Quality of Life with Brain Damage

Abstract

My nominee for the key issue in the study of language and the brain during the first century of the third millennium is a concept that is slippery, burning, neglected, and crucial. That concept is definition and measurement of quality of life (QOL) with brain damage, especially brain damage that compromises the prodigy of human language. Since ancient times humans have been taken aback and fascinated by the peculiar and convoluted utterances that fell from the mouths of their brain-struck companions. These strange and confusing disorders, some of which came to be known as ‘‘aphasia,’’ have proven to be fertile ground for bemused scholars who at times seemed to be obsessed to record it, label it, rename it, sort it, resort it, categorize it, argue about it, and generally regard it as a weird and wonderful subject to study. (LaPointe, 1983) As one of my colleagues observed in the days before ‘‘person first’’ language was de rigueur, ‘‘It seems that researchers are more interested in aphasia than in aphasics.’’ The idea that shattered language can and should be mended is all too recent. The idea that there might be a connection between remediation, recovery, and perceived improvements in life quality is embryonic. In my view, the time is ripe. The impetus of the World Health Organization’s influence on the incorporation of individualistic and societal interpretations of health and wellness is gaining favor. As has been noted elsewhere (LaPointe, 1999) the definition and measurement of QOL has been tricky. What constitutes wellness? What are the dimensions of improved life quality? Oliver Wendell Holmes (1860), just one year before all of the excitement created by Tan and Pierre Paul Broca in Paris, commented on the importance and complexity of a complete life: