CONTENT WARNING: This piece contains mentions of strokes, seizures, hospitals, surgery, and death.

Disclaimer: Names have been changed. Some events have been fictionalized, but the narratives are based on a collection of interviews and real experiences.

Normalcy

The morning started like every other.

Marie opened her eyes to the gentle buzzing of her watch; it was time to get up and start the day.

With a drawn-out yawn, she propped herself up on her elbows while her husband Scott snored beside her.

How I ever got used to that sound, Marie wondered, is a total mystery.

Marie went about her normal routine. The way she swung her legs out of bed was normal, and the way she showered was normal. The way she brushed her teeth, combed her hair, and got dressed was utterly normal.

Marie shut her bedroom door softly behind her as the family’s new puppy, Tonks, happily rubbed against her legs. Tonks whined, trying to tell Marie that she needed to go outside.

“Alright, let’s go!” Marie whispered, careful not to speak too loudly and wake her kids.

Back inside from their early morning walk, Marie started making her lunch while Tonks crunched her breakfast in the mudroom. Marie could hear Scott getting out of bed, and she stopped cutting peppers to start making coffee.

Marie grabbed the coffee pot and walked over to the sink, only to stop and stew in frustration as she noticed the dirty dishes still sitting there from the night before.

Staring at the dishes, Marie remembered a conversation she’d recently had with her husband about how she didn’t want to have to ask him to do the dishes — that he should know to do them because they’re dirty and sitting in the sink.

Scott didn’t seem to understand and kept saying “If you want me to do them, then just ask!”. By the end of the conversation, Marie was biting her tongue. She wanted Scott to understand, but she didn’t want to cause more conflict.

The next day while scrolling through the morning news, Marie came across the terms ‘emotional labour‘ and ‘invisible labour‘ in an article. The terms perfectly described her’s and other women’s experiences as the caregivers of the household and of society. Marie put so much effort into remembering birthdays and doing the unacknowledged work of being a mother — no matter the state of her health or mind. The work she did for her family and around the house often went thankless and overlooked. Managing emotional and invisible labour was an unpaid job that men didn’t understand.

With a deep sigh, Marie shoved some dishes aside and filled the coffee pot with water. She pressed ‘start’ and the coffee machine awoke with a hiss.

Marie turned from the counter to the fridge to grab the milk.

~*~

Charlotte awoke to a small body burrowing its way into her covers. She opened her eyes to see her bedroom door slightly ajar and Samson, her orange tabby cat, peering in.

Wriggling around under her duvet was Adam, her five-year-old son and human alarm clock. He would wake up around 5:30 a.m. every morning and crawl into her bed.

“Mama,” Adam whispered loudly, “are you up yet?”

Charlotte rolled over to face him.

“I am now, sweets.” Charlotte sat up and rubbed the sleep from her eyes. Adam bounced on the bed, now fixated on Samson in the doorway. He patted the end of the bed, whispering psspsspsspsspss.

“C’mere, Sammy,” Adam said. Samson blinked twice and then — in true cat fashion — turned around and walked away. Adam began to pout, but Charlotte scooped him up in her arms before the tears could start.

“Ready to start the day, my little man?” Charlotte asked. Adam nodded.

By 7:45 a.m., Adam and his backpack were tucked into the back seat of Charlotte’s car and by 8:07 a.m., she was dropping him off at school.

Charlotte watched from the sidewalk as Adam’s kindergarten teacher lined the students up by the brick wall of the school and began her headcount. After she passed by Adam in his bright green shirt — he picked it out himself — he turned to his mom and waved, just like he did every day.

And just like she did every day, Charlotte waved back.

~*~

It was 2:57 a.m. and Annette had hardly slept.

Christopher, her husband, had begun sleep talking recently. This, coupled with the hum of his new Continuous Positive Airway Pressure (CPAP) machine to combat his sleep apnea, meant Annette hadn’t had a restful night in nearly a month.

She’d often lie awake in fear that despite his machine, Christopher would stop breathing entirely. It had happened a few months before he got the CPAP machine, and Annette swore it felt like an eternity before he started breathing again. In reality, it had only been a few seconds.

In their 52 years of marriage, Annette never thought a bit of snoring and a machine would cause her this much anxiety.

