To review this book, I have to tell you about my grandmother.
When I bought my house, I was thirty years old and single – with little apparent prospect of that changing (not that I hadn’t tried to get married, but all the women I’d asked to marry me – some of whom I even knew – had refused). However, my grandmother, my little Italian Nonna, was living with my parents, ten minutes walk away. It was, as the marketing men say, a no brainer: I asked her to move in with me.
May I say that there is no more cushy or comfortable life, for a thirtysomething single male, than having your Italian grandmother living with you. Washing, cooking, cleaning, dusting, ironing, sewing – it was all done. Just so you don’t get too jealous of the tempting, mouth watering delights that must have been served up to me each night, I must say that the one area in which Nonna was not all Italian was cooking: she was terrible. Well, maybe that’s slightly too strong a word: her risotto and lasagne were good, but out of her two dish comfort zone, things tended to get, well, slabby: I still remember with a slight shudder the thick slices of deep fried polenta, quivering like vulcanised yellow rubber, that she served up at least once a week. But in all other respects, it was a wonderfully cushy life – and it meant I really got to know my Nonna (particularly as she had only recently moved to England).
It was a glorious interlude, and one that lasted four years. But then, I got married (I sprang the proposal on my wife so completely out of the blue that she didn’t have time to dodge). Nonna moved out. Wife moved in.
Nonna went back to my parents, taking over many of the housekeeping duties there, while always, whatever the weather, taking a daily constitutional through the park.
Then she had a stroke. A little one. Some weakness in her left arm, a limp, soon recovered from, and half an aspirin daily.
It didn’t work. The second stroke was a major one. Hospital, beeping machines, then relief. She would live. It was the left side again, but this time, worse. No movement in her left leg or arm, face pulled down on that side – at least, being the left side, there was no language loss. But she couldn’t walk.
Out of danger, they moved Nonna from the general hospital to Finchley Memorial Hospital, which was then devoted to recuperation and physiotherapy. And the physios set about her: exercise, effort, every day for five, six weeks.
By the end of that time, there was a little improvement, but not that much, and we assembled to meet the doctor to hear what the plan was for her continuing treatment.
There wasn’t one. They’d done all they could. The first six weeks after stroke were crucial – after that window, there wouldn’t be any further improvement. Nonna didn’t speak English. The doctor told us to tell Nonna she would never walk again. As he got up to leave, he told us to set about arranging moving her into a nursing home. And that was it.
For a year, Nonna sat in the lounge in the nursing home, watching television she didn’t understand, and I’d visit her each day and talk to her – the despairing small talk of family and friends and weather that substituted for hope. According to the doctors, there wasn’t any.
I think it was anger, the slowly nurtured anger at helplessness and fate and God, that did it. The doctors might not want to do anything, but anything was better than this waiting room of death (the staff were lovely and caring, but that is what the place was).
So what if the doctors said they wouldn’t do anything. We would. We found a physiotherapist who spoke Italian, and paid for her to visit Nonna and work with her. And, you know, there was something – some small improvement. Nonna began to be able to move her left hand, and then her arm.
And then the cavalry arrived, in the small, squashy shape of our first child, Theo – Nonna’s great grandson.
Nonna loved Theo. She brightened, she cooed, she came alive when we brought him to see her. And, when I held him, dangling, just out of reach as the physio worked on her standing and posture, Nonna pushed herself up, unthinking, focused on him and not on what she could not do, and she began, she began to stand.
Nonna was going to be the first resident of the nursing home to walk out of there on her own two feet, rather than being carried out in a box.
I still remember her chuckling laugh as she reached out to chaff Theo’s cheek, standing and not even realising it, and wishing we had started this so much earlier.
Then Nonna had a third stroke. She was reduced to a pair of wandering eyes, rolling without control, in a shell of flesh without any movement at all. She didn’t walk out of the nursing home. Six months later, she went out in the box.
I wish I’d read this book then, before all this happened. But it hadn’t been written. Back then, the six weeks window was all there was. The brain was a hard-wired thinking machine: break it, and it stayed broke.
This is the mistake of metaphor. We’ve learned to understand the body and the mind through our inventions: clocks and hydraulics, circuits and computers. Mechanical, fixed things. But the brain is alive; it’s not caught by these metaphors. And what we see in this remarkable book is the dawning realisation among researchers and doctors that brain and body, mind and effort are all intimately, and directly, connected. Unlike an electronic circuit, the brain can find new connections, fresh ways of doing things, particularly when reinforcing the new connections with physical learning.
It’s an insight that some people seem uncomfortable with. A quite remarkable (in all the wrong ways) review, by Jonathan Ree, of The Brain’s Way of Healing in The Guardian concludes thus:
The publicity tells us that The Brain’s Way of Healing will provide new hope for millions of unlucky sufferers. Hope is a tricky commodity however, and while some of us may find it heartening, for others it could be another turn of the fatal screw. The neuroplastic revolution is part of a contemporary stampede towards the moralisation of medicine: patients are encouraged to blame themselves for their sufferings, and to think that their chances of recovery depend not on random tricks of fate, or the luck or good judgment of their doctors, but on their own willpower and moral fibre. Sick people need to be cared for, but they also have a right to be left in peace.
This is the judgement that condemned Nonna after six weeks; this is the end of hope and the acceptance of the TV lounge; this is morally stupid and intellectually offensive. Why should hope and effort be placed in opposition to care and medicine? Only in the judgement of the reviewer. For myself, I wish this book had been written then. Maybe Nonna would still have left the nursing home in a box, but the stay would have been a battle, and not a defeat.
Hope emerged last from Pandora’s box. After all else is gone, hope remains.
