halfway through a stay on
the rehab unit that's intended to

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help him back into the world.

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So we did talk about this
earlier in the team meeting.

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Yes. We were talking about...

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..thinking about making a
visit home.

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Yes. Do you want to talk about that?

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Months, months.

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Three months.

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You haven't been home
in three months?

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Four months. Four months.

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Four months.

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Do you mean it's four months
since the stroke?

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Yes. Or you're not due to go home...

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..for four months?

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Ah... Since the stroke?

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Four months.

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Four...months.

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Four months haven't

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go home.

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You haven't been home
in four months?

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Yes. Yes.

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It's a long time. Ah...

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Are you looking forward
to going home?

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No. No.

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Why not?

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Are you scared? Yeah.

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Yeah. What makes you frightened?

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Four months. Four months.

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Four months.

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So this is the CT scan,

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so the Cat scan that was performed
on Barry when he was initially

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admitted to
Watford General Hospital.

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So in this scan the white areas,
the bright white is bone.

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And what you can see here
are Barry's eyes and his nose.

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And it is immediately apparent,
is it, that there's a lot of...

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I couldn't see it terribly clearly
that there is a lot of damage. OK.

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So that's the initial scan.

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OK.

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This is the normal side of
the brain, the right side.

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Yeah. And this darker bit...

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..is what we call
kind of the low density.

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So it's much darker.

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This is all the affected area
of the brain here.

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So, basically, the brain tissue,

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when the blood supply has been cut
off, the brain tissue dies.

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This is the brain of a man in his
70s who died of a cancer-related
death,

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so it's essentially,
from a neuropathological
perspective, a normal brain.

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The vast majority of the brain
is the cerebrum,

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which is divided into left
and right cerebral hemispheres.

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So when you're looking from the
outside of the brain, what you are

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seeing, really,
is the cerebral cortex.

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So different areas
of the cerebral cortex

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are involved in different functions,
different neurological functions,

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so the area I've marked in blue
at the back of the temporal lobe

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is Wernicke's area,

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and that's an area that's important
in the comprehension of language.

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The other important speech area,
which I've marked in red here,

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is at the bottom of the frontal
lobe, the left frontal lobe.

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That is called Broca's area,
and that's responsible for the

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production and planning of speech.

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So in the vast majority of people,

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language areas are entirely
on the left hemisphere.

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What do you understand
language to be?

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I would say language is something
that's almost completely uniquely

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human and it's one of the
things that has enabled us

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to do so well as a species.

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And the reason for that, I think,

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is because it allows us
to model the world.

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So how can we plan for something
that we're going to do next
Wednesday

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if we don't have language? So "next
Wednesday" allows us to talk about a

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specific potential event forward in
time and without language we can't

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really do that. We can have a
concept of time and a concept of
things

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happening in the future or the past,
and I suspect other animals do that,

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but for precise planning,
we really need language.

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And language is a form
of abstraction.

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It's a way of abstracting the world
and getting control of it.

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Barry, 55 years old -
still young for a stroke.

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Why had it happened? The frightening
thing is that it wasn't fully clear.

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The only certainty is that for this
landlord and father of three

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grown-up children, married to
his childhood sweetheart, Linda,

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life has been dramatically
knocked off course.

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Now Barry is living alongside other
men and women recovering from a

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variety of neurological conditions,

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their days divided between
therapies and family visits.

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Barry, what's your
favourite biscuits?

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Jammie Dodgers? Yeah.

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Linda visits most afternoons,

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often bringing cake and biscuits
to share with the other patients.

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One day, she tells the story
of Barry's stroke,

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describing how an ordinary working
day had ended with the whole family

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concerned that Barry
had not come home.

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Jess was calling all the hospitals.

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She thought maybe you'd been in an
accident and they hadn't identified

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you. So Jess was on
the phone all night.

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Sam calling, calling all night
all the hospitals.

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So then, at about 7.30
in the morning,

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Sam called a private detective and
he was able to tell us roughly the

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vicinity where your phone was.

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So Ben and Sam jumped in Ben's car
and went towards Borehamwood,

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where your phone was.

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Jess and Tammy went down the A1
and Tammy said, "Stop, stop!

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"I think that's my daddy's van."

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And Tammy ran back down
the A1 and found you.

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Oh! And then she called
the ambulance.

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We've estimated you were maybe
12, 15 hours in the van.

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Ten. Ten hours.

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Ten hours.

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What's ten hours? In a van?

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Yeah. Oh...

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Do you remember being
in the van, Barry?

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No.

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It's good you don't remember that.
It's better.

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I worked hard to...

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..accept what had happened...

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..but I couldn't really do that
until I got over the shock,

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the shock of him being in the van
on his own all night,

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the shock of him having the stroke.

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Then I worked on accepting the
situation it put him and myself...

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..and our children.

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Barry was always a real
people's person, full of life.

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A bit of a lad. I just think...

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..at times he must feel
very lonely, very isolated.

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Not fully understanding
what one is saying.

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Not being able to join in
the conversation.

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So, for me, that's
the biggest challenge.

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COMMENTATOR: It's a flick on from
Junior Agogo. It's Richard Walker.

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Can he find Ryan Williams? He does!
It's Agogo!

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Surely! It is!

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This is Junior Agogo,

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former Premier League footballer and
former patient on the neuro-rehab
unit.

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Junior had had a stroke in January
2015 when he was just 36 years old,

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two years after ending
his football career.

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Today, he lives in London with his
dog, Blanket, and his mother,
Jeannie.

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The flat is a shrine
to his football days.

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He's made a good physical
recovery from his stroke,

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but he still struggles greatly
with the impact that it's had

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on his language.

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Do you remember how long it was
before Junior was able to speak
again?

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I think it's after...
It's after a year.

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No, no, no.
No, after six months, sorry.

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No, no, no. After three months.

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Was it? No, no, no, three months,
the first word you said was...

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BOTH: "Fucking hell."
Yeah, yeah. "Fucking hell."

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And I said, "Don't be swearing!"

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Then the second one was...

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There were some things that he was
saying and I couldn't understand

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what it was. He was trying,
he was struggling, you know?

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I think it was after six months
that you started...
The speech started coming out.

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Yeah, yeah. When he started
doing his speech therapy.

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Did they find out why
you had a stroke?

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No. No, they still can't,
you know... No.

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But...

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I'm alive, I'm well.

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Let's see what...
Yeah, but deep down in your heart,

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there is something bothering you.

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Yes, yes, yes. Yeah?

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OK, look, let's get on
to my football days, yeah?

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HE LAUGHS

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Oh, God! Yeah!

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So, where are we here?

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This one was Barnet.

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Barnet.

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That's Nottingham.

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Nottingham. Bristol.

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There's Ghana. Yeah, Ghana, as well.

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Ghana? How many times
did you play for Ghana?

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27 times.

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Wow! How many years
did you play for?

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For 17 years.

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At the very top level?
Yeah, yeah, yeah.

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Come on.

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This is the Hall of Fame, is it?
Yeah.

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This one.

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Michael Essien. Yeah.
Chelsea. Yeah.

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Yeah.

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Samuel Eto'o.

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Oh, right. Didier Drogba.

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Wow, Drogba. Are these guys
you're in touch with?

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Um, now, nobody
gets in touch with me.

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LAUGHTER

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Really? Yeah.

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Do you think that's because... Is
that you, because you're not getting

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in touch with them?
I don't know, man,

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because I used to talk with a couple
of boys in the national team,

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but when the stroke happened,
they all said, "No".

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How do you know that?
Do you mean they said "No",

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or you stopped talking to them?
Because I couldn't speak.

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Yeah? Yeah.

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Yeah, Blanket!

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Blanquito, out.

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Are you still struggling
to find words,

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or are you just not putting yourself
in a position where you use them

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because you're anxious about
language because of
what happened to you?

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Yeah, yeah.
I'm anxious about language.

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You're anxious. Yes.

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What about finding
the words and stuff?

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Are you able to...? No, no, I can
find the words, but I'm anxious

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to... Because I am anxious
if I get the word wrong.

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Does that happen often?

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00:14:01,440 --> 00:14:02,800
Oh, many times. Yeah.

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He's just struggling
to bring out that word,

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that particular word he wants to
say, and that word is not

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coming out, you know?
So that's also...

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I want to speak like you three.

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Um-hm. Yeah.

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Yeah.

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That's all.

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It seemed to me that Junior's
language is pretty good.

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He can describe his world,
present and past.

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But he of course doesn't
see it like that.

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He is living with an
acute sense of loss.

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Four months after his stroke,

248
00:14:45,600 --> 00:14:48,640
Barry has none of Junior's
admittedly hesitant fluency.

249
00:14:50,720 --> 00:14:55,000
One day, so that Barry's speech
therapist Jonathan might know him
better,

250
00:14:55,000 --> 00:14:59,480
Linda brings in a DVD of a BBC
programme, Homes Under The Hammer,

251
00:14:59,480 --> 00:15:01,960
in which Barry had appeared
some years before.

252
00:15:04,320 --> 00:15:06,680
There he is.

253
00:15:06,680 --> 00:15:09,840
LUCY ALEXANDER: The new owners
are brothers Barry and Tony.

254
00:15:09,840 --> 00:15:13,960
They like to buy houses that need
some TLC and bring them back to
life.

255
00:15:13,960 --> 00:15:16,880
Part of the appeal
for Barry was the location.

