Andrew Marr: My Brain and Me

-Welcome.

-Hey, Andrew. How are you?

-Hi, Tom.

-You all right?

-Very, very well indeed.

Fantastic.

Come through.

'There has never, never been a better time to be a political journalist...

'but, after a stroke which nearly killed me four years ago,

'everything has become just a bit trickier.

'It's a brain thing.'

The whole point of this, there is an area of my brain, probably now about

the size of a small tomato, which simply doesn't exist.

To get any movement back, to get the brain working on those movements,

subconscious or conscious movements, I have to regrow

or rewire the brain.

-Good.

-I do this better when I'm not being filmed.

And that requires endless repeated actions -

hints and nudges to help the brain regrow.

It's a very strange mix.

There I am, lifting up tiny little bits of plastic and putting them

into a bowl as if I was a three-year-old at a nursery school

while, at the same time, trying to work out what's the best approach to

a Cabinet crisis. Yeah, it's... Talk about multitasking.

I really don't want to do that much of this on camera.

I've had enough of this.

I said no.

PHONE RINGS

-Is that my phone?

-Yes, yeah.

-Ooh, could you get it?

I'm sorry. It could be Iain Duncan Smith.

What... We've got him? Brilliant. Brilliant, brilliant, brilliant! That's fantastic news.

OK. The whole day is going to go well.

Great, OK.

-'OK, I'll talk to you later.'

-Thanks, Rob. Cheers.

We have Iain Duncan Smith. That's brilliant.

Our political editor, Andrew Marr, is at Westminster.

'I've been a journalist for more than 35 years.'

-Mr President, thank you so much.

-Thank you so much. I enjoyed it.

'But in a single moment, at the age of 53, my life changed forever.

'For a while, I couldn't even speak properly, and I still haven't recovered

'the full use of my left side.

'I want to know more about what's happened to my brain...'

Goat and train.

-This is the left hemisphere.

-It looks like a mad cabbage.

'..how stroke affects the million-plus survivors in Britain...'

You can sing, but you can't talk.

-Is that right?

-Yes.

-'..and visit America for a striking new treatment.'

'Hi!

'It's me!'

I can talk!

I can walk!

'So this is a very personal story at a time of huge political change.'

This means that the UK has voted to leave the European Union.

This is the biggest story I've covered.

'Recovering from stroke's a different kind of story.

'It's intimate, sometimes embarrassing and, in this, I am nothing special.'

Everything is worth a go.

I will try everything or anything.

RADIO BULLETIN BEEPING

'In the past few minutes, it's been announced that

'the Work and Pensions Secretary, Iain Duncan Smith, has resigned.

'There's been a row over one of his reforms to disability payments.'

My week begins a little blearily at six every Sunday.

-Brenda?

-Here.

-Good morning.

-Good morning.

I have some friends with me this morning.

Oh, I see. Hi. Good morning.

I arrive in the morning, looking like a kind of pink, blobby lump of human chaos,

and Brenda transforms me into a glowing Adonis...

SHE CHUCKLES

Ish.

-INTERVIEWER:

-So how long have you known Andrew?

Since the beginning of the show, really.

-Ten years, 12 years.

-Ten. Yes. Yeah.

And everybody who comes on the show gets make-up because the lights on

the TV studio are so harsh that, if you don't have make-up,

you look like you are a living corpse.

We don't want that.

We've got an hour yet.

An hour to go.

'Oh, it was a terrible shock.'

Really.

It's one of the worst things that could happen, really, cos I thought, my God, is it his voice?

But thankfully the voice and the brain is as sharp as ever.

And this is my office.

Quite often, in this office, you arrive and somebody has been sleeping

overnight and there's a kind of ripe smell,

a few socks and a blanket and so on, but not today, I'm glad to say.

-Rob?

-Yeah?

IDS, Mail On Sunday, the strongest paper?

Looks like it, yeah.

'I think everyone was completely shocked by it,'

you know. Even people who didn't know Andrew

but just knew of him through his TV career.

They were completely shocked by it and, if you're on the outside, you don't

have any idea of the severity of it.

Think again on benefits cuts,

Iain Duncan Smith warns the Prime Minister...

But clearly he's a very driven man so he was determined to come back.

Because you're cutting taxes for the better-off at the same time as you're cutting

benefits for disabled people. Do you think that's unfair?

Juxtaposed as it is, as it came through in the budget,

that is deeply unfair.

'I always rather naively assumed that strokes were something which

'happened to much older people.'

It never crossed my mind that someone as relatively young and fit

as Andrew could possibly have a stroke.

Although there's lots of arguments about why strokes happen to

individuals, I am fairly clear in my own mind about why my stroke happened.

I think the cause of the stroke was frankly two years of

excessively hard work where I was travelling the world, making a TV documentary

and writing a long book at the same time

while simultaneously doing Start The Week on Radio 4

and The Andrew Marr Show on BBC One.

It's as if you've left Britain behind, almost.

Why the long silence?

He'd always been a workaholic, ever since I first met him, and so we

just thought that was the way he was and that he would always be fine

because he did keep fit at the same time.

He was immensely fit.

I think there were two occasions when he felt funny and he had to

have a lie down. Now, those signs, obviously, in hindsight probably were signs.

It was 99% my own fault for driving myself ridiculously hard.

You had come on kindly to review the papers.

-Yes.

-And we were sitting at breakfast.

-We were.

-And you thought I looked pretty iffy.

I remember vividly. You said to me, "You can rest when you're dead."

We've plenty of time to rest when you're dead.

That's exactly what you said, and I thought, oh, OK.

You know, flip remark, left it at that,

and then, of course, the very next day...

It actually happened when I was on a rowing machine,

overdoing it, like a lot of men.

I was pushing myself too hard.

I just felt very odd...

