“She signed to me yesterday,” I told him happily.

“Signed? As in used sign language?”

“Yeah. It was tough for her and she didn’t have a ton of control, but I knew what she was saying,” I replied with a shrug.

“That’s a wonderful sign on both the mental and physical levels,” he said thoughtfully. “No pun intended, of course.” I waved his comment away and looked at him, waiting for further elaboration. There wasn’t any for a few minutes, and he seemed to be composing his thoughts. “It’s very doubtful that she’ll ever regain her powers of speech, even at the most rudimentary levels,” he said sadly after awhile. “But if we can help her get even basic movement and control back in her hands, sign language could be a very useful alternative.”

I just stared at him in silence for a second, not wanting to believe what I’d just heard. Of course, it wasn’t like it came as a complete shock, but I’d been holding out hope that the surgery would have given her at least some chance of speaking again. To hear him say that there was basically no chance of it hurt.

He must have sensed my sadness, because his eyes were sad when they met mine. “I’m very sorry; I know it’s not what we were hoping for. But the good news is that I’m fairly certain we can get enough control back in her hands to do at least basic signing.”

“And the rest of her body?” I asked, unable to stop myself.

“I can’t say for certain, and as I said, the sooner we get her into therapy the more she’ll be able to do. But I don’t expect her to be able to fully care for herself. She’ll probably need at least part-time care for basic tasks that she won’t quite be able to do for herself,” he said gently, not meeting my eyes.

“I can take care of her,” I said firmly.

He sighed and looked at the floor. “Mrs. Fairbanks, I understand that you want to do that, but for the type of care Alice might end up needing, you’d have to become certified as a nurse. It might be possible, because as I said we can’t know anything for sure at this point, but chances aren’t good that she’ll be able to regain her full range of motion, her sense of balance, or enough control to really be able to do what she needs to even with those things intact. After a stroke of this magnitude, the patient has to start all over since the memory of learning those movements has been completely erased. What she’s been able to do so far is incredible for how severe the stroke was, but it’s only the tip of the iceberg in terms of body movement and control.”