Christopher had been silent for a while, save for the softness of his breathing and the dull hum of the CPAP machine. Annette allowed her eyes to close and was on the brink of sleep when Christopher twitched, kicking her on the side of her leg. He muttered something incoherent before falling still.

Annette couldn’t help feeling a little frustrated. Her eyes wanted to close so badly, but her wandering mind and racing heart kept her wide awake.

At 4:26 a.m., after hours of staring at the ceiling, Annette gently lifted herself out of bed. As long as she stayed in the room with Christopher, she wouldn’t sleep.

As guilty as that made her feel, Annette reassured herself she’d be able to hear Christopher if he needed her.

She would keep their bedroom door and the door to the spare room — where she intended on spending the rest of the night — open.

No Warning

It happened in an instant.

As Marie stood from grabbing the milk out of the fridge, she was hit with a wave of dizziness unlike anything she’d ever experienced. She placed the jug on the counter and shut the door, waiting to see if she was just having a head rush from standing too quickly.

But the dizziness didn’t fade. Marie turned to walk out of the kitchen and sit down. As she started to walk, she realized her left leg was dragging. She couldn’t lift it as well as she could a minute ago.

Marie sat at the kitchen table, confused. She felt fine, aside from her leg and the dizziness. Marie tried moving a little from her spot at the table, and as she did, her left arm began to feel the same way her left leg did. She sat back down.

As she sat there trying to figure out what just happened, Scott emerged from the hallway and gave her a confused look.

“Everything okay,” he asked. Marie just looked at him.

“I — I’m not sure,” she said. Marie explained what had just happened as Scott pulled up a chair. He looked worried.

Scott started asking Marie a series of questions, just in case something was affecting her memory. What was her name? How old was she? Where did she live? What were their kids’ name? All the standard questions Marie had taught him to ask in an emergency that she’d learned from working at a hospital.

“Well,” Scott said, “Your face isn’t drooping.” He’d started going through the F.A.S.T acronym used to determine if someone is having a stroke.

“My arm feels funny, though,” Marie said. “But maybe it’s just something in my back or neck?”

“Yeah, maybe,” Scott said, but he didn’t look convinced. “You aren’t slurring either.”

They sat in silence for a moment, wondering ‘what next?’.

“I should go to the ER,” Marie said, finally, “just in case.”

~*~

It happened in an instant.

One second, Charlotte was standing on the sidewalk waving to Adam. The next, she was on the ground. Faces and hands blurred in front of her as Charlotte tried to make sense of what was going on.

Charlotte could hear Adam yelling from somewhere in the distance.

Her head felt like it was going to explode.

“What’s happening?” Charlotte asked, but the words didn’t quite sound right. It felt like she was talking in slow motion and she could barely move the left side of her mouth.

She could still hear Adam yelling and his voice, coupled with the sound of sirens and the movement of other people around her, made her head feel like it was going to explode.

“What’s your name, dear?” a paramedic kneeling next to her asked. Charlotte felt someone slide a board underneath her right side.

Charlotte blinked at them. She knew the answer: her name was Charlotte. But every time she tried to say it, the word slipped out of her grasp.

Adam was crying now.

Charlotte tried to turn her head to find him, but someone had secured her head with a brace.

Adam needs me, something’s wrong, Charlotte thought. But how could she be there for him when she was the something wrong?

Charlotte felt her body heave and suddenly she was in an ambulance. The blurry bodies of the paramedics in their blue uniforms rushed around her. Charlotte thought they looked like what the wind might look like if you could see it.

Amid the gusts of blue, Charlotte spotted a speck of green.

Adam.

Her boy, her baby boy. Charlotte tried to reach out to him with her left hand, but it wouldn’t move.

Charlotte felt her body seize, and her vision went black.

~*~

It happened in an instant.

Annette watched Christopher through the open door for a moment. As she turned to walk to the spare bedroom, a wave of sudden, violent dizziness came over her.

Annette tried to catch herself. Her left hand collided with the doorway, but it did nothing to stop her fall.

Annette hardly realized she’d touched the wall at all.

All she felt in her left hand and foot was a tingling sensation.

Christopher often said that when his foot fell asleep, it felt like what television static looked like.

Annette’s entire left side of her body felt like TV static, but static that could fill the jumbotron at her grandson’s hockey games instead of her 55-inch TV at home.

As Annette fell, her shoulder hit the wall and slid down to the floor. She couldn’t push herself up.