..and I started to get a really bad headache and then I got kind of

cascades of blinding light, like, quite pretty, actually.

A bit like rainbows in front of my eyes.

Went to bed, assuming it was a migraine...

..and then the next thing I remember was waking up on the floor of the bedroom, unable to get up.

AMBULANCE SIREN WAILS

Then things happened very fast.

An hour later, I was in hospital fighting for my life and, frankly, losing.

Quite strange to be back.

It's such an intense time when you're here, you know? It's all kind of...

It's like another world.

You go back into the real world then you come back here again, yeah.

Strange.

-BEEP

-'Pull the door, please.'

Oh, hello. Thanks.

There we go, it worked.

This is the first time I've been back to the ward since.

-Hello.

-Hello.

-Hello, we're here filming.

-Welcome.

-Thank you so much.

-Just to have a look?

-Yes, just to have a look.

-We have your room over there.

-That was my room there, wasn't it? H?

-Yes. Still empty now.

-Is it?

-Yeah, today it's empty.

OK. Can I have a little peer inside?

-Yeah, sure.

-That's kind of you.

Thank you very much. Oh, yes. Yeah, yeah.

That was where I was.

-INTERVIEWER:

-How long were you here in this room for, then?

I was in this room for two months.

Yes, I'm pretty sure it was two months.

Most of it conscious,

most of it kind of reading and thinking and all the rest of it.

Popping out of that bed endlessly.

Well, not popping. I couldn't pop in those days.

There's a big cemetery down there,

which kind of cheers you up when you're kind of low -

to know that's where you might end up.

I never thought that I was going to die...

..but other people did.

Well, first of all, they said he might not pull through at all and so,

for several days, we were faced with that prospect.

But then they said, even if he did pull through,

he might have lots of mental deficiencies and he may be completely paralysed.

Jackie said to me, you know,

they'd been told twice that I was going to die and then a third time that

I was going to make it, but I'd be basically a cabbage in a wheelchair.

For the first five days, I was pretty much out of it.

When I came round, trying to work out what day it was, I reached for the diary.

So this is my writing.

It's not very neat, before the stroke...

..and then this is after the stroke. See the writing goes all over the place?

And I'm doing virtually no drawing at this point and then suddenly I start

to do some drawing because these are terrible poems, which I'm not going to

allow to be broadcast. Yes, there's a drawing.

It's my bad hand sitting in this hospital bed.

Various cards and stuff behind me.

And then again, there's a drawing, I think, of that... Yes,

there's the hospital bed.

There's the view. "Hammersmith Skyline, February the 21st."

And that's the kind of mayhem on the bed.

Lots of crumpled sheets, books, tissues, bits of this and that.

They're not great drawings, but they show that I was drawing again,

which is a good sign.

Flowers from Rupert Everett.

Handwritten letters from Judi Dench, Tony Blair, Boris Johnson,

Vince Cable, Ed Miliband, most of the Cabinet, Gillian Ayres.

Messages from David Hockney, Chris Patten, Tony Hall.

So I'm quite proud of that, you know,

at the same time as I may be quite close to dying.

-It's very strange.

-Any tear-stained pages?

No tear-stained pages.

You know me better than that!

I think there is no...

there is no kind of human crime worse than self-pity.

I think that's the most nauseating kind of human quality of all.

-Hello again. How nice to see you.

-How are you?

-I'm very, very well.

-How are you?

-Well. Well, you're looking very well.

The neurologist, Omid Halse, discovered the cause of the stroke -

an interruption to the blood supply to the brain.

-In the internal carotid artery, there was a tear in that artery.

-Mm.

So, a little tear, and it was made in quite a severe narrowing.

But because it's in the lining of the inside of the artery,

what it actually causes is this turbulent blood flow,

and it means clots can build up where that tear is.

So, basically, eventually it blocks the artery?

Blocks or causes clots of blood to flick off further upstream.

What you can see here, this artery, which should be a normal, thick,

kind of a pipe, like where my arrow is...

-Yes, yeah.

-..narrows down quite dramatically.

-And is that where the stroke, as it were, occurred?

-Well, this is where the tear occurred.

-Yeah.

This was the cause of the stroke.

A bit of clotted blood went upstream and blocked a small artery

in the brain.

It's great to see... See you in the flesh,

to be honest, and see how you've done so fantastically well.

-Likewise, actually, likewise. Really good to see you.

-Yeah.

You did a great job. Thank you.

And I hope everything continues to go along well with it.

I'll let you get to the next Andrew Marr sitting on a gurney downstairs.

-All right, thanks a lot.

-Take care.

'I'd become part of another statistic.

'Stroke is the biggest cause of disability in the UK.'

At first he couldn't do anything at all. He couldn't get out of bed.

We needed two nurses, three nurses to help him go to the bathroom

and he had nothing at all in the left arm and the left leg, so, erm...

But at that time we were just so pleased he'd pulled through

that the disability seems very unimportant.

This has lots of memories. I spent a lot of time here.

When I came in here, they knew I wanted to go back on television.

My voice was really very poor at that time,

so they actually rigged up a home-made autocue for me to read.

I think it was just sat there, and I sat and read the autocue

for hours and hours and hours.

So, you've got a moving screen with the words on it

and you have to look at the camera and read the words.

-Hello!

-Hello.

-How lovely to see you, Marick.

-Lovely to see you. Fantastic.

-Yeah.

Two fantastic physiotherapists who got me on my feet and got me going

right at the beginning. Without which, I would not have recovered.

-So, thank you very much indeed.

-That's a pleasure.

Was it you that did the autocue for me?

-Yes.

-Yeah! You see?

-That's right.

-That's fantastic.

I remember one evening sitting and just thinking,

how we can help you to go back to work, and I came up with autocue.

