Dr. Martha Sarno, former director of speech-language pathology at the Rusk Institute of Rehabilitation Medicine.

Words to Live By

A Pioneer in Speech Pathology Marks Her Sixth Decade at the Rusk Institute of Rehabilitation Medicine

Many years ago, a young woman working as a cigarette girl at the old New York nightclub El Morocco stepped into a cab to go home late one night when she was suddenly struck speechless by a brain aneurysm. The driver, thinking her mentally ill, took her to a psychiatric hospital, where she remained for three months, speaking only gibberish. Finally, someone thought of contacting Martha Sarno, MA, MD (honorary), former director of speech-language pathology at NYU Langone Medical Center’s Rusk Institute of Rehabilitation Medicine.

“It turned out she had aphasia,” explains Dr. Sarno, “meaning that her damaged brain had lost its ability to access words. It shows how essential language is for relating to the world. To lose the ability to communicate with other human beings is incredibly isolating.”

Typically caused by a stroke or head trauma, aphasia affects 1.5 million Americans. Yet Dr. Sarno, who is celebrating her 60th year as head of the program she founded, remembers a time when this devastating condition was virtually ignored. “When Dr. Howard Rusk hired me,” she recalls, “the word ‘stroke’ was taboo, and there was virtually no treatment for aphasia.”

One of Dr. Sarno’s first steps was to devise techniques that helped patients retrieve words, practice conversation, develop compensatory skills, and acquire peer support. She created the first tool of its kind to assess how people with aphasia use everyday language. This helped to shape the theory and practice of aphasia rehabilitation worldwide. Dr. Sarno’s contributions range from researching recovery and rehabilitation in aphasia to helping patients’ families cope with daily challenges. To supplement coverage for those without adequate insurance, Dr. Sarno established programs staffed by volunteers so that patients can practice conversing free of charge.

“The therapeutic process can’t be rushed,” says Dr. Sarno, “because the brain needs time to heal.” Over months or years, patients often regain some of their former vocabulary. Still, even the most successful patients may never communicate with the same facility. “You don’t recover from aphasia,” she adds, “you recover with it.”

Bernard Aptekar, a retired art professor who received speech therapy at Rusk after suffering a stroke 10 years ago, exemplifies both the possibilities and limitations of aphasia treatment. Today, he speaks fluently, if a bit slowly. A listener would never guess that he had once been reduced to grunts and gestures. “I knew what I was trying to say,” he recalls, “but nothing would come out.”

Frustrated and angry, Aptekar resisted treatment—until his young granddaughter hopped off his lap one day, bored by his inability to respond to her chatter. Determined to do whatever it took to speak again, he began to visit Rusk five days a week, signing up for every aphasia program available. After three years, he spoke well enough to return to teaching. A near-complete recovery like Aptekar’s is rare, though.

One evening during the mid-1980s, after delivering a speech on the social plight of aphasics, Dr. Sarno was seized by the need to do something concrete to back up her words. Accordingly, she founded the National Aphasia Association, devoted to sharing information and linking patients to local support groups. “The association’s website had 400,000 hits last year,” she says proudly. That speaks volumes about what Dr. Sarno and the Rusk Institute have done for a condition that, like its victims, has finally emerged from behind closed doors.