0:00:02 > 0:00:09This programme contains some strong language
0:00:11 > 0:00:14As many days of the year as possible, I begin here.
0:00:15 > 0:00:18Other than constant chatter in my head,
0:00:18 > 0:00:20it's a time that is largely language-free.
0:00:21 > 0:00:25If, that is, it is ever possible to be language-free.
0:00:28 > 0:00:33In 2011, my brother-in-law, Dennis, had a stroke that significantly
0:00:33 > 0:00:36affected his ability to use language -
0:00:36 > 0:00:40particularly cruel for a man whose living had been as a journalist,
0:00:40 > 0:00:41a writer.
0:00:54 > 0:00:56Until Dennis had his stroke,
0:00:56 > 0:01:00I hadn't realised just how common aphasia is.
0:01:00 > 0:01:03Dennis had joined the ranks of over a third of a million people living
0:01:03 > 0:01:08in the UK whose language, to some degree, has gone missing -
0:01:08 > 0:01:11the vast majority the result of stroke.
0:01:13 > 0:01:14People like Barry.
0:01:14 > 0:01:19I...need...some...help.
0:01:19 > 0:01:20And Junior.
0:01:20 > 0:01:23I'm anxious about language.
0:01:23 > 0:01:25- You're anxious?- Yes.
0:01:25 > 0:01:28Two men who know what it is to live in a world where a sudden storm in
0:01:28 > 0:01:32the brain has left them unable to rely on what is the invisible
0:01:32 > 0:01:34mainstay of life - language.
0:01:38 > 0:01:41This is a film about language and its loss,
0:01:41 > 0:01:45about aphasia and about the organ that controls it all.
0:01:56 > 0:02:00Queen's Square in London and the National Hospital for Neurology
0:02:00 > 0:02:01and Neurosurgery.
0:02:04 > 0:02:08Everything that goes on behind these walls is about the brain.
0:02:11 > 0:02:14In February 2017, I meet Barry,
0:02:14 > 0:02:17an inpatient on the hospital's neuro-rehab unit.
0:02:19 > 0:02:22Barry has been in hospital every day since a devastating stroke
0:02:22 > 0:02:24four months earlier.
0:02:25 > 0:02:27Once a gym-loving fitness fanatic,
0:02:27 > 0:02:32he now finds himself in a wheelchair barely able to use the right-hand
0:02:32 > 0:02:34side of his body,
0:02:34 > 0:02:35and barely able to speak.
0:02:37 > 0:02:41He's now halfway through a stay on the rehab unit that's intended to
0:02:41 > 0:02:42help him back into the world.
0:02:45 > 0:02:48So we did talk about this earlier in the team meeting.
0:02:48 > 0:02:49- Yes.- We were talking about...
0:02:51 > 0:02:54..thinking about making a visit home.
0:02:54 > 0:02:56- Yes.- Do you want to talk about that?
0:02:59 > 0:03:01Months, months.
0:03:01 > 0:03:02Three months.
0:03:03 > 0:03:05You haven't been home in three months?
0:03:06 > 0:03:08- Four months.- Four months.
0:03:08 > 0:03:10Four months.
0:03:10 > 0:03:11Four months.
0:03:11 > 0:03:15Do you mean it's four months since the stroke?
0:03:15 > 0:03:17- Yes.- Or you're not due to go home...
0:03:19 > 0:03:21..for four months?
0:03:21 > 0:03:23- Ah...- Since the stroke?
0:03:24 > 0:03:25Four months.
0:03:28 > 0:03:30Four...months.
0:03:31 > 0:03:36Four months haven't
0:03:36 > 0:03:39go home.
0:03:39 > 0:03:40You haven't been home in four months?
0:03:40 > 0:03:42Yes. Yes.
0:03:42 > 0:03:44- It's a long time.- Ah...
0:03:44 > 0:03:46Are you looking forward to going home?
0:03:46 > 0:03:48- No.- No.
0:03:48 > 0:03:49Why not?
0:03:50 > 0:03:51- Are you scared?- Yeah.
0:03:51 > 0:03:53Yeah. What makes you frightened?
0:03:57 > 0:04:00Four months. Four months.
0:04:00 > 0:04:03Four months.
0:04:03 > 0:04:05So this is the CT scan,
0:04:05 > 0:04:09so the Cat scan that was performed on Barry when he was initially
0:04:09 > 0:04:12admitted to Watford General Hospital.
0:04:12 > 0:04:17So in this scan the white areas, the bright white is bone.
0:04:17 > 0:04:20And what you can see here are Barry's eyes and his nose.
0:04:20 > 0:04:22And it is immediately apparent, is it, that there's a lot of...
0:04:22 > 0:04:25- I couldn't see it terribly clearly that there is a lot of damage.- OK.
0:04:27 > 0:04:28So that's the initial scan.
0:04:31 > 0:04:32OK.
0:04:32 > 0:04:35This is the normal side of the brain, the right side.
0:04:35 > 0:04:38- Yeah.- And this darker bit...
0:04:39 > 0:04:43..is what we call kind of the low density.
0:04:43 > 0:04:44So it's much darker.
0:04:44 > 0:04:47This is all the affected area of the brain here.
0:04:47 > 0:04:48So, basically, the brain tissue,
0:04:48 > 0:04:52when the blood supply has been cut off, the brain tissue dies.
0:05:06 > 0:05:11This is the brain of a man in his 70s who died of a cancer-related death,
0:05:11 > 0:05:14so it's essentially, from a neuropathological perspective, a normal brain.
0:05:16 > 0:05:19The vast majority of the brain is the cerebrum,
0:05:19 > 0:05:23which is divided into left and right cerebral hemispheres.
0:05:23 > 0:05:25So when you're looking from the outside of the brain, what you are
0:05:25 > 0:05:27seeing, really, is the cerebral cortex.
0:05:27 > 0:05:32So different areas of the cerebral cortex
0:05:32 > 0:05:36are involved in different functions, different neurological functions,
0:05:36 > 0:05:39so the area I've marked in blue at the back of the temporal lobe
0:05:39 > 0:05:41is Wernicke's area,
0:05:41 > 0:05:44and that's an area that's important in the comprehension of language.
0:05:44 > 0:05:48The other important speech area, which I've marked in red here,
0:05:48 > 0:05:51is at the bottom of the frontal lobe, the left frontal lobe.
0:05:51 > 0:05:54That is called Broca's area, and that's responsible for the
0:05:54 > 0:05:57production and planning of speech.
0:05:57 > 0:05:59So in the vast majority of people,
0:05:59 > 0:06:02language areas are entirely on the left hemisphere.
0:06:09 > 0:06:11What do you understand language to be?
0:06:11 > 0:06:16I would say language is something that's almost completely uniquely
0:06:16 > 0:06:19human and it's one of the things that has enabled us
0:06:19 > 0:06:21to do so well as a species.
0:06:21 > 0:06:22And the reason for that, I think,
0:06:22 > 0:06:26is because it allows us to model the world.
0:06:27 > 0:06:31So how can we plan for something that we're going to do next Wednesday
0:06:31 > 0:06:34if we don't have language? So "next Wednesday" allows us to talk about a
0:06:34 > 0:06:39specific potential event forward in time and without language we can't
0:06:39 > 0:06:43really do that. We can have a concept of time and a concept of things
0:06:43 > 0:06:45happening in the future or the past, and I suspect other animals do that,
0:06:45 > 0:06:48but for precise planning, we really need language.
0:06:48 > 0:06:51And language is a form of abstraction.
0:06:51 > 0:06:56It's a way of abstracting the world and getting control of it.
0:06:58 > 0:07:03Barry, 55 years old - still young for a stroke.
0:07:04 > 0:07:09Why had it happened? The frightening thing is that it wasn't fully clear.
0:07:09 > 0:07:13The only certainty is that for this landlord and father of three
0:07:13 > 0:07:17grown-up children, married to his childhood sweetheart, Linda,
0:07:17 > 0:07:19life has been dramatically knocked off course.
0:07:22 > 0:07:26Now Barry is living alongside other men and women recovering from a
0:07:26 > 0:07:28variety of neurological conditions,
0:07:28 > 0:07:32their days divided between therapies and family visits.
0:07:33 > 0:07:36Barry, what's your favourite biscuits?
0:07:36 > 0:07:38- Jammie Dodgers?- Yeah.
0:07:39 > 0:07:42Linda visits most afternoons,
0:07:42 > 0:07:45often bringing cake and biscuits to share with the other patients.