Brilliant, brilliant. It helped a lot, yeah.

I don't know if it was yourself or Jackie who asked,

"Will the hand get better?"

-I can do that much.

-Yeah, so that's... That's a change, yeah.

-And I can move the arm around a bit.

-Yeah.

-And it's going to get better yet.

-Good, good.

-It's a work in progress, Jenny, it's a work in progress.

-Yes.

-Yeah.

It's been quite mildly stressful coming back.

Quite odd. I mean, it's lovely to see people like Marick,

who I worked with very closely, and Jenny...

and the doctors as well.

They did a wonderful job on me and I'm really grateful,

and it's lovely to see them again,

but being back in the same place where it all happened

is a bit weird.

You're looking for me to be emotional. I'm not going to be emotional yet...

or possibly ever.

-I was not!

-Yes, you were.

-I was not.

-You wanted a little tear.

You're not going to get a tear.

I'm not that kind of person.

Once you get out of hospital,

you don't have nearly enough support for people.

Physiotherapy is expensive and lots of people aren't very motivated.

You need people to motivate you

and then to actually do the work with you

for a long, long time to come.

Months and very often, certainly in my case, years.

And that's expensive and most people don't have the money for it.

'I'm pretty clear about why my stroke happened.'

Now, I think it's time for tea.

'But what exactly did it do to my brain?'

Ooh, bugger!

'And its function?'

Professor Cathy Price has been studying stroke survivors

for 20 years.

And now she's going to show me the extent of the damage.

-Nice to meet you.

-I'm Cathy.

-Hello, Cathy.

What we aim to do is to have a look to see, first of all,

where your stroke is,

-and then we hope to ask you to do a few things in the scanner...

-Sure.

..and we'll see how your brain is activated.

Which bits of the brain light up when I'm doing different things?

-That's right.

-If any bits light up!

-I'm sure they will.

-Worrying if nothing does!

And then we look to see which bits are compensating

for the loss of the lost bits.

And as part of the compensation that will tell us

how different regions are talking to one another.

'Before I clamber into the scanner, I need to get rid of all metal.'

No money, no keys.

'Including the brace I wear to support my paralysed left foot.'

I think the last time someone peered into my cranium was about

two years ago.

In terms of the structure, it will be fascinating to see

if there's been a change over the last couple of years

when I've been recovering from the stroke,

and getting more functional use back of my limbs, and so forth.

But has the brain itself changed? I don't know.

Goat and train.

Zebra and fence.

'The scanner detects increased blood flow in those areas of my brain

'activated when I describe...'

Man and lion.

'..a series of simple images.'

The dolphin is jumping through the hoop.

The penguin is eating the fish.

The whale is jumping in the sea.

And the lighting up bits, you need more time to process.

-For those, we do...

-Yeah.

-..because there, we have to compare,

-how did the signal change from...

-Yeah.

-..every scan to another time?

Interesting.

-You can see immediately where your stroke is.

-There.

-Here.

-Yes.

-Yes.

Quite big...he said.

THEY LAUGH

-It's a relatively small stroke...

-Is it? All right.

..compared to many of the others. So...

if we come down here,

here you can see the undamaged putamen,

in the left side of the brain,

and here you can see that the same structure of the right hemisphere

is very dark, and that's where the damage has occurred.

So, this dark area here is...

..what has been lost.

And, em...

There's just a tiny little bit of damage here to the caudate.

And the caudate is also involved in the control of, um...

..motor systems.

That includes the control of speech and decision-making.

So, looking at this,

is this classic for somebody who can't really move their arm and leg very well?

Yes. It's also quite a common, common stroke as well.

I say! How very dare you!

THEY LAUGH

So, this is a 3-D movie of your brain. This is the left hemisphere.

It looks like a kind of mad cabbage.

Yes! A mad cabbage, that's right.

-And that's the red area.

-The red area is the part of your brain

that's been damaged by the stroke.

'The putamen and caudate on the right side of the brain

'are part of a network which regulates movement,

'including that of the mouth,

'which is why both my speech and mobility were affected.'

But I was very lucky.

I got my speech back within a few weeks.

One in three patients suffers for much longer.

In Plymouth, Lorraine Dunn had a stroke four years ago...

Yeah, remember that?

..but her speech never properly came back.

I...

I don't...

know...

..what...

..is going on.

SHE SIGHS

-Hello.

-Hello.

Nice to meet you. I'm Andrew.

'Lorraine's case is unusual, because although she can barely speak,

'she can vocalise coherently in...

'well, another way.'

# Show me the way to go home.

# I'm tired and I want to go to bed

# I had a little drink about an hour ago

# And it's gone right to my head. #

-APPLAUSE

-Yay!

And do you find it easier to sing than to speak, as it were, normally?

Yes. Very good.

It's funny, so the words come when you're singing?

-Singing.

-Is it the rhythm? The movement, is it, that helps, do you think?

-Yes.

As Lorraine's shown she can do it for counting

and for saying the days of the week.

So, once she's got a rhythm and she's learnt the pattern

and the routine,

then she can recite it without

stumbling over her speech.

Have you seen your brain before?

-No.

-As we come into the left hemisphere, here,

can you see this dark area here?

-This is where the stroke...

-Oh, yes.

-..has affected you.

My stroke was in the right hemisphere,

and hit a part which controls the mechanics of speech.

But Lorraine's was on the left side, in areas that regulate

the thought processes behind speech.

So, when we see somebody like Lorraine who can sing,

but can't form normal sentences, or finds it very hard to do so,

that suggests that it must be, part of the brain there is for singing,

and part of the brain is for talking.

But I suspect it's much more complicated than that.

Or, perhaps, it's simpler than that.

She's using the same part of her brain

for speaking and for singing,

but she needs more than that.

