While window-shopping for his wife’s birthday, a businessman was struck by a speeding taxi that jumped the curb at 55th and Madison. In the few minutes it took the ambulance to reach the University emergency room, he had lapsed into a coma. Brain imaging revealed a large blood clot compressing the brain. The only hope for his survival was immediate drainage of the clot.
The on-call neurosurgeon was primarily an animal researcher, a deeply lined other-worldly looking man with thick glasses and massive salt-and-pepper eyebrows that extended across his forehead like a bird in flight. Because of the extreme urgency, the patient was taken directly to the operating room, where, without anesthesia or even placing the patient in proper restraints, the surgeon drilled two large burr holes in the man’s skull.
As soon as the neurosurgeon drained the clot, the patient awakened. Unrestrained, he began to flail his arms and legs; it took several aides to hold him down. The neurosurgeon remained expressionless. He read the patient’s name on his I.D. tag, leaned over, inches from the wild-eyed man’s face, and calmly said, “Do not worry, Vinny. We’re just operating on your brain.”
The patient’s mouth opened wide. Startled at hearing nothing coming from what undoubtedly was the scream of his lifetime, he tried to rip off the surgeon’s mask. The neurosurgeon stepped back, but the nurses fought to secure the leather restraints. Once the patient was pinned to the operating room table, the surgeon told the senior resident, “Finish the case. I’ve got to get back to the lab.”
The man quickly recovered his strength but remained speechless. Each day, on morning rounds, the operating neurosurgeon told him not to worry, that his speech would soon return. On the fourth day, after hearing the reassurance yet again, he glared at the neurosurgeon. The surgeon said, “Trust me, Vinny.”
The man blurted out, “Fuck you, Fuck you, Fuck you.”
The neurosurgeon patted him on the hand.
“Fuck you,” the man repeated himself.
“Very good,” the neurosurgeon said.
As though the patient was not there, the neurosurgeon explained to me that, with resolving aphasia, the first words to return are often the most emotion laden. “Do not take anything they say literally. Look at body language and listen closely to intonation and context as if trying to understand a stranger speaking a foreign language.” He turned back to the man. “Isn’t that right?”
“Fuck you forever,” the man said.
“Be patient.”
“Fuck you,” he said again. “My name is Vincent.”
“See, Vinny, you’re going to be just fine.”
“Fuck you, Doctor,” Vincent said, extending his hand.
