Aphasia and the Art of Navigation

Posted on June 30, 2012


If you have been following my blog, you know that a little more than three years ago a hemorrhage introduced me to the world of aphasia. The hemorrhage occurred in a meningioma attached to the right frontal lobe of my brain. The hemorrhage created all the appearances, symptoms and after effects of a bleeding stroke. One common after effect of a stroke is aphasia, literally a loss of words.

Aphasia is a communication disorder resulting in the partial or total inability to process language but does not affect intelligence. In my case, aphasia has diminished the speed at which I can process language and make decisions. I don’t believe it has affected my ability to make correct decisions. It has only affected the speed at which I can make, communicate or implement those decisions. Since verbal communication is more spontaneous and offers less time to process language and reflect on the underlying ideas, I have more problems with verbal communications than written communications.

This difference has been brought home to me many times in the past several weeks as I have had to serve as navigator for me and my wife as we have had to find our way around our new town. With my history of seizure activity and potential for future seizures, I have had to relinquish my driver’s license and quit driving. This has forced us to rely on my wife to be our chauffeur.

My wife is basically a good driver. However, she would readily admit that she doesn’t like driving in heavy traffic. She would also admit that she is “geographically challenged.” East-west-north-south do not register with her. She doesn’t like to read maps. She wants to know whether to go straight or to turn right or left at the next intersection.

My wife and I approach driving very differently. Our approaches to driving are the exact reflections of our approaches to cooking. My wife is an excellent cook. People are always complimenting her cooking and asking her for her recipes. Prior to my episode and before I was told to stay away from electronic utensils and objects that had sharp edges or points, I liked to experiment in the kitchen and try different combinations. People would also compliment my creations. However, when asked for my recipes, I couldn’t supply them because I didn’t use fixed recipes. On the other hand my wife is a recipe cook. She wants a list of instructions to follow precisely. This practice carries over to her driving. She much prefers a list of directions over a map.

In my battle with aphasia, I have come to the conclusion that, “I am a lousy navigator.” In familiar areas, I know where to turn and what is the best lane to be in. In unfamiliar areas, by reading a map I know where to turn. However, in both situations I can’t seem to find the words quick enough to give my wife sufficient warning of what to do next. When I find the words to indicate an impending turn, I raise the volume of my voice to emphasize the urgency of an upcoming turn. This sometimes startles my wife or makes her think I am yelling at her. Both of those outcomes could be disturbing in the least or dangerous at the worst. When she misses a turn or makes a wrong turn, I get very upset with myself. Because I am angry my next several comments will usually reflect those feelings. I am not upset with my wife. I am just upset that I didn’t direct us appropriately.

I can hear some of you saying right now, “Why don’t you use a GPS?” We have tried two different GPS’s with less than satisfactory results. GPS’s operate off of optimization principles and programs. I am reminded of the computerized room scheduling programs that were being offered to colleges 30 years ago. The claim was that these programs would greatly increase room usage efficiency by filling dead space. The claims these programs made concerning more efficient use of space were undeniable. However, the results of these scheduling programs were neither satisfying to faculty or students. It was difficult for these programs to take into account the room preference of faculty, or the desire of students to have back-to-back classes scheduled in nearby rooms. There were too many variables for these programs to account for. The human mind of an individual who knew the curriculum, the facilities, and understood faculty and student preferences was a better scheduler than a computer.

GPS’s are only as good as the optimization programs on which they operate and the information that is entered into the data bank of the GPS. How old is the basic map that is used in the GPS? New roads are added every year and occasionally roads are closed. The major choices GPS’s give you to calculate optimal routes are: 1) shortest route (based on mileage); 2) shortest time (based on estimated time to cover the route calculated using posted speed limits); 3)toll roads (use or don’t use toll roads); and 4) roads to avoid. Any changes to the optimization strategies are difficult if not illegal for the driver to make while the car is moving. Construction and local conditions like accidents are not always known before one begins the trip. Dangerous intersections are not always accounted for by the GPS. Shortest or normally quickest routes may include left hand turns against traffic, which during rush hours or school change hours can be very problematic.

We do use a GPS on longer distance trips. However, on trips around town where road conditions seem to be more volatile, even with the speed at which I can communicate route changes, I seem to be a better navigational choice for us.

These events have convinced me that there are at least two jobs that are beyond my capabilities at this moment. I would be a disaster as a spotter for a NASCAR racing team or as an air traffic controller.