Dr. Charles E. McClelland of the University of New Mexico is working at the University in Berlin this summer and graciously reported on the gathering for dinner on June 17 of the Berlin circle of Paul’s friends who have been helping him since his stroke.
Paul seems to be recovering nicely from the stroke. I spoke with him as recently as earlier today and his speech has definitely improved, though his problem with balancing himself with which he was troubled even before the stroke resulted in his taking a nasty fall backwards down some stairs. He has, fortunately, almost fully recovered from that mishap. Though still unsteady, he does seem to be improving as time goes on.
Here are a few of Dr. McClelland’s comments.
As promised, here’s a little report on Paul and the dinner in his honor last Wednesday (17 June).
To my surprise Paul himself appeared in the Restaurant Entrecote, a nice French place that happens to be just around the corner from where I live in Mitte. There were over a dozen people present, and the meal (and Paul) lasted about 3 hours. I am attaching a few photos I took.
Paul’s friends at the dinner ran the gamut from people who had only recently met him and were looking after his dog Max to old fraternity brothers. One of these, Gert Dyckerhoff (who lives in Bavaria and travels a lot on business), hosted the dinner. I gather he, Dr. Moeller and the lawyer Ms. Salein (who were not present) had gone out to visit Paul earlier in the day and decided to work toward getting Paul back into his apartment, with appropriate look-in help, in maybe 6 weeks. I think that tells you a lot about the visible progress Paul has been making.
I learned a few tidbits about Paul’s biography I had not known. When he was a student in Munich (long before I was!) he had been one of the first Americans to be invited to join one of the exclusive duelling fraternities! As a university historian I am aware how important these are, but I had no idea (as one of them explained over dinner) that theirs has a fund to help out “brothers” in difficulties. There were in all four of his “brothers” at the dinner. That is very reassuring to me.
Charles, I know I speak for everyone who depends on this blog for news of Paul when I say how much I appreciate your report and your sending me the pictures.
Today Dr. Helmut Möller replied to a request from me for information about Paul by saying that he had picked up some of Paul’s things from his apartment and taken them to him at his new location earlier in the day. He commented that Paul’s walking was much improved and that he would be participating in speech therapy from today forward. He promised to let me know just as soon as there is a phone number for Paul. And of course, once I’ve learned that number, I’ll share it with you as well.
On a personal note, let me thank you all for your comments made to Paul on this blog. I do try to convey them to him whenever he and I talk. And also I’d like to thank you for your expressions of appreciation to me for my effort to keep you up to date at this stage. I am only doing what I would hope one of my friends would do for me if I were in Paul’s predicament.
Because Paul has so many of you out there across the globe who care about him, this blog probably provides the best way for me to reach out to that considerable network of people. I encourage you, if you wish to, to talk to each other in the commentary section and discuss your concerns, suggestions, hopes and fears for Paul so that this blog becomes not just a place to hear about Paul, but also a place for you to share your input and thoughts. Maybe together we will stumble over a way to do more than just spectate and instead contribute in some meaningful way to his recovery.
I’ll let you know the crucial details of how to communicate with him as soon as I know them and I can conveniently do so. Of course if he tells us he’s getting too many calls after the phone is installed, we’ll just have to get him one of those 900 numbers and charge an exorbitant fee to talk with him and then we could apply the proceeds to help pay for his care.
Today I heard from Dr. Helmut Mõller that Paul has been moved to his own room in a new location where he can receive all the physical and speech therapy that he will need. Although I don’t yet have all the details of where he is or how to communicate with him in writing, Helmut says that during the 10 days that he (Helmut) was away in France, Paul’s “language and his walking have very much improved” to the extent that Helmut described himself as “astonished!” He hopes to provide Paul with his television and a telephone in the “next (few) days” “and also perhaps his computer.” This, as I’m sure you will agree, is very good news, yet I have to keep my own hopes in check since during my last conversation with him Paul was telling me about how frustrating he found it that he couldn’t even manipulate the remote control for the television very well. It will probably be a while therefore before he can type again, but this move definitely signifies a very positive step in the right direction.
I will close with the Helmut’s own words which I find very encouraging. He ended his email by saying “then there is much hope he can get back in his own apartment.”
Here is some reassuring photographic evidence for those of you who may have been concerned that Paul has not been able to see Maxe since his stroke. The picture is dated February 24, 2009. It was sent to Paul at his Gmail address by Wolfi Petri, who is apparently a member of the family that has taken responsibility for caring for Paul’s beloved companion, Maxe, while our friend Paul is working through his rehabilitation.
I spoke with Paul as recently as this past Thursday and he seemed in good spirits.