She can't initiate her speech because she's lost something else,

which is the mapping between what she's thinking,

and the words that she wants to produce.

-# ALL:

-Memories are made of this... #

'I temporarily lost the mechanics of speech -

'frozen lips, saggy tongue.

'Lorraine lost the ability to originate language,

'to scramble for the right words, in the right order.

'But her memory is still intact,

'which is why she can still sing.'

-WITH MUSIC:

-Ba-bum bum.

APPLAUSE

My speech returned because of something essential to this story -

the brain's ability to rewire and work around the problem.

Today, I'm going to show you the results of the experiment you did,

one that we called a functional imaging experiment.

This is where you ask the questions and I respond and we see, what,

if anything, in my brain lights up?

That's right, yes.

And we're going to look to see whether or not the stroke

has changed how you produce speech,

because we know that your speech has recovered,

but it might have recovered because the rest of your brain

can compensate for the loss of the area that's been damaged.

The lit up areas show activity during speech

that isn't usually seen in undamaged brains.

In other words, it shows how my brain is finding new ways around.

So, you've already seen the structure of your brain before...

-Yes, yes.

-..and this is just a cut through this way,

which is where you can see this very discrete stroke, here.

-Yes.

-The dark area.

-The leaf shape.

-Yes, a leaf shape, here.

And when we look to see what's happening

when you're producing speech,

we see, here, that this part, here,

-the globus pallidus, is highly activated.

-Right.

Now, we don't know if this is because

it's playing a functional role to help you with your speech...

So, what we're saying is an area right beside,

or approximate to where the stroke happened

seems to be activated more.

That's correct, yes.

We have also seen this isn't the only region that's changed.

You also have more activity in your left cerebellum.

And you also have more activity in your supplementary motor area.

And you also have more activity, here, in the dorsal part

-of your premotor cortex.

-I'm very busy.

You are very busy, indeed.

So, what is interesting, here,

is that you've had damage to

just the right putamen and the right caudate.

Other parts of your brain have become very busy to help compensate,

and this is during speech, of course,

so what we're showing is, these areas have enabled you to speak.

But, clearly isn't sufficient to enable you to be able to use

your hand as well as you used to be able to.

OK, so my brain can rewire for speech,

but it's not doing the same for my arm and my leg.

Ever since I left hospital, I've been paying for

twice-weekly therapies from Tom Balchin,

a stroke survivor himself, who concentrates on physical strength...

..and Jo Tuckey, for mainstream physiotherapy.

What I'm doing is a lot of,

perhaps, more precise movements, at the moment,

and it's very much aimed at getting

more control in fingers,

wrists, and arms.

OK, and stop.

I went on a detox diet to give myself the best chance -

no booze, or tea or coffee for four months.

I'm losing weight. Yes, I've lost quite a bit of weight.

My tummy, which was referred to by the family as Murphy, has vanished.

We now play a game called Where's Murphy? He's gone. He's vanished.

So that's good news, I guess.

Despite all of this, I know that I'm not getting much better.

In the jargon, I have plateaued.

We talk about plateau...

With Andrew, I'd say, certainly in his arm and his hand,

we'd get little bits of new movement,

but I'd say for the last 12 months we haven't seen anything.

This is a frustration experienced by many stroke survivors,

but I am going to try something different.

So, now I'm off to the Radcliffe Hospital in Oxford,

which is one of the places that they do this

transcranial electrical stimulation,

which is simply, as it were,

warming up bits of the brain with electrical current.

And the idea is that if you do it in combination with physiotherapy,

you get better results after doing this.

I have no idea at this stage whether it will work for me,

but as far as I'm concerned, at this stage in my recovery,

everything is worth a go.

I will try everything or anything.

'This treatment's based on a trial which was carried out on 24 patients

'whose recovery, like mine, had stalled...'

-This is Emily, who's going to be doing...

-Hello. Andrew.

'..and they improved. But will I?'

So, what Emily's going to do first of all is just measure

a few points on your head so that we know where to put that electrode.

It's going to go into here to complete our circuit.

It's a sort of hot, prickly feeling.

Smoke begins to come out of my nostrils.

And a strange smell of burning flesh.

And apart from that, it's absolutely fine.

So, when we're stimulating,

we are putting a very low-level current through the brain.

So, it's about a milliamp, which is about a 10,000th of what goes through a light bulb.

So, it's very small.

And what we think that does is just increase the activity

in bit of the brain that we're stimulating,

and we think that helps the brain to learn

whatever it is you do at that point in time. So, we're going to do that

whilst Andrew is doing some movements with his hand...

So, pushing it in. Really good.

..in the hope that that will help those movements to happen.

They've measured my hand and arm movement -

these are standard tests -

and they'll do it again at the end of the therapy.

He's got a lot of strength in some of his muscles,

and he's got a lot of determination, and those are really...

That's the most important thing, really.

So, we'll keep going, we'll keep doing the best we can,

but we just have to see whether or not it has any effect.

'There is no part of this I enjoy.

'I will be gently electrocuting my brain

'and twisting bloody beanbags for the next three weeks.'

That's good.

As you can see, those are very, um...

unpleasant and boring exercise for me to do.

The question is, do I improve on them, you know?

So, I wasn't doing particularly well in any of those compared with

what I was doing a couple of years ago. I don't think I've seen much improvement

on those particular ones. On other things I have seen improvement, but not those.

So, we'll see if, over the next couple of weeks, they get better. That's the question. We'll see.

'Transcranial brain stimulation is based on the theory

'that we can regrow our brains -

'a process known as neuroplasticity.'

Professor Heidi Johansen-Berg is in charge of the Oxford trial.

So, what you can see in this video...

So, this is where they've grown brain cells in a dish.

