When the Words Aren’t Yours
Hi, I’m Michael, and I’m a stroke survivor.
What Is Aphasia?
One of the more common impacts of stroke is aphasia — a brain condition that affects a person’s ability to speak. Like strokes themselves, no two cases are exactly alike, but there are some consistent patterns.
One of the more standout — and often embarrassing, confusing, or even offensive — aspects of aphasia is swearing.
Why Do Stroke Survivors Swear?
Let me put it simply. When you have a stroke, the neural pathway for speech gets damaged. That doesn’t mean you lose the words — you still know the language, even multiple languages — but your ability to form sentences or pronounce words clearly can be compromised.
This is why many stroke survivors sound like they’re slurring or drunk. They’re not. They’re re-learning how to speak.
But here's where it gets interesting (and sometimes awkward):
Speech isn’t just one system in the brain. There are different areas responsible for different kinds of speech — like automatic and emotional speech.
The Brain’s Speech Shortcuts
Because automatic and emotional speech are stored in other parts of the brain, they often remain intact even when regular speech is impaired.
So, what happens?
You see someone, and you can say “Hi!” or “How are you?” perfectly — because it’s automatic.
You get frustrated, and instead of saying, “This is bad,” your brain blurts out, “This is fucked.”
Or, “That is shit.”
These are emotional reflexes. You don’t plan them. You don’t mean to offend.
They just… come out.
When Words Fail You—Literally
For me, it got so bad that I started giving content warnings before public speaking engagements — especially when addressing business leaders or donors.
Just the other night, I was on stage talking about the “door to diagnosis” phase when someone arrives at the emergency department. I couldn’t get the word diagnosis out properly.
After three attempts — and with a microphone in hand — I snapped and said:
“That fucking word.”
The room laughed awkwardly. Fortunately, I’d warned them beforehand that swearing might happen. It’s not anger or crudeness. It’s a neurological condition.
It’s Not Personal—But It Still Hurts
Most of these outbursts are self-directed, like:
“I can’t hold the knife — my hand is fucked.”
It’s not, “Fk off” or “Fk you.” But sometimes, people misinterpret the context and respond with scolding or criticism.
Telling a stroke survivor not to use “offensive language” can backfire. It corners them emotionally, triggers frustration, and ironically, can lead to more swearing — this time directed at the person confronting them.
The result? The stroke survivor might leave the group or quit the sport, feeling unsafe, embarrassed, or isolated.
Acceptance Means Understanding
Recovery is about more than rehab. It’s also about acceptance — by the stroke survivor and by the people around them.
We don’t swear to shock or insult. We swear because sometimes, that’s the only part of speech that still works.
So next time it happens, a little understanding goes a long way.