You've had a 𝙢𝙖𝙨𝙨𝙞𝙫𝙚 stroke? Hold her beer!

Michelle Mack has been a celebrity among brain-obsessed ubernerds (like me hello ¯\_(ツ)_/¯) for two decades. She had her stroke before she was born. Not only that, but her stroke obliterated an entire hemisphere (and more) of her brain. In a case of she didn't know that she wasn't supposed to so she went ahead and did it anyway, Michelle has done quite well with a stroke so large it would have killed anyone else. 

A while ago I got in touch with Michelle Mack's mom, Carol Mack. Here's what I found out...

A Misdiagnosed Savant

Michelle was born in 1973 (47 as of 2020). Carol could tell something was wrong when Michelle was a baby: she couldn't roll over—a skill that is usually developed at four months old. Doctors didn't know what was wrong, and misdiagnosed her with a variety of syndromes. Carol pointed out that Michelle was traumatized by a lot of her medical treatment. "In her early years she—unknown to us—felt traumatized by all the doctor visits and lab work that was done on her," Carol told me in one of our conversations. "Because she rarely forgets anything, all of these memories remain with her." She barely forgets anything. With half a brain. This is a grand example of acquired savant syndrome. The brain injury itself unveils some hidden talent. Michelle is also amazing with dates. Carol told me that Michelle watched a lot of Wheel of Fortune. "She plays the game against the TV and wins every night."

Teach the Teachers

One of the things that Michelle asked me to remind the world was this: Teach the teachers to do not horrible to people like me. School was tough for Michelle. In school teachers and students ridiculed her and call her a behavior problem. In their defense, teachers were not particularly well trained for any sort of cognitive issues until quite recently. This was true with ADHD, dyslexia, as well as any sort of brain injury. I am dyslexic and I have ADHD, and even with those—relative to Michelle—mild issues, most (not all) teachers were pretty horrid back in the 60's and 70's. It wasn't until 1975 that congress mandated that schools provide kids with learning differences (trust me that's what they are) with "appropriate public education." Before that it was mostly just You're dumb, or you're lazy, but I suspect both. Sit down, shut up, and don't disturb the smart kids.

Finally: The Diagnosis

Michelle was misdiagnosed and sent into a schooling system that treated her badly. Then in 1997 something changed: Her brain was scanned. Here is the scan:  

This image looks like right side of Michelle's brain is gone. But this this image is taken in radiological convention. What is radiological convention? Imagine you've entered a patient's room. You are at the foot of the bed looking at them. That's radiological convention: As if you're standing at the foot of their bed.

In the cartoon below, you are person A.

The scan shows that the stroke took the left side of Michelle's brain. And for those of you that have had stroke on the left side of your brain, you know there's one really important function there: Language. Broca's area (thinking of words to say) and Wernicke's area (understanding words you hear) are both on the left side.

But what about Michelle? Did she lose language? Nope. Michelle could always talk. And her ability to speak has always been appropriate for her age. She would sometimes perseverate quite a bit (I want, I want, I want...), and was not able to be subjective; everything was black-and-white. A big day came when Michelle was sarcastic to Carol. Bottom line: No left hemisphere, spoke and understood language perfectly.

A North Star for folks with brain injury

Michelle Mack is an inspiration, straight up. I'm sure she doesn't feel like one, but she should. She's an inspiration for people with brain injury. But she's also a North Star for people like me. We all think we're dumb sometimes, but we're not. Our disabilities can reveal greatness.

Coda

When people have a brain injury—including stroke—during the first year of life its called cerebral palsy, or CP. Most cases of CP are in utero strokes. That's what happened to Michelle.  

Stroke survivors often describe their stroke as massive. But the term is pretty useless. What is generally meant is that the stroke was big; so big it was massive. But there is no scientific definition of how big a stroke has to be to be "massive". One thing I suggest to survivors is this: If you've had a stroke, there's an image. Get it. As painful as it may be to look at, get a copy of any post-stroke image of your brain.  This may actually be good news. You may imagine the infarct (the "dead zone") as much larger than it is.