256
00:15:16,880 --> 00:15:18,520
Barry, where is your shirt?

257
00:15:22,760 --> 00:15:24,200
All right, hang on a minute.

258
00:15:25,520 --> 00:15:26,840
Can I just pause?

259
00:15:26,840 --> 00:15:28,880
Barry, You look so different.

260
00:15:28,880 --> 00:15:31,160
You've got dreadlocks.

261
00:15:31,160 --> 00:15:32,920
And no top on.

262
00:15:32,920 --> 00:15:34,560
LAUGHTER

263
00:15:38,000 --> 00:15:39,240
It must have been warm.

264
00:15:39,240 --> 00:15:41,640
Yes, yes.

265
00:15:41,640 --> 00:15:43,080
So I want to know all about you.

266
00:15:43,080 --> 00:15:47,040
Well, I spent 25 years
with a big plc.

267
00:15:47,040 --> 00:15:50,760
And I managed to get made
redundant four years ago.

268
00:15:50,760 --> 00:15:52,440
And that was an opportunity.

269
00:15:52,440 --> 00:15:56,120
It was an opportunity to do what I'm
doing now. Having spent many years

270
00:15:56,120 --> 00:16:00,440
with a big company, working my
12 hours a day, short hair, suit,

271
00:16:00,440 --> 00:16:03,040
I can now do what I want.
You've gone mad.

272
00:16:03,040 --> 00:16:07,720
I mean, look at me, I can do what
I want, which is great. And I'm
delighted I'm doing what I'm doing.

273
00:16:07,720 --> 00:16:09,880
I wish I'd done it
ten years earlier.

274
00:16:09,880 --> 00:16:12,240
You are a landlord?
I am a landlord, yes.

275
00:16:12,240 --> 00:16:13,960
What type of landlord are you, then?

276
00:16:13,960 --> 00:16:16,200
As my wife would say,
I'm a very soft landlord.

277
00:16:16,200 --> 00:16:19,040
I'm too easy-going. I believe, in
life, if you're courteous with

278
00:16:19,040 --> 00:16:23,800
people, if you're fair with people,
they reciprocate. It goes both ways.

279
00:16:23,800 --> 00:16:24,840
Can I pause it?

280
00:16:26,640 --> 00:16:29,720
I really got a sense of you
as quite a bubbly character.

281
00:16:29,720 --> 00:16:31,640
Yeah. Yeah.

282
00:16:31,640 --> 00:16:35,040
And you were really talking
lots and lots and lots.

283
00:16:36,680 --> 00:16:39,120
Yes, yes, yes.

284
00:16:39,120 --> 00:16:40,160
I...

285
00:16:41,680 --> 00:16:46,640
That was fun...

286
00:16:48,480 --> 00:16:50,720
So your talking was really clear.

287
00:16:51,960 --> 00:16:54,120
Yeah? Yeah.

288
00:16:54,120 --> 00:16:56,960
Yeah. The other part of you
as a landlord,

289
00:16:56,960 --> 00:16:58,800
you said to be courteous to people.

290
00:16:58,800 --> 00:17:03,840
Yes. So there's something about you
and your communication that is very

291
00:17:04,480 --> 00:17:06,080
fair, courteous.

292
00:17:06,080 --> 00:17:07,920
Yes. Yes.

293
00:17:07,920 --> 00:17:10,640
Yes. We notice that now,

294
00:17:10,640 --> 00:17:13,680
we still notice that
you have that...

295
00:17:15,080 --> 00:17:16,760
..sort of value of courtesy.

296
00:17:16,760 --> 00:17:18,560
Yes, yes, yes.

297
00:17:18,560 --> 00:17:22,040
Even though you have got aphasia.

298
00:17:22,040 --> 00:17:23,080
No.

299
00:17:27,760 --> 00:17:30,280
Thirsty...

300
00:17:33,360 --> 00:17:36,200
Courtesy. Kirsty. Mm-hm.

301
00:17:39,120 --> 00:17:40,240
That...

302
00:17:42,160 --> 00:17:43,160
Oh!

303
00:17:58,720 --> 00:18:01,080
Brains have been around
for a very, very long time.

304
00:18:01,080 --> 00:18:05,600
Human language, possibly as little
as 100,000 or 200,000 years.

305
00:18:05,600 --> 00:18:09,360
So the view is it must have somehow
been grafted onto brain regions that

306
00:18:09,360 --> 00:18:12,440
were already there. And if we look
at some of those brain regions,

307
00:18:12,440 --> 00:18:15,080
those areas of the brain,
we know do other things anyway.

308
00:18:15,080 --> 00:18:17,040
So the frontal part of the brain
is to do with...

309
00:18:18,480 --> 00:18:21,880
..decision-making, memory.

310
00:18:22,960 --> 00:18:24,920
For instance, we have
a verbal working memory,

311
00:18:24,920 --> 00:18:28,360
which seems to involve certain parts
of the brain quite similar to,

312
00:18:28,360 --> 00:18:31,760
very close to, or identical
with language areas.

313
00:18:31,760 --> 00:18:34,160
So it's possible,
in the extreme view,

314
00:18:34,160 --> 00:18:37,560
that there is no such thing as a
purely language part of the brain.

315
00:18:39,640 --> 00:18:41,160
Now I've sliced the brain,

316
00:18:41,160 --> 00:18:43,800
you can see the left side
here where the red ink is...

317
00:18:45,080 --> 00:18:46,920
..is the Broca's speech area.

318
00:18:48,120 --> 00:18:51,480
Where a lesion there - a stroke
or a tumour, for example -

319
00:18:51,480 --> 00:18:55,760
may cause an expressive aphasia,

320
00:18:55,760 --> 00:19:00,040
where they knew what they wanted to
say, they could comprehend language,

321
00:19:00,040 --> 00:19:02,320
but they struggled to get
the words out.

322
00:19:03,960 --> 00:19:08,160
You can see further back,
where the blue ink is,
that's the Wernicke area.

323
00:19:08,160 --> 00:19:11,600
A stroke there, for example,
would cause receptive aphasia,

324
00:19:11,600 --> 00:19:14,320
where the sufferer
can speak fluently

325
00:19:14,320 --> 00:19:16,040
but often devoid of any meaning.

326
00:19:19,880 --> 00:19:22,440
So I have here slices
of a different brain.

327
00:19:22,440 --> 00:19:23,480
You can see...

328
00:19:25,120 --> 00:19:29,240
..in this area here,
in the inferior frontal lobe,

329
00:19:29,240 --> 00:19:32,600
at this level there
is an old cavity there,

330
00:19:32,600 --> 00:19:34,960
which is an old stroke
or cerebral infarct.

331
00:19:34,960 --> 00:19:36,400
So, it's literally a hole, yeah.

332
00:19:36,400 --> 00:19:40,360
So the blood flowing to that part of
the brain will have been cut off

333
00:19:40,360 --> 00:19:42,640
and that part of the brain
will have died.

334
00:19:42,640 --> 00:19:47,640
So this patient may have had an
expressive aphasia during life

335
00:19:48,080 --> 00:19:51,600
where they know what they want to
say, but they can't get the words
out.

336
00:19:53,320 --> 00:19:57,320
The modern view is that language is
instantiated within the brain as a

337
00:19:57,320 --> 00:20:02,360
network of key nodes and that's
probably why people can improve with

338
00:20:03,080 --> 00:20:07,760
therapy, because if there was just
one region that did one job and

339
00:20:07,760 --> 00:20:12,240
nothing else, if that bit becomes
damaged, how can anything take over?

340
00:20:12,240 --> 00:20:14,560
It's not possible, it's gone.

341
00:20:14,560 --> 00:20:16,600
Unless you grow a new bit of brain.

342
00:20:16,600 --> 00:20:19,960
Whilst the brain is changing all the
time - it's a dynamic environment -

343
00:20:19,960 --> 00:20:22,800
it doesn't seem like you can grow a
new brain any more than you can grow

344
00:20:22,800 --> 00:20:25,640
a new finger. But if we think
of language function,

345
00:20:25,640 --> 00:20:29,640
if it's shared across multiple
regions with multiple connections
and there's damage to thatnetwork,

346
00:20:29,640 --> 00:20:33,400
that gives us some hope that therapy
could work, because with a bit of

347
00:20:33,400 --> 00:20:37,400
experience-dependent learning we
can perhaps retrain the brain

348
00:20:37,400 --> 00:20:38,760
to learn.

349
00:20:40,360 --> 00:20:44,320
Retraining Barry's brain to improve
his communication is the business

350
00:20:44,320 --> 00:20:47,920
of the speech and language
therapists on the neuro-rehab unit.

351
00:20:47,920 --> 00:20:50,640
Do you know any good strikers, then?

352
00:20:50,640 --> 00:20:52,200
Rooney.

353
00:20:52,200 --> 00:20:55,600
Sometimes Barry's sessions with
Jonathan focus on straightforward

354
00:20:55,600 --> 00:21:00,080
conversation, the give and take
that underpins all relationships.

355
00:21:00,080 --> 00:21:02,840
He's a striker? Yes.
All right. Tell me that.

356
00:21:02,840 --> 00:21:07,880
So... Wayne Rooney... Is a...

357
00:21:07,880 --> 00:21:09,600
Striker.

358
00:21:09,600 --> 00:21:10,680
Right.

359
00:21:11,760 --> 00:21:13,920
Who does he play for?