0:07:46 > 0:07:50One day, she tells the story of Barry's stroke,
0:07:50 > 0:07:53describing how an ordinary working day had ended with the whole family
0:07:53 > 0:07:56concerned that Barry had not come home.
0:07:56 > 0:07:59Jess was calling all the hospitals.
0:07:59 > 0:08:02She thought maybe you'd been in an accident and they hadn't identified
0:08:02 > 0:08:04you. So Jess was on the phone all night.
0:08:04 > 0:08:08Sam calling, calling all night all the hospitals.
0:08:08 > 0:08:10So then, at about 7.30 in the morning,
0:08:10 > 0:08:15Sam called a private detective and he was able to tell us roughly the
0:08:15 > 0:08:17vicinity where your phone was.
0:08:18 > 0:08:24So Ben and Sam jumped in Ben's car and went towards Borehamwood,
0:08:24 > 0:08:26where your phone was.
0:08:26 > 0:08:32Jess and Tammy went down the A1 and Tammy said, "Stop, stop!
0:08:32 > 0:08:34"I think that's my daddy's van."
0:08:35 > 0:08:39And Tammy ran back down the A1 and found you.
0:08:39 > 0:08:41- Oh!- And then she called the ambulance.
0:08:41 > 0:08:45We've estimated you were maybe 12, 15 hours in the van.
0:08:46 > 0:08:50Ten. Ten hours.
0:08:50 > 0:08:52Ten hours.
0:08:54 > 0:08:57- What's ten hours?- In a van?
0:08:57 > 0:09:00Yeah. Oh...
0:09:05 > 0:09:07Do you remember being in the van, Barry?
0:09:07 > 0:09:09No.
0:09:09 > 0:09:12It's good you don't remember that. It's better.
0:09:18 > 0:09:19I worked hard to...
0:09:21 > 0:09:24..accept what had happened...
0:09:26 > 0:09:28..but I couldn't really do that until I got over the shock,
0:09:28 > 0:09:31the shock of him being in the van on his own all night,
0:09:31 > 0:09:33the shock of him having the stroke.
0:09:33 > 0:09:37Then I worked on accepting the situation it put him and myself...
0:09:39 > 0:09:41..and our children.
0:09:41 > 0:09:45Barry was always a real people's person, full of life.
0:09:46 > 0:09:49A bit of a lad. I just think...
0:09:50 > 0:09:55..at times he must feel very lonely, very isolated.
0:09:57 > 0:10:00Not fully understanding what one is saying.
0:10:00 > 0:10:03Not being able to join in the conversation.
0:10:07 > 0:10:10So, for me, that's the biggest challenge.
0:10:15 > 0:10:18- COMMENTATOR:- It's a flick on from Junior Agogo. It's Richard Walker.
0:10:18 > 0:10:20Can he find Ryan Williams? He does! It's Agogo!
0:10:20 > 0:10:23Surely! It is!
0:10:23 > 0:10:25This is Junior Agogo,
0:10:25 > 0:10:30former Premier League footballer and former patient on the neuro-rehab unit.
0:10:30 > 0:10:33Great ball to Agogo. What a goal!
0:10:33 > 0:10:39Junior had had a stroke in January 2015 when he was just 36 years old,
0:10:39 > 0:10:41two years after ending his football career.
0:10:44 > 0:10:48Today, he lives in London with his dog, Blanket, and his mother, Jeannie.
0:10:50 > 0:10:52The flat is a shrine to his football days.
0:10:53 > 0:10:56He's made a good physical recovery from his stroke,
0:10:56 > 0:10:58but he still struggles greatly with the impact that it's had
0:10:58 > 0:11:00on his language.
0:11:01 > 0:11:05Do you remember how long it was before Junior was able to speak again?
0:11:05 > 0:11:08I think it's after... It's after a year.
0:11:08 > 0:11:10- No, no, no. - No, after six months, sorry.
0:11:10 > 0:11:13No, no, no. After three months.
0:11:13 > 0:11:17Was it? No, no, no, three months, the first word you said was...
0:11:17 > 0:11:21- BOTH:- "Fucking hell." - Yeah, yeah.- "Fucking hell."
0:11:21 > 0:11:23And I said, "Don't be swearing!"
0:11:23 > 0:11:25Then the second one was...
0:11:25 > 0:11:28There were some things that he was saying and I couldn't understand
0:11:28 > 0:11:32what it was. He was trying, he was struggling, you know?
0:11:32 > 0:11:36I think it was after six months that you started... The speech started coming out.
0:11:36 > 0:11:39- Yeah, yeah.- When he started doing his speech therapy.
0:11:39 > 0:11:40Did they find out why you had a stroke?
0:11:40 > 0:11:44- No.- No, they still can't, you know...- No.
0:11:44 > 0:11:45But...
0:11:45 > 0:11:48I'm alive, I'm well.
0:11:50 > 0:11:53- Let's see what... - Yeah, but deep down in your heart,
0:11:53 > 0:11:55there is something bothering you.
0:11:55 > 0:11:56- Yes, yes, yes.- Yeah?
0:11:56 > 0:12:01OK, look, let's get on to my football days, yeah?
0:12:01 > 0:12:03HE LAUGHS
0:12:03 > 0:12:05- Oh, God!- Yeah!
0:12:05 > 0:12:07So, where are we here?
0:12:07 > 0:12:08This one was Barnet.
0:12:08 > 0:12:10Barnet.
0:12:10 > 0:12:12That's Nottingham.
0:12:12 > 0:12:14Nottingham. Bristol.
0:12:15 > 0:12:18- There's Ghana.- Yeah, Ghana, as well.
0:12:18 > 0:12:20Ghana? How many times did you play for Ghana?
0:12:20 > 0:12:2227 times.
0:12:22 > 0:12:25Wow! How many years did you play for?
0:12:25 > 0:12:27For 17 years.
0:12:28 > 0:12:30- At the very top level? - Yeah, yeah, yeah.
0:12:30 > 0:12:32Come on.
0:12:32 > 0:12:34- This is the Hall of Fame, is it? - Yeah.
0:12:34 > 0:12:35This one.
0:12:36 > 0:12:38- Michael Essien.- Yeah. - Chelsea.- Yeah.
0:12:40 > 0:12:41Yeah.
0:12:42 > 0:12:44Samuel Eto'o.
0:12:44 > 0:12:46- Oh, right.- Didier Drogba.
0:12:46 > 0:12:51Wow, Drogba. Are these guys you're in touch with?
0:12:51 > 0:12:55Um, now, nobody gets in touch with me.
0:12:55 > 0:12:56LAUGHTER
0:12:56 > 0:12:58- Really?- Yeah.
0:12:58 > 0:13:01Do you think that's because... Is that you, because you're not getting
0:13:01 > 0:13:03- in touch with them? - I don't know, man,
0:13:03 > 0:13:10because I used to talk with a couple of boys in the national team,
0:13:10 > 0:13:15but when the stroke happened, they all said, "No".
0:13:15 > 0:13:17How do you know that? Do you mean they said "No",
0:13:17 > 0:13:21- or you stopped talking to them? - Because I couldn't speak.
0:13:21 > 0:13:23- Yeah?- Yeah.
0:13:25 > 0:13:28Yeah, Blanket!
0:13:28 > 0:13:30Blanquito, out.
0:13:30 > 0:13:32Are you still struggling to find words,
0:13:32 > 0:13:35or are you just not putting yourself in a position where you use them
0:13:35 > 0:13:39because you're anxious about language because of what happened to you?
0:13:39 > 0:13:42Yeah, yeah. I'm anxious about language.
0:13:42 > 0:13:44- You're anxious.- Yes.
0:13:45 > 0:13:47What about finding the words and stuff?
0:13:47 > 0:13:53- Are you able to...?- No, no, I can find the words, but I'm anxious
0:13:53 > 0:13:57to... Because I am anxious if I get the word wrong.
0:13:59 > 0:14:01Does that happen often?
0:14:01 > 0:14:02- Oh, many times.- Yeah.
0:14:02 > 0:14:05He's just struggling to bring out that word,
0:14:05 > 0:14:09that particular word he wants to say, and that word is not
0:14:09 > 0:14:13coming out, you know? So that's also...
0:14:13 > 0:14:16I want to speak like you three.
0:14:16 > 0:14:19- Um-hm.- Yeah.
0:14:19 > 0:14:20Yeah.
0:14:20 > 0:14:22That's all.
0:14:22 > 0:14:23That's all.
0:14:25 > 0:14:29It seemed to me that Junior's language is pretty good.
0:14:29 > 0:14:32He can describe his world, present and past.
0:14:34 > 0:14:36But he of course doesn't see it like that.
