When Staying Down Is Not An Option

^{(Picture is for illustrative purposes only . I do not own the copyright of this image. Photo credit: Google)}

Angeline Toh (not real name) is a loving mother and wife, who also happened to be a successful entrepreneur in her 50s. She is best known for her market acumen, financial prowess, and excellent operational skills. She along with her partner owned a business that has lasted over 20 years while carefully raising their kids into responsible, peace loving, wonderful humans. Life has been beautiful, stable, uninterrupted.

This however abruptly changed when she was diagnosed with breast cancer in 2015 and a year later with a brain metastasis. Hit by such a whirlwind, she underwent a brain surgery to remove the the cancerous tissues, followed by adjuvant chemo and radiotherapies. A year later, while recovering from the first surgery and making some good progress physically, she landed herself again at the hospital’s emergency department, presenting with right sided hemiparesis (weakness) and seizure. An emergency radiological investigation revealed a recurrent mass in the adjacent parieto-occipital region and required yet another live saving surgery.

Post-operatively, she developed a rare form of speech disorder called conduction aphasia where the patient experience prominent impairment with repetition, some degree of anomia (word finding difficulty) and somewhat functional comprehension]. As if her life hasn’t been hard hit enough, along with the aphasia, Angeline developed signs of yet another rare form of neurological disorder known as Gerstmann Syndrome, a condition where patients would exhibit four cardinal cognitive symptoms : i) agraphia – loss of ability to express themselves through writing; ii) acalculia – loss of ability to perform simple calculations or arithmetics; iii) finger agnosia -inability to recognise their own fingers or others; and iv) left and right disorientation – difficulty to distinguish the left or right side of one’s body.

While administering both neuropsychological and aphasia assessments over a period of time (to establish her cognitive strengths, deficits and the severity of the impairments), I couldn’t help but to notice her courageous spirit, resilience and immense hope. She would try her level best to respond to all stimuli as accurately as possible, and when she fails, she would outrightly refuse to give up, and insist on trying until she got it right. Despite the aforementioned deficits and limitations, Angeline has always always been motivated to overcome these hurdles and find her final path towards the elusive recovery. An epitome of unbreakable spirit, she refuses to give up in what may appear to be a bleak lonely future. I pray that she will emerge victorious in this journey, one day at a time.

(The name, age and other personal identifiers of the patient is altered to protect patient identity and not to breach the privacy and confidentiality).