04 Was Rita unique in her ability to recover from a stroke?
An interesting question that can be given the two answers ‘maybe’ and ‘no’. ‘Maybe’ to the extent that I do not know, nor have heard, of any other stroke survivor who has been written off as a “no-hoper” as Rita was, two years after their stroke, and then gone on to recover so well that people who meet her for the first time rarely pick up that there was ever anything wrong with her. But my experience is limited and it might well have happened elsewhere.
I believe the more correct answer is “No, there is no reason whatever to assume she is unique”. Just because she failed to make any significant recovery for 30 months, then suddenly made what amounted to an almost complete recovery during the next 30 months, does not make her recovery unique. The reasons this happened must be tied in with the facts that, 2½ years after her stroke, both her environment and her treatment changed dramatically, almost overnight.
The reason her history appears unique is, I am sure, down to the fact that very few seriously disabled stroke survivors suddenly, after 30 months, experience both a major change to their living environment and simultaneously a major change to their rehabilitation programme (in the unlikely event they still have one). Rita’s recovery must be explained by some factor(s) within these sudden and unusual changes – moving away from the UK winter to the South African summer, and from effectively no therapy in the UK to several hours of rehabilitation every day, seven days a week, near Cape Town.
These changes are described in detail in Pushing the Boundaries; it is not difficult to identify which factors might be the important ones enabling her sudden progress towards recovery.
One necessary assumption is that Rita always had the ability to recover, but this was not found under her UK living conditions and treatment regime. Once in South Africa, with its very different environment and treatment programme, her ability to recover was discovered and she blossomed.
My view is that her sudden recovery had nothing to do with any uniqueness, but to rational factors caused by differences between UK and South African treatment programmes. And we were extremely lucky to discover this – serendipity again?
If the above analysis is true, there is an important question to ask. How many other seriously disabled stroke survivors in the UK might also have the hidden ability to recover, but this is never found? I believe there is circumstantial evidence that this number could be significant. But I do not know and, so far as I am aware, no-one has made any attempt to measure this proportion experimentally. I personally cannot do this because my name carries no weight in stroke rehabilitation circles; it needs a professor of rehabilitation medicine to carry out a statistically robust analysis that will be accepted as valid. However, I do not believe this is a difficult or expensive project to set up and it just might give some very interesting answers. The format for a suggested project is outlined in the last appendix of Pushing the Boundaries.