As a nurse I have had occasion to care for many stroke victims. It is an illness that has always puzzled me. In one moment an active, vocal, mobile person becomes helpless. How is this to be understood? Is it a punishment, or a curse?

Once, during a nursing conference this theme was addressed by a lecturer, Dr. Marie van Deventer. In her typical alto voice she said, "it is a grace of the spiritual world." At first we, the listeners, were speechless. Then she started to explain, saying, "you must understand life after death to understand the meaning of a stroke. After death we have to get used to living without a body, without our physical legs, our vocal chords, and without the whole stimulus of our senses. A stroke is a like a preparatory phase; you become prepared to move into that state.”

As a nurse, of course, you cannot just say that this is a blessing, and good-bye. You do everything possible to encourage the return of mobility and speech as long as the person is on earth. You want to help ensure that the patient is as conscious as possible.

There are gradations of stroke. Some people are hardly bothered, some have minor speech impairments, and some are bound to their bed.

I personally have not had a stroke, but what these patients have taught me is an immense gratitude for the functions of walking, speaking and thinking, received when we are young. These functions in particular we try to support in stroke patients.

Besides exercising the limbs to encourage resumption of vitality, there is the additional awareness that feet normally touch the ground and now need extra foot wraps.

Then there is the discovery of an aspect of speech which is nonverbal. For example, you ask questions to which patients only have to answer yes or no; sometimes you communicate with a letter chart, or, in a severe stroke, you must observe carefully and interpret apparently meaningless movements.

It is good for us to learn this nonverbal communication because it teaches us to become more aware that the dead are with us, and so we can remain close to those people after death. It is a two-way learning process.

And then there is the experience of the "I" to be enhanced, not just through thinking, but also through sense perception. As a matter of fact the latter never ceases to function, and can even become extremely heightened in such a vulnerable condition.

Ego experience during life is normally centered on ourselves; how much we earn, what we can do. With a stroke a totally different side of the ego now becomes centered in the periphery, almost like a newborn baby with new caring for a person for eight weeks before she died. She could do nothing, and was fed through a tube. However she could enjoy the smell of a tangerine although she could not eat it, and I started cleaning the room with Rosemary Bath Milk because the regular cleaning materials almost made her nauseous.

Then there is the incredible importance of art. I have seen completely unresponsive patients suddenly say something clear when there was music.

Are these three functions of walking, speaking and thinking perhaps not so physically bound? Is there a walking, speaking and thinking independent of the physical function? I don't know because as a nurse I am always dealing with the physical.

If someone is unconscious you still talk to them. You create a rhythm around them. You wash them, feed them and bring some entertainment, but you also give them rest because they need that too.

These are the functions that make us human and connect us on another level. Just because someone has lost a leg and cannot walk, doesn't make them less themselves as individuals, but these functions make us human, even when another human fulfills them. Stroke may mean total dependence on another person; which in itself is an act of love. And that is not restricted to the physical body.

Jannebeth Roell received her degree in nursing in the Hague, Netherlands. She worked in private practice with an anthroposophical physician, and focusing on external therapies. During the course of her practice she worked extensively with the dying. Presently Jannebeth is making anthroposophical medicine.