360
00:21:13,920 --> 00:21:17,080
Erm... W... No, no, no.

361
00:21:18,160 --> 00:21:20,880
Ma... No, no, no.

362
00:21:20,880 --> 00:21:23,960
However effortful and fractured
the conversation,

363
00:21:23,960 --> 00:21:27,000
it's still possible and meaningful.

364
00:21:27,000 --> 00:21:30,440
And Barry's identity,
the Barry-ness of Barry,

365
00:21:30,440 --> 00:21:32,560
seems to transcend language.

366
00:21:32,560 --> 00:21:34,960
Manchester United.

367
00:21:36,280 --> 00:21:37,320
United.

368
00:21:38,560 --> 00:21:40,000
Manchester United. Yes.

369
00:21:41,280 --> 00:21:42,320
OK.

370
00:21:43,440 --> 00:21:45,240
So... Oh!

371
00:21:46,920 --> 00:21:50,920
Other sessions with Jonathan
can feel more like a linguistic

372
00:21:50,920 --> 00:21:54,840
boot camp, in which Barry's given
very specific language drills.

373
00:21:54,840 --> 00:21:56,880
Jacket. With me...

374
00:21:58,240 --> 00:22:01,520
BOTH: Where's my jacket?

375
00:22:01,520 --> 00:22:05,640
When, for example,
you ask him to repeat phrases,

376
00:22:05,640 --> 00:22:08,240
are you...

377
00:22:08,240 --> 00:22:11,040
just trying to give him, like,
a kind of card he can carry

378
00:22:11,040 --> 00:22:16,040
so he can answer that, he can use
that as a useful sentence in social
situations,

379
00:22:16,120 --> 00:22:19,000
or is the act of repeating
and repeating and repeating

380
00:22:19,000 --> 00:22:23,040
somehow fixing a broken bit
of his brain?

381
00:22:23,040 --> 00:22:27,400
I think we know that with
the therapy that we're doing,

382
00:22:27,400 --> 00:22:32,360
what we're trying to achieve
is generate neuro-plasticity,

383
00:22:32,520 --> 00:22:35,960
so the areas that are functioning in
the brain that are still working for

384
00:22:35,960 --> 00:22:40,720
Barry, we're really trying to target
and we're really trying to get to

385
00:22:40,720 --> 00:22:44,160
work better and compensate for the
area that's been really damaged.

386
00:22:45,160 --> 00:22:47,600
So with exercises
like the repetition,

387
00:22:47,600 --> 00:22:51,880
or with exercises like looking at
pictures and hearing a sentence

388
00:22:51,880 --> 00:22:55,600
and trying to understand
the meaning of that,

389
00:22:55,600 --> 00:23:00,360
we're working towards activating
areas around the damaged area.

390
00:23:00,360 --> 00:23:04,720
I...need...some...help.

391
00:23:04,720 --> 00:23:06,480
Yeah?

392
00:23:06,480 --> 00:23:11,520
I...need...some...help.

393
00:23:12,440 --> 00:23:15,240
Good. You're using most
of your brain all the time,

394
00:23:15,240 --> 00:23:19,240
you can't afford to have
any spare bits doing nothing,

395
00:23:19,240 --> 00:23:23,040
but we've mentioned how the brain is
a network and when you've got
networks,

396
00:23:23,040 --> 00:23:27,880
it means you've got the potential
to re-channel, so it's
a simple analogy,

397
00:23:27,880 --> 00:23:32,920
but I think it's a reasonable one.
If you think of a metro network like
the London Underground and you take

398
00:23:33,120 --> 00:23:37,280
out King's Cross,
a major node in that network,

399
00:23:37,280 --> 00:23:40,440
you say, "Well, is the whole
thing going to come to a halt?"

400
00:23:40,440 --> 00:23:43,000
Initially, of course,
there'll be all sorts of problems,

401
00:23:43,000 --> 00:23:46,360
but over time and with a
bit of help, you could bypass.

402
00:23:46,360 --> 00:23:50,120
You're going to have to change here,
here and here, whereas you would
only have changed once.

403
00:23:50,120 --> 00:23:53,200
And I personally think that
happens a lot with language.

404
00:23:53,200 --> 00:23:56,480
I think that's mainly what we're
doing in terms of neuro-plasticity.

405
00:24:01,200 --> 00:24:04,600
The brain's plasticity
is related to its age.

406
00:24:04,600 --> 00:24:08,200
The younger it is, the more it can
adapt to new circumstances.

407
00:24:09,880 --> 00:24:13,760
Junior had youth on his side
in his impressive recovery.

408
00:24:13,760 --> 00:24:15,800
That and the fact that,
unlike Barry,

409
00:24:15,800 --> 00:24:17,800
he was brought quickly to hospital.

410
00:24:19,240 --> 00:24:23,280
In the world of neurology,
they say "time is brain".

411
00:24:23,280 --> 00:24:25,480
For every hour without treatment,

412
00:24:25,480 --> 00:24:29,240
a stroke-affected brain ages by
more than three and a half years.

413
00:24:31,480 --> 00:24:35,760
Junior was in hospital within 60
minutes of the onset of his symptoms

414
00:24:35,760 --> 00:24:39,360
and was given medication to dissolve
the clot which was also physically

415
00:24:39,360 --> 00:24:40,720
removed from his brain.

416
00:24:44,600 --> 00:24:47,440
What happened on the day
you had the stroke?

417
00:24:47,440 --> 00:24:50,960
I know you don't remember it all,
but can you kind of take us through
what happened?

418
00:24:52,160 --> 00:24:57,200
I was running with my dog,
I was coming back home

419
00:24:57,400 --> 00:24:58,840
and...

420
00:24:58,840 --> 00:25:01,160
DOG WHIMPERS

421
00:25:01,160 --> 00:25:04,080
..I was near the Marriott Hotel...

422
00:25:04,080 --> 00:25:06,080
Shut up. ..and the stroke happened.

423
00:25:06,080 --> 00:25:10,400
Shut up. And when I got up,
I was in hospital...

424
00:25:11,800 --> 00:25:15,520
..with my mum saying
that I couldn't speak.

425
00:25:17,160 --> 00:25:18,760
I was...

426
00:25:18,760 --> 00:25:20,200
I was in a bad way.

427
00:25:21,920 --> 00:25:23,400
Yeah? Mmm.

428
00:25:25,000 --> 00:25:27,240
But now, I'm doing OK, but...

429
00:25:28,440 --> 00:25:31,520
..yeah. Just came out of the blue?

430
00:25:31,520 --> 00:25:33,760
Yeah. No warning?

431
00:25:33,760 --> 00:25:38,000
No. No, I don't think so.

432
00:25:38,000 --> 00:25:40,880
I thought you said you had a
blackout, you felt dizzy.

433
00:25:40,880 --> 00:25:43,320
Yeah, no, no, no, I felt dizzy.

434
00:25:43,320 --> 00:25:46,360
But I was thinking that...

435
00:25:47,360 --> 00:25:48,880
..I've not eaten.

436
00:25:48,880 --> 00:25:50,600
Oh, OK. Yeah.

437
00:25:50,600 --> 00:25:52,120
On the day. Yeah.

438
00:25:52,120 --> 00:25:54,040
Cos I run in the morning...

439
00:25:55,600 --> 00:25:56,840
..at five, no...

440
00:25:58,160 --> 00:26:01,520
..five o'clock. Was Blanket actually
with you when you had the stroke?

441
00:26:01,520 --> 00:26:04,880
Yeah. What did he do?

442
00:26:04,880 --> 00:26:08,040
He ran home? No, no, no, no,
he came to my...

443
00:26:08,040 --> 00:26:09,920
He went on my test.

444
00:26:09,920 --> 00:26:11,720
Chest. Chest.

445
00:26:11,720 --> 00:26:13,640
Yeah.

446
00:26:13,640 --> 00:26:18,680
Actually, the ambulance,
the lady that treated him,

447
00:26:19,240 --> 00:26:24,280
said Blanket was sitting on his
chest and Blanket didn't
want anyone to touch him.

448
00:26:24,560 --> 00:26:29,640
So, like, if they wanted to take
off his clothes, he was barking.

449
00:26:31,360 --> 00:26:35,200
When you woke up, you came round,
can you remember
what you were thinking?

450
00:26:35,200 --> 00:26:38,360
Cos you couldn't speak -
could you not have thoughts?

451
00:26:38,360 --> 00:26:40,680
Yeah, I had thoughts.

452
00:26:40,680 --> 00:26:44,240
But I'm saying that,
"Where is my voice?"

453
00:26:45,640 --> 00:26:47,680
I was baffled, man.

454
00:26:49,480 --> 00:26:51,560
Could you understand what
people were saying to you?

455
00:26:51,560 --> 00:26:54,400
Yes, yes, yeah.

456
00:26:54,400 --> 00:26:57,000
But I was thinking, like,
"Where is my voice?"

457
00:26:58,400 --> 00:26:59,720
I cannot speak.

458
00:27:03,360 --> 00:27:06,920
Were you able to sort of have kind
of conversations in your head?

459
00:27:06,920 --> 00:27:11,480
Were you able to kind of form in
your mind what you wanted to say?

460
00:27:11,480 --> 00:27:12,480
Yeah.

461
00:27:14,160 --> 00:27:18,600
Yeah. But it was mad, man.

