The Existential Horror of Aphasia

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On March 30, Emma Willis–the wife of Bruce Willis–wrote a post on Instagram on behalf of her husband. She announced that Willis had been diagnosed with aphasia. He had begun to lose his ability to speak; thus, he would be stepping away from a brilliant acting career spanning more than four decades.

Aphasia is a condition that stifles a person's language expression and comprehension. There are three types of aphasias: receptive aphasia, expressive aphasia, and global aphasia. Physicians use this classification to define symptoms and pinpoint the area of brain damage. However, these labels don't specify the cause of the aphasia, which could range from something sudden–such as a head injury or stroke–to something more smoldering, like a growing tumor or worsening dementia.

In receptive aphasia, patients do not understand the words of others and cannot express themselves. At first glance, patients may appear to talk fluidly, but as you listen in, you realize that they make no sense, saying gibberish or words that do not fit the context of the discussion. Fascinatingly, receptive aphasia patients are largely unaware of their deficits.

Compared to patients with receptive aphasia, patients with expressive are aware of their deficiencies. They can understand spoken and written language, but they speak and write haltingly, often struggling to find the right words.

And the patients with the most limited verbal skills are those with global aphasia. In this condition, the brain's expressive and receptive language centers are injured, resulting in extreme difficulty in reading, writing, understanding speech, and speaking fluidly. They are both unable to understand others or express themselves through words.

Imagine a world where you couldn't talk to your loved ones. How horrifying would it be not to be aware of your own illness, as in receptive aphasia? And how frustrating would you be if words kept on escaping your grasp, as in expressive aphasia?

There may be no one more suited to answer these questions than former U.S. Congresswoman Gabrielle Giffords. In 2011, a lone gunman shot Giffords and 18 others at the congresswoman's constituent rally. Giffords was shot in the head, and after heroic and successful efforts to save her life, Giffords underwent months of grueling physical, cognitive, and language therapy. She retrained herself to read and speak in short phrases and eventually learned to use longer sentences.

Gabrielle Giffords had come back from the brink; she responded to Emma Willis's post by posting, "I'm thinking of Bruce Willis and his family today. Aphasia makes it hard for me to find the right words. It can be lonely and isolating."

Words are a vital medium to interface with others and let our own needs and thoughts be known. To be cut off from such an essential means of communication would mean having your connections severed and being forced to withdraw from the world. It is a devastating condition, and Bruce Willis and his family have a long and difficult road ahead of them. But perhaps in the public expression of their loss and pain, we could all learn to cherish each moment that we have with our loved ones.