The Book of Stephen

The aftermath of a stroke becomes a new field of learning for a philosopher who must rebuild himself -- body, mind and spirit

Cover Story

April 20, 2003|By Story by Tom Dunkel | Story by Tom Dunkel,SUN STAFF

For in much wisdom is much grief;

and he that increaseth knowledge increaseth sorrow.

Ecclesiastes 1:18

A bomb went off inside Stephen Vicchio's head.

The explosion occurred shortly before 7:30 p.m. on Wednesday, September 25th. It was a crisp, cusp-of-autumn evening in Annapolis. Vicchio -- a stocky, square-jawed philosophy professor at the College of Notre Dame; author of ten books, two plays, and scores of newspaper essays; a fixture on local radio talk shows; the lunchpail intellectual whom one colleague calls "Baltimore's philosopher laureate" -- was walking across the campus of St. John's College, where he was about to conduct an adult education class.

The topic would be the Book of Job, which he has read some three hundred times and which served as the subject of his doctoral thesis. Poor, put-upon Job. God's punching bag. He of the let's-test-your-faith boils, broken family and monumental bad luck.

Boom! It was, he recalls, like being whacked in the back of the skull by a two-by-four. Vicchio dropped to his knees, then crumpled on the ground. He'd been walking alongside Bill Braithwaite, a St. John's faculty member, who ran to a nearby student and borrowed a cell phone. Braithwaite dialed 911. In less than half an hour Vicchio was at Anne Arundel Medical Center and doctors were zeroing in on their diagnosis: left middle cerebral artery stroke. Although he never lost consciousness, he could not speak, could not hear out of his right ear, could not see out of his right eye. Indeed, the entire right side of his body was paralyzed, as unresponsive as stone.

Even while lying on his back in a daze, Vicchio was aware that fuses were blowing, that he was about to become a different person. He often speaks of "my old life," as if his existence, like the Bible he has been contemplating since his childhood days in parochial school, is divided into two epochs. Before and After. The Old Stephen and The New Stephen.

There are two types of strokes: hemorrhagic (a burst blood vessel) and ischemic (a deadly blood clot). Vicchio was felled by the latter; unusual for someone about to turn 52, since ischemic strokes are a product of the hardened arteries associated with old age. Deposits similar to the grit on coarse sandpaper somehow adhere to the silky-smooth inner surface of the vessels that feed the brain. The result is what doctors refer to as a "turbulent flow" of blood that can clot and block an arterial passageway. With its oxygen supply cut, the brain begins to die. Cell by cell, The Old Stephen was slipping away.

"I was sitting down to watch the season premiere of West Wing," says Sandra Vicchio.

That's when the telephone rang. That's when she learned what had happened to her husband. That's when Sandra called a friend, Ginny Larsen, and asked if she would drive her from Baltimore to Annapolis... now. As the two women sped down Route 97, Sandra Vicchio was given a crash course in brain physiology. She was on her cell phone with hospital personnel who explained the risks and benefits of t-PA, a controversial blood-thinning agent that can dissolve clots and mitigate the effects of an ischemic stroke, providing it's given within three hours of an attack. And assuming all goes well. Sandra was told there was about a 6 percent chance that t-PA would trigger potentially fatal bleeding. Next-of-kin approval was needed, but the doctors couldn't afford to delay treatment until she got to Stephen's bedside. What to do? Play the odds or play it safe? Sandra opted to put her faith in God and in t-PA, giving her consent over the phone. She then waited and agonized until the lights of Annapolis popped into view.

"I didn't know," she says, "if I was going to drive to the hospital and find my husband dead because I gave him the wrong drug."

Her husband was alive. Working in his favor was the fact that, despite a history of high cholesterol and elevated blood pressure, he was in good overall condition: Stephen had been on a stationary bicycle kick, having pedaled some 5,200 miles in the past nine months. Working against him was the fact that he hadn't recognized the classic warning signs of an impending stroke.

He had met Braithwaite for dinner before class. Vicchio slurred some of his words during the meal, his tongue inexplicably in need of obedience training. Earlier he'd had a few episodes of blurred vision. Leaving the restaurant, his legs felt wobbly, as if the sidewalk was made of Jell-O. The prudent course of action would have been to get medical assistance. But he had other things on his mind: "I was mostly worried about whether I was going to get to class. I had a responsibility to teach."

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