Singing Beatles hits helped Peter speak again after a stroke
The ability to talk is not something most of us give a second thought—it had certainly never occurred to me how bereft I’d feel without my voice. Then one day I woke up in a hospital bed robbed of the power to utter a single word.
I’d had a stroke. It came without warning and wreaked havoc on my well-being and ability to communicate.
It happened as I was preparing for a picnic in June last year. I was with my youngest daughter, Isabella, 12, putting up the garden umbrella when I suddenly felt strange, dizzy and light-headed.
At the same time I felt something ‘click’ inside my head. I didn’t lose consciousness, my face didn’t droop — some of the characteristic signs of a stroke — but it felt like the worst migraine ever, with flashing lights and double vision.
I tried to speak but all the words were jumbled. My partner, Barbara, realised I was having a stroke and drove me to hospital.
At that point I was still walking and talking, though with decreasing fluency. The stroke, which was caused by a blood clot in the brain, was yet to have its full impact.
I remained at the University hospital of South Manchester NhS Foundation Trust, in Wythenshawe, for three hours while I was scanned and tested.
eventually, I was transferred by ambulance, blue lights flashing, to a special stroke centre 15 miles away f or clot- busting treatment. All the while my speech was fading.
I stayed in the centre overnight while doctors checked that the treatment had worked and that they had stopped the stroke before it could do any more damage.
BUT when I woke, after a restless night, I realised with increasing panic that I couldn’t speak. I could only gesture.
Another scan revealed the stroke had occurred on the left side of my brain — the side that controls speech.
I was taken back to the University hospital, which has a stroke rehabilitation unit that offers intensive therapy whatever your needs — physio, occupational or, in my case, speech and language therapy.
I would need to learn to speak again. My predicament is known formally as aphasia — the inability to produce speech as the result of brain damage.
There are 400,000 people with aphasia in the Uk, many of them because of a stroke. I suffer from expressive aphasia, which means I know what I want to say, but have trouble getting the words out or even writing what I mean.
There are three other types: receptive, where you hear a voice or see words on a page, but they make no sense; anomic, where you have trouble thinking of the right words in the first place; and global, where you can’t speak, understand speech, read or write.
At that point in hospital, the finer details of my form of aphasia seemed meaningless.
I have worked as a journalist and documentary film-maker for 40 years and communication is key to everything I do. As I lay in my hospital bed, I could only think that this was it: my life as I knew it was over.
There was sadness, rage and a stifling sense of loss.
For the first time in my life I felt depressed and retreated into my own world. The one thing that gave me any pleasure was music.
Then suddenly I found hope. Four days after my stroke I was lying in bed listening to a Beatles track and found that I could sing along. To the amusement of the ward, I was singing aloud I Should have known Better. There was no effort needed to get the words out.
But when my headphones came off and the music stopped, so did my speech — and I was back to drawing pictures and gesturing to communicate with everyone.
I filmed myself singing using my phone, ready to show to anyone who thought I was delusional.
When Cat Blakemore, my speech therapist in the stroke unit, saw my film, she suggested that a treatment known as Melodic Intonation Therapy (MIT) could work for me.
MIT was first used for patients with aphasia in the U.S. in the late Seventies. however, without much evidence to go on there were doubts about its effectiveness; it is still not entirely clear how MIT works.
The idea is to reduce the brain’s dependency on the left side for speech by engaging other brain areas to do the job instead. With the help of a speech therapist, patients put their words — the everyday things they want to say — to familiar music.
The brain is effectively being rewired and eventually this means speech can be generated from the right side of the brain.
Dr Gottfried Schlaug, an associate professor of neurology at harvard Medical School and leading researcher on musicbased treatments for neurological impairment, has seen the effects of music on brain scans and is convinced MIT can help.
‘ Most of t he connections between brain areas that control movement and t hose t hat control hearing are on the left side of the brain,’ he says.
‘If you damage the left side, the right side has trouble fulfilling that role. But as patients learn to put their words to melodies, the crucial connections are encouraged to form on the right side of their brains instead.’
MIT begins by establishing simple target phrases such as ‘I am thirsty’ to the beat of something familiar, for instance, a nursery rhyme. In my case, because I remembered Beatles tracks so well, we used melodies from their songs to stimulate my brain.
On my left hand, Cat would tap ‘Can I have a cup of tea?’ — a beat for each word or syllable. Then I would repeat it while I tapped, but this time singing the words to the tune of a Beatles song.
The left hand is chosen because it is controlled by the right side of the brain.
NO ONe i s sure why tapping helps, but Dr Schlaug believes it acts as an internal pacemaker, stimulating the brain. Indeed, a study published in the journal Brain in 2011 suggested that this rhythmic element of MIT is as important for recovering speech after a stroke as the musical notes.
My first attempts at rewiring my brain were mundane. It was a hesitant: ‘I want . . . a cup . . . of . . . tea ’, set to the beat of I Want To hold Your hand.
After much coaxing, I was able to say the words. It was a pivotal and poignant moment.
From not being able to talk at all, I repeated the phrase so much I was in danger of being awash with tea. After two weeks in hospital, I was sent home only able to utter a few words and phrases.
I had daily visits from Cat and we continued MIT and tried other ways of restoring my speech, including repeating simple games such as filling in missing words.
After four weeks of intensive therapy, I was left to fend for myself. When I woke up I would concentrate on the first word that came into my mind and repeat it through songs.
As time has passed, I no longer need to sing sentences in my head as much. But it was nine months or so before I could have full conversations with my friends and family.
I sometimes have to sing a sentence under my breath as a practice run before talking to a stranger or when having a conversation on the phone.
Some days are better than others, but I can hold my own and have even delivered lectures to speech therapists and other health professionals about getting my voice back.
I cannot say my recovery is all down to the effects of MIT, but it certainly helped.
So John Lennon and Paul McCartney deserve my thanks. Over the years they have seen me through some good and bad times — but none so important as now.