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Stroke Victims: Treatment

My Lords, it was very interesting to hear the history of his stroke from the noble Lord, Lord Rodgers. I am delighted that he has introduced this debate this evening. I remember the recovery of the noble Lord, Lord Clinton-Davis, how patient the House was, and how rapidly and determinedly he recovered. The noble Lord’s speech came back to what it is now, but it was a difficult time for him. My husband had a stroke in 2003. The interesting thing is that whereas the noble Lord, Lord Rodgers, gets his words backwards, Kevin’s problem is that he sees things backwards. The problem depends on where in your brain the damage is. He can go to a great deal of trouble to set his pullover out carefully, the way he has been taught, in order to pick it up and put it on. This week he coped brilliantly with this, but then I looked over and said, ““That is marvellous. It is on the right way, but happens to be inside out””. He had not noticed. Obviously he has suffered loss of orientation to a degree. Sadly, he tells me that he has also lost his sense of taste, which he really regrets. He was fortunate enough to be under a marvellous consultant: Doctor Pelly at the Chelsea and Westminster Hospital, which has a very good stroke unit. Dr Pelly has no permanent registrar. The reason is not that there is no post; there is a post and there are people who would like that post. However, the rotation is so badly organised that it is shared between the central London post in Fulham and other places way outside London. So no registrar, who is going to have to do a bit here and a bit there, can decide where to live; it is quite impractical and no one wants that job. If only the medical school, or someone, would take the trouble to rearrange the rotation there could be a permanent registrar, which would be a great help to Dr Pelly, who is the splendid consultant in charge of the stroke unit. It is interesting that when my husband had his stroke, he had no idea that he had it. As a trained dentist, I did not really know what had happened to him. I phoned him and said, ““How are you?””—because I was thinking of going home at that time—and he said, ““I am not myself. I dropped my wallet, and then I lost my bus pass. I went to get a new photo for a new bus pass, and I hit a taxi””. I said, ““What do you mean you hit a taxi? A taxi hit you?””. He said, ““No, I hit a taxi. I walked right into the taxi””. I said, ““How could that be?””. He said, ““I got the photo for the bus pass, and I hit two more taxis on the way home””. I said, ““I am coming straight home””, which I did, and I could see that there was something wrong with him. There was blood all down his forehead in the photo that he had taken for the bus pass. The taxi driver had pulled up and said, ““Are you all right, guv?””, as obviously he realised something was a bit wrong, but no one picked it up. We had our very good cleaner there that day, and I asked her whether she had noticed anything. She said, ““Yes I noticed that he was a bit funny. I thought maybe he was drunk””. She has never seen him drunk. In all his life, I have only seen him drunk once in 50 years. She did not think of it. The noble Baroness, Lady Rendell, did not spell this out in words, but I will spell it out in words. FAST is the slogan of the Stroke Association—F for facial weakness; A for arm weakness; S for speech problems; T for test all three. As a dentist, I have a modicum of medical training, and I said, ““There is something wrong; we are going to the hospital””. He said, ““I do not know that is necessary””. That is the sort of reaction people give. I should have been able to recognise it, as I knew that something was wrong. We went to the hospital, which admitted him, and it still took a good many hours to do the scan. He was at the hospital within four or five hours, but the scan was not done until the next day. People must be available to operate the MRI scanners at any time that a patient arrives, because until they know whether it is a thrombosis or a haemorrhage they do not know which way to treat it, and if you treat it the wrong way you will kill the patient. That is the most basic and essential first step. I support the view of the noble Baroness, Lady Rendell, that prevention is the ultimate; if we could prevent everything, that would be marvellous. But following that, the next answer is fast—not only in the sense of the slogan of the Stroke Association—assessment of the condition, so that they know what it is and how to treat it. Willpower is very important in recovery. Points have been made about frustration, and there is a degree of frustration. Kevin never suffered depression, but he does suffer a degree of frustration. For someone who had marvellous manual dexterity, his left hand can no longer do what it used to do. Anyone who loses any degree of capability is very conscious of that, perhaps more so than those who never had that ability. The statement that impressed me in the speech made by the noble Baroness, Lady Rendell—of course she can always turn a good word—was, ““Time lost is brain lost””. That is absolutely true, and we must develop a rapid response. FAST is the word for diagnosis and assessment.