The Woman Who Could Write, But Couldn't Read
A recent stroke left one 40-year-old woman with some unusual symptoms.
By Francie Diep

One morning, a kindergarten teacher was about to take attendance for her class when she realized she couldn't read the paper in her hands. She tried looking over her lesson plans, but like the attendance sheet, they seemed to be covered in incomprehensible symbols.

She didn't know it yet, but the teacher, identified only as M.P. in a recent case study her doctors published about her in the journal Neurology, had had a stroke. The stroke afflicted a very specific part of her brain, leaving the 40-year-old woman with some unusual, but not unprecedented, symptoms—and plenty of functioning outside of that. Her case study is a fascinating look at what the brain, and human ingenuity, are capable of.

It turns out M.P.'s stroke interrupted the connection between the "language zone" of her brain and her visual cortex, her doctors wrote. At the same time, other sensory inputs still connected into her language zone. The results were decidedly weird. She couldn't read, but she could still write and understand spoken English, a symptom called "word blindness." Plus, she still had emotional reactions to seeing words, even though she couldn't recognize them:

For instance, when shown the word 'dessert' in writing, M.P. exclaimed, 'Oooh, I like that!' When shown the word 'asparagus' moments later, however, her response was rather different. 'I'm not doing this word! Something's upsetting me about this word!' she exclaims.

Nor have these intuitions been without utility. S.P. [M.P.'s mother] relates a recent anecdote in which, during an afternoon therapy session, her daughter was shown 2 letters from the mailbox at home. Nonplussed, M.P. quickly handed one letter back to her mother and tucked the other into her purse, saying, 'This is my friend, and this is your friend.' When asked who these friends were, she could not say, but their names nevertheless provoked an emotional response that served as a powerful contextual clue.

M.P. had her stroke in October 2012, her doctors report. Since then, she's rebuilt her life remarkably. She can't teach anymore and teared up when she told her doctors about missing reading with children; she used to be a reading specialist. But she has a new job and volunteers. And she's come up with her own way of reading, one that gets around her disability in a clever way:

Given a word, M.P. will direct her attention to the first letter, which she is unable to recognize. She will then place her finger on the letter and begin to trace each letter of the alphabet over it in order until she recognizes that she has traced the letter she is looking at. 'That is the letter M,' she declares, after tracing the previous 12 letters of the alphabet with her finger while deciphering a word in front of her. Three letters later, she is able to shorten this exercise with a guess: 'This word is 'mother,'' she announces proudly.

There are many more details in the full case study, which Neurology has posted for free. It's an approachable paper. We can't help but wonder if one day, M.P.'s case will become as well known as, say, Phineas Gage's… which would mean one more way the tenacious M.P. continued to contribute to society after her stroke.