0:14:37 > 0:14:39He is living with an acute sense of loss.
0:14:43 > 0:14:45Four months after his stroke,
0:14:45 > 0:14:48Barry has none of Junior's admittedly hesitant fluency.
0:14:50 > 0:14:55One day, so that Barry's speech therapist Jonathan might know him better,
0:14:55 > 0:14:59Linda brings in a DVD of a BBC programme, Homes Under The Hammer,
0:14:59 > 0:15:02in which Barry had appeared some years before.
0:15:04 > 0:15:06There he is.
0:15:06 > 0:15:09- LUCY ALEXANDER:- The new owners are brothers Barry and Tony.
0:15:09 > 0:15:13They like to buy houses that need some TLC and bring them back to life.
0:15:13 > 0:15:16Part of the appeal for Barry was the location.
0:15:16 > 0:15:18Barry, where is your shirt?
0:15:22 > 0:15:24All right, hang on a minute.
0:15:25 > 0:15:26Can I just pause?
0:15:26 > 0:15:28Barry, You look so different.
0:15:28 > 0:15:31You've got dreadlocks.
0:15:31 > 0:15:32And no top on.
0:15:32 > 0:15:34LAUGHTER
0:15:38 > 0:15:39It must have been warm.
0:15:39 > 0:15:41Yes, yes.
0:15:41 > 0:15:43So I want to know all about you.
0:15:43 > 0:15:47Well, I spent 25 years with a big plc.
0:15:47 > 0:15:50And I managed to get made redundant four years ago.
0:15:50 > 0:15:52And that was an opportunity.
0:15:52 > 0:15:56It was an opportunity to do what I'm doing now. Having spent many years
0:15:56 > 0:16:00with a big company, working my 12 hours a day, short hair, suit,
0:16:00 > 0:16:03- I can now do what I want. - You've gone mad.
0:16:03 > 0:16:07I mean, look at me, I can do what I want, which is great. And I'm delighted I'm doing what I'm doing.
0:16:07 > 0:16:09I wish I'd done it ten years earlier.
0:16:09 > 0:16:12- You are a landlord? - I am a landlord, yes.
0:16:12 > 0:16:13What type of landlord are you, then?
0:16:13 > 0:16:16As my wife would say, I'm a very soft landlord.
0:16:16 > 0:16:19I'm too easy-going. I believe, in life, if you're courteous with
0:16:19 > 0:16:23people, if you're fair with people, they reciprocate. It goes both ways.
0:16:23 > 0:16:24Can I pause it?
0:16:26 > 0:16:29I really got a sense of you as quite a bubbly character.
0:16:29 > 0:16:31Yeah. Yeah.
0:16:31 > 0:16:35And you were really talking lots and lots and lots.
0:16:36 > 0:16:39Yes, yes, yes.
0:16:39 > 0:16:40I...
0:16:41 > 0:16:46That was fun...
0:16:48 > 0:16:50So your talking was really clear.
0:16:52 > 0:16:54- Yeah?- Yeah.
0:16:54 > 0:16:57- Yeah.- The other part of you as a landlord,
0:16:57 > 0:16:58you said to be courteous to people.
0:16:58 > 0:17:04- Yes.- So there's something about you and your communication that is very
0:17:04 > 0:17:06fair, courteous.
0:17:06 > 0:17:07Yes. Yes.
0:17:07 > 0:17:10- Yes.- We notice that now,
0:17:10 > 0:17:13we still notice that you have that...
0:17:15 > 0:17:16..sort of value of courtesy.
0:17:16 > 0:17:18Yes, yes, yes.
0:17:18 > 0:17:22Even though you have got aphasia.
0:17:22 > 0:17:23No.
0:17:27 > 0:17:30Thirsty...
0:17:33 > 0:17:36- Courtesy.- Kirsty.- Mm-hm.
0:17:39 > 0:17:40That...
0:17:42 > 0:17:43Oh!
0:17:58 > 0:18:01Brains have been around for a very, very long time.
0:18:01 > 0:18:05Human language, possibly as little as 100,000 or 200,000 years.
0:18:05 > 0:18:09So the view is it must have somehow been grafted onto brain regions that
0:18:09 > 0:18:12were already there. And if we look at some of those brain regions,
0:18:12 > 0:18:15those areas of the brain, we know do other things anyway.
0:18:15 > 0:18:17So the frontal part of the brain is to do with...
0:18:18 > 0:18:21..decision-making, memory.
0:18:22 > 0:18:24For instance, we have a verbal working memory,
0:18:24 > 0:18:28which seems to involve certain parts of the brain quite similar to,
0:18:28 > 0:18:31very close to, or identical with language areas.
0:18:31 > 0:18:34So it's possible, in the extreme view,
0:18:34 > 0:18:37that there is no such thing as a purely language part of the brain.
0:18:39 > 0:18:41Now I've sliced the brain,
0:18:41 > 0:18:43you can see the left side here where the red ink is...
0:18:45 > 0:18:46..is the Broca's speech area.
0:18:48 > 0:18:51Where a lesion there - a stroke or a tumour, for example -
0:18:51 > 0:18:55may cause an expressive aphasia,
0:18:55 > 0:18:59where they knew what they wanted to say, they could comprehend language,
0:18:59 > 0:19:02but they struggled to get the words out.
0:19:03 > 0:19:08You can see further back, where the blue ink is, that's the Wernicke area.
0:19:08 > 0:19:11A stroke there, for example, would cause receptive aphasia,
0:19:11 > 0:19:14where the sufferer can speak fluently
0:19:14 > 0:19:16but often devoid of any meaning.
0:19:19 > 0:19:22So I have here slices of a different brain.
0:19:22 > 0:19:23You can see...
0:19:25 > 0:19:29..in this area here, in the inferior frontal lobe,
0:19:29 > 0:19:32at this level there is an old cavity there,
0:19:32 > 0:19:35which is an old stroke or cerebral infarct.
0:19:35 > 0:19:36So, it's literally a hole, yeah.
0:19:36 > 0:19:40So the blood flowing to that part of the brain will have been cut off
0:19:40 > 0:19:42and that part of the brain will have died.
0:19:42 > 0:19:48So this patient may have had an expressive aphasia during life
0:19:48 > 0:19:51where they know what they want to say, but they can't get the words out.
0:19:53 > 0:19:57The modern view is that language is instantiated within the brain as a
0:19:57 > 0:20:03network of key nodes and that's probably why people can improve with
0:20:03 > 0:20:07therapy, because if there was just one region that did one job and
0:20:07 > 0:20:12nothing else, if that bit becomes damaged, how can anything take over?
0:20:12 > 0:20:14It's not possible, it's gone.
0:20:14 > 0:20:16Unless you grow a new bit of brain.
0:20:16 > 0:20:19Whilst the brain is changing all the time - it's a dynamic environment -
0:20:19 > 0:20:22it doesn't seem like you can grow a new brain any more than you can grow
0:20:22 > 0:20:25a new finger. But if we think of language function,
0:20:25 > 0:20:29if it's shared across multiple regions with multiple connections and there's damage to that network,
0:20:29 > 0:20:33that gives us some hope that therapy could work, because with a bit of
0:20:33 > 0:20:37experience-dependent learning we can perhaps retrain the brain
0:20:37 > 0:20:38to learn.
0:20:40 > 0:20:44Retraining Barry's brain to improve his communication is the business
0:20:44 > 0:20:47of the speech and language therapists on the neuro-rehab unit.
0:20:47 > 0:20:50Do you know any good strikers, then?
0:20:50 > 0:20:52Rooney.
0:20:52 > 0:20:55Sometimes Barry's sessions with Jonathan focus on straightforward
0:20:55 > 0:21:00conversation, the give and take that underpins all relationships.
0:21:00 > 0:21:02- He's a striker?- Yes. - All right. Tell me that.
0:21:02 > 0:21:07- So...- Wayne Rooney...- Is a...
0:21:07 > 0:21:09Striker.
0:21:09 > 0:21:10Right.
0:21:11 > 0:21:13Who does he play for?
0:21:13 > 0:21:17Erm... W... No, no, no.
0:21:18 > 0:21:20Ma... No, no, no.
0:21:20 > 0:21:24However effortful and fractured the conversation,
0:21:24 > 0:21:27it's still possible and meaningful.
0:21:27 > 0:21:30And Barry's identity, the Barry-ness of Barry,
0:21:30 > 0:21:32seems to transcend language.
0:21:32 > 0:21:35Manchester United.
0:21:36 > 0:21:37United.
0:21:38 > 0:21:40- Manchester United.- Yes.
