My “extremely rare” post-surgery experience: I Didn’t Speak English
Coming-to from my tonsillectomy was a real hoot.
My adult tonsillectomy — they kept telling me it was an adult tonsillectomy — would be much more painful than a child’s. Due to added years of tonsil infections, my already-too-big tonsils would have additional scar tissue through which the surgeon would hack his way. I would have 2–4 weeks of recovery, and it would suck.
My friend Leann reported that her adult tonsillectomy was “100 times as painful as my c-section.”
What no one warned me about was what would happen when the anesthesia wore off:
In what would turn out to be an “extremely rare” but known phenomenon, I would not be able to speak my native language, English.
And by “speak,” I mean write. My adult tonsillectomy had left me with bloody pulp for a throat, so when I woke up with a pleasant nurse hovering above me, I struggled mightily to communicate at all. First I tried to use American Sign Language sign to say “thank you.” When that meant nothing to her, I made the international wrist-wiggle that means, “I need some paper.” So she handed me a clipboard.
“Probé decir ‘Gracias,’” I wrote.
I tried to say “thank you.”
I looked down at the paper. No, this wasn’t right.
I meant to write that in English, I thought, How peculiar.
I have spoken English for (checks watch) 37 years or so, while I have been learning Spanish for only about two years, mostly on a cell phone app. I have practiced every day, but my skills are intermediate at best.
“Oh!” the nurse said, looking at the paper. “Hablas español?”
Kind of?
I shook my head no, then nodded my head yes. Then no again. Then yes again. The nurse did not speak Spanish, so I knew she was essentially asking if I only spoke Spanish. As in: should she even try communicating with me in English?
“Estoy probando aprender español,” I wrote.
I am trying to learn Spanish.
But even this sentence, I had meant to write in English.
This is when it really struck me: I can’t find English. It isn’t here, like a computer program that won’t turn on.
The nurse had clearly dealt with a lot of strange things, but not this. She looked from me, to the page, to me, blinking with confusion.
“No recorder como decir en inglés. WEIRD! Ha ha!” I wrote, clumsily not-conjugating my verbs.
I don’t remember how to talk in English. WEIRD! Ha ha!
Maybe it’s back!, I thought, recognizing the word “weird” as English, and the words “ha ha” as something like it.
“Quiero ver [a] mi prometido,” I wrote.
I want to see my fiancé.
The nurse must have gone to find Drew anyway, because in an instant, he was by my side.
“Should I get a translator?” the nurse asked Drew.
“No,” he said, a little confused. “She speaks English.”
“Oh…” she said, gesturing to the paper, which Drew looked at quizzically.
“She’s been learning on an app…” Drew said, slowly, trying to process what he was looking at.
The nurse cocked her head, mentally searching for some way this explanation was an explanation.
All three of us looked at one another, unsure how to proceed. Not quite lost, and not quite found. Like three people bobbing on the edge of a dock, unsure how to tie up the boat.
I kept writing. For some reason, I was desperate to communicate my gratitude for the surgery itself, more than to recover the only language I speak fluently.
“Very thankful, thank you.” I wrote, then lit up with relief. The sentence had come out in English!
Drew glanced at the page.
“Oh, she wants to say thank you,” he said.
“It’s no problem, of course,” said the nurse, relaxing. She began giving Drew my post-op instructions, but I wasn’t done.
“No tonsils!” I wrote, flagging them for attention. “Tonsils bad, no thanks!”
Drew read the message and gave me a thumbs-up, then waved his hand at the nurse, letting her continue without this important update.
My English disappeared again, and I wrote, “No recorder como decir en inglés! Gracias? ‘Thank you’? Es correcto?”
I don’t remember how to say it in English! “Thank you”? Is that right?
Drew nodded and smiled warmly.
I continued my notes, proceeding in English for the rest of the twenty or so minutes as she gave us instructions.
The whole episode in which I could speak (write) only in Spanish lasted maybe three minutes. I took photos of the notes, sent them to a few friends, and posted them to Instagram, delighted at the strangeness of the human mind.
The vast majority of the comments on my photos were to the tune of either, “That must have been scary!” (it wasn’t), or “How cool!” (it was). But a tiny minority had had a similar experience, waking from anesthesia and similarly finding themselves unable to access their native tongue, though most for a much briefer period than I. A few confused words in Spanish or German or ASL, then English.
Now I was really curious, so I pulled up Harvard’s research library website and searched the anesthesia literature for “foreign language.”
Amazingly, this phenomenon, considered “extremely rare,” was documented in the literature only five times, all single case studies. The most thorough overview was written by Juraj Sprung and Emily Pollard, two Mayo Clinic practitioners. It was printed in the Journal of Clinical Anesthesia in 2017, after Sprung and Pollard witnessed a patient only able to speak Norwegian — for five whole hours! — after anesthesia, though his native tongue was English.
The authors note that “foreign language syndrome” appears most often (though still quite rarely) in brain damage cases, while post-anesthesia cases are so unusual, only four can be found in the literature, with the authors noting a fifth.
All of the case study writers — anesthesiologists all — had similar theories about the cause: native languages are, for the most part, nestled neatly into one area of the brain, while languages adopted later (and by later, I mean old enough to be banned from the kids’ menu) are more diffuse throughout different regions of the brain. We are evolved to intuitively harness language within the first few years of life; if we attempt to learn it later, we find it much harder, and more of the brain comes on the scene to help with the process.
Add to this the peculiar waking process inherent in anesthesia, in which the brain popcorns awake unpredictably (quite apart from the way our brains naturally wake up, in a roughly consistent manner), and the odds of the native language being available before the others is slightly reduced. With my native language asleep, I would have been completely nonverbal had I not known a little Spanish. But with a kind nurse leaning over me expectantly, the drive to communicate was so strong that my other regions hopped alive, ready to offer their rudimentary Spanish as a substitute.
Interestingly, Pollard and Sprung note that all five of the case studies in the literature are men.
“…while this may be a coincidence, another plausible explanation may be considered,” they write. “Language is more strongly lateralized in males than females, and women have bilateral activation during speech versus men who have left dominant activation. It has also been described that males have a higher incidence of aphasia [language loss] after lesions to the left hemi-sphere.”
(While it is not stated explicitly, the five men appear to be cis, and the broad characterizations above appear to reflect findings across mostly cis brains. Things might change substantially with a broader view of what “man” means.)
The comments on my Instagram post (and a related Facebook post) seemed to be relatively gender-diverse, so I contacted Dr. Sprung via email and related my story to him, attaching photos.
“Thanks lot for letting me know,” he replied. “Extremely rare event after anesthesia, and not a ton of people — even in our circle [of anesthesiologists] — is aware of this phenomenon.”
I asked if he had heard from anyone else since publication, and if so, if any were women. He replied, “Yes, a couple of months ago from an anesthesiologist in the Middle East. Patient was male.”
Of course, with only five official cases in the literature, the male-dominance could merely be a coincidence. Or it could reflect some other variable that’s more common in men, like certain forms of neurodivergence (hello, my family!).
In any case, it is an honor to finally be the First Woman to Do Something, even if that something is speak pretty bad Spanish, and even if I am actually not the first woman at all… just the First Woman to Have Post-Anesthesia Foreign Language Syndrome and Email a Researcher About It.
“I wish you all the best,” Sprung closed his email to me. “And progress with Spanish even without tonsils.”