The connection between Paul’s friends in Europe and those of us in the U. S. seems to be growing by the day. I have created an email distribution list for a number of people who want to hear any news that becomes available about Paul, and I am exploring the possibility of setting up a discussion list so that we may all share news, ideas, wishes and hopes that may help Paul recover and get back to communicating directly with us all as soon as possible. As you all know, Paul was a prolific communicator who extended his circle of friends worldwide. So as soon as this discussion list materalizes, I’ll tell you how to sign up (if you choose) so that you can join his circle of support. Please stay tuned for the latest news on that when it becomes available.
For a little over a week, I’ve been talking with Paul almost daily. Usually our conversation lasts no more than about 10 or 15 minutes, but it has been regular direct contact with him which has been encouraging to us both.
Dr. Robert K. Bolan, Paul’s former physician when he was in the U. S., recently raised an interesting point that he has given me permission to share with all of you. I’ll do that below after I tell you that I read Bob’s comments to Paul who wanted a copy of them so that he could share them with his speech therapist on Wednesday of this coming week. Bob found it encouraging, as did I, that Paul comprehended them when I read them to him. It says that what is going on inside his head is just fine. The primary problem he seems to have manifests itself when he tries to express his thoughts verbally.
So here is the email exchange that Bob Bolan and I had during the last several days.
Hi Perry,
This is pretty obvious but I’ll ask it anyway since I haven’t seen mention of it–music… Has anyone thought to bring Paul a selection of his favorite music? Music is processed in a much different way than written or spoken communication and even though we don’t know the exact extent or subtleties of Paul’s neurological damage I wager that music may bring him an inner fluency he might not otherwise be able to experience.
Bob
Hi, Bob.
To the best of my knowledge no one has brought Paul a selection of his favorite music. Who would dare? That would be like buying a bottle of wine from your local Walgreen’s for a connoisseur, wouldn’t it?
Seriously though, I understand the logic behind your suggestion and it is probably an excellent idea. I’ll ask him the next time I talk with him whether he has access to his music and whether he might like to have a personal CD player to permit him to listen to some things from his collection.
I’ve spoken to him about four times in the last week and to me he seems in good spirits. His extended sentences do sometimes drift off into verbiage that doesn’t connect with the original direction of his thought, so I’ve tried not to tax him by giving him too many open ended questions, but that’s hard to avoid without considerable thought and concentrated effort.
That raises a question for me. Is it generally desirable or not to require someone recovering from a stroke to stretch himself by challenging him with such open ended questions or is it better not to place any more demands on him than are necessary? I know that he (and anyone in his position) experiences frustration when he can’t express what he wants to say because his brain won’t find the right words. But just as you have to exercise muscles to strengthen them, perhaps you also have to do the same with the brain. Should I push him or coddle him?
Regards,
Perry
Perry,
Hahaha. Nah, you just buy the most expensive bottle they have and make sure it doesn’t have a screw cap.
The brain is like any other organ: when it is damaged a functional unit (like speech) will compensate by using surviving, but often less efficient, pathways to transmit the nerve impulses. And perhaps it may even develop some new pathways. One problem with brain injury is that neural tissue is probably the slowest to repair or regenerate of any in the body. Another problem is that brain functions are so incredibly complex with innumerable modulating interconnections that are built up over a lifetime of hearing, seeing, processing, remembering and speaking, and each of these “associations” combine to determine how you “remember” what you want to say about something. So if a new pathway or a less used one lacks some or many of these associations you may be able to recall something under some circumstances but not others. What I’ve said so far assumes that the input or receptive arm of communication remains intact; if not, then receptive aphasia results and you have a more profound communication problem. I assume from what I’ve heard so far that Paul’s problem is a “pure” expressive aphasia. But the punch line is that the brain can and does repair itself after injury, albeit slowly and incompletely if enough “good” tissue remains.
This is kind of where the music connection fits in. What I said earlier about familiar music creating an inner fluency that might not otherwise exist was intended as an attempt to bring him pleasure where he is now most likely experiencing frustration (to the extent that he knows that what he says is not being understood and that is because he is not speaking correctly). But the other reason I mention it is for a purely hypothetical reason. Maybe a clever neurolinguist (kind of a special speech therapist) could use Paul’s music to help him recover proper speech. I’m not sure how this might be attempted other than by having him name instruments while listening to music, or through some other associative exercise that they might dream up. There is actually a whole discipline of music therapy and it is doubtless much more advanced than I know about.
Another thing was that I did a cursory literature review and learned that there is active research into speech recovery among aphasics. There is evidence that some language activity may be able to transfer from one brain hemisphere to the other (which is quite an incredible thing) and that perhaps therapy as mundane as exercising the non dominant hand at the same time as intensive speech/naming therapy can “force” or “encourage” this switch. Further, I discovered a whole literature on bilingual aphasia recovery and learned that language facility may not be lost equally when one has more than one learned language. So, this tells me that there may be some hope that with appropriate therapy Paul may recover quite a bit. It will probably take time however.
So to finally come to your concern about overtaxing him; no, do not worry about that. You aren’t going to slow or confuse his recovery. Patient persistence will be reassuring to him. He’ll let you know when he’s tired, then you can leave him be, just as you would when he was in the pink of health and became weary.