0:21:41 > 0:21:42OK.
0:21:43 > 0:21:45- So...- Oh!
0:21:46 > 0:21:50Other sessions with Jonathan can feel more like a linguistic
0:21:50 > 0:21:54boot camp, in which Barry's given very specific language drills.
0:21:54 > 0:21:56- Jacket.- With me...
0:21:58 > 0:22:01- BOTH:- Where's my jacket?
0:22:01 > 0:22:05When, for example, you ask him to repeat phrases,
0:22:05 > 0:22:08are you...
0:22:08 > 0:22:11just trying to give him, like, a kind of card he can carry
0:22:11 > 0:22:16so he can answer that, he can use that as a useful sentence in social situations,
0:22:16 > 0:22:19or is the act of repeating and repeating and repeating
0:22:19 > 0:22:23somehow fixing a broken bit of his brain?
0:22:23 > 0:22:27I think we know that with the therapy that we're doing,
0:22:27 > 0:22:32what we're trying to achieve is generate neuro-plasticity,
0:22:32 > 0:22:35so the areas that are functioning in the brain that are still working for
0:22:35 > 0:22:40Barry, we're really trying to target and we're really trying to get to
0:22:40 > 0:22:44work better and compensate for the area that's been really damaged.
0:22:45 > 0:22:47So with exercises like the repetition,
0:22:47 > 0:22:51or with exercises like looking at pictures and hearing a sentence
0:22:51 > 0:22:55and trying to understand the meaning of that,
0:22:55 > 0:23:00we're working towards activating areas around the damaged area.
0:23:00 > 0:23:04I...need...some...help.
0:23:04 > 0:23:06Yeah?
0:23:06 > 0:23:12I...need...some...help.
0:23:12 > 0:23:15- Good.- You're using most of your brain all the time,
0:23:15 > 0:23:19you can't afford to have any spare bits doing nothing,
0:23:19 > 0:23:23but we've mentioned how the brain is a network and when you've got networks,
0:23:23 > 0:23:27it means you've got the potential to re-channel, so it's a simple analogy,
0:23:27 > 0:23:33but I think it's a reasonable one. If you think of a metro network like the London Underground and you take
0:23:33 > 0:23:37out King's Cross, a major node in that network,
0:23:37 > 0:23:40you say, "Well, is the whole thing going to come to a halt?"
0:23:40 > 0:23:42Initially, of course, there'll be all sorts of problems,
0:23:42 > 0:23:46but over time and with a bit of help, you could bypass.
0:23:46 > 0:23:50You're going to have to change here, here and here, whereas you would only have changed once.
0:23:50 > 0:23:53And I personally think that happens a lot with language.
0:23:53 > 0:23:56I think that's mainly what we're doing in terms of neuro-plasticity.
0:24:01 > 0:24:04The brain's plasticity is related to its age.
0:24:04 > 0:24:08The younger it is, the more it can adapt to new circumstances.
0:24:09 > 0:24:13Junior had youth on his side in his impressive recovery.
0:24:13 > 0:24:15That and the fact that, unlike Barry,
0:24:15 > 0:24:17he was brought quickly to hospital.
0:24:19 > 0:24:23In the world of neurology, they say "time is brain".
0:24:23 > 0:24:25For every hour without treatment,
0:24:25 > 0:24:29a stroke-affected brain ages by more than three and a half years.
0:24:31 > 0:24:35Junior was in hospital within 60 minutes of the onset of his symptoms
0:24:35 > 0:24:39and was given medication to dissolve the clot which was also physically
0:24:39 > 0:24:40removed from his brain.
0:24:44 > 0:24:47What happened on the day you had the stroke?
0:24:47 > 0:24:50I know you don't remember it all, but can you kind of take us through what happened?
0:24:52 > 0:24:57I was running with my dog, I was coming back home
0:24:57 > 0:24:58and...
0:24:58 > 0:25:01DOG WHIMPERS
0:25:01 > 0:25:04..I was near the Marriott Hotel...
0:25:04 > 0:25:06- Shut up.- ..and the stroke happened.
0:25:06 > 0:25:10- Shut up.- And when I got up, I was in hospital...
0:25:11 > 0:25:15..with my mum saying that I couldn't speak.
0:25:17 > 0:25:18I was...
0:25:18 > 0:25:20I was in a bad way.
0:25:21 > 0:25:23- Yeah?- Mmm.
0:25:25 > 0:25:27But now, I'm doing OK, but...
0:25:28 > 0:25:31- ..yeah.- Just came out of the blue?
0:25:31 > 0:25:33- Yeah.- No warning?
0:25:33 > 0:25:37- No.- No, I don't think so.
0:25:37 > 0:25:40I thought you said you had a blackout, you felt dizzy.
0:25:40 > 0:25:43Yeah, no, no, no, I felt dizzy.
0:25:43 > 0:25:46But I was thinking that...
0:25:47 > 0:25:48..I've not eaten.
0:25:48 > 0:25:50- Oh, OK.- Yeah.
0:25:50 > 0:25:52- On the day.- Yeah.
0:25:52 > 0:25:54Cos I run in the morning...
0:25:55 > 0:25:56..at five, no...
0:25:58 > 0:26:01- ..five o'clock.- Was Blanket actually with you when you had the stroke?
0:26:01 > 0:26:04- Yeah.- What did he do?
0:26:04 > 0:26:08- He ran home?- No, no, no, no, he came to my...
0:26:08 > 0:26:09He went on my test.
0:26:09 > 0:26:11- Chest.- Chest.
0:26:11 > 0:26:13Yeah.
0:26:13 > 0:26:19Actually, the ambulance, the lady that treated him,
0:26:19 > 0:26:24said Blanket was sitting on his chest and Blanket didn't want anyone to touch him.
0:26:24 > 0:26:29So, like, if they wanted to take off his clothes, he was barking.
0:26:31 > 0:26:35When you woke up, you came round, can you remember what you were thinking?
0:26:35 > 0:26:38Cos you couldn't speak - could you not have thoughts?
0:26:38 > 0:26:40Yeah, I had thoughts.
0:26:40 > 0:26:44But I'm saying that, "Where is my voice?"
0:26:45 > 0:26:47I was baffled, man.
0:26:49 > 0:26:51Could you understand what people were saying to you?
0:26:51 > 0:26:54Yes, yes, yeah.
0:26:54 > 0:26:57But I was thinking, like, "Where is my voice?"
0:26:58 > 0:26:59I cannot speak.
0:27:03 > 0:27:06Were you able to sort of have kind of conversations in your head?
0:27:06 > 0:27:11Were you able to kind of form in your mind what you wanted to say?
0:27:11 > 0:27:12Yeah.
0:27:14 > 0:27:18Yeah. But it was mad, man.
0:27:18 > 0:27:22Because I could think it, but I couldn't say it.
0:27:23 > 0:27:24And it was mad.
0:27:27 > 0:27:30Do you think a big part of the next challenge is your confidence?
0:27:30 > 0:27:32Yeah.
0:27:33 > 0:27:36I haven't got any confidence.
0:27:36 > 0:27:39- You've lost that.- Yeah, yeah.
0:27:39 > 0:27:40But it's OK.
0:27:40 > 0:27:42Did you tend to hide away, or...?
0:27:42 > 0:27:43Yeah.
0:27:48 > 0:27:50But that's life.
0:27:56 > 0:27:59Junior's stroke seemed to haunt him.
0:27:59 > 0:28:03His mother said that sometimes he spent whole days in bed,
0:28:03 > 0:28:06avoiding the risk of being in situations where his language
0:28:06 > 0:28:07might let him down.
0:28:11 > 0:28:13Do you make chicken soup?
0:28:13 > 0:28:14Yes.
0:28:15 > 0:28:18It's quite... It's quite nice, but it's not very difficult.
0:28:18 > 0:28:21It's not something that's... It's quite easy to do.
0:28:21 > 0:28:23Chicken soup.
0:28:23 > 0:28:26- Chicken soup.- Am I right?
0:28:26 > 0:28:27Chicken soup.
0:28:27 > 0:28:32For Barry, his world since his stroke is dominated by the here and now,
0:28:32 > 0:28:36his days divided between various therapies preparing him for the
0:28:36 > 0:28:39ultimate goal of a return to life at home.
0:28:41 > 0:28:44There's occupational therapy with Shauna,
0:28:44 > 0:28:48his key worker helping him with all aspects of practical daily life.
0:28:48 > 0:28:51Well done, yeah, that's OK. Bring your hand in.
0:28:55 > 0:29:00Physiotherapy is with Ellen, working to get Barry back on his feet.