What they are showing is that if you squirt a bit of glutamate -

so, this is one of the chemicals that the brain uses to communicate -

you squirt a bit of glutamate onto those brain cells,

sort of recreating as if the brain were being active,

then you can see these little processes that are growing

-in response to that squirt of chemical.

-Yes.

So, this is recreating what's going on in your brain all the time.

-Every time...

-Just like Gardener's World, really, isn't it?

Yes. Certainly. You see them growing up there.

So, this conversation is making parts of our brain

-alter themselves.

-Absolutely, yes.

-Yes.

-Fascinating.

I think plasticity is really interesting.

I think we all have this notion we've learned...

Once you've got your brain, then it doesn't change very much.

This is 100% wrong.

Our brains are changing all the time.

What we do affects who we are,

and I think that is the ultimate lesson of brain plasticity.

'So, if stimulating the brain is good for you, then at long last,

'I've got an excuse for staying busy.'

Hello, it's that time of year when we turn to the light side.

Tilted a little more towards the sun...

The amount of work he does... Um...

I don't know. I wouldn't do it.

I have a butterfly mind.

I alight on a subject very briefly,

suck a little bit of moisture out of it, and then flutter off again.

I'm not very good at long-term concentration.

-Saturday, I've got Tom coming.

-Tom, yeah.

-And then, show.

-Show.

'Of course, you don't want to overdo it.

'Overwork helped to cause my stroke,

'but I'm plagued with a very short attention span.'

Andrew's never going to be the sort of person that is going to sit there

and do nothing. So for him,

not working is almost as stressful as working too hard.

"When I am sad and weary.

"When I think all hope has gone.

"When I'm walking down High Holborn.

"I think of you with nothing on."

LAUGHTER

He could work every day of the week, seven days a week, you know,

ten hours a day, if he wanted to.

Because he's... Everybody wants a piece of him.

I'm working really hard at the moment. I'm making films,

I've got the Sunday programme,

I've got Start The Week, I've got a social life and a family life

to cope with.

'So, if there's a morality tale here about Andrew Marr working too hard,

'here's the ironic twist -

'the Oxford trial has to be squeezed in as well.'

Death looms.

He's endlessly interested in these... In different things.

It's the grave, its necrosis.

"China. Oh, I really want to do a six-part series on China."

And all that's left is a stench.

I'm not quite sure what drives him, no.

Madness.

And it's coming soon, aye!

THEY LAUGH Sorry.

Do you worry you might have another one?

It's always at the back of your mind.

There's the famous stroke-survivor's adage that Robert McCrum

told me about - "It's the second stroke that kills you."

Now, of course, it would be very convenient if politics

went gentle and quiet for a while.

But as you may recall, that isn't quite what happened.

-NEWSREADER:

-The people have voted for a new destiny for Britain.

This means that the UK has voted to leave the European Union.

It is a decision...

-Morning.

-Morning.

-Rob?

-Yeah?

-Lots to talk about.

-I know, I know.

Not to talk about on camera, though.

-No, no. I know. Um, there's a huge number of changes, obviously.

-Yeah.

It should be a good show. It's extraordinary times.

We've got so many political crises all happening at the same time,

we don't quite know what's what.

This is the biggest story I've covered.

On Friday morning, the resignation of the British Prime Minister -

for story number two, or story number three?

I think the country requires fresh leadership to take it...

It wasn't the most important story. Imagine that.

It's extraordinary.

This is bigger than the fall of Margaret Thatcher, which is the other...

It's bigger than the Falklands War.

Plus, at the bottom here, "Sorry, Leavers, we'll have to keep free movement."

Yes, that's a great one.

You know, it's a huge, huge story.

Hi, we can see Heidi Alexander's resigned.

Is it bigger than the Iraq war?

Well, that's a very, very difficult question,

because huge numbers of people lost their lives in the Iraq war,

and afterwards, and I don't think anyone's going to lose their lives,

pray God, from now on, in this conflict.

Looking across the papers,

the overwhelming sense is that the entire British political class

has been kind of toppled by this.

'Politically, in terms of the British political set-up and establishment,

'the relationship between that and the British electorate'

is the biggest story of my lifetime.

But then, I'm young.

'Keep calm and carry on.'

And never a moment when we required it more.

And now, over to Andrew Neil at Westminster for more on this

extraordinary morning.

Take his press, take his press.

-APPLAUSE

-We are off the air.

Fantastic show.

You're not going to make me look like

Ed Miliband with his bacon sandwich, I hope.

Oh!

The most interesting political fact in the last 12 hours -

Alastair Campbell has a ketchup phobia.

He hates ketchup. He can't even see the sight of ketchup sachets.

Isn't that extraordinary?

This whole Primrose Hill thing,

it's a bit absurd for anyone coming from Scotland.

This would not be regarded as a hill at all.

I suppose "Primrose Nipple" doesn't sound as good.

'The stroke affected every single area of my life.

'For instance, we moved from a large home in the suburbs

'to a much smaller one, bang in the centre of London.

'Even for me, a perfectly walkable walk

'away from the BBC headquarters.'

Nous arrivons, mon dieu.

'But in the centre of town I need space.

'I need somewhere to be really messy.'

Did you hear that? A rat the size of a pony on the bird table.

It's a very exciting neighbourhood, this.

'I suppose you could say, somewhere to splash around.'

So, this is my personal, private, pleasure ground.

It's where I come to hide from the world.

It's my painting studio.

And whenever I'm stressed, whenever I've got time, I just come here

and I paint. It's what matters to me most.

It matters to me more than politics.

It matters to me more than stroke recovery.

It matters to me almost more than anything else in the world.

Gosh.

That shut you up!

Oh, this is Zandra.

Former literary agent, former all-sorts-of-kinds-of agent,

who owns this house and has been incredibly kind to me.