462
00:27:18,600 --> 00:27:22,280
Because I could think it,
but I couldn't say it.

463
00:27:23,680 --> 00:27:24,920
And it was mad.

464
00:27:27,640 --> 00:27:30,920
Do you think a big part of the next
challenge is your confidence?

465
00:27:30,920 --> 00:27:32,000
Yeah.

466
00:27:33,480 --> 00:27:35,960
I haven't got any confidence.

467
00:27:35,960 --> 00:27:39,280
You've lost that. Yeah, yeah.

468
00:27:39,280 --> 00:27:40,720
But it's OK.

469
00:27:40,720 --> 00:27:42,400
Did you tend to hide away, or...?

470
00:27:42,400 --> 00:27:43,680
Yeah.

471
00:27:48,280 --> 00:27:50,120
But that's life.

472
00:27:56,920 --> 00:27:59,800
Junior's stroke seemed to haunt him.

473
00:27:59,800 --> 00:28:03,320
His mother said that sometimes
he spent whole days in bed,

474
00:28:03,320 --> 00:28:06,080
avoiding the risk of being in
situations where his language

475
00:28:06,080 --> 00:28:07,560
might let him down.

476
00:28:11,600 --> 00:28:13,360
Do you make chicken soup?

477
00:28:13,360 --> 00:28:14,400
Yes.

478
00:28:15,680 --> 00:28:18,480
It's quite... It's quite nice,
but it's not very difficult.

479
00:28:18,480 --> 00:28:21,720
It's not something that's...
It's quite easy to do.

480
00:28:21,720 --> 00:28:23,200
Chicken soup.

481
00:28:23,200 --> 00:28:25,960
Chicken soup. Am I right?

482
00:28:25,960 --> 00:28:27,640
Chicken soup.

483
00:28:27,640 --> 00:28:32,720
For Barry, his world since
his stroke is dominated by
the here and now,

484
00:28:32,960 --> 00:28:36,600
his days divided between various
therapies preparing him for the

485
00:28:36,600 --> 00:28:39,240
ultimate goal of a return
to life at home.

486
00:28:41,800 --> 00:28:44,720
There's occupational
therapy with Shauna,

487
00:28:44,720 --> 00:28:48,640
his key worker helping him with all
aspects of practical daily life.

488
00:28:48,640 --> 00:28:50,960
Well done, yeah, that's OK.
Bring your hand in.

489
00:28:55,680 --> 00:29:00,720
Physiotherapy is with Ellen, working
to get Barry back on his feet.

490
00:29:00,960 --> 00:29:02,280
Thank you. Can you still breathe?

491
00:29:02,280 --> 00:29:04,400
No. Yeah. Yes.

492
00:29:04,400 --> 00:29:06,520
Can you still breathe? Yes. Good.

493
00:29:07,600 --> 00:29:12,600
Left, right, left, right foot,
left foot, right foot.

494
00:29:14,440 --> 00:29:17,520
And most weeks, Barry has
a session with the unit's

495
00:29:17,520 --> 00:29:20,080
neuropsychologist, Sherilyn.

496
00:29:20,080 --> 00:29:23,360
It's her role to help Barry
with his emotional life,

497
00:29:23,360 --> 00:29:26,760
especially his anxiety
about returning home.

498
00:29:26,760 --> 00:29:28,600
Who's going to be at home tomorrow?

499
00:29:28,600 --> 00:29:31,280
I don't know. Cos Linda's
in Spain, isn't she?

500
00:29:31,280 --> 00:29:33,680
Yes. Do you still have a house key?

501
00:29:35,400 --> 00:29:36,720
Yes.

502
00:29:36,720 --> 00:29:38,640
Wowee!

503
00:29:38,640 --> 00:29:41,200
Home seems to hover over everything.

504
00:29:41,200 --> 00:29:45,040
Sometimes, the prospect appears
to excite Barry, but mostly,

505
00:29:45,040 --> 00:29:46,440
it fills him with dread.

506
00:29:46,440 --> 00:29:50,080
And then, if you feel comfortable,
we will drive up to here.

507
00:29:50,080 --> 00:29:52,480
He'd made it clear that he
was worried that with his

508
00:29:52,480 --> 00:29:55,040
language problems,
he couldn't call for help.

509
00:29:55,040 --> 00:29:56,400
But it feels deeper than that.

510
00:29:57,560 --> 00:30:00,880
A series of home visits
are planned by Barry's team.

511
00:30:00,880 --> 00:30:05,920
Photos and videos of his house are
shown to him to try and reduce his
anxiety.

512
00:30:06,080 --> 00:30:08,480
Is this a room that you
would sit in a lot?

513
00:30:08,480 --> 00:30:09,960
I don't know. OK.

514
00:30:09,960 --> 00:30:12,360
I don't know.

515
00:30:12,360 --> 00:30:14,960
Are you trying to say to us that
you're not sure how you're going to

516
00:30:14,960 --> 00:30:17,480
feel about this?

517
00:30:17,480 --> 00:30:21,800
I don't know. I don't know.

518
00:30:23,880 --> 00:30:26,080
It's been a while, hasn't it?
I don't know.

519
00:30:29,480 --> 00:30:31,680
OK, shall we look at
another picture, Barry?

520
00:30:32,920 --> 00:30:35,960
What's this one? Bathroom.

521
00:30:35,960 --> 00:30:37,240
Have things changed much?

522
00:30:39,640 --> 00:30:42,240
Yes. Yes.

523
00:30:42,240 --> 00:30:43,600
In the house or with you?

524
00:30:45,080 --> 00:30:46,400
Erm...

525
00:30:47,920 --> 00:30:52,080
Both. Does it still feel
like your house?

526
00:30:52,080 --> 00:30:53,120
No.

527
00:30:54,920 --> 00:30:56,400
Yeah.

528
00:30:56,400 --> 00:30:59,640
But we'll do this in small stages
until you feel comfortable,

529
00:30:59,640 --> 00:31:03,240
until you get used to it and then
until it starts feeling more like

530
00:31:03,240 --> 00:31:05,080
your home.

531
00:31:05,080 --> 00:31:07,560
You're doing really well. No, no.

532
00:31:07,560 --> 00:31:11,360
No, no, these things will be
difficult, Barry, they will.

533
00:31:12,480 --> 00:31:14,960
But this is the best way to do it,

534
00:31:14,960 --> 00:31:17,240
rather than just take you there
and leave you.

535
00:31:18,240 --> 00:31:20,640
To deal with it, the anxiety.

536
00:31:20,640 --> 00:31:25,440
This is a nice, gradual way for you
to get used to seeing it again.

537
00:31:25,440 --> 00:31:27,640
For you to connect again
with your home.

538
00:31:29,680 --> 00:31:30,760
Oh.

539
00:31:34,120 --> 00:31:39,160
Barry, I think this plan of going
there and experiencing what it feels

540
00:31:39,720 --> 00:31:43,320
like to be there will be
really helpful for you.

541
00:31:43,320 --> 00:31:46,400
Thank you. Yeah. You're not going
to do it on your own. Yeah.

542
00:31:48,880 --> 00:31:50,560
Oh...

543
00:31:50,560 --> 00:31:52,000
Ready for another one? Yes.

544
00:31:52,000 --> 00:31:54,600
Go on, then. I'm going to show you
the outside of the van first.

545
00:31:54,600 --> 00:31:55,800
Are you ready?

546
00:31:58,080 --> 00:32:01,520
Linda said that you loved this van
almost more than her.

547
00:32:03,080 --> 00:32:04,840
Is that true?

548
00:32:04,840 --> 00:32:05,840
Yeah.

549
00:32:07,720 --> 00:32:09,720
She's got a lot to
compete with, hasn't she?

550
00:32:11,680 --> 00:32:14,360
That van...

551
00:32:14,360 --> 00:32:16,800
Happy. Happy.

552
00:32:16,800 --> 00:32:20,720
Happy, lucky, seven days a week.

553
00:32:20,720 --> 00:32:23,680
Seven days a week you'd be
in that van. Yeah.

554
00:32:23,680 --> 00:32:27,000
No wonder Linda thinks
you love it more than she does.

555
00:32:28,960 --> 00:32:31,440
P, Q, R...

556
00:32:31,440 --> 00:32:33,640
Now you're just doing the alphabet.

557
00:32:36,920 --> 00:32:39,320
Michael's going to bring you up, OK?
Thank you.

558
00:32:45,040 --> 00:32:47,240
Oh. How are you feeling about this?

559
00:32:48,880 --> 00:32:52,520
I don't know whether...

560
00:32:52,520 --> 00:32:53,760
I... Confused.

561
00:32:55,960 --> 00:32:59,440
Confused. You're feeling confused?

562
00:32:59,440 --> 00:33:00,800
Yes.

563
00:33:16,080 --> 00:33:17,520
One minute. OK.

564
00:33:23,520 --> 00:33:25,320
Can we just drive up
quite slowly, Mike?

565
00:33:25,320 --> 00:33:30,360
Is that OK? Just drive past quite
slowly. OK. So we're just going to
drive slowly past.

566
00:33:31,600 --> 00:33:34,320
No. Yeah. No.

567
00:33:34,320 --> 00:33:37,000
That one there. That one there.

568
00:33:37,000 --> 00:33:38,840
That one there.

569
00:33:38,840 --> 00:33:40,040
OK.

570
00:33:51,440 --> 00:33:54,400
Yeah, ready, steady...