Best,
Bob
Hi, Bob.
Fascinating stuff! Thanks for going to the trouble to explain it in depth to me. I have just gotten off the phone with Paul to whom I read your message. He asked that I send a copy of it to him by air mail as soon as possible because he has a scheduled session with a therapist and he wants to “lay it on him” when they meet. I’m going to print out your message therefore and send it out today by the quickest means possible. Paul said to tell you how grateful he is for your comments.
Again, I’d like you to know that both Paul and I found your message very interesting and encouraging and that we sincerely appreciate it.
Regards,
Perry
Perry,
Wow! That’s terrific that Paul understood and is going to “lay it on” his therapist. I so hope this helps.
Bob
I was able to package this exchange with Dr. Bolan up in a PDF file and email it to one of Paul’s Berlin friends, who has printed it out and will deliver it to him on Monday.
Christian Steinhoff visited Paul today and shared this picture of him.
By clicking on the image, you will get a larger display of it and you may then save that image to your own hard disk if you wish.
Christian reports that Paul is receiving therapy at the hospital and will be able to stay there for perhaps another three weeks maximum. Afterward other arrangements will have to be made. Right now Christian doesn’t believe Paul is yet able to manipulate a computer keyboard and his speech, though improved, is still quite limited.
On Friday, April 3, I heard from Stefan Kempinski, who is now back in Berlin after a three week absence, that he had seen Paul the day before and found him in better shape than previously. Stefan said that Paul can now walk without help and that his psychological situation is also much better. He noted that Paul is now able to speak some sentences absolutely clearly, although extended conversations with him remain difficult because after a while Paul becomes less articulate.
Stefan mentioned that Paul “still has a weakness in his right hand and leg.” This is the first time I recall his mentioning Paul’s right side weakness, though it is normal for stroke patients who have significant aphasia to also have such a weakness on that side of the body. I had said to Stefan that if Paul’s hospital had an Internet connection we could arrange to supply him a laptop so that he could get back in touch with his friends worldwide. Stefan commented, “We will see whether he can type on his computer keyboard.”
He closed his message by saying that on April 6, Paul will be moved to a short term care institution for three or four weeks and after that a decision will have to be made about whether he can go home or whether he must go into a nursing home. He gave Paul’s next address as Sozialstation Biedermann, Iranische Strasse 2-4, 13347 Berlin. He also noted that it is located on the property of the “Juedisches Krankenhaus.”
In a recent comment on the previous posting, Paul’s friend Leonard Marcus expressed his concern that there had been no new posting to the blog since Paul’s birthday. I realize that others may share that concern, so I felt it appropriate to share my email reply to Leonard with you all to allay any fears that the lack of news may cause.
Here’s what I told Leonard.
My name is Perry Nelson and I am the administrator of Paul’s blog. I have been posting second hand information that I’ve received from his friends in Germany about his condition since his stroke. My primary contact, Dr. Stefan Kempinski, said in his last communication the day after Paul’s birthday that he was sitting up and had a lot of presents and flowers that day. Stefan had planned to take him out on his birthday for a meal away from the hospital, but when the day arrived, Stefan felt that Paul wasn’t yet up to going out so that event was canceled. In that same message, Stefan told me that he (Stefan) would be away from Berlin for the next three or four weeks so I haven’t had any further word since then. Stefan’s absence therefore accounts for why there hasn’t been any further posting on the blog so you shouldn’t infer anything ominious about the lack of later information. Unfortunately I myself don’t have any direct way to communicate with Paul.
I will continue to post to the blog as I learn other details and I am hopeful that the time will come soon when he will be able to carry on some kind of conversation by phone or gain access to the Internet and be able to communicate by email. If and when that occurs, I’ll let everyone know via the blog.
As most of you probably already know, today is Paul’s 85th birthday so I know you join me in wishing him well and hoping that his next birthday finds him in much better shape.
On Sunday, Birgitte Grimstad left a comment on one of the previous posts that you may not have noticed if you don’t go through the comments regularly. She visited with Paul recently, and I encourage you to read her comment for a recent report on his current condition.
Dr. Kempinski had planned on possibly taking Paul out of the hospital for while today for lunch, but when I emailed him yesterday and asked if that were still going to happen, he replied that he thought it was still a bit too soon for him to go out just yet. He did report earlier in the week that he had seen some improvement in Paul’s ability to speak in short sentences. Progress in recovering from a stroke is frequently a long uphill battle so even little achievements must be celebrated.
Paul’s friend Fred North asked whether I could provide a room number for Paul at the new hospital so that any mail sent to him might arrive without undue delay, and prompted by Fred’s request, I have learned that the address to use is as follows:
Paul Moor
Evangelisches Geriatriezentrum Berlin
Haus 1, Station 1, Room 204
Reinickendorfer Straße 61
13347 Berlin