And has saved my life over the last years, Zandra,

by giving me place to paint.

Well, "You saved my life" is a bit strong.

I've been painting all my life

and I very nearly went to art school.

One of my big regrets in a way, is that I didn't go to art school.

Maybe that was because I was just too scared.

I don't know.

-Scared of?

-Scared of failure.

Now, I think these are pretty interesting,

because this is what Andrew was painting before his stroke.

And they're lovely. And if you look at those and you think of those

Hockney, Yorkshire landscapes...

..they have that same thing in common.

You can recognise the landscape if you happen to stand on that hill.

-Yeah, they're not Hockney, though.

-But, no, no. Wait, I was going to say something.

But Hockney's pushed on

somewhere else. He's exaggerated the direction of the truth,

or he's done something, whatever...

These don't exaggerate at all.

They're as real, it seems to me, as they can get.

I take my canvas out and look at a landscape,

and then try to produce something which pretty much looks like

what I was looking at. It was mimetic, I suppose.

After the stroke, I really couldn't do that any more.

Physically, it was just too difficult.

That's the kind of painting I was doing before the stroke.

That's the kind of painting I'm doing now. So, you can see,

it's been a fairly radical change.

Does that mean your personality's changed, do you think, since your stroke?

You're expressing yourself in a different way?

I think personality's too big a word to say that that's changed,

but I certainly think my temperament has loosened up a lot since the stroke.

I'm very much aware that we're only on this planet

for a short period of time.

I am much less tolerant of losing a day,

or losing an hour, and I want to be in the moment.

And...

therefore, when it comes to something like painting,

I want to be more extreme.

If I can push something further, why not?

There she is. Now you'll have to ask Andrew about this,

because I don't really have much thoughts.

-Oh, no, that's... No, no, no, no that's the wrong one!

-Sorry.

Oh, no, that's terrible! Terrible, terrible!

-All right, we'll put it away.

-Awful. Awful daub!

'Although the paintings have changed,

'my vision is unaffected by the stroke,

'but for many survivors, that's not the case.'

'Bob Coshott had a stroke eight years ago.

'He's out to meet his wife of 25 years.'

Well, I don't see anybody here.

The lady reading the paper is the right build

and colouring for my wife.

There are other clues that I can use,

she's wearing a very similar wedding ring.

It makes me think it's more likely to be her.

-I think you're Claire...

-THEY LAUGH

..and I claim my £5.

Bob can't recognise his wife

because he suffers from a rare condition

called prosopagnosia,

otherwise known as face blindness.

His stroke damaged an area of the brain

called the fusiform gyrus.

In Bob's case, following his brain injury, he suffered damage

to these areas, here. These are the

areas at the back of your brain, here.

-Right back here.

-Right at the very back, at the back of your head.

So, the expression that your eyes are in the back of your head

is quite apt, really, cos

that's where vision tends to take place in the brain.

One way in which we test whether people have impairments with faces

is to look at what we call famous face recognition.

Bob, do you want to give us an idea on who you think this...

No, I don't know who that is.

That is Margaret Thatcher.

Yeah. Margaret Thatcher.

-But then without the hairstyle, and the famous blue...

-It's much harder.

And again, this is a key point, is that

those kind of external cues are really what people

-with prosopagnosia often rely on...

-Exactly.

-..to recognise a face,

and by taking them away it really causes problems

with face recognition.

I think it's Stephen Fry,

but the reason I say that is that I know that he's got a bent nose.

And what I'm picking up on is that specific feature

-rather than the whole face.

-Yeah.

-And it's definitely Stephen Fry.

-It is. It's definitely Stephen Fry.

-No, I don't know.

-Very, very ugly. No idea who that is(!)

-That would be Andrew.

-Oh, it's him!

-Andrew Marr!

THEY LAUGH

Well, again, that shows you. Sitting next to the gentleman concerned,

-and I don't recognise the image there.

-Mmm.

So, it's a little piece of analytical hardware

-that you're lacking, if I can put it that way, Bob.

-Mmm.

-Yeah.

'Bob may have to live with his condition for the rest of his life,

'but I am not yet ready to accept my disability.'

Other one going on the other side.

'After three weeks of brain electrocution,

'it's time to find out

'if my left side movement has improved.'

Good.

'In a test at the beginning,

'I scored 27 out of 57.'

Can you try and put your hand behind your head?

'What now?'

OK.

The numbers say that you've got one point better.

Well, that's almost nothing.

So it's... I think things are fairly stable.

-There's a little bit of noise depending on how tired you are, what else has been going on.

-Sure.

So, I don't think we can say very much from that.

I...I never say never to anything.

But this time around, at this period,

I don't think I've got a big improvement in it.

You know, everything is worth trying,

you never know what's going to work and what isn't going to work.

-It's just a shame. We know some people improve with this...

-And some don't.

..some people improve less, you know. So, I'm sorry.

Well, it was... No, no, it was an interesting experiment.

-Thank you very much.

-No, it's been very interesting, but...

-Thanks.

-Yes, I wish we knew in advance who it was going to help,

-and who it wasn't.

-Yes, well, you can't, of course, yes.

Not at the moment. No. One day, hopefully, but...

It's helped your recovery, hasn't it, the painting?

Well... So, today...

I've walked across Primrose Hill...

..up and over.

And I've now spent probably about an hour standing upright.

It's more than that, isn't it, Andrew?

Oh, I see. You're talking about psychology and emotions

and all that stuff, he said crossly.

I mean, I think, I suppose, if there's the bleak times

when you think, "I'm not going to go back to work."

That was a long time ago, now, but those sort of times.

Or when you think,

"I'm not going to recover properly", which I might well not...

completely, then painting is a solace,

because it's about nothing except painting.

You know, it's not about anything else.

It's not about the stroke, it's not about...

career. It's not about politics.

