Music helps woman reclaim her voice
Playing the piano was crucial to Allison Woyiwada’s recovery following brain surgery
OTTAWA — It all started with the smell of rotting garbage.
In the summer of 2011, retired Ottawa music teacher Allison Woyiwada was plagued by horrible odours that could not be detected by anyone else.
She took to her computer in search of answers and was unnerved by what she discovered: The phenomenon, known as phantosmia, could be caused by anything from a simple infection to a brain tumour or Parkinson’s disease. In late October, her family doctor referred her to The Ottawa Hospital for a brain scan.
Woyiwada and her husband, Robert McMechen, received the results a week before Christmas.
The scan had uncovered a giant aneurysm — a balloonlike bulge in a major blood vessel in her brain. On Christmas Eve, a diagnostic imaging test confirmed the existence of a sleeping giant the size of a crabapple.
Neurosurgeon Dr. Howard Lesiuk presented the 60-yearold Woyiwada with some terrible calculus. If she did nothing, and lived with her sleeping giant, she would face a 40 per cent chance of a catastrophic rupture within five years. If she opted instead for surgery — a complex operation in a hardto-reach region of the brain — there was a 10 to 20 per cent chance that she would suffer a stroke or die.
Woyiwada shared her diagnosis with family and friends through an email group labelled, ‘Allison’s Brain.’ On Jan. 20, 2012, in her second update, she told the group that she had made up her mind.
“If it (the aneurysm) can stay put for the next few weeks, I’ll let the surgeons work their magic,” she wrote.
That decision launched Woyiwada on an epic medical odyssey.
The teacher
Allison Cameron took up piano as a Grade 4 student in Portage la Prairie, Man. Her aunt owned the local music store which helped satisfy Allison’s voracious appetite for new, more challenging sheet music. She became the pianist for a church choir and a residential school glee club; she played the national anthem each morning at school.
In high school, a guidance counsellor told her about a music degree offered by Brandon University and she leaped at the chance. Allison graduated four years later with a teaching certificate and a yearbook caption that best captured her life’s philosophy: “If there is no struggle, there is no progress.”
In Winnipeg, she launched a career as a music teacher, pursued opportunities as an opera singer, and married a fellow musician and lawyer, Rick Woyiwada. Together they raised two children, Tyler and Marya. The family moved to Ottawa in 1981. There, Woyiwada began her tenure at Hopewell Avenue Public School the next year.
Woyiwada became a muchloved institution at the school, directing the school band and staging countless musicals.
When she retired in 2008, Hopewell named its music
The activity of playing allows my mind to do anything it cares to do.
ALLISON WOYIWADA
award and a wing of the school in her honour.
Not yet 60, she went to work as an office manager for Robert McMechen, the Ottawa tax lawyer with whom she had fallen in love with after splitting up with Rick Woyiwada in the early 1990s. The couple was planning to slow down and travel more when she suddenly began to smell garbage in all the wrong places.
The surgery
After several anxiety-inducing delays, Woyiwada’s surgery was set for 8 a.m. on May 28, 2012 — the early start needed because it was expected the operation would last a full day.
The surgical plan was complex. Woyiwada’s heart and lung function would be taken over by a machine. Her blood would be circulated through the machine and cooled until her body was hypothermic. At a critical point in the surgery, her circulation would be stopped altogether as the aneurysm was removed and her arteries repaired. Woyiwada’s circulation would then be restored and her body slowly rewarmed as surgeons managed the inevitable bleeding.
The surgery, which effectively puts the patient in a state of hibernation or suspended animation, had been performed only once before in Ottawa.
The operation took place at the University of Ottawa Heart Institute because it had the heart- lung bypass machine required to interrupt Woyiwada’s circulation and still her heart.
Lesiuk and fellow neurosurgeon Dr. Amin Kassam, who had planned and rehearsed the operation for weeks with the surgical team, opened Woyiwada’s skull, exposed her brain, and prepared it for the operation’s climactic phase: when the blood flow in her body would be halted.
Once that happened, they would have 30 minutes to remove the aneurysm and repair the artery. Depriving the brain of blood any longer would increase the chance of permanent damage.
When the heart-lung machine was shut off, the surgeons worked quickly. They dissected around Woyiwada’s sleeping giant — it was even larger than they had anticipated — cleaned out some clotted blood, then deflated and collapsed the aneurysm.
Thirteen hours later, the surgical team completed its work. Lesiuk called McMechen and told him the operation had gone “fairly smoothly” and that the team was happy with the results.
Much later, Lesiuk would tell McMechen that Woyiwada had come “as close to dying as anyone can without actually dying” during surgery.
The music
Three months after the operation, Marya Woyiwada wheeled her mother to a piano in a public lounge on the second floor of The Ottawa Hospital’s Civic campus.
Woyiwada’s recovery had been more fraught than expected. By late August, she still had immense difficulty communicating. Although voluble at times, her sentences made little sense. Her working memory was not functioning.
Woyiwada was in a wheelchair and still wearing a helmet — the bone flap in her skull had yet to be replaced — when she sat at the piano. Some sheet music had been left behind.
Woyiwada looked at the piece — the second movement of Beethoven’s Sonata Pathétique, adjusted her hands on the keyboard, and played. Beautifully.
Marya was near tears. Woyiwada’s performance proved to Marya — and others — that the ‘old Allison’ was still there, deep inside a muddled brain.
Inspired by his wife’s sonata, McMechen searched for ways to incorporate more music into her rehabilitation. He found Cheryl Jones’s name online.
A longtime Ottawa music teacher, Jones had returned to university to study music therapy after seeing it help two of her students manage terminal illnesses. “I began to see music playing a role in people’s lives that went beyond education,” she says, “and I began to read everything I could find about the neurology of music, the way it stimulates different sites in the brain.”
Jones, a music therapist since 2007, began to work with Woyiwada in September 2012. At that first meeting, Jones pointed to a cup and Woyiwada called it a “raindrop.” A pen was “a lion.” A briefcase was “a book.”
Since it was obvious Woyiwada needed help finding the right words, Jones devised a plan to use music as a “back door” to her brain’s language repository. The idea was to recruit neural networks from the right hemisphere of Woyiwada’s brain — where melody is processed — to make up for damage in the speech centre of her brain’s left hemisphere.
Jones began by associating short phrases such as, “I am tired,” with a simple melody. Playing the notes helped Woyiwada deploy the associated words. She learned to sing them in response to such questions as, “How are you feeling?”
The music steadily worked its magic. After 15 months, Woyiwada was able to retrieve newly learned phrases without a melodic cue.
The encore
Late last year, Woyiwada returned to the stage.
At a Christmas concert with the Ottawa Brahms Choir, Woyiwada was able to sing in English, French and German. Little more than a year after fearing she might never again have the ability to make herself understood, Woyiwada completed a bravura performance in three languages.
Today, Woyiwada has few cognitive deficits. She relies on the dictionary for help sometimes and has problems with conversations that take sudden, unexpected shifts, but otherwise she’s back to being the ‘old Allison.’
She regards her medical journey as another lesson in a lifetime of teaching.
It’s one of the reasons that Woyiwada and her husband wrote a book — Allison’s Brain — about their experience.
Woyiwada credits her surgeons, family and speech and music therapists with helping her reclaim her life.
But fundamental to that successful recovery, she believes, was her faith in hard work: “If there is no struggle, there is no progress.”
The piano, she says, remains her instrument of freedom:
“The activity of playing allows my mind to do anything it cares to do.”