0:29:00 > 0:29:02- Thank you.- Can you still breathe?
0:29:02 > 0:29:04- No. Yeah.- Yes.
0:29:04 > 0:29:06- Can you still breathe?- Yes.- Good.
0:29:07 > 0:29:14Left, right, left, right foot, left foot, right foot.
0:29:14 > 0:29:17And most weeks, Barry has a session with the unit's
0:29:17 > 0:29:20neuropsychologist, Sherilyn.
0:29:20 > 0:29:23It's her role to help Barry with his emotional life,
0:29:23 > 0:29:26especially his anxiety about returning home.
0:29:26 > 0:29:28Who's going to be at home tomorrow?
0:29:28 > 0:29:31- I don't know.- Cos Linda's in Spain, isn't she?
0:29:31 > 0:29:33- Yes.- Do you still have a house key?
0:29:35 > 0:29:36Yes.
0:29:36 > 0:29:38Wowee!
0:29:38 > 0:29:41Home seems to hover over everything.
0:29:41 > 0:29:45Sometimes, the prospect appears to excite Barry, but mostly,
0:29:45 > 0:29:46it fills him with dread.
0:29:46 > 0:29:50And then, if you feel comfortable, we will drive up to here.
0:29:50 > 0:29:52He'd made it clear that he was worried that with his
0:29:52 > 0:29:55language problems, he couldn't call for help.
0:29:55 > 0:29:56But it feels deeper than that.
0:29:57 > 0:30:00A series of home visits are planned by Barry's team.
0:30:00 > 0:30:06Photos and videos of his house are shown to him to try and reduce his anxiety.
0:30:06 > 0:30:08Is this a room that you would sit in a lot?
0:30:08 > 0:30:09- I don't know.- OK.
0:30:09 > 0:30:12I don't know.
0:30:12 > 0:30:14Are you trying to say to us that you're not sure how you're going to
0:30:14 > 0:30:17feel about this?
0:30:17 > 0:30:21I don't know. I don't know.
0:30:23 > 0:30:26- It's been a while, hasn't it? - I don't know.
0:30:29 > 0:30:31OK, shall we look at another picture, Barry?
0:30:32 > 0:30:36- What's this one?- Bathroom.
0:30:36 > 0:30:37Have things changed much?
0:30:39 > 0:30:42Yes. Yes.
0:30:42 > 0:30:43In the house or with you?
0:30:45 > 0:30:46Erm...
0:30:47 > 0:30:52- Both.- Does it still feel like your house?
0:30:52 > 0:30:53No.
0:30:54 > 0:30:56Yeah.
0:30:56 > 0:30:59But we'll do this in small stages until you feel comfortable,
0:30:59 > 0:31:03until you get used to it and then until it starts feeling more like
0:31:03 > 0:31:05your home.
0:31:05 > 0:31:07- You're doing really well.- No, no.
0:31:07 > 0:31:11No, no, these things will be difficult, Barry, they will.
0:31:12 > 0:31:14But this is the best way to do it,
0:31:14 > 0:31:17rather than just take you there and leave you.
0:31:18 > 0:31:20To deal with it, the anxiety.
0:31:20 > 0:31:25This is a nice, gradual way for you to get used to seeing it again.
0:31:25 > 0:31:27For you to connect again with your home.
0:31:29 > 0:31:30Oh.
0:31:34 > 0:31:39Barry, I think this plan of going there and experiencing what it feels
0:31:39 > 0:31:43like to be there will be really helpful for you.
0:31:43 > 0:31:46- Thank you.- Yeah.- You're not going to do it on your own.- Yeah.
0:31:48 > 0:31:50Oh...
0:31:50 > 0:31:51- Ready for another one?- Yes.
0:31:51 > 0:31:54- Go on, then.- I'm going to show you the outside of the van first.
0:31:54 > 0:31:55Are you ready?
0:31:58 > 0:32:01Linda said that you loved this van almost more than her.
0:32:03 > 0:32:04Is that true?
0:32:04 > 0:32:05Yeah.
0:32:07 > 0:32:09She's got a lot to compete with, hasn't she?
0:32:11 > 0:32:14That van...
0:32:14 > 0:32:16- Happy.- Happy.
0:32:16 > 0:32:20Happy, lucky, seven days a week.
0:32:20 > 0:32:23- Seven days a week you'd be in that van.- Yeah.
0:32:23 > 0:32:27No wonder Linda thinks you love it more than she does.
0:32:29 > 0:32:31P, Q, R...
0:32:31 > 0:32:33Now you're just doing the alphabet.
0:32:36 > 0:32:39- Michael's going to bring you up, OK? - Thank you.
0:32:45 > 0:32:47- Oh.- How are you feeling about this?
0:32:48 > 0:32:52I don't know whether...
0:32:52 > 0:32:53I... Confused.
0:32:55 > 0:32:59- Confused.- You're feeling confused?
0:32:59 > 0:33:00Yes.
0:33:16 > 0:33:17- One minute.- OK.
0:33:23 > 0:33:25Can we just drive up quite slowly, Mike?
0:33:25 > 0:33:31- Is that OK?- Just drive past quite slowly. OK. So we're just going to drive slowly past.
0:33:31 > 0:33:34- No.- Yeah.- No.
0:33:34 > 0:33:37- That one there.- That one there.
0:33:37 > 0:33:38That one there.
0:33:38 > 0:33:40OK.
0:33:51 > 0:33:54Yeah, ready, steady...
0:33:56 > 0:33:57It's all right.
0:34:03 > 0:34:06OK. So just look around slowly.
0:34:07 > 0:34:10Those pictures of your kids up on the mantelpiece.
0:34:14 > 0:34:15OK.
0:34:16 > 0:34:20Yep. All up there. Lots of pictures, aren't there?
0:34:20 > 0:34:24- Uh.- Three kids. Yeah, lovely.
0:34:24 > 0:34:26Are you happy to sit here for a while?
0:34:26 > 0:34:29- No, no, no.- Or do you want to go somewhere else?
0:34:29 > 0:34:33- I don't know.- Remember we said that you might be happy in the kitchen?
0:34:39 > 0:34:40Oh.
0:34:42 > 0:34:43Oh.
0:34:50 > 0:34:51OK.
0:34:58 > 0:35:00Look at this one.
0:35:01 > 0:35:02Oh.
0:35:07 > 0:35:10I don't know whether...
0:35:13 > 0:35:15It's a lovely photo, isn't it?
0:35:18 > 0:35:20Is it after you got married?
0:35:20 > 0:35:22You've got a ring on the finger there.
0:35:28 > 0:35:29Yeah. OK.
0:35:34 > 0:35:36And then more photos up here.
0:35:36 > 0:35:38These look like photos of parents.
0:35:38 > 0:35:39- Yeah.- Yeah.
0:35:41 > 0:35:42Is that... Is that you?
0:35:42 > 0:35:43- Yes.- Oh!
0:35:43 > 0:35:45Is that you and your brother?
0:35:45 > 0:35:47- Yeah.- Oh, and you had a dog, as well.
0:35:49 > 0:35:51Do you want to leave, Barry?
0:35:51 > 0:35:53Do you want to leave?
0:35:53 > 0:35:55- Yes.- You want to leave.
0:35:55 > 0:35:58- Yes.- All right.
0:35:58 > 0:36:00- Back to the ambulance. - Thank you.- OK.
0:36:05 > 0:36:09Aphasia is sometimes described as an invisible disability.
0:36:09 > 0:36:13It's only when you talk to someone that you might know it's there.
0:36:13 > 0:36:17And it's only by talking or trying to talk that a person with aphasia
0:36:17 > 0:36:20can make any degree of recovery.
0:36:20 > 0:36:22"Use it or lose it,"
0:36:22 > 0:36:25I was constantly told by the neurologists and therapists.
0:36:26 > 0:36:30Two years after his stroke, Junior's still struggling with this.
0:36:31 > 0:36:35He makes occasional visits to the neuro-rehab unit to discuss his
0:36:35 > 0:36:39progress with consultant speech and language therapist Jax.
0:36:39 > 0:36:41How has your week been?
0:36:41 > 0:36:44My week hasn't been too good.
0:36:44 > 0:36:45Why?
0:36:47 > 0:36:50Because the stroke, man.
0:36:50 > 0:36:54I know that it's for the rest of my life, yeah.
0:36:54 > 0:36:58- Yeah.- But it's getting me down a bit.
0:36:58 > 0:36:59Who do you talk to about that?
0:37:01 > 0:37:02No-one.