571
00:33:56,320 --> 00:33:57,600
It's all right.

572
00:34:03,800 --> 00:34:06,000
OK. So just look around slowly.

573
00:34:07,240 --> 00:34:10,240
Those pictures of your kids
up on the mantelpiece.

574
00:34:14,000 --> 00:34:15,040
OK.

575
00:34:17,000 --> 00:34:20,320
Yep. All up there.
Lots of pictures, aren't there?

576
00:34:20,320 --> 00:34:24,240
Uh. Three kids. Yeah, lovely.

577
00:34:24,240 --> 00:34:26,280
Are you happy to sit here
for a while?

578
00:34:26,280 --> 00:34:29,280
No, no, no. Or do you want
to go somewhere else?

579
00:34:29,280 --> 00:34:33,080
I don't know. Remember we said that
you might be happy in the kitchen?

580
00:34:39,360 --> 00:34:40,400
Oh.

581
00:34:42,680 --> 00:34:43,680
Oh.

582
00:34:50,520 --> 00:34:51,760
OK.

583
00:34:58,880 --> 00:35:00,080
Look at this one.

584
00:35:01,120 --> 00:35:02,120
Oh.

585
00:35:07,360 --> 00:35:09,960
I don't know whether...

586
00:35:13,600 --> 00:35:15,560
It's a lovely photo, isn't it?

587
00:35:18,160 --> 00:35:20,240
Is it after you got married?

588
00:35:20,240 --> 00:35:22,640
You've got a ring
on the finger there.

589
00:35:28,120 --> 00:35:29,520
Yeah. OK.

590
00:35:34,200 --> 00:35:36,000
And then more photos up here.

591
00:35:36,000 --> 00:35:38,280
These look like photos of parents.

592
00:35:38,280 --> 00:35:39,680
Yeah. Yeah.

593
00:35:41,200 --> 00:35:42,360
Is that... Is that you?

594
00:35:42,360 --> 00:35:43,880
Yes. Oh!

595
00:35:43,880 --> 00:35:45,720
Is that you and your brother?

596
00:35:45,720 --> 00:35:47,840
Yeah. Oh, and you had
a dog, as well.

597
00:35:49,080 --> 00:35:51,600
Do you want to leave, Barry?

598
00:35:51,600 --> 00:35:53,520
Do you want to leave?

599
00:35:53,520 --> 00:35:55,400
Yes. You want to leave.

600
00:35:55,400 --> 00:35:58,240
Yes. All right.

601
00:35:58,240 --> 00:36:00,640
Back to the ambulance.
Thank you. OK.

602
00:36:05,560 --> 00:36:10,000
Aphasia is sometimes described
as an invisible disability.

603
00:36:10,000 --> 00:36:13,840
It's only when you talk to someone
that you might know it's there.

604
00:36:13,840 --> 00:36:17,680
And it's only by talking or trying
to talk that a person with aphasia

605
00:36:17,680 --> 00:36:20,440
can make any degree of recovery.

606
00:36:20,440 --> 00:36:22,200
"Use it or lose it,"

607
00:36:22,200 --> 00:36:25,240
I was constantly told by
the neurologists and therapists.

608
00:36:26,600 --> 00:36:30,480
Two years after his stroke,
Junior's still struggling with this.

609
00:36:31,600 --> 00:36:35,560
He makes occasional visits to the
neuro-rehab unit to discuss his

610
00:36:35,560 --> 00:36:39,400
progress with consultant speech
and language therapist Jax.

611
00:36:39,400 --> 00:36:41,640
How has your week been?

612
00:36:41,640 --> 00:36:44,440
My week hasn't been too good.

613
00:36:44,440 --> 00:36:45,520
Why?

614
00:36:47,240 --> 00:36:50,240
Because the stroke, man.

615
00:36:50,240 --> 00:36:54,760
I know that it's for the rest
of my life, yeah.

616
00:36:54,760 --> 00:36:58,080
Yeah. But it's getting me
down a bit.

617
00:36:58,080 --> 00:36:59,520
Who do you talk to about that?

618
00:37:01,080 --> 00:37:02,360
No-one.

619
00:37:03,800 --> 00:37:05,520
So he had his stroke two years ago.

620
00:37:05,520 --> 00:37:07,880
Presented with severe aphasia.

621
00:37:07,880 --> 00:37:11,360
It was difficult to assess him cos
his language was so impaired.

622
00:37:11,360 --> 00:37:13,320
Was he speaking at all?

623
00:37:13,320 --> 00:37:16,280
Not at the beginning, he wasn't
speaking at all at the beginning.

624
00:37:16,280 --> 00:37:18,840
When I first saw him, he couldn't
say anything at all.

625
00:37:20,320 --> 00:37:23,160
But started to make quite a...

626
00:37:24,240 --> 00:37:26,520
..quick recovery in
the early stages

627
00:37:26,520 --> 00:37:29,000
of some words, some gestures.

628
00:37:29,000 --> 00:37:31,440
But it's been much slower
in the last year.

629
00:37:31,440 --> 00:37:34,400
Is that because of the area of
the brain that's been damaged,

630
00:37:34,400 --> 00:37:38,640
or is that because of his approach
to the problem that he now faces?

631
00:37:38,640 --> 00:37:41,480
I think it's both. I think it's a
psycho-social adjustment to the

632
00:37:41,480 --> 00:37:46,520
level he's at. It's about who you
are, how you want to move forward.

633
00:37:46,720 --> 00:37:51,720
You know, some people with a level
of language as Junior might do more,

634
00:37:52,760 --> 00:37:55,000
some people might do much less.

635
00:37:55,000 --> 00:37:58,280
But he doesn't go outside
his safety zone at the moment.

636
00:37:58,280 --> 00:38:02,400
Your aphasia isn't the thing that's
really stopping you doing these

637
00:38:02,400 --> 00:38:04,720
things any more, your aphasia's...

638
00:38:04,720 --> 00:38:06,560
You're good.

639
00:38:06,560 --> 00:38:08,960
Am I good?

640
00:38:08,960 --> 00:38:13,920
Yeah. But you see it, but why
doesn't other people see it?

641
00:38:13,920 --> 00:38:16,120
See what? That I'm good.

642
00:38:17,320 --> 00:38:19,560
Do you behave differently,
less confident?

643
00:38:19,560 --> 00:38:21,200
Yeah. Yeah.

644
00:38:21,200 --> 00:38:23,800
So in this room, you're quite
confident, aren't you?

645
00:38:25,440 --> 00:38:27,040
Yeah. Do you remember...

646
00:38:27,040 --> 00:38:28,960
Why is that? Why do you think?

647
00:38:28,960 --> 00:38:31,320
But I know you?

648
00:38:31,320 --> 00:38:33,080
But when I spoke to...

649
00:38:33,080 --> 00:38:34,480
You don't like being judged.

650
00:38:34,480 --> 00:38:37,160
Yes. You don't like your
communication being judged, do you?

651
00:38:37,160 --> 00:38:38,640
Yeah.

652
00:38:38,640 --> 00:38:42,960
But I was... But no-one likes that,
being judged on their communication.

653
00:38:42,960 --> 00:38:45,080
No, of course.
No, of course they don't.

654
00:38:45,080 --> 00:38:50,080
Of course they don't. With me, you,
other people here,

655
00:38:51,040 --> 00:38:53,080
he communicates really quite well,

656
00:38:53,080 --> 00:38:56,120
in the moment, functionally, ably,

657
00:38:56,120 --> 00:38:58,760
and socially, to some degree.

658
00:38:58,760 --> 00:39:00,880
But beyond that,

659
00:39:00,880 --> 00:39:05,280
he doesn't have the free flow of
language to communicate his needs,

660
00:39:05,280 --> 00:39:06,280
his thoughts.

661
00:39:07,400 --> 00:39:08,800
But is that...? It's a concern.

662
00:39:08,800 --> 00:39:11,000
But if he's having
trouble having thoughts...

663
00:39:12,920 --> 00:39:15,840
..is that because he can't...?
He says he doesn't have.

664
00:39:15,840 --> 00:39:18,240
But does he need language
to have thoughts?

665
00:39:18,240 --> 00:39:20,800
Well, that's... That's
the million-dollar question.

666
00:39:23,640 --> 00:39:28,240
Some patients claim that
they just really have
a problem with word-finding.

667
00:39:28,240 --> 00:39:31,720
They feel like it's about this gap
between having ideas and then

668
00:39:31,720 --> 00:39:33,920
having the words to express them.

669
00:39:33,920 --> 00:39:36,840
They just can't grab the words in
order to spit them out to tell them

670
00:39:36,840 --> 00:39:38,480
to you. And in that case,

671
00:39:38,480 --> 00:39:41,240
you can almost think of them as
someone who is language-locked-in,

672
00:39:41,240 --> 00:39:43,600
so that inside their head,

673
00:39:43,600 --> 00:39:46,640
everyday language is going on
relatively normally.

674
00:39:46,640 --> 00:39:49,240
But when they want to communicate
with you and find those language

675
00:39:49,240 --> 00:39:52,800
tokens and spit them out as
speech, they can't do it.

676
00:39:52,800 --> 00:39:54,480
I'm not sure how common
that happens.

677
00:39:54,480 --> 00:39:57,480
I think there's a bit of a halfway
house where if your word-finding

678
00:39:57,480 --> 00:39:59,440
difficulties are bad enough,
you will also...

