Ram Dass shares his battle against stroke

By Adele Slaughter, Spotlight Health
With medical adviser Stephen A. Shoop, M.D.

By Ted Shuttleworth Ram Dass survived a potentially life-threatening, massive cerebral hemorrhage five years ago.

In his 1971 classic, Be Here Now, Ram Dass found his faith. But recovery from his stroke challenged his belief in God's grace."

"Everyone said, 'Poor Ram Dass, poor Ram Dass' and I thought my guru's grace had deserted me," says Ram Dass. "I doubted God. My practice wasn't strong enough for the physical, emotional, and spiritual pain I was feeling. I talked to my guru's picture and he spoke to me, he was all around me."

"I realized that stroke was Maharajji's grace," adds the inspirational speaker and author. "I had been superficial and arrogant and the stroke helped me to be humble. I had gotten power from helping people and now I need help for everything. That was the grace. The stroke happened to the ego, and when I could witness the pain, my life got better."

Now 70, five years ago Ram Dass was struck by a potentially life-threatening, massive cerebral hemorrhage. It happened in the middle of a rewrite of Still Here: Embracing Changing, Aging and Dying. As he was imagining being an old man, the telephone rang.

"When I answered the phone, my right side wasn't working, my words were slurred, and the friend on the phone was worried," recalls Ram Dass. "My friends called 911. I was on the floor when these big young firemen came. They stared at me and suddenly, I knew what it was to be old."

"Ram Dass almost died, in fact, up to 50% of the people who have a hemorrhagic stroke as he did, die within 90 days of the incident," says Dr. Rick Frires, Chairman Department of Emergency Medicine Huron Hospital, Cleveland Clinic Health System.

"On the gurney I remember the pipes and the long faces of the doctors and nurses. Later, I found out they thought I was dying," says Ram Dass.

The now of stroke

A stroke occurs when there is lack of blood flow to a certain part of the brain causing cellular death and leaving patients with multiple defects, such as an inability to walk, move arms and legs, or speak. Often stroke survivors experience a dysfunction of the senses, including numbness, visual, speaking, hearing, and tasting problems.

Ram Dass has lost most of the movement in his right arm and leg.

Stroke is the third leading cause of death and the number one leading cause of disability in America. Approximately one in 1,000 people is afflicted by stroke. For those over 75 however, the incidence of stroke increases to 20-30 per thousand. About 700,000 Americans have a stroke each year, often leaving survivors financially and socially devastated. Patients frequently lose the ability to walk, speak, and care for themselves. Stroke related costs total over 30 billion dollars a year in the U.S.

"There are different types of strokes. Probably the most common would be an ischemic stroke," says Frires. "About 80-85 % of all strokes are ischemic which happens when a blood clot blocks the flow of oxygenated blood to a portion of the brain. Only about 15-20 % of all strokes are hemorrhagic strokes, where cranial blood vessels rupture and leak blood into brain tissues."

The risk factors for an ischemic stroke are very similar to the risk factors for heart attacks. Associated with high cholesterol, atherosclerotic disease of the blood vessels is the most common cause for ischemic strokes. Other factors include:

• High blood pressure
• Diabetes
• Advancing age
• Male gender
• Smoking
• Sedentary lifestyle

Influences that may lead to a hemorrhagic stroke are similar to ischemic, but also include a history of prior strokes and excessive alcohol intake. However, most hemorrhagic strokes are associated with hypertension.

"Ram Dass had a massive left hemorrhagic stroke and I believe he had chronic hypertension," notes Frires. "Since I am not his personal physician, I cannot tell you how closely his blood pressure was followed nor if it was controlled, so that may have played a part in his stroke."

Hypertension has no symptoms. To prevent a stroke, Americans must check and control their blood pressure. One natural way of reducing hypertension is a proper diet, low in salt and saturated fats; also recommended are:

• Daily exercise such as swimming or walking
• Stress reduction
• Avoiding tobacco
• Moderate intake of alcohol
• Meditation and yoga

"There were signs before the stroke," says Ram Dass, "but I did not know what they were. Once, when I was scuba diving, I had pains down my right side; but they went away and I thought it was from the air tanks."

Fierce grace

"Stroke taught me that pain is a worthy adversary. The physical pain is great. My right arm and leg are numb. I can't really move my arm up very much," says Ram Dass. "In public I have to use a wheelchair because I have to concentrate on walking so much that I can't look up or I will fall. I have to be here now."

Because of his aphasia — brain damage that affects the language center — it is often hard for Ram Dass to find words. But he maintains that silence deepens the spirit.

"My words are in a bombed-out closet," says Ram Dass "The words are there in the closet, but I can't open the door to get the clothes, and when I do, nothing is in the right place."

The trend nowadays is to initiate rehabilitation as soon as possible after a stroke. Patients who suffer an ischemic stroke are put on aspirin, which helps reduce clotting as well as coumadin to prevent further clotting.

"A person like Ram Dass who had a hemorrhagic stroke cannot be on blood thinners. I started Ram Dass on Citicholine," says Frires. "In Europe this drug has had dramatic results regarding improvement in all kinds of functions: cognitive functions, motor functions. Since he began that drug about three years ago, he has had dramatic improvements. We don't know if it is exclusively from that drug because Ram Dass has been doing a lot of alternative therapies, including hyperbaric oxygen therapy, acupuncture, and physical therapies."

"I miss getting out into nature. I miss taking long walks," says Ram Dass. "Because of my spiritual perspective, I tend to devalue my body. That's my failing. The body has to be as spiritual as the mind and as the heart."

Ram Dass, however, does not think of recovering, but of healing, which he insists is getting closer to the Divine. He is not at all angry or resentful that he has to deal with stroke.

"If I was to get angry, I would be angry with God," he says, "and I can't take the pain of the separation from God."