0:37:03 > 0:37:05So he had his stroke two years ago.
0:37:05 > 0:37:07Presented with severe aphasia.
0:37:07 > 0:37:11It was difficult to assess him cos his language was so impaired.
0:37:11 > 0:37:13Was he speaking at all?
0:37:13 > 0:37:16Not at the beginning, he wasn't speaking at all at the beginning.
0:37:16 > 0:37:18When I first saw him, he couldn't say anything at all.
0:37:20 > 0:37:23But started to make quite a...
0:37:24 > 0:37:26..quick recovery in the early stages
0:37:26 > 0:37:28of some words, some gestures.
0:37:28 > 0:37:31But it's been much slower in the last year.
0:37:31 > 0:37:34Is that because of the area of the brain that's been damaged,
0:37:34 > 0:37:38or is that because of his approach to the problem that he now faces?
0:37:38 > 0:37:41I think it's both. I think it's a psycho-social adjustment to the
0:37:41 > 0:37:46level he's at. It's about who you are, how you want to move forward.
0:37:46 > 0:37:52You know, some people with a level of language as Junior might do more,
0:37:52 > 0:37:54some people might do much less.
0:37:54 > 0:37:58But he doesn't go outside his safety zone at the moment.
0:37:58 > 0:38:02Your aphasia isn't the thing that's really stopping you doing these
0:38:02 > 0:38:04things any more, your aphasia's...
0:38:04 > 0:38:06You're good.
0:38:06 > 0:38:08Am I good?
0:38:08 > 0:38:13- Yeah.- But you see it, but why doesn't other people see it?
0:38:13 > 0:38:16- See what?- That I'm good.
0:38:17 > 0:38:19Do you behave differently, less confident?
0:38:19 > 0:38:21- Yeah.- Yeah.
0:38:21 > 0:38:23So in this room, you're quite confident, aren't you?
0:38:25 > 0:38:27Yeah. Do you remember...
0:38:27 > 0:38:29- Why is that?- Why do you think?
0:38:29 > 0:38:31But I know you?
0:38:31 > 0:38:33But when I spoke to...
0:38:33 > 0:38:34You don't like being judged.
0:38:34 > 0:38:37- Yes.- You don't like your communication being judged, do you?
0:38:37 > 0:38:38Yeah.
0:38:38 > 0:38:42- But I was...- But no-one likes that, being judged on their communication.
0:38:42 > 0:38:45No, of course. No, of course they don't.
0:38:45 > 0:38:51Of course they don't. With me, you, other people here,
0:38:51 > 0:38:53he communicates really quite well,
0:38:53 > 0:38:56in the moment, functionally, ably,
0:38:56 > 0:38:58and socially, to some degree.
0:38:58 > 0:39:00But beyond that,
0:39:00 > 0:39:05he doesn't have the free flow of language to communicate his needs,
0:39:05 > 0:39:06his thoughts.
0:39:07 > 0:39:08- But is that...?- It's a concern.
0:39:08 > 0:39:11But if he's having trouble having thoughts...
0:39:12 > 0:39:15- ..is that because he can't...? - He says he doesn't have.
0:39:15 > 0:39:18But does he need language to have thoughts?
0:39:18 > 0:39:20Well, that's... That's the million-dollar question.
0:39:23 > 0:39:28Some patients claim that they just really have a problem with word-finding.
0:39:28 > 0:39:31They feel like it's about this gap between having ideas and then
0:39:31 > 0:39:33having the words to express them.
0:39:33 > 0:39:36They just can't grab the words in order to spit them out to tell them
0:39:36 > 0:39:38to you. And in that case,
0:39:38 > 0:39:41you can almost think of them as someone who is language-locked-in,
0:39:41 > 0:39:43so that inside their head,
0:39:43 > 0:39:46everyday language is going on relatively normally.
0:39:46 > 0:39:49But when they want to communicate with you and find those language
0:39:49 > 0:39:52tokens and spit them out as speech, they can't do it.
0:39:52 > 0:39:54I'm not sure how common that happens.
0:39:54 > 0:39:57I think there's a bit of a halfway house where if your word-finding
0:39:57 > 0:39:59difficulties are bad enough, you will also...
0:39:59 > 0:40:02Certain ideas are hard to grasp, as well,
0:40:02 > 0:40:05because you just cannot hold certain abstract ideas in your mind if you
0:40:05 > 0:40:07haven't got those language tokens...
0:40:08 > 0:40:09..as sort of placeholders.
0:40:12 > 0:40:13But we can almost judge from behaviour,
0:40:13 > 0:40:18so patients with aphasia have not lost knowledge of the world,
0:40:18 > 0:40:21they do not have what we call a semantic problem with the world.
0:40:21 > 0:40:25They may make what we call semantic errors, so when they want to say dog, they may come out with cat,
0:40:25 > 0:40:27but that is a sort of language error.
0:40:27 > 0:40:30They know what a dog is, they know what a cat is, they know who you
0:40:30 > 0:40:32are, they know who they are, they know everything around them.
0:40:32 > 0:40:35So they don't have a problem with understanding the world,
0:40:35 > 0:40:38but they have a problem with the language aspects,
0:40:38 > 0:40:40the way of understanding the world in a more abstract level.
0:40:46 > 0:40:49It seemed to me that Junior's discomfort in the world in a sense
0:40:49 > 0:40:53confirms his understanding of the world and the situation that he
0:40:53 > 0:40:55finds himself in with his aphasia.
0:40:58 > 0:41:01- Hello, Daddy.- She's videoing you.
0:41:01 > 0:41:04My brother-in-law's aphasia was very different.
0:41:04 > 0:41:09- Hello.- Dennis' stroke had been like a sniper attack on his language only,
0:41:09 > 0:41:10sparing his mobility,
0:41:10 > 0:41:13but leaving him speaking a sort of colourful gibberish,
0:41:13 > 0:41:16with all the rise and fall of meaning,
0:41:16 > 0:41:18but none of the actual sense,
0:41:18 > 0:41:20at least not to anyone else.
0:41:20 > 0:41:23Dennis, can you say something for the camera?
0:41:23 > 0:41:25Say something, make a speech.
0:41:25 > 0:41:27Hello.
0:41:27 > 0:41:30UNINTELLIGIBLE WORDS
0:41:30 > 0:41:32LAUGHTER
0:41:35 > 0:41:38It wasn't ever entirely clear -
0:41:38 > 0:41:42did Dennis think he was making sense and we were not?
0:41:42 > 0:41:46Did he understand others from their words or from their actions and gestures?
0:41:48 > 0:41:51Dennis lived like this for four years until his death.
0:41:51 > 0:41:54It must have been isolating, lonely,
0:41:54 > 0:41:57despite being at home with those he loved.
0:41:59 > 0:42:01Is it nearly lunchtime?
0:42:07 > 0:42:09In the weeks after Barry's first home visit,
0:42:09 > 0:42:11his mood declines dramatically.
0:42:14 > 0:42:16He seems to withdraw from the world,
0:42:16 > 0:42:20as if the home visit had been a sort of statement of all that he's lost,
0:42:20 > 0:42:22something too much to bear.
0:42:22 > 0:42:25Barry, I'm going to do your hair.
0:42:25 > 0:42:29Even with his closest friend, Barry seems to shut down.
0:42:29 > 0:42:31Barry, do I look funny with glasses?
0:42:31 > 0:42:32Yeah.
0:42:37 > 0:42:40I'm quite nervous doing your hair, by the way.
0:42:40 > 0:42:42It's very tricky, you know.
0:42:42 > 0:42:43Very tricky, Barry.
0:42:45 > 0:42:49- OK?- It's hard to know what's going on in Barry's head.
0:42:50 > 0:42:53It must be exhausting, forever hunting for that
0:42:53 > 0:42:56tip-of-the-tongue thing when you can't quite
0:42:56 > 0:42:58get to the word, the name or the place
0:42:58 > 0:43:01that you know is in there somewhere. If only.
0:43:03 > 0:43:07And I'd heard that one patient with aphasia had described his thoughts
0:43:07 > 0:43:11as sticky, as though the inner chitchat of daily thinking
0:43:11 > 0:43:14got constantly snagged on its way out into the world.
0:43:14 > 0:43:16This is true friendship.
0:43:16 > 0:43:18It's been a pleasure.
0:43:18 > 0:43:20I'm going to take this off.
0:43:20 > 0:43:22How long have you two guys known each other?
0:43:24 > 0:43:27Barry, how long have we known each other?
0:43:27 > 0:43:28Barry.
0:43:28 > 0:43:30How long have you known me?