It's just about, "Will this red be improved if I put

"a little bit more blue-black behind it or not?"

And the answer is, yes, it will, in this case. Which is quite nice.

'So, that Oxford trial was disappointing,

'but there are other options...

'..and one of them is taking place in Glasgow,

'not so far from where I was born.'

'Billy Elder had a stroke a year ago.

'Just like me, he has limited movement on his left side.'

-There you go, dear.

-Thank you very much, dear.

-Thank you.

-Bet you think I do this all the time.

He doesn't.

SHE LAUGHS

Loads of things you cannae do.

Even in the pub, you've got to get somebody to go up and get your pint

at the bar, and bring it over to you.

It would be brilliant if they did get a miracle.

I don't believe in miracles, right enough.

Billy is about to have stem cells injected

directly into the damaged area in his right hemisphere.

He's one patient in a trial at the Queen Elizabeth University Hospital

run by Professor Keith Muir.

The procedure involves implanting a dose of cells.

We do that by injection deep into the middle part of the brain,

close to where the damage caused by the stroke is.

Professor Muir, can I just start right at the beginning

and ask a kind of simple, daft, laddy question -

what are stem cells?

So, stem cells are the cells that we rely on to grow

into all the tissues in the body.

And they retain this ability to develop into

lots of different types of cells.

But stem cells have

abilities to trigger response,

which is going to stimulate repair,

mobilising the body's own stem cells.

DRILL WHIRS

2 million stem cells are injected into Billy's brain.

The ones we are using in the particular trial

are originally taken from tissue from a foetus,

and the cells have been modified genetically

so that they remain immortal.

So, one sample of cells persists forever.

So, there's a certain amount of the yuck factor, here.

Is there any evidence at all, at this stage,

that this actually works?

What we observed in the first study was that there was some

modest improvement in a group of patients

who we wouldn't really expect to improve.

That's your operation all finished, then, Mr Elder. All right?

It'll be a couple of months before Billy knows

whether the stem cells have made any difference...

..but before I volunteer to have my bonce broken open,

I'm looking further afield.

Oh, yes, that's very suitable for Miami Beach.

Thank you very much. I'm slightly nervous, because...

-I'm a bit nervous.

-What I'm nervous about is if it doesn't work,

what will happen to morale?

There's a chap in Florida, a doctor in Florida,

who says he's operated on some 2,000 patients,

of which 80% have seen significant improvements.

If the figures are as good as he claims to be, then it is worth,

certainly, having a go at it, I think.

I'm heading to the United States for a new and controversial treatment...

..an anti-inflammatory drug normally used for arthritis.

Perispinal etanercept, which is what I'm getting,

has not had big, randomised controlled trials,

in a proper, approved, kind of, medical way.

The fact that I have to go to Florida to a private clinic

and pay out quite a lot of my own dosh to get the treatment

shows that it is still an outlier. It's still, if you like, a bit dodgy.

It may not work. It probably doesn't work for everybody,

and it may be oversold.

S-e-e-v-en...

One of the treatment's biggest successes is Linda,

a former teacher from Maine who couldn't speak

until moments after the injection.

Hi!

It's me!

Oh, my...

If you watch her husband - I take it this is the husband -

he's about to burst into tears.

I can talk. I can walk.

Haa!

Woohoo!

You can't get neural regrowth this fast.

So, something odd is happening.

It may simply be placebo effect, I don't know.

But, on the basis of these kind of films, this is a miracle cure.

Hi!

For some people. Maybe not for me.

HE LAUGHS

I haven't heard of any adverse side effects,

and all new ideas have to start somewhere,

so I'm going to give it a go.

We've come to Florida to meet Dr Ed Tobinick,

who heads the Institute Of Neurological Recovery.

He is not a neurologist. He started out as a skin specialist.

-Pleased to meet you.

-Hi.

-Hi.

I can do that with my fingers.

I can move them out a bit, and I can bring them in but, as you can see,

it's very limited.

'His first task is to chart my plateau.'

From my point of view, the single biggest disability I've got

is my left ankle, which is completely out.

Can you try to point your foot down?

-OK, not really.

-Not really, no.

OK. I'm going to ask you to smile.

Good.

One...

Two...

Stroke causes a chronic inflammatory response

in the brain that doesn't go away.

It shuts down certain neural circuits in areas,

particularly, that are around the area of the stroke.

Etanercept works by neutralising a chemical

that causes inflammation, thereby allowing those brain cells

that were not able to talk to each other to communicate, and function.

-How many...? How long was it?

-Five minutes.

Five minutes and nine seconds.

-OK. There's our baseline.

-There's the target, yeah.

In terms of the injection itself, it really doesn't hurt,

so you don't have to be concerned about...

The needle is too short to...

It cannot reach your spinal cord,

so it cannot cause

any problems from the injection itself.

The treatment comprises just two injections, seven days apart,

and at a cost of 7,000.

I think we're ready to go, so we're going to...

-..cut off the cameras. Right?

-That's right.

-Yep.

-OK.

And I'll bring my team in.

There's a leading scientist in the UK, a neurologist,

and this is a quote from him, that...

"You operate in the twilight zone."

Mmm. I... I'm not familiar with that quote,

but I can tell you that there hasn't been a neurologist from the UK

that's come over.

There have been other scientists from other parts of the world,

from.... Neuroscientists from the United States have come and seen it.

And they are very positive

about the results and have said that they're...

That our results are actually duplicating

what they've seen in their animal studies.

-You feeling all right?

-I'm feeling fine, yeah.

OK. So, you're feeling well?

I'm feeling fine, yes, I'm feeling good.

Can you tell anything has changed?

It's... I... To be honest, not really.

-Well, what about the face?

-Yep.

-What about the left side?

