The Broken Class

When a stroke strikes, it hits hard — and its victims are often left penniless and defenseless

By Alan Fisk

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Illustration by Lorraine Tuson

Peter Cornelis was a rising star in the industrial fastener industry and often called on the Detroit Three automakers for business. He was an international marketing executive and super-salesman who was about to go on a world tour of his company’s facilities when he had his first stroke.

“I was on the way up; I was the golden boy,” says Cornelis, now 57, who has survived six strokes. “Then I blacked out in my office at home one day. I woke up in a puddle of pee and called 911. I knew it was a stroke, and it was severe.”

Cornelis had suffered an aneurysm — a blood vessel had burst in his brain and caused damage that eventually paralyzed the left side of his body. Luckily, he got to a hospital and was quickly treated. The outcome for stroke victims is much better if they’re treated within three hours. Or as Cornelis puts it, “time loss is brain loss.”
Cornelis tried to go back to work but, suffering from chronic headaches, was let go by his employer, entering the ranks of what he calls “the broken class.” He had several more strokes and surgeries to put coils into his brain to reduce the blood flow to the aneurysm. Finally he had a craniotomy to repair the aneurysm and relieve the pressure on his brain. Afterward he couldn’t speak. “I was lucid and heard and understood everything,” Cornelis says. “But you look like an inanimate object.”

After months in hospitals, he spent many more months in nursing homes and in physical and occupational therapy. When he got home all he could move was his left hand. Slowly, he re-taught himself to paint, eventually using both hands. He spent a year and a half in a wheelchair and is now on disability, suffering from fatigue and short-term memory loss. He’s now able to walk around his neighborhood, if somewhat erratically, with assistance.

“But the big losses are beyond physical damage,” he says. “It’s the emotional damage. You shed tears or laugh at the most inopportune times. You even laugh at funerals.” Cornelis says he knows stroke survivors who have blind spots, “like looking through Swiss cheese. Some people see only half of the food on their plates.”

Every 45 seconds, someone in the United States has a stroke, the third leading cause of death after heart disease and cancer, and the leading cause of long-term disability among adults. And the costs are enormous — to the victims, their families, and to businesses, insurers, and governments. According to the American Stroke Association, almost $62.7 billion in stroke-related medical costs and disability occurred in 2007.

About 700,000 strokes occur in the United States each year, and over 160,000 people die, says the National Stroke Association. About 500,000 of these are first, or new strokes. Nearly three-quarters of all strokes occur in people over the age of 65, and the risk of having a stroke more than doubles each decade after age 55 — not good news for aging Baby Boomers. In turn, four out of five families will be affected by stroke at some time, while 65 percent of those who have a stroke either die or require special care.

In Michigan, about 5,000 people die each year from strokes and stroke complications, an average of 13 deaths a day in 2006, according to the state’s Department of Community Health.

Blue Cross Blue Shield of Michigan estimates its average cost for a stroke statewide in 2007 was $10,000 to $15,000 just for the hospital stay, surgery, and drugs, according to spokesman Jon Ogar. That does not include doctor fees and rehabilitation costs, including physical and occupational therapy, which can go on for years and be tremendously expensive. It is estimated that of those who survive and who had been working full time, only 53 percent are back at work one year after the most common type of stroke.

A stroke is an interruption of the blood supply to any part of the brain, sometimes called a “brain attack.” If blood flow is stopped for longer than a few seconds, the brain cannot get oxygen. Brain cells can die, causing permanent damage.