0:43:32 > 0:43:34How long have you known me, Barry?
0:43:35 > 0:43:36Ten years?
0:43:38 > 0:43:42- 22 years.- 22 years, yeah, move forward a bit.
0:43:42 > 0:43:4422 years, roughly.
0:43:44 > 0:43:45All right.
0:43:47 > 0:43:50I'll clean you up, don't worry.
0:43:50 > 0:43:51You happy? OK.
0:43:53 > 0:43:56OK. Give me two minutes, I'll just finish it.
0:44:09 > 0:44:10How are you?
0:44:12 > 0:44:14How are you feeling in yourself?
0:44:16 > 0:44:17I hear it's been a hard week.
0:44:19 > 0:44:20Yeah?
0:44:24 > 0:44:31I know that when you come closer to going home, it gets difficult.
0:44:31 > 0:44:36OK. But when you go home, you will have more support,
0:44:36 > 0:44:39there will be more therapists from the community.
0:44:40 > 0:44:43OK? Six months here is a long time.
0:44:43 > 0:44:49It's good to get home because you won't need to be in a hospital,
0:44:49 > 0:44:53you'll need to be at home with people coming to you,
0:44:53 > 0:44:56you know, doing the things you want to do in your house.
0:44:56 > 0:44:58OK?
0:44:58 > 0:45:00Because here, it's not home.
0:45:00 > 0:45:01You know?
0:45:03 > 0:45:05But you will still have ongoing...
0:45:06 > 0:45:08..rehabilitation, OK?
0:45:08 > 0:45:10It doesn't stop when you leave us.
0:45:11 > 0:45:13Yeah?
0:45:17 > 0:45:18OK.
0:45:20 > 0:45:23So when I see Barry on his own in the day room, sitting there,
0:45:23 > 0:45:26is his head sort of in conversation, or is it a blank space?
0:45:27 > 0:45:29Erm...
0:45:29 > 0:45:31- Or we don't know?- Who can know?
0:45:31 > 0:45:33He can't tell us, so everything is...
0:45:35 > 0:45:36..an assumption, really.
0:45:36 > 0:45:38You know, it's very difficult, you know,
0:45:38 > 0:45:44if somebody is not able to write and is not able to speak,
0:45:44 > 0:45:46it's very difficult to know exactly what's going on.
0:45:47 > 0:45:51We can ask whether he has a word in his head, you know,
0:45:51 > 0:45:54but he can't get it out, or he's searching for a word.
0:45:54 > 0:45:56It's very difficult to drive that down.
0:45:56 > 0:45:58I would imagine
0:45:58 > 0:46:01there's a lot of activity there - whether it's with words,
0:46:01 > 0:46:03it's difficult to say for him.
0:46:03 > 0:46:07But we are aware he is significantly cognitively impaired, as well.
0:46:07 > 0:46:09His ability to process things,
0:46:09 > 0:46:13the speed with which he kind of works through things and generates
0:46:13 > 0:46:15an output has been impacted on.
0:46:24 > 0:46:27You would have trouble understanding your place in the world if you lived
0:46:27 > 0:46:29on a desert island and had nobody to talk to,
0:46:29 > 0:46:31so when you discuss things with people, your ideas change.
0:46:31 > 0:46:33That's the whole point.
0:46:33 > 0:46:36The other thing I'd say is that language is social.
0:46:36 > 0:46:38I mean, Wittgenstein tells us that and I think he's right.
0:46:38 > 0:46:41So there's no such thing as a private language, there's no...
0:46:41 > 0:46:44There's no utility to a private language, there's no point in it.
0:46:44 > 0:46:46I'm not sure I fully understand that.
0:46:46 > 0:46:51Is that the notion that language only exists for social interaction?
0:46:51 > 0:46:56So we may all have a different, or slightly different, perception of
0:46:56 > 0:47:00red, or what we would call red. I mean, this is a classical argument.
0:47:00 > 0:47:03How do I know that the red you're seeing is the red I'm seeing?
0:47:03 > 0:47:06At some level, we'll never know that, because that's to do with perception.
0:47:06 > 0:47:09But as soon as we give it a label, and we call it red, that's when we
0:47:09 > 0:47:12start discussing it and it becomes a thing for both of us.
0:47:12 > 0:47:16And we know that we've got a shared object or subject that we're talking
0:47:16 > 0:47:18about, and that's really what Wittgenstein meant when he said
0:47:18 > 0:47:21there's no such thing as a private language.
0:47:21 > 0:47:24Sorry, Barry, just giving your leg a bit of a stretch.
0:47:27 > 0:47:29So, Barry, if I wanted to buy in south London...
0:47:29 > 0:47:32- Yeah.- ..what area would you recommend me to buy?
0:47:32 > 0:47:36- Leytonstone. - What about South London?
0:47:36 > 0:47:38- Clapham.- Clapham?
0:47:38 > 0:47:40- Yeah.- That's expensive.
0:47:40 > 0:47:42Not for my budget, I don't think.
0:47:42 > 0:47:44- Lewisham.- Lewisham.
0:47:44 > 0:47:46OK. Catford area, around there?
0:47:46 > 0:47:48- Maybe.- Yeah.
0:47:50 > 0:47:54£800,000.
0:47:54 > 0:47:56- £800,000?- Yeah.
0:47:56 > 0:47:57Yeah, I don't have that kind of money,
0:47:57 > 0:48:02I don't think I've got a deposit to put on that.
0:48:02 > 0:48:05I'm going to have to move out of London, Barry.
0:48:05 > 0:48:07Yes. Yes.
0:48:10 > 0:48:12Good. Better.
0:48:14 > 0:48:16OK.
0:48:16 > 0:48:17- You all right?- Yes.
0:48:17 > 0:48:20So we're going to do some walking on that leg.
0:48:20 > 0:48:21- Yes.- OK. Off we go.
0:48:24 > 0:48:26Right, bigger steps. You OK?
0:48:26 > 0:48:29- Yes.- OK. Bigger step on the right.
0:48:29 > 0:48:31Big step.
0:48:31 > 0:48:33Good. Now, a bit faster.
0:48:39 > 0:48:42That's it. Bigger step on that leg.
0:48:42 > 0:48:46For both Barry and Junior - for everyone with aphasia -
0:48:46 > 0:48:49it seems that being able to be in the world with depleted language
0:48:49 > 0:48:53is the most essential, but also the hardest task of all.
0:48:57 > 0:48:59What have you been up to?
0:48:59 > 0:49:01Now?
0:49:01 > 0:49:03No, since I last saw you.
0:49:03 > 0:49:05Since I last saw you?
0:49:07 > 0:49:09I went to the cinema...
0:49:11 > 0:49:13..this weekend.
0:49:13 > 0:49:15I saw Fast And Furious 8.
0:49:17 > 0:49:18It was good, man.
0:49:20 > 0:49:22But this...
0:49:22 > 0:49:28Vin Diesel has got to stop acting in Fast And Furious.
0:49:28 > 0:49:31He's done it eight times, man.
0:49:33 > 0:49:34Yeah.
0:49:36 > 0:49:41Yeah, but, Vin Diesel is a good actor.
0:49:43 > 0:49:44What have you got coming up, any plans?
0:49:44 > 0:49:46I need to get my...
0:49:48 > 0:49:51..communication back on point
0:49:51 > 0:49:54with speech and language therapists.
0:49:54 > 0:49:56Have you found one you're going to work with?
0:49:56 > 0:49:58Yeah. Yeah.
0:49:58 > 0:50:01Great. How often are you seeing someone?
0:50:01 > 0:50:02- Twice a week.- Great.
0:50:03 > 0:50:05Is that going well?
0:50:06 > 0:50:08It's going OK.
0:50:08 > 0:50:11- It's going OK.- Good.
0:50:17 > 0:50:21I'm cold, man. Yeah, yeah.
0:50:21 > 0:50:22- You better go.- Yeah.
0:50:24 > 0:50:26- See you later, man.- OK.
0:50:26 > 0:50:28- All right.- Thank you for coming here.
0:50:35 > 0:50:37Yeah, cool.
0:50:37 > 0:50:41- Oh!- As Barry's stay on the unit approaches its end,
0:50:41 > 0:50:43despite his many improvements,
0:50:43 > 0:50:46he remains reluctant to accept that he will soon be moving home.
0:50:48 > 0:50:50After almost seven months in hospital,
0:50:50 > 0:50:54it's understandable that the institution has become the home.
0:50:55 > 0:50:57But it feels more than that.
