Yale Panel Examines History, Health care and Humanity of Stroke
A panel of experts in history, women studies, medicine and public health examined aspects of the stroke that felled President Woodrow Wilson in his second term of office in 1919. The symposium, part of the Yale School of Public Health’s centennial celebration, was held in collaboration with the Long Wharf Theatre’s premiere of The Second Mrs. Wilson, which opened May 16.
Eric Jordan, a bass with the Metropolitan Opera and stroke survivor, performed and spoke to an audience of 100 people about his ongoing recovery from stroke and the role music has played.
President Wilson’s stroke came as World War I was winding down after four horrible years and the international balance of power was poised to change.
It was a “plastic moment” in American history, said Beverly Gage, a professor of U.S. history at Yale. President Wilson was a chief architect of the League of Nations and the Treaty of Versailles. Meanwhile, the country was experiencing widespread labor and hunger strikes, protests by suffragettes, the Red Scare, prohibition and immigration issues, and there was not congressional support for passing the treaty to end the war. Just when he needed to build support for his peace plan, Wilson was incapacitated by a stroke.
For nearly eight months, Wilson’s cabinet did not meet, and his wife, Edith, in effect ran the White House. At the time, “nervous exhaustion” that limited a person’s activity was a common diagnosis, and Mrs. Wilson was able to control the press so the country remained largely unaware of the president’s condition, said Henry Cowles, an assistant professor of the history of medicine at Yale.
“Edith Wilson was in a sense our first American woman president,” said Laura Wexler a professor of women’s gender and sexuality studies as well as American studies at Yale. The first lady exerted a lot of influence and the men in Wilson’s cabinet did not trust her power.
While knowledge about strokes has improved dramatically, the disease still takes a heavy toll. In the United States alone, some 800,000 people suffer from stroke annually and there are seven million stroke survivors, said Judith Lichtman, chair of the Department of Chronic Diseases Epidemiology at the Yale School of Public Health and co-chair of the event. Lichtman specializes in the epidemiology and prevention strokes and heart attacks.
David Greer, Yale’s Dr. Harry M. Zimmerman and Dr. Nicholas and Viola Spinelli Professor of Neurology and Professor of Neurosurgery, explained that it is only since the mid-1990s that useful drugs for breaking up clots and opening blood flow have been available. Just four months ago, however, results from studies of a new breakthrough procedure were published in the New England Journal of Medicine. This procedure allows surgeons to extract an offending blood clot from the brain using a stent thrombectomy procedure developed by Medtronic, resulting in significantly reduced disability among patients who suffered a stroke. While still time sensitive, the procedure will revolutionize emergency stroke surgery, said Greer.
Recovery has also advanced in the last 100 years. In Wilson’s day, bed rest in a dark room was the typical stroke remedy. Today, it is known that activity and rehabilitation should begin as soon as possible to take advantage of the elasticity of the brain. “Our main aim today is to restore function, maximize quality of life, and minimize the possibility of recurrence,” said Alyce Sicklick, an assistant clinical professor of orthopedics and rehabilitation at Yale and medical director of inpatient rehabilitation at Gaylord Hospital in nearby Wallingford.
Cognitive limitations after stroke and untreated depression are limiting factors in physical rehabilitation, but motivation and dedication to the work of recovery make a difference in the improvement patients make. Accounts describe President Wilson as having become delusional about his abilities (he thought he’d run for a third term) and rigid in his personality—he was unwilling to compromise with the senators who could have passed the Treaty of Versailles, legislation he considered a moral underpinning for international peace.
Metropolitan Opera bass, Eric Jordan, had a stroke at age 42. The father of a toddler, he shared with the audience the experience of re-learning to speak through singing the ABCs and other songs with his son, who even at that tender age could point out when his father mixed up his letters. Surprisingly, Jordan discovered that although his speech was severely affected by the stroke, his memory of opera scores remained intact.
Jordan made a triumphant return to the Met just a couple months after his stroke. He shared many of the songs that he sang on his way to recovery, including Puff the Magic Dragon, Folsom Prison Blues, All You Need is Love and Pro Peccatis from Rossini's Stabat Mater, which he will perform in Czechoslovakia in a few weeks. Pianist William Braun, DMA ’90, accompanied him, and he was interviewed by Dr. Charles Matouk, Assistant Professor of Neurosurgery and of Diagnostic Radiology at the Yale School of Medicine.
“I fundamentally believe that this kind of trans-disciplinary perspective across history, public health, medicine, music and theater is powerful and inspiring,” said Jeannette Ickovics, a professor at the Yale School of Public Health and co-chair of the event. This event was part of the The Yale School of Public Health centennial celebration. One of the oldest accredited schools of public health in the United States, today it advances public health through research, education and practice in its home city of New Haven, across the United States and throughout the world.
Medtronic and Pfizer sponsored this symposium with support from the American Heart Association and collaboration with the Long Wharf Theatre. The Second Mrs. Wilson runs at the Long Wharf Theatre through May 31.