Understanding Stroke Recovery as John Fetterman’s Political Future Comes Up for a Vote
Pennsylvania Lt. Governor John Fetterman, the Democratic nominee for the state’s US Senate seat, is recovering from a stroke while campaigning. Photo by AP Photo/Gene J. Puskar
Understanding Stroke Recovery as John Fetterman’s Political Future Comes Up for a Vote
The health of the Pennsylvania US Senate candidate has become an issue in the race
Steven Feske wanted no part of this story at first.
I said to him, “I’m writing about John Fetterman.”
“I’m not going to comment about him,” Feske replied, pleasantly but firmly.
Fetterman is the Pennsylvania Democratic candidate for the US Senate who had a stroke early in the campaign, and his health has become a key issue in the hotly contested race with Republican Mehmet Oz. Feske is a BU Aram V. Chobanian & Edward Avedisian School of Medicine associate professor of neurology and the neurology department vice chair for education. More specifically, he is an expert in stroke and cerebrovascular disease and critical care neurology.
With the way politics are, the outcome of the Pennsylvania race could very well determine control of the Senate and the future of President Biden’s term. In his and Oz’s debate last week, Fetterman was usually on point—and tough on Oz—but he used closed captioning monitors to help with auditory processing issues, and his speech was occasionally halting.
Feske made clear he would not diagnose Fetterman long-distance, based on TV clips, but he would talk generally about stroke recovery, the sorts of issues Fetterman and others who suffer strokes face, and why those issues are so difficult to anticipate.
Q&A
With Steven Feske
BU Today: Why should we be very careful looking at Fetterman on television and deciding we know things about his condition? Why don’t we want to do that?
Feske: Without understanding a lot more about what happens, you can’t predict outcomes. Outcomes are very variable. They’re more variable with some aspects of function than others, but they’re certainly very variable with speech and cognitive function. And so I think you know, without a lot of other information, it’s impossible to opine in any way.
BU Today: Auditory processing disorder—tell us what that is, how it works, and why that results from a stroke.
Feske: Well, every cognitive function we have, every one you perform, requires neurological processing. And so saying something is a processing disorder is simply saying that a certain function is not acting properly in order for us to use language in the normal way.
That is, spoken language. We have to hear it, we have to process what we hear, we have to translate that into some sense of meaning, and then respond appropriately with some output. So, yes, that’s a complicated network of interconnections. And if there is any kind of lesion, whether it’s a stroke or a different type of lesion, anything that affects that network and affects that processing, that makes it not work properly, makes it work slowly.
BU Today: You said there is a very wide range of outcomes and timings and recovery possibilities here for people.
Feske: You have to realize that when you say somebody had a stroke, you’re using a very shorthand term for a lot of possible different things having happened to them. And so among the differences are differences in size. How big was it, how much brain injury did it cause, and also where exactly it was, because the brain is topographically organized—different parts of the brain do different things. And so, because there’s a variability in size, a variability in the location, and there’s also variability in different people’s anatomy and how they respond based on their age or other things [such as their other health].
BU Today: The majority of people who have strokes tend to recover with time and treatment, correct?
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BU Today: Is there any way for the average citizen to judge these things? Without being able to look at his chart or have the ability to diagnose his condition, how should people think about his ability to carry out the job? Do we just have to trust his doctor’s public statements?
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