Why am I on the floor? Annette thought. She was tired; shouldn’t she be in bed? Annette tried to stand, but the dizziness persisted and her left side still felt staticky.

Why couldn’t she move her left side? And why was she on the floor?

Right. She had tried to go from her bedroom to the spare bedroom to get some sleep.

But why did she need to move bedrooms? And why am I on the floor in the hallway?

Annette looked up to see a figure walking towards her. The vision in her left eye skewed, and she could hardly see in the dark. For all Annette knew, an intruder had broken in and was about to rob her.

“Annette? Annette, honey, why are you on the floor?” Christopher asked.

Christopher.

Christopher came into view. He knelt in front of Annette and grabbed her hands, but her left one laid limp in his.

“Oh, god,” Christopher whispered. “I’m calling an ambulance.” He got up and started for the landline beside their bed.

Watching him walk away, Annette suddenly felt very alone.

She wanted to call out to him — to the man who’d just tried to help her — but she couldn’t remember his name.

After

The rest of Marie’s day was spent at the hospital getting various tests done to determine the cause of her episode. The first few came back negative; the doctors couldn’t find anything wrong.

The waiting stressed Marie out the most. She couldn’t help but wonder if there really wasn’t anything wrong, and she was just wasting the hospital’s time.

The doctors kept coming back and forth to take her for more tests. After the second MRI (magnetic resonance imaging), the doctors came back to Marie with an answer.

“You’ve had a stroke,” the neurologist said.

She went on to explain that Marie had a transient ischemic attack (TIA) — essentially a mini-stroke. They still weren’t sure yet how Marie had the stroke, but they were going to start doing tests on her heart to see how the blood clot had gotten through to her brain.

Hours later, they had their answer.

Marie had a patent foramen ovale (PFO), which is a small hole in the heart that doesn’t close during development. A PFO is so small that it’s virtually undetectable unless something happens — like a stroke — that brings attention to it.

All the news from the day sent Marie’s mind into a tailspin. Her only saving grace was Scott, who managed to keep her somewhat distracted. But all too soon, visiting hours were over and Scott had to return home to the kids. Their kids were young adults, so they could take care of themselves, but Scott had been talking to them throughout the day and Marie knew they were worried.

Once Scott left and Marie was alone in her room (well, as alone as one can be with three other snoring patients), her thoughts went south.

She couldn’t help but worry about what the next day would bring, and she kept picturing how it could’ve been so much worse.

I’m only forty-six, Marie thought. Strokes are for old people. I’m not old.

The recovery period for Marie never went away, but it slowly got easier over time. She was lucky enough to have an incredible support system behind her. Marie struggled for a while to get through the bad days but now, the good days far outweigh the bad.

~*~

Three weeks after the surgery to fix a brain bleed caused by a hemorrhagic stroke, Charlotte finally had enough strength to squeeze Adam’s fingers with her left hand.

It wasn’t the strongest squeeze in the world, but it was something.

Adam laughed as Charlotte worked to squeeze one finger at a time. She couldn’t help but smile, despite the left side of her face still being a little weak.

“Daddy, look!” Adam said to the man sitting in a chair in the corner, “Mama can squeeze me!”

Jeremy, Charlotte’s ex-husband, barely looked up.

“Cool, kiddo,” Jeremy said. He hadn’t gotten off his stupid phone once since he got there.

Whenever Charlotte was in the room, incapacitated or not, Jeremy always took a backseat with his parenting role.

Women are the more parental ones, he’d tell her. It’s just… more natural.

Not true, Charlotte would respond. Men are just as ‘natural’ at being parents as women. Jeremy would scoff at her and go back to watching TV or playing his video games.

Conversation: over.

As untrue as Jeremy’s statements were, they’d always win. No matter how many times Charlotte asked for help with Adam, with the laundry, or the dishes, Jeremy would look at her and say:

“That’s a woman’s job.”

To keep the peace for the sake of her son and to make sure the house stayed moderately clean, Charlotte swallowed her feelings for years.

She never once regretted the divorce.

Adam looked up from the squeezing-fingers game when a doctor gently knocked on the door of Charlotte’s room.

“Hi Charlotte,” Dr. Pearson said as she walked in, “how are we feeling today?”

Charlotte managed a lopsided smile. “Well enough, all things considered.”