679
00:39:59,440 --> 00:40:02,160
Certain ideas are hard
to grasp, as well,

680
00:40:02,160 --> 00:40:05,480
because you just cannot hold certain
abstract ideas in your mind if you

681
00:40:05,480 --> 00:40:07,360
haven't got those language tokens...

682
00:40:08,320 --> 00:40:09,800
..as sort of placeholders.

683
00:40:12,320 --> 00:40:13,960
But we can almost judge from
behaviour,

684
00:40:13,960 --> 00:40:18,520
so patients with aphasia have not
lost knowledge of the world,

685
00:40:18,520 --> 00:40:21,520
they do not have what we call a
semantic problem with the world.

686
00:40:21,520 --> 00:40:25,720
They may make what we call semantic
errors, so when they want to say
dog, they may come out with cat,

687
00:40:25,720 --> 00:40:27,760
but that is a sort
of language error.

688
00:40:27,760 --> 00:40:30,360
They know what a dog is, they know
what a cat is, they know who you

689
00:40:30,360 --> 00:40:32,840
are, they know who they are,
they know everything around them.

690
00:40:32,840 --> 00:40:35,240
So they don't have a problem
with understanding the world,

691
00:40:35,240 --> 00:40:38,240
but they have a problem
with the language aspects,

692
00:40:38,240 --> 00:40:40,760
the way of understanding the world
in a more abstract level.

693
00:40:46,240 --> 00:40:49,920
It seemed to me that Junior's
discomfort in the world in a sense

694
00:40:49,920 --> 00:40:53,560
confirms his understanding of the
world and the situation that he

695
00:40:53,560 --> 00:40:55,800
finds himself in with his aphasia.

696
00:40:58,320 --> 00:41:01,600
Hello, Daddy. She's videoing you.

697
00:41:01,600 --> 00:41:04,400
My brother-in-law's aphasia
was very different.

698
00:41:04,400 --> 00:41:09,160
Hello. Dennis' stroke had been like
a sniper attack on his language
only,

699
00:41:09,160 --> 00:41:10,920
sparing his mobility,

700
00:41:10,920 --> 00:41:14,040
but leaving him speaking a sort of
colourful gibberish,

701
00:41:14,040 --> 00:41:16,280
with all the rise and fall
of meaning,

702
00:41:16,280 --> 00:41:18,320
but none of the actual sense,

703
00:41:18,320 --> 00:41:20,160
at least not to anyone else.

704
00:41:20,160 --> 00:41:23,480
Dennis, can you say
something for the camera?

705
00:41:23,480 --> 00:41:25,040
Say something, make a speech.

706
00:41:25,040 --> 00:41:27,040
Hello.

707
00:41:27,040 --> 00:41:30,160
UNINTELLIGIBLE WORDS

708
00:41:30,160 --> 00:41:32,960
LAUGHTER

709
00:41:35,920 --> 00:41:38,440
It wasn't ever entirely clear -

710
00:41:38,440 --> 00:41:42,120
did Dennis think he was
making sense and we were not?

711
00:41:42,120 --> 00:41:46,000
Did he understand others from
their words or from their
actions and gestures?

712
00:41:48,360 --> 00:41:51,760
Dennis lived like this
for four years until his death.

713
00:41:51,760 --> 00:41:54,560
It must have been isolating, lonely,

714
00:41:54,560 --> 00:41:57,120
despite being at home
with those he loved.

715
00:41:59,680 --> 00:42:01,200
Is it nearly lunchtime?

716
00:42:07,080 --> 00:42:09,840
In the weeks after
Barry's first home visit,

717
00:42:09,840 --> 00:42:11,760
his mood declines dramatically.

718
00:42:13,960 --> 00:42:16,400
He seems to withdraw from the world,

719
00:42:16,400 --> 00:42:20,120
as if the home visit had been a sort
of statement of all that he's lost,

720
00:42:20,120 --> 00:42:22,600
something too much to bear.

721
00:42:22,600 --> 00:42:25,040
Barry, I'm going to do your hair.

722
00:42:25,040 --> 00:42:29,240
Even with his closest friend,
Barry seems to shut down.

723
00:42:29,240 --> 00:42:31,320
Barry, do I look funny with glasses?

724
00:42:31,320 --> 00:42:32,440
Yeah.

725
00:42:37,160 --> 00:42:40,400
I'm quite nervous doing your hair,
by the way.

726
00:42:40,400 --> 00:42:42,400
It's very tricky, you know.

727
00:42:42,400 --> 00:42:43,640
Very tricky, Barry.

728
00:42:45,600 --> 00:42:49,560
OK? It's hard to know what's
going on in Barry's head.

729
00:42:50,960 --> 00:42:53,680
It must be exhausting,
forever hunting for that

730
00:42:53,680 --> 00:42:56,360
tip-of-the-tongue thing
when you can't quite

731
00:42:56,360 --> 00:42:58,960
get to the word,
the name or the place

732
00:42:58,960 --> 00:43:01,720
that you know is in there somewhere.
If only.

733
00:43:03,960 --> 00:43:07,400
And I'd heard that one patient with
aphasia had described his thoughts

734
00:43:07,400 --> 00:43:11,240
as sticky, as though the inner
chitchat of daily thinking

735
00:43:11,240 --> 00:43:14,440
got constantly snagged
on its way out into the world.

736
00:43:14,440 --> 00:43:16,800
This is true friendship.

737
00:43:16,800 --> 00:43:18,680
It's been a pleasure.

738
00:43:18,680 --> 00:43:20,960
I'm going to take this off.

739
00:43:20,960 --> 00:43:22,880
How long have you two guys
known each other?

740
00:43:24,280 --> 00:43:27,320
Barry, how long have we
known each other?

741
00:43:27,320 --> 00:43:28,760
Barry.

742
00:43:28,760 --> 00:43:30,240
How long have you known me?

743
00:43:32,800 --> 00:43:34,560
How long have you known me, Barry?

744
00:43:35,600 --> 00:43:36,600
Ten years?

745
00:43:38,880 --> 00:43:42,480
22 years. 22 years, yeah,
move forward a bit.

746
00:43:42,480 --> 00:43:44,240
22 years, roughly.

747
00:43:44,240 --> 00:43:45,360
All right.

748
00:43:47,600 --> 00:43:50,080
I'll clean you up, don't worry.

749
00:43:50,080 --> 00:43:51,840
You happy? OK.

750
00:43:53,560 --> 00:43:56,200
OK. Give me two minutes,
I'll just finish it.

751
00:44:09,600 --> 00:44:10,840
How are you?

752
00:44:12,640 --> 00:44:14,240
How are you feeling in yourself?

753
00:44:16,120 --> 00:44:17,520
I hear it's been a hard week.

754
00:44:19,720 --> 00:44:20,800
Yeah?

755
00:44:24,920 --> 00:44:29,920
I know that when you come closer
to going home, it gets difficult.

756
00:44:31,040 --> 00:44:36,040
OK. But when you go home,
you will have more support,

757
00:44:36,360 --> 00:44:39,320
there will be more therapists
from the community.

758
00:44:40,440 --> 00:44:43,840
OK? Six months here is a long time.

759
00:44:43,840 --> 00:44:48,840
It's good to get home because you
won't need to be in a hospital,

760
00:44:49,560 --> 00:44:53,080
you'll need to be at home
with people coming to you,

761
00:44:53,080 --> 00:44:56,480
you know, doing the things
you want to do in your house.

762
00:44:56,480 --> 00:44:58,000
OK?

763
00:44:58,000 --> 00:45:00,720
Because here, it's not home.

764
00:45:00,720 --> 00:45:01,760
You know?

765
00:45:03,160 --> 00:45:05,000
But you will still have ongoing...

766
00:45:06,240 --> 00:45:08,480
..rehabilitation, OK?

767
00:45:08,480 --> 00:45:10,240
It doesn't stop when you leave us.

768
00:45:11,720 --> 00:45:13,040
Yeah?

769
00:45:17,480 --> 00:45:18,600
OK.

770
00:45:20,880 --> 00:45:23,280
So when I see Barry on his own
in the day room, sitting there,

771
00:45:23,280 --> 00:45:26,640
is his head sort of in conversation,
or is it a blank space?

772
00:45:27,760 --> 00:45:29,560
Erm...

773
00:45:29,560 --> 00:45:31,560
Or we don't know? Who can know?

774
00:45:31,560 --> 00:45:33,880
He can't tell us,
so everything is...

775
00:45:35,640 --> 00:45:36,880
..an assumption, really.

776
00:45:36,880 --> 00:45:38,960
You know, it's very difficult,
you know,

777
00:45:38,960 --> 00:45:44,000
if somebody is not able to write
and is not able to speak,

778
00:45:44,440 --> 00:45:46,720
it's very difficult to know
exactly what's going on.

779
00:45:48,000 --> 00:45:51,960
We can ask whether he has a word
in his head, you know,

780
00:45:51,960 --> 00:45:54,520
but he can't get it out,
or he's searching for a word.

781
00:45:54,520 --> 00:45:56,600
It's very difficult
to drive that down.

782
00:45:56,600 --> 00:45:58,360
I would imagine

783
00:45:58,360 --> 00:46:01,800
there's a lot of activity there -
whether it's with words,

784
00:46:01,800 --> 00:46:03,920
it's difficult to say for him.