0:50:57 > 0:51:00It seems that part of the problem for Barry is not being able to
0:51:00 > 0:51:03acknowledge the progress that he is making,
0:51:03 > 0:51:06nor perhaps accept the extent of the damage to his brain.
0:51:06 > 0:51:13That's what it looks like if you've got a problem in your language area.
0:51:13 > 0:51:16Brains just don't get better easily.
0:51:16 > 0:51:18As you know. How many months?
0:51:22 > 0:51:24Six months. Seven months.
0:51:24 > 0:51:25Yes, yes.
0:51:25 > 0:51:27And have you got better?
0:51:28 > 0:51:29- No.- No?
0:51:31 > 0:51:33- Yes.- What's got better?
0:51:34 > 0:51:36What can you do now?
0:51:36 > 0:51:38What can your brain still do?
0:51:39 > 0:51:42- Think.- Think, yeah.
0:51:42 > 0:51:44- Talk?- Talk.
0:51:47 > 0:51:50- Walk.- Walk.- It's supposed to be walk, it's a funny gesture.
0:51:50 > 0:51:53- Walk.- Sometimes, you get cross because it's not happening
0:51:53 > 0:51:55- quick enough.- Yeah.
0:51:56 > 0:51:58Are you OK about that some days?
0:51:58 > 0:51:59And then not on other days?
0:51:59 > 0:52:00- No.- No.
0:52:00 > 0:52:03- Always want it to be quicker, don't you?- Yes, yes.- It's all right.
0:52:03 > 0:52:06It's a tough one. So tough, Barry.
0:52:10 > 0:52:11How do you...
0:52:12 > 0:52:16How do you, you know, keep getting motivated?
0:52:16 > 0:52:20- I don't know.- Because you are so good at that.
0:52:20 > 0:52:22Oh, you hate people praising you, don't you?
0:52:24 > 0:52:26You don't like it when I praise you. No.
0:52:28 > 0:52:31It's not a great thing, is it, a stroke? No.
0:52:36 > 0:52:39Five days before his final discharge,
0:52:39 > 0:52:41Barry goes on one last home visit.
0:52:45 > 0:52:49On Tuesday, then, what time do want to go?
0:52:49 > 0:52:51I don't know.
0:52:51 > 0:52:54Most people kind of stick around until just after lunch.
0:52:54 > 0:52:56- They have some tea and cake with everybody.- Yeah.
0:52:56 > 0:53:00- Do you want to do something like that so that you can say goodbye to everyone?- Yes. No.
0:53:02 > 0:53:04I don't want...
0:53:06 > 0:53:08- ..fuss.- You don't want a fuss?
0:53:10 > 0:53:14OK. And when you are saying you do not want a fuss,
0:53:14 > 0:53:16what do you mean by that, Barry?
0:53:20 > 0:53:22Are you talking about when you come home?
0:53:27 > 0:53:30I don't know whether...
0:53:32 > 0:53:34..it's viable.
0:53:36 > 0:53:37- Viable?- Viable.
0:53:37 > 0:53:40- Yes.- OK.
0:53:40 > 0:53:44So you... Are you talking about coming home and managing at home?
0:53:47 > 0:53:49- No.- OK.
0:53:49 > 0:53:51Are you talking about needing some help at home?
0:53:51 > 0:53:53- Yes.- Yeah.
0:53:53 > 0:53:58Debs and the community team, they are there to help you get stronger.
0:53:58 > 0:54:00So rehab isn't over.
0:54:01 > 0:54:03You don't need to stay in with us, Barry.
0:54:03 > 0:54:05You need to come home now.
0:54:09 > 0:54:10Yeah?
0:54:12 > 0:54:14On the eve of Barry's last day in the unit,
0:54:14 > 0:54:19he and Linda have a final meeting with a neuropsychologist, Hannah.
0:54:20 > 0:54:25How do you feel about your relationships at the moment
0:54:25 > 0:54:27with Linda or with your children?
0:54:29 > 0:54:31In terms of being able to speak with them?
0:54:33 > 0:54:36How do you feel you get on with Linda when you can't speak so clearly?
0:54:41 > 0:54:44Hit and miss. And can I ask Linda the same question?
0:54:44 > 0:54:46Yes.
0:54:46 > 0:54:50How is it for you in terms of your relationship with Barry since he has
0:54:50 > 0:54:52not been able to speak so clearly?
0:54:54 > 0:54:55Sad.
0:54:57 > 0:55:02One of the things which we know following a stroke is that people
0:55:02 > 0:55:04have lots of losses.
0:55:04 > 0:55:07- Yes.- And one of the most significant losses that can happen is
0:55:07 > 0:55:09- in terms of aphasia...- Yes.
0:55:09 > 0:55:13..and not being able to speak so clearly or understand easily.
0:55:13 > 0:55:20- Yes, yes.- And it then leads to a whole element of
0:55:20 > 0:55:26what your role is and what other people's role is who you know
0:55:26 > 0:55:29and the difficulties that can follow
0:55:29 > 0:55:33in the renegotiation of relationships.
0:55:33 > 0:55:35Is that something that you have experienced, Linda?
0:55:35 > 0:55:36Mm.
0:55:40 > 0:55:43Hassle, hassle, hassle.
0:55:43 > 0:55:45- Hassle.- Yeah.
0:55:45 > 0:55:49Is that hassle for you, or do you feel that you are a hassle?
0:55:57 > 0:55:58I don't know.
0:55:59 > 0:56:00I don't know.
0:56:02 > 0:56:04Hassle, hassle, hassle.
0:56:06 > 0:56:07Hassle for who?
0:56:09 > 0:56:12- You.- Me?
0:56:12 > 0:56:15- Me, you.- For you, as well?
0:56:15 > 0:56:17- Yes.- And for me?- Yes.
0:56:17 > 0:56:22What you used to say all the time was, "It is what it is."
0:56:22 > 0:56:25- Yeah.- When things happened. - Yeah.- Well, it is what it is.
0:56:25 > 0:56:29- Yes.- So, it is what it is, you have had a stroke,
0:56:29 > 0:56:32and now you need to come home tomorrow and continue with your
0:56:32 > 0:56:34rehabilitation at home.
0:56:34 > 0:56:35Yes.
0:56:35 > 0:56:40# Regrets, I've had a few
0:56:40 > 0:56:43# But then again...
0:56:43 > 0:56:46# Too few to mention... #
0:56:46 > 0:56:47I don't know.
0:56:51 > 0:56:53Six months. Six months he has been in this bed.
0:56:54 > 0:56:56Six long months.
0:57:00 > 0:57:04# I've planned each charted course
0:57:05 > 0:57:08# Each careful step... #
0:57:09 > 0:57:11Are you feeling ready for this?
0:57:13 > 0:57:14Yes.
0:57:15 > 0:57:17# Much more than this...
0:57:17 > 0:57:22# I did it my way. #
0:57:26 > 0:57:30OK, so, which hand do you want to shake with? That hand, or that hand?
0:57:30 > 0:57:32I don't know.
0:57:36 > 0:57:38Both hands.
0:57:39 > 0:57:40Really good.
0:57:42 > 0:57:44Yeah.
0:57:44 > 0:57:48- Thank you, thank you, thank you. - Thank you.- Thank you.
0:57:48 > 0:57:49You are very welcome.
0:57:49 > 0:57:53- Yeah, yes. Yeah. - I've enjoyed working with you.
0:57:53 > 0:57:57- Thank you, thank you, thank you. - You're very welcome.
0:57:57 > 0:57:59Oh, well done.
0:57:59 > 0:58:00It's been a pleasure.
0:58:06 > 0:58:07Bye-bye.
0:58:09 > 0:58:11Bye-bye.
0:58:14 > 0:58:16- No tears.- Bye, Barry.
0:58:16 > 0:58:17I'm going to cry.
0:58:20 > 0:58:22All the very best.
0:58:22 > 0:58:25Do you know what? We are going to turn around.
0:58:25 > 0:58:28Are you going down? Yeah, we're going down.
0:58:28 > 0:58:30Oh, look, we've got the farewell party.
0:58:30 > 0:58:32Ellen and Shauna.
0:58:32 > 0:58:34Our girls, our best girls.
0:58:37 > 0:58:41- Bye. Bye.- Bye.
0:58:41 > 0:58:43Bye. Bye.
0:58:43 > 0:58:49# And now, as tears subside
0:58:49 > 0:58:54# I find it all so amusing
0:58:56 > 0:59:00# To think I did all that
0:59:01 > 0:59:07# And may I say, not in a shy way
0:59:08 > 0:59:13# Oh, no, oh, no, not me
0:59:14 > 0:59:19# I did it my way... #