Jeremy stood from his chair in the corner.

“So, Doc,” he started. Charlotte cringed. “When do you think she’ll be able to go home? I’ve got plans, and I’m not used to having Adam full-time. It’s a little exhausting.”

Dr. Pearson looked at Jeremy like she was trying to turn him to stone.

“Sir, your wife —”

“Ex-wife,” Charlotte and Jeremy said at the same time.

“Pardon me,” Dr. Pearson said. “your ex-wife had a brain bleed that caused a hemorrhagic stroke, in case you weren’t aware. It’s not exactly an easy thing to go through. The recovery process is going to be much longer than three weeks.”

“But she can still look after Adam for a while, right? I mean, she’s a woman. They bounce back pretty fast.”

Dr. Pearson gave Charlotte a look that clearly said: is this guy for real? Charlotte tried not to laugh.

“No,” Dr. Pearson said, “she can’t take Adam for a while. Charlotte is going to need to stay here for a while longer for monitoring and physiotherapy. The least you can do for her is to step up and take on a bigger parenting role. Help her alleviate the load.”

Charlotte was grateful for Dr. Pearson. Even she couldn’t stand up to Jeremy half the time, especially when it came to helping around the house. Jeremy, unsurprisingly, had no clue about the weight of emotional and invisible labour women carry.

~*~

Christopher hung his head as he sat in the waiting room. His son, Liam, sat beside him and held his hand.

“There’s nothing you could’ve done, Dad,” Liam said softly. Christopher looked up at him. It was like looking at a mirror image of Annette. Christopher looked away.

Ten minutes prior, Christopher held Annette’s hand as they took her off life support. She’d been pronounced brain dead a day earlier, but the doctors promised to keep her on life support until Liam arrived so they could say goodbye.

After a long conversation with the hospital to get funeral arrangements made, Christopher went home, and Liam went back to his wife and kids at their hotel.

The first thing Christopher noticed when he walked in his front door was how he didn’t hear the click of the lock behind him. He turned around, half expecting to see Annette standing there with the keys in hand. But she wasn’t there, and the keys were in Christopher’s hands instead. Annette was always the one who locked the door behind them.

Getting ready for bed, Christopher noticed all the ways in which Annette was missing. She always grabbed them each a glass of water, turned off the hallway lights, turned on the denture cleaners, and fluffed the pillows before bed.

In his grief, Christopher did none of those things. Instead, he lay in bed and tried to think of all the small, tiny details of their lives Annette had managed that Christopher forgot throughout the years. He managed to think of five before losing his train of thought and falling into a restless sleep.

A few hours later, Christopher woke up gasping for air. He sat in bed trying to catch his breath and reached a hand up to face, wondering why his CPAP machine stopped working.

But it wasn’t on his face, which is why Christopher couldn’t breathe. He could hear Annette’s voice in his head saying Christopher, mask, just like she did every night before they settled into bed.

Christopher missed Annette; oh god he missed Annette. He looked over to her side of the bed and noticed a picture on her bedside table. It was one of those dual picture frames, with one photo on top and one on the bottom.

The photo on top was a black and white polaroid of Christopher and Annette dancing on the day they got married in 1969. The bottom photo was of the two of them in the exact same pose from their 50^th wedding anniversary.

Christopher reached over and grabbed the picture frame. He held it to his chest for a moment before setting it down on his own nightstand, right beside his CPAP machine. He silently vowed to look at it every night and so for as long as the frame stayed there, Annette would always remind him to do one last thing.

If you think you or a loved one might be experiencing a stroke, remember the acronym F.A.S.T:

F: Facial drooping (Typically only on one side of the face)

A: Arm weakness (Again, typically only on one side of the body)

S: Speech difficulties (Are they slurring? Can they speak in full sentences?)

T: Time to call 911 if you or someone else is experiencing any or all of these symptoms.

Strokes of all kinds occur in both men and women but are largely mis- or underdiagnosed in women.

Societally, women are expected to bear the weight of the invisible and emotional loads of their households, even while undergoing recovery for illnesses like strokes. A recovery process in which a woman is expected to fully resume her life as a caregiver immediately after falling ill is not a recovery at all. According to the George Institute for Global Health, women are more likely than men to survive a stroke but have a poorer quality of life afterwards.

For more information on strokes, visit https://www.heartandstroke.ca/.