Navigating Tracie’s Brain

How Grady Health System Changed the Paradigm of Stroke Care

Excerpts of the full story below. Originally published by Maya Linson and Sandy Laycox - read the full story at http://wallsdownmag.org.

Tracie Johnson Steadman is a poet. And right now, a hospital waiting room is her stage. “This poem is called ‘Authorized to Heal,’” Tracie says. She pauses for a moment, and then she chants.

He is read to heal your soul / Take control / Then create a mold / Covered in his blood / Oh so pure / is it the cure..

Her voice, deep and throaty, loses any sign of hesitation. It lifts up, weaving words into melody as she implores you to let go, surrender to something else, someone else. Is it God or physician she’s referring to? It’s both, she says. The line, in trauma, becomes blurred.

On Oct. 8, 2011, Tracie awoke at 1 am, thinking she had to go to the bathroom. “When I tried to get out of the bed, I fell. I kept trying to get up, over and over again.”

“My husband, he picked me up and he sat me in the restroom. He asked me to raise my arms, he asked me to raise my legs, and he asked me to talk. By then, the look on his face, I could tell something was wrong.”

Looking in the mirror, Tracie saw her own twisted face. And she began to pray.

Three days earlier, she had received notice that her house was to be sold. It would follow the car and the job she’d held for 10 years. Her life, as she describes it, was full of clutter. And now, her brain was clogged as well.

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Stroke can occur in one of two ways. A blood vessel in the brain can become blocked, cutting off the blood supply. Or, it can burst, spilling blood into the spaces surrounding brain cells. Tracie was suffering from the former — acute ischemic stroke. It is the most common form of stroke, accounting for about 87 percent of all cases. Deprived of the blood’s oxygen and vital nutrients, brain cells quickly begin to die. This deterioration can continue for days, leaving permanent damage, or it can kill almost instantaneously.

In the 1980s and early 1990s, stroke treatment was limited, with no real way to reduce the damage to the nervous system. Some considered it untreatable. But in 1991, the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health, began a clinical trial to test a drug called tissue plasminogen activator (tPA) on stroke. tPA is a clot-busting medicine doctors have used since the 1980s to restore blood flow in heart attack patients. There was hope it would work for ischemic stroke too.

Michael Frankel, MD, led the trial of tPA for stroke victims at Atlanta’s Grady Health System. “[Grady was] a leading site for the study, which really changed how we look at that disease,” says Frankel, who is now chief of neurology and director of the Marcus Stroke and Neuroscience Center at Grady. “And that’s a disease that’s really important to people in Georgia.”

“As the premier level I trauma center for this region, for all these people, in a growing population, an aging population, and a stroke-prone population, we had to be stroke-ready,” Frankel says.

Georgia is a part of the stroke belt, a region of the southeastern United States that sees a higher than average rate of stroke occurrence and mortality — in some cases, double that of other parts of the country. “As the premier level I trauma center for this region, for all these people, in a growing population, an aging population, and a stroke-prone population, we had to be stroke-ready,” Frankel says.

The model of care Grady applied to all critical injuries in its level I trauma center was the right model for stroke victims as well. Frankel and his team built an infrastructure for staff to recognize stroke symptoms as quickly as possible. If stroke is suspected, they immediately x-ray the brain using a computerized tomography (CT) scan. Once they review the CT scan, they can determine if the patient is suffering from acute ischemic stroke and, if appropriate, deliver tPA. Grady paramedics aboard ambulances also learned to identify the symptoms and notify the hospital before arriving with stroke patients.

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That infrastructure was in place as Tracie’s ambulance sped through Atlanta toward Grady that October night. She describes her husband’s insistence that she go there despite her apprehension. “I didn’t want to go to Grady,” she recalls. But he was firm: “You’re going to Grady.” “He’s a Grady baby,” is her explanation. As she speaks, Brahms’ Lullaby begins to play throughout the hospital. Another Grady baby is born.

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Read the full story at http://wallsdownmag.org

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“You know, we all go through things in our life, [but] when I come in this room, it brightens my day. These people, they keep me alive,” Tracie says, motioning to the room behind us. We are in the stroke center’s family waiting room, where Tracie is now employed.

Tracie spent two days at Grady recovering from her stroke. Just like with any trauma patient, her life had been startlingly interrupted. An unexpected blood clot in the brain isn’t that different from a sudden car crash or a tornado. It freezes your life for a moment. Everything else falls away and you focus on survival. But for Tracie, survival meant more than just being able to move again. It meant keeping the promise of change she made during that six-hour freeze-frame of her life.

But she couldn’t do it alone. “I got the best care here,” she says. “The nurses, everybody was just so nice, just made sure that I was comfortable. There was a guy that even held my hand in surgery. I will never forget him.” The care Tracie received at Grady made an indelible impression, and she wanted the hospital to know it. So she called and said as much. Impressions being reciprocal, several months later, Grady called Tracie.

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Read the full story at http://wallsdownmag.org

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“At first I couldn’t talk about [the] experience,” Tracie says of her stroke. “But when I started working here and I became a part of this unit, my heart began to go out to the people that come in here. They’re hurting, and they’re in pain, and they’re believing … for their loved one to live. Whatever I can give them, to make it easier for them … When they hear my story, it may be a totally different situation, but when they hear my story, they’re inspired.” Adds Frankel, “She’s had the experience, she knows what it’s like, and I think that that comforts people in a way that no doctor ever could.”

The poetry she had been writing for years and now reciting to stroke families became a book — 31 Days of Live Inspiration. And her stage in the stroke center’s family waiting room became churches and shelters and conferences and workshops across the country, where she can be found reciting poetry, sharing her experience as a stroke survivor, and helping people understand the symptoms of stroke. And yet, like the doctor who inspired her, she remains ever humble, ever grateful, for the chance.

Coming home from a speaking engagement in California, Tracie’s car breaks down. “Here I am, lugging my bags to get on the bus. I’m tired, I’ve been on a plane all night. [And] I look up and see my picture.” With her phone dead, Tracie nabs a nearby police officer and asks him to snap it for her. Staring at the larger than life image of Tracie covering a wall in Atlanta’s bohemian Little Five Points district, the office responds, “You know what, I thought that was an actor.” “No,” Tracie says, “I’m a stroke survivor. I’m a stroke thriver.”


Originally published at wallsdownmag.org.