102 Chapter 5
On the first day of aphasia therapy, the clinician asks Charlene to describe the events surround-
ing her stroke. Using telegraphic speech, she says, “My sister, uh, coffee the patio. Ducks... creek.
Crash coffee f loor. Oh my God! What’s wrong. Talk to me. Talk to me. No can talk. Go hospital.
Talk to me! My sister, uh. Charlene, talk to me! Here I be.”
During the weeks of therapy, Charlene’s expressive vocabulary improves, especially for func-
tion words and prepositions, and the telegraphic utterances are nearly eliminated. Even when
she uses telegraphic speech, it is more complex and includes more function words. Eventually,
Charlene is able to return to her home and resume management of the restaurant.
Case Study 5-4: A 68- Year- Old Man With Predominantly
Receptive Aphasia and Auditory- Acoustic Agnosia
Blair preferred to be called a character actor. He has a long list of credits to his name and has
played hundreds of supporting roles in plays, in movies, and on tele vi sion. Long ago he accepted
the fact that people would say, “ Aren’t you in the movies?” while never remembering his name.
Blair has never been plagued by hordes of fans seeking an autograph. He started to act at age 7,
when his parents moved to California to work in the technical trades of the burgeoning movie
industry. He first worked as an extra and then took bit parts with three or four lines. As he grew
older, the jobs became more plentiful and his agent, a crusty ex- stuntman with great movie busi-
ness sense, kept him in nearly full- time employment. During his 30s and 40s, Blair took several
supporting roles as a cowboy; many of these movies were shot in the beautiful towering red rocks
of Sedona, Arizona. Later in life, along with many other actors, artists, and celebrities, he returned
to Sedona to retire.
Celia and Blair married when they were in their early 20s. Throughout their marriage, Celia
was the sensible business man ag er, a role Blair gladly avoided. She negotiated and purchased their
California and Arizona homes, invested wisely, and focused on the practical side of life. Blair was
the consummate artist, creative and often oblivious to practical realities. One of their friends said
Celia was the logical left hemi sphere and Blair the creative right hemi sphere to their brain union.
Celia was a self- taught businessperson, and when Blair suffered his stroke, she deci ded to educate
herself. She listened intently to the doctors and specialists as they described Blair’s brain damage
and symptoms, searched the Internet, and spent hours in libraries searching medical books and
journals for information about strokes and their devastating effect on the ability to communicate.
When she called the speech and hearing clinic and was asked about the nature of Blair’s symptoms,
she matter-of-factly stated: “He has acoustic agnosia.”
In the initial diagnostic session, Blair sat at the clinical table with Celia next to him. The clini-
cian knew that patients or family members must be allowed to provide the presenting story, an
uninterrupted account of the situation as they perceive it; other wise, some patients feel slighted and
frustrated. The clinician said, “Please tell me about the stroke and the communication disorder.”