785
00:46:03,920 --> 00:46:07,360
But we are aware he is significantly
cognitively impaired, as well.

786
00:46:07,360 --> 00:46:09,800
His ability to process things,

787
00:46:09,800 --> 00:46:13,200
the speed with which he kind of
works through things and generates

788
00:46:13,200 --> 00:46:15,040
an output has been impacted on.

789
00:46:24,440 --> 00:46:27,520
You would have trouble understanding
your place in the world if you lived

790
00:46:27,520 --> 00:46:29,320
on a desert island
and had nobody to talk to,

791
00:46:29,320 --> 00:46:31,760
so when you discuss things with
people, your ideas change.

792
00:46:31,760 --> 00:46:33,760
That's the whole point.

793
00:46:33,760 --> 00:46:36,400
The other thing I'd say is
that language is social.

794
00:46:36,400 --> 00:46:38,560
I mean, Wittgenstein tells us
that and I think he's right.

795
00:46:38,560 --> 00:46:41,720
So there's no such thing as a
private language, there's no...

796
00:46:41,720 --> 00:46:44,480
There's no utility to a private
language, there's no point in it.

797
00:46:44,480 --> 00:46:46,720
I'm not sure I fully
understand that.

798
00:46:46,720 --> 00:46:51,720
Is that the notion that language
only exists for social interaction?

799
00:46:51,720 --> 00:46:56,120
So we may all have a different, or
slightly different, perception of

800
00:46:56,120 --> 00:47:00,600
red, or what we would call red. I
mean, this is a classical argument.

801
00:47:00,600 --> 00:47:03,040
How do I know that the red you're
seeing is the red I'm seeing?

802
00:47:03,040 --> 00:47:06,080
At some level, we'll never know
that, because that's to do with
perception.

803
00:47:06,080 --> 00:47:09,240
But as soon as we give it a label,
and we call it red, that's when we

804
00:47:09,240 --> 00:47:12,160
start discussing it and it
becomes a thing for both of us.

805
00:47:12,160 --> 00:47:16,120
And we know that we've got a shared
object or subject that we're talking

806
00:47:16,120 --> 00:47:18,880
about, and that's really what
Wittgenstein meant when he said

807
00:47:18,880 --> 00:47:21,400
there's no such thing
as a private language.

808
00:47:21,400 --> 00:47:24,320
Sorry, Barry, just giving your
leg a bit of a stretch.

809
00:47:27,040 --> 00:47:29,960
So, Barry, if I wanted
to buy in south London...

810
00:47:29,960 --> 00:47:32,880
Yeah. ..what area would you
recommend me to buy?

811
00:47:32,880 --> 00:47:36,800
Leytonstone.
What about South London?

812
00:47:36,800 --> 00:47:38,360
Clapham. Clapham?

813
00:47:38,360 --> 00:47:40,200
Yeah. That's expensive.

814
00:47:40,200 --> 00:47:42,240
Not for my budget, I don't think.

815
00:47:42,240 --> 00:47:44,360
Lewisham. Lewisham.

816
00:47:44,360 --> 00:47:46,960
OK. Catford area, around there?

817
00:47:46,960 --> 00:47:48,400
Maybe. Yeah.

818
00:47:50,280 --> 00:47:54,480
£800,000.

819
00:47:54,480 --> 00:47:56,440
£800,000? Yeah.

820
00:47:56,440 --> 00:47:58,000
Yeah, I don't have that kind
of money,

821
00:47:58,000 --> 00:48:02,440
I don't think I've got
a deposit to put on that.

822
00:48:02,440 --> 00:48:05,160
I'm going to have to move
out of London, Barry.

823
00:48:05,160 --> 00:48:07,560
Yes. Yes.

824
00:48:10,520 --> 00:48:12,360
Good. Better.

825
00:48:14,640 --> 00:48:16,440
OK.

826
00:48:16,440 --> 00:48:17,920
You all right? Yes.

827
00:48:17,920 --> 00:48:20,120
So we're going to do some
walking on that leg.

828
00:48:20,120 --> 00:48:21,440
Yes. OK. Off we go.

829
00:48:24,040 --> 00:48:26,640
Right, bigger steps. You OK?

830
00:48:26,640 --> 00:48:29,560
Yes. OK. Bigger step on the right.

831
00:48:29,560 --> 00:48:31,440
Big step.

832
00:48:31,440 --> 00:48:33,680
Good. Now, a bit faster.

833
00:48:39,320 --> 00:48:42,040
That's it. Bigger step on that leg.

834
00:48:42,040 --> 00:48:46,080
For both Barry and Junior -
for everyone with aphasia -

835
00:48:46,080 --> 00:48:49,880
it seems that being able to be in
the world with depleted language

836
00:48:49,880 --> 00:48:53,040
is the most essential,
but also the hardest task of all.

837
00:48:57,600 --> 00:48:59,680
What have you been up to?

838
00:48:59,680 --> 00:49:01,240
Now?

839
00:49:01,240 --> 00:49:03,280
No, since I last saw you.

840
00:49:03,280 --> 00:49:05,400
Since I last saw you?

841
00:49:07,720 --> 00:49:09,120
I went to the cinema...

842
00:49:11,240 --> 00:49:13,080
..this weekend.

843
00:49:13,080 --> 00:49:15,880
I saw Fast And Furious 8.

844
00:49:17,040 --> 00:49:18,240
It was good, man.

845
00:49:20,080 --> 00:49:22,360
But this...

846
00:49:22,360 --> 00:49:27,440
Vin Diesel has got to stop
acting in Fast And Furious.

847
00:49:28,600 --> 00:49:31,320
He's done it eight times, man.

848
00:49:33,320 --> 00:49:34,360
Yeah.

849
00:49:36,640 --> 00:49:41,080
Yeah, but, Vin Diesel
is a good actor.

850
00:49:43,200 --> 00:49:44,880
What have you got
coming up, any plans?

851
00:49:44,880 --> 00:49:46,160
I need to get my...

852
00:49:48,240 --> 00:49:51,000
..communication back on point

853
00:49:51,000 --> 00:49:54,320
with speech and language therapists.

854
00:49:54,320 --> 00:49:56,560
Have you found one
you're going to work with?

855
00:49:56,560 --> 00:49:58,760
Yeah. Yeah.

856
00:49:58,760 --> 00:50:01,000
Great. How often are
you seeing someone?

857
00:50:01,000 --> 00:50:02,440
Twice a week. Great.

858
00:50:03,480 --> 00:50:05,560
Is that going well?

859
00:50:06,760 --> 00:50:08,760
It's going OK.

860
00:50:08,760 --> 00:50:11,440
It's going OK. Good.

861
00:50:17,800 --> 00:50:21,000
I'm cold, man. Yeah, yeah.

862
00:50:21,000 --> 00:50:22,240
You better go. Yeah.

863
00:50:24,080 --> 00:50:26,120
See you later, man. OK.

864
00:50:26,120 --> 00:50:28,640
All right. Thank you
for coming here.

865
00:50:35,200 --> 00:50:37,080
Yeah, cool.

866
00:50:37,080 --> 00:50:41,800
Oh! As Barry's stay on the unit
approaches its end,

867
00:50:41,800 --> 00:50:43,880
despite his many improvements,

868
00:50:43,880 --> 00:50:46,880
he remains reluctant to accept
that he will soon be moving home.

869
00:50:48,560 --> 00:50:50,920
After almost seven months
in hospital,

870
00:50:50,920 --> 00:50:54,200
it's understandable that the
institution has become the home.

871
00:50:55,200 --> 00:50:57,520
But it feels more than that.

872
00:50:57,520 --> 00:51:00,640
It seems that part of the problem
for Barry is not being able to

873
00:51:00,640 --> 00:51:03,240
acknowledge the progress
that he is making,

874
00:51:03,240 --> 00:51:06,920
nor perhaps accept the extent
of the damage to his brain.

875
00:51:06,920 --> 00:51:11,920
That's what it looks like if you've
got a problem in your language area.

876
00:51:13,640 --> 00:51:16,600
Brains just don't get better easily.

877
00:51:16,600 --> 00:51:18,920
As you know. How many months?

878
00:51:22,080 --> 00:51:24,240
Six months. Seven months.

879
00:51:24,240 --> 00:51:25,880
Yes, yes.

880
00:51:25,880 --> 00:51:27,120
And have you got better?

881
00:51:28,320 --> 00:51:29,880
No. No?

882
00:51:31,760 --> 00:51:33,080
Yes. What's got better?

883
00:51:35,000 --> 00:51:36,600
What can you do now?

884
00:51:36,600 --> 00:51:38,320
What can your brain still do?

885
00:51:39,520 --> 00:51:42,120
Think. Think, yeah.

886
00:51:42,120 --> 00:51:43,960
Talk? Talk.

887
00:51:47,400 --> 00:51:50,000
Walk. Walk. It's supposed to be
walk, it's a funny gesture.

888
00:51:50,000 --> 00:51:53,520
Walk. Sometimes, you get cross
because it's not happening

889
00:51:53,520 --> 00:51:55,320
quick enough. Yeah.

890
00:51:56,640 --> 00:51:58,320
Are you OK about that some days?

891
00:51:58,320 --> 00:51:59,480
And then not on other days?

892
00:51:59,480 --> 00:52:00,960
No. No.

893
00:52:00,960 --> 00:52:03,600
Always want it to be quicker, don't
you? Yes, yes. It's all right.

