- Playwright and screenwriter Aaron Sorkin, 61, has announced that he had a stroke last fall
- There are multiple factors—both medical and social—that impact your risk
- It’s important to know that social determinants of health, like income and education levels, are increasingly being researched by those interested in uncovering stroke risk factors.
This week, renowned playwright and producer Aaron Sorkin revealed that he had a stroke late last year.
In an article from the New York Times, Sorkin has shared that his sense of identity, his own perception of his health, and his approach to life have all been affected—alongside the initial slurring of speech and physical barriers that affected him during his recovery.
“There was a minute when I was concerned that I was never going to be able to write again,” he told the New York Times.
While Sorkin may be a high-profile example of a stroke survivor, the number of people having a stroke equates to one every 40 seconds in the US, according to the US Centers for Disease Control and Prevention.
Signs of a stroke
A stroke occurs when a blood supply to the brain is blocked or if a blood vessel ruptures. A lack of oxygen in the brain can cause serious symptoms and in severe cases death.
Signs of a stroke can include slurred speech, weakness on one side of the body, facial drooping, numbness and confusion, according to the American Heart Association.
Risk factors for stroke
Dr, Alyse Sicklick said she sees may people who have had a stroke at her practice as the medical director of inpatient rehabilitations at Gaylord Specialty Healthcare.
Sicklick and others commonly put the risk factors of a stroke in two distinct categories.
“There are two big buckets of risk factors for stroke,” Sicklick says, “There’s the ones that we can do something about. And then there’s the whole bucket that we can’t do anything about that we call non-modifiable risk factors.”
Age, blood pressure, and whether or not you smoke can all be a factor for stroke risk.
Sorkin told the New York Times that, pre-stroke, he associated high-risk health activities, like smoking cigarettes, with his identity as an artist.
He said he wanted to share his story in hopes it will inspire people to quit smoking.
According to Bernadette Boden-Albala, DrPh, founding dean of the program in public health at University of California-Irvine, the seemingly simple divide between modifiable and non-modifiable risk factors gets complicated by what are known as social determinants of health.
These can include someone’s income and education levels, level of community safety, and the social units they exist within. “We don’t live our lives alone. We live our lives, with families in networks. And we’re totally inspired sometimes… So, if everybody’s a smoker in my household, and you tell me ‘Don’t smoke, because you’re at high risk for heart disease [and] stroke,’ but everybody else in my house smokes, how likely am I going to be to stop smoking?”
How long does recovery take?
Sicklick says that, in her experience, an average inpatient stay for someone in her care is around three weeks and she works with a large interdisciplinary team to formulate a care plan.
“The world of inpatient rehab is overwhelmingly dominated by patients that have experienced a stroke, it’s the number one reason, the number one diagnosis for admission for inpatient rehabilitation, because it is such a common occurrence.”
Cases like Sorkin’s, where speech is affected, can be created by weakened facial muscles (known as dysarthria) as well as aphasia, which is where areas of the brain that are used to produce or understand language are affected.
For those who are dysarthric, muscle strengthening exercises and visual feedback might be in order. For someone who is aphasic, that might mean using alternative modes of communication, like an iPad, to work through recovery.
Karen Sullivan, PhD, a neuropsychologist and founder of Pinehurst Neuropsychology in North Carolina, says that when working through recovery the very reality of the brain’s role can become a barrier in and of itself, especially when someone’s stroke affects their ability to use and understand language.
“What’s so key about brain stuff is we’re using the organ that’s impaired to try to reason through the impairment of the organ,” Sullivan said.
Stroke’s effect on identity
Sullivan says that stroke can have a severe impact on self-identity, especially for those who didn’t conceive of themselves as at risk for a stroke prior to having one. She said there needs to be more understanding of mental healthcare where strokes are involved.
“It’s really so much more than a medical condition. It’s really a psychological trauma. But the problem is the medical system medicalizes it and we focus a lot on what is visible. And we don’t focus a lot on the mental health experience of being shocked into reality with a stroke.”
Experts say they are seeing a worrying trend of strokes occurring in younger people.
According to the American Heart Association, rates of stroke are declining in older populations while they are rising for those 49 and younger.
Boden-Albala said she’s hopeful more people are learning about stroke and the risk factors for the condition.
“We’re spending an equal amount of time, finally, in trying to understand these social determinants and how they impact the risk of stroke, and then how they impact the outcomes,” Boden-Albala said. “And I would just add that work now involves going beyond describing these social determinants, and going to really try to intervene on them.”
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