-Yeah, I think that is a bit better.

-Yeah.

-Slightly improved on the left side, good.

Yes, there you go, good. I think that's pretty good actually, yeah.

-I think it's a little bit different.

-Yeah, yeah.

'Feeling slightly more alert,'

and focused, perhaps, than I had been.

Definitely had an impact of some kind.

And then we've seen a range of slight improvements,

I think on the shoulder, and possibly on the walking.

And what I'm going to be doing over the next few hours

is just constantly monitoring my walking. It'll be very weird,

I'll be thinking about every step I take to see if there's

a bit of extra fluidity of movement.

The next day I'm less optimistic.

-Hello, Andrew.

-ON PHONE: 'Hello.'

How did you sleep last night?

'I slept very well, Ed. But, um...

'I'm afraid, I don't think, for me, it's worked.

'I've been to the gym, I've done a lot of self-monitoring.

'Um... And I don't really see any change...

'as disappointing as that is.'

OK. And what has Jackie said about everything else? Or...

'I... I... She rather agrees with me, I think.'

He sounded a bit disappointed today.

Yes. We'll have to see...

how things progress over time.

-Morning.

-Good morning.

'I am disappointed,

'and that makes it hard to meet Linda,

'who had such a miraculous response.'

You had that very, very emotional, wonderful moment when you woke up

and you could suddenly... You felt totally different.

Yes.

You can't even begin to imagine.

When I came for the treatment, I anticipated,

I expected, hoped for some improvement.

-But I never dreamed...

-That it would be that good.

..that it would be that profound.

At this stage in the process,

I haven't had the same kind of improvements Linda has had.

You... You had much less neurologic disability

than the usual stroke survivor.

You might have had less inflammation

than the majority of patients.

There's still a possibility that you'll have a delayed response

to treatment, that can happen.

And, you know, the fact that people characteristically

improve within a few minutes, start to improve,

-it's not really their total response.

-No.

And that is what happened.

Over the ensuing week, I did start to see

flickers of movement in my paralysed ankle,

and my forefinger.

Not a lot, but not nothing either.

And then I came back for a second dose.

Well, it appears you're still with us.

Yes, I appear to be still here.

Still alive, that's good news, that's a good start.

Well, let's see how you do with bringing your knee up.

You'll have to tell me if it feels any different.

-It's so difficult, this. You're trying to kind of...

-Hard to tell.

-..judge very small things over a period of time.

-It's OK.

-But...

Point up.

-There it goes.

-That's actually a little bit...

-There is a little bit of movement there.

-Yes.

-Reasonable.

-Yes.

-Good.

There's definitely power there.

-Yes, there is.

-OK, then. That's important in walking.

-Yeah.

-Pushing off.

-Yep.

So there's movement in both directions.

It's still a slightly uneven gait,

but he seems to be going a little bit faster to me.

-Here we are.

-Yeah. Oh, that's great. 4.46.

Five minutes and nine seconds pre-treatment.

'23 seconds faster - not Usain Bolt, but a result for me.'

When I came here, in my head, I was thinking about two possibilities.

One is that I'd have a miraculous cure, I'd walk away, no brace,

no nothing, and all my physical defects

would magically have disappeared and I'd be

running and swimming and cycling again.

Or it wouldn't work, there'd be no change at all,

and I'd go back dejected, a bit depressed,

and worried about the future.

In fact, I guess, as with life generally, it's in-between.

There has been a change,

not nearly as big a change as perhaps I'd hoped for.

Frankly, for a stroke survivor, any change is good.

But it's not "Pick up thy bed and walk."

Yes, look at that. See that finger coming up?

I couldn't do that before.

And you can see, it's very small, but...

There we go. Moving again.

It wasn't doing that at all before.

The sun has risen on an independent United Kingdom.

2016 has been a remarkable year for politics.

Nothing you can do, folks.

A turning point for good...

or bad.

She was a human being, and she was perfect.

I am at least optimistic about the future of stroke treatment.

What used to be an automatic life-sentence no longer is.

Eight weeks after Billy Elder had stem-cell therapy,

he is now able to move his once completely paralysed left arm.

And a month after Florida,

my physiotherapist, Jo, is encouraged.

And just try and straighten that finger.

Oh. Good movement.

'When Andrew said he was going to go off and have this,

'I'd never heard of it, so, obviously,

'I went and looked it up.'

'The independent review I found,'

they were fairly damning about it.

Having seen Andrew, now, for over three years, all I can say is,

he went away, there was no movement in his foot...

He's come back,

he's got some movement in his foot.

If we work hard for a year or so on this,

do you think we have a good chance of getting a functional foot back,

that doesn't need a brace on?

-I don't know. I'll be completely honest, I don't know.

-Mmm. Mmm.

I'd love to say that.

I'm more optimistic, I'm going to get movement back.

I'm going to get rid of this brace. It's going to go, eventually.

'I don't think we should be a people who accept things and shrug, and sort of'

shrivel into our lot, if you put it like that.

I think we have to carry on looking for answers and looking for solutions.

It's the same with stroke, cancer, any major diseases,

and we are lucky to be living when we do.

So, what happens now?

He has improved so much since he had the stroke.

And I think that's what, you know, you need to concentrate on.

Look at where he was when he came out of hospital.

And, by the way, is anyone in charge?

There is no magic bullet, because if there was,

everyone would be after it, and there wouldn't be this great question mark.

My only neutral BBC thought is this...

If I want there to be any sort of lesson out of this,

it's that it's worth never giving up.

Probably, it won't be quite as good as you hope,

nor quite as bad as you fear. Probably.

We need tears now, Andrew.

I'm sorry. I know the BBC has a special contract

that I'm to burst into tears at one point in this programme,

but I can't do it.

I come from Dundee. THEY LAUGH