894
00:52:03,600 --> 00:52:06,360
It's a tough one. So tough, Barry.

895
00:52:10,200 --> 00:52:11,240
How do you...

896
00:52:12,520 --> 00:52:16,880
How do you, you know,
keep getting motivated?

897
00:52:16,880 --> 00:52:20,280
I don't know. Because you are
so good at that.

898
00:52:20,280 --> 00:52:22,400
Oh, you hate people
praising you, don't you?

899
00:52:24,520 --> 00:52:26,800
You don't like it when
I praise you. No.

900
00:52:28,440 --> 00:52:31,400
It's not a great thing,
is it, a stroke? No.

901
00:52:36,880 --> 00:52:39,600
Five days before
his final discharge,

902
00:52:39,600 --> 00:52:41,840
Barry goes on one last home visit.

903
00:52:45,640 --> 00:52:49,800
On Tuesday, then,
what time do want to go?

904
00:52:49,800 --> 00:52:51,600
I don't know.

905
00:52:51,600 --> 00:52:54,320
Most people kind of stick around
until just after lunch.

906
00:52:54,320 --> 00:52:56,760
They have some tea and cake
with everybody. Yeah.

907
00:52:56,760 --> 00:53:00,960
Do you want to do something
like that so that you can say
goodbye to everyone? Yes. No.

908
00:53:02,680 --> 00:53:04,400
I don't want...

909
00:53:06,560 --> 00:53:08,240
..fuss. You don't want a fuss?

910
00:53:10,720 --> 00:53:14,800
OK. And when you are saying
you do not want a fuss,

911
00:53:14,800 --> 00:53:16,640
what do you mean by that, Barry?

912
00:53:20,240 --> 00:53:22,280
Are you talking about
when you come home?

913
00:53:26,960 --> 00:53:30,960
I don't know whether...

914
00:53:32,600 --> 00:53:34,880
..it's viable.

915
00:53:36,080 --> 00:53:37,920
Viable? Viable.

916
00:53:37,920 --> 00:53:40,320
Yes. OK.

917
00:53:40,320 --> 00:53:44,920
So you... Are you talking about
coming home and managing at home?

918
00:53:47,040 --> 00:53:49,080
No. OK.

919
00:53:49,080 --> 00:53:51,520
Are you talking about
needing some help at home?

920
00:53:51,520 --> 00:53:53,200
Yes. Yeah.

921
00:53:53,200 --> 00:53:58,240
Debs and the community team, they
are there to help you get stronger.

922
00:53:58,440 --> 00:53:59,960
So rehab isn't over.

923
00:54:01,920 --> 00:54:03,760
You don't need to stay
in with us, Barry.

924
00:54:03,760 --> 00:54:05,000
You need to come home now.

925
00:54:09,080 --> 00:54:10,120
Yeah?

926
00:54:12,040 --> 00:54:14,880
On the eve of Barry's
last day in the unit,

927
00:54:14,880 --> 00:54:19,120
he and Linda have a final meeting
with a neuropsychologist, Hannah.

928
00:54:20,560 --> 00:54:25,120
How do you feel about your
relationships at the moment

929
00:54:25,120 --> 00:54:27,640
with Linda or with your children?

930
00:54:29,080 --> 00:54:31,080
In terms of being able
to speak with them?

931
00:54:33,280 --> 00:54:36,920
How do you feel you get on with
Linda when you can't speak so
clearly?

932
00:54:41,960 --> 00:54:44,840
Hit and miss. And can I ask
Linda the same question?

933
00:54:44,840 --> 00:54:46,560
Yes.

934
00:54:46,560 --> 00:54:50,840
How is it for you in terms of your
relationship with Barry since he has

935
00:54:50,840 --> 00:54:52,680
not been able to speak so clearly?

936
00:54:54,720 --> 00:54:55,880
Sad.

937
00:54:57,120 --> 00:55:02,120
One of the things which we know
following a stroke is that people

938
00:55:02,120 --> 00:55:04,040
have lots of losses.

939
00:55:04,040 --> 00:55:07,280
Yes. And one of the most significant
losses that can happen is

940
00:55:07,280 --> 00:55:09,680
in terms of aphasia... Yes.

941
00:55:09,680 --> 00:55:13,920
..and not being able to speak
so clearly or understand easily.

942
00:55:13,920 --> 00:55:18,960
Yes, yes. And it then leads
to a whole element of

943
00:55:20,680 --> 00:55:25,640
what your role is and what other
people's role is who you know

944
00:55:26,880 --> 00:55:29,960
and the difficulties that can follow

945
00:55:29,960 --> 00:55:33,520
in the renegotiation
of relationships.

946
00:55:33,520 --> 00:55:35,800
Is that something that you
have experienced, Linda?

947
00:55:35,800 --> 00:55:36,840
Mm.

948
00:55:40,040 --> 00:55:43,320
Hassle, hassle, hassle.

949
00:55:43,320 --> 00:55:45,600
Hassle. Yeah.

950
00:55:45,600 --> 00:55:49,040
Is that hassle for you, or do
you feel that you are a hassle?

951
00:55:57,040 --> 00:55:58,080
I don't know.

952
00:55:59,200 --> 00:56:00,240
I don't know.

953
00:56:02,280 --> 00:56:04,760
Hassle, hassle, hassle.

954
00:56:06,560 --> 00:56:07,840
Hassle for who?

955
00:56:09,840 --> 00:56:12,440
You. Me?

956
00:56:12,440 --> 00:56:15,080
Me, you. For you, as well?

957
00:56:15,080 --> 00:56:17,400
Yes. And for me? Yes.

958
00:56:17,400 --> 00:56:22,240
What you used to say all the
time was, "It is what it is."

959
00:56:22,240 --> 00:56:25,720
Yeah. When things happened.
Yeah. Well, it is what it is.

960
00:56:25,720 --> 00:56:29,800
Yes. So, it is what it is,
you have had a stroke,

961
00:56:29,800 --> 00:56:32,320
and now you need to come home
tomorrow and continue with your

962
00:56:32,320 --> 00:56:34,240
rehabilitation at home.

963
00:56:34,240 --> 00:56:35,720
Yes.

964
00:56:35,720 --> 00:56:40,720
# Regrets, I've had a few

965
00:56:40,840 --> 00:56:43,160
# But then again...

966
00:56:43,160 --> 00:56:46,680
# Too few to mention... #

967
00:56:46,680 --> 00:56:47,720
I don't know.

968
00:56:51,080 --> 00:56:53,480
Six months. Six months he
has been in this bed.

969
00:56:54,480 --> 00:56:56,160
Six long months.

970
00:57:00,320 --> 00:57:04,640
# I've planned each charted course

971
00:57:05,680 --> 00:57:08,200
# Each careful step... #

972
00:57:09,760 --> 00:57:11,440
Are you feeling ready for this?

973
00:57:13,120 --> 00:57:14,280
Yes.

974
00:57:15,280 --> 00:57:17,640
# Much more than this...

975
00:57:17,640 --> 00:57:22,000
# I did it my way. #

976
00:57:26,640 --> 00:57:30,520
OK, so, which hand do you want to
shake with? That hand, or that hand?

977
00:57:30,520 --> 00:57:32,320
I don't know.

978
00:57:36,760 --> 00:57:38,120
Both hands.

979
00:57:39,200 --> 00:57:40,600
Really good.

980
00:57:42,520 --> 00:57:44,040
Yeah.

981
00:57:44,040 --> 00:57:47,960
Thank you, thank you, thank you.
Thank you. Thank you.

982
00:57:47,960 --> 00:57:49,400
You are very welcome.

983
00:57:49,400 --> 00:57:53,840
Yeah, yes. Yeah.
I've enjoyed working with you.

984
00:57:53,840 --> 00:57:57,120
Thank you, thank you, thank you.
You're very welcome.

985
00:57:57,120 --> 00:57:59,360
Oh, well done.

986
00:57:59,360 --> 00:58:00,760
It's been a pleasure.

987
00:58:06,000 --> 00:58:07,480
Bye-bye.

988
00:58:09,800 --> 00:58:11,200
Bye-bye.

989
00:58:14,560 --> 00:58:16,600
No tears. Bye, Barry.

990
00:58:16,600 --> 00:58:17,880
I'm going to cry.

991
00:58:20,440 --> 00:58:22,400
All the very best.

992
00:58:22,400 --> 00:58:25,280
Do you know what?
We are going to turn around.

993
00:58:25,280 --> 00:58:28,320
Are you going down?
Yeah, we're going down.

994
00:58:28,320 --> 00:58:30,040
Oh, look, we've got
the farewell party.

995
00:58:30,040 --> 00:58:32,240
Ellen and Shauna.

996
00:58:32,240 --> 00:58:34,560
Our girls, our best girls.

997
00:58:37,480 --> 00:58:41,080
Bye. Bye. Bye.

998
00:58:41,080 --> 00:58:43,440
Bye. Bye.

999
00:58:43,440 --> 00:58:48,480
# And now, as tears subside

1000
00:58:49,320 --> 00:58:54,360
# I find it all so amusing

1001
00:58:56,200 --> 00:59:00,400
# To think I did all that

1002
00:59:01,920 --> 00:59:07,000
# And may I say, not in a shy way

1003
00:59:08,960 --> 00:59:13,160
# Oh, no, oh, no, not me

1004
00:59:14,800 --> 00:59:19,560
# I did it my way... #