Read My Year Off for Free Online

of the moon.
    It’s the brain, or more accurately the central nervous system, that is threatened by stroke. In Britain, and in North America, the traditional term ‘stroke’ is slowly being replaced by ‘brain attack’, in the hope that new language will change our attitude towards the illness, and perhaps help modify our behaviour towards it (making us less complacent about it, and helping to improve survival rates). But even the new term ‘brain attack’ does not convey the whole story. A stroke is all to do with blood, or the absence of it. In medicine, ‘stroke’ is the description of an acute disturbance of the brain due to an interruption of the flow of the blood supply.
    There are many different kinds of stroke, ranging from the most minor neurological episode — the transient ischemic attack (TIA), which can be so slight and quick that the sufferer is unaware of having had it, to the stroke which leaves the victim utterly unconscious. It’s worth making the point that a TIA can presage a larger stroke, and that if someone who suffers a TIA can see a doctor immediately, there are preventive measures that can dramatically reduce the risk of a subsequent and more severe assault on the brain. (In America, especially, some doctors are experimenting with the use of the drug tissue plasminogen activator, TPA; in Britain the only drugs used in TIA are aspirin, warfarin and persantin, and of these aspirin is by far the commonest.)
    If you suffer a TIA you are thirteen times more likely to suffer a stroke in the following year. The signs of a TIA might include a mild slurring of speech or an unexplained transient weakness in an arm or leg. In such cases, the doctor’s attention will be focused on threeessential fields: first, the potential narrowing of arteries in the neck, from which bits of blood clot might break off and travel up to the brain; second, the possibility of clots in the heart; and third, the presence or absence of high blood pressure. Once these areas have been examined, the search will move to the the quality of the patient’s blood and the cell biology of the patient’s blood vessels. I was given the same three tests to determine what had happened to me. In my case, having passed them with flying colours, I was subjected to a closer and closer scrutiny of my blood. In the end, however, I was advised that, so far as could be determined after the fact, there was no treatment that would have prevented my stroke, and no certain explanation for why it had happened. Like most such episodes, it came out of the blue. I am occasionally asked if I am troubled by this, but the answer is, I’m not! (Life is too short.)
    So, throughout my convalescence, I regularly gave blood, a procedure I came to dislike intensely. Once the doctors had ruled out the most common cause of stroke (smoking and high blood pressure), they began searching for more subtle causes. In recent years the scientific analysis of blood has become markedly more sophisticated. Perhaps I was suffering from Leiden Factor V? Was Lupus Anticoagulant to blame? I gave blood samples to, among others, a Dr Thomas, a Dr Cohen, a Dr Abraham, and finally to Professor Sam Machin, a no-nonsense haematologist of world renown. One of the many fears I encountered in the aftermath of my stroke was the anxiety that if Sarah and I were to have children I might somehow pass on the weakness in my brain. (Each of these excellent doctors assured me that this is quite impossible.)
    During my year off I have turned repeatedly tospeculation about the genetic programming in my head that led up to that moment on 29 July. Was this simply a catastrophic version of a weakness that had already manifested itself in the lives of my ancestors? Did old Robert McCrum — who died in 1915 — die of stroke? I have, of course, no sure way of knowing (his death certificate refers simply to ‘respiratory failure’), and the experts scorn the notion that one can inherit such