Janel Nadeau was lazily watching TV with a friend on a warm summer's night when she got up to go to the bathroom.
As soon as the 19-year-old old stood, she collapsed to the ground. Her right side was paralyzed and, as she tried to speak, a nonsensical jumble of words tumbled out.
Deep in Ms. Nadeau's brain, a blood vessel had exploded; she was suffering a life-threatening hemorrhagic stroke.
Fortuitously, her friend called 911 and Ms. Nadeau was rushed immediately to the stroke unit at Foothills Hospital in Calgary.
The stroke was in 2001, but Ms. Nadeau is still there - not because her treatment went badly, but because it went amazingly well.
Today, she is Dr. Janel Nadeau, a 27-year-old intern and neurologist-in-training at Foothills Hospital, one with a particular affinity for the stroke unit.
"This is my calling," Dr. Nadeau said, explaining her decision to pursue a career helping those who, like her, have been felled by stroke and other brain disorders.
She will admit that it is "a bit weird" and a "little surreal" to be working alongside the nurses and doctors who saved her life. But above all, she said, "it's awfully inspiring."
The road from patient to doctor, from healed to healer, has been a long one for Dr. Nadeau. It is a tale of perseverance and a striking example of how the once-accepted belief that the brain could not heal is simply not true.
After the stroke, she spent nearly four months in the stroke rehabilitation unit at Foothills, learning to walk and talk again, and relearning to eat and read and write as the brain rewired itself. She estimates that she's recovered about 90 per cent of her previous brain function.
Dr. Nadeau also made a fateful decision: "After the stroke, I had one overriding goal in mind - to become a doctor. The recovery was tough sometimes but that kept me going."
Prior to her stroke, Dr. Nadeau had already completed one year of university, in life sciences. She decided to return to her undergraduate studies.
She also decided to have surgery to improve the flow of blood to the left side of her brain in the hope of reducing the chance of a second stroke.
There are two principal types of stroke: an ischemic stroke, in which a clot blocks blood flow to the brain, and a hemorrhagic stroke, in which a blood vessel ruptures. Strokes killed 14,054 Canadians in 2005, the most recent year for which data are available from Statistics Canada.
While strokes generally strike older people, they can occur in younger people who have sustained damage to their arteries. In Dr. Nadeau's case, she suffered from chicken pox as a child, a virus that is known to attack blood vessels in the brain and weaken them, and she may have a congenital problem as well.
Specifically, she suffered from Moyamoya syndrome, which results in blockage of the carotid arteries to the brain and the development of a huge clump of smaller blood vessels to compensate. (On a diagnostic image, these look like a puff of smoke - which is what "moyamoya" means in Japanese.) After her stroke and surgery, Dr. Nadeau wanted to help others with similar challenges, and became a volunteer with the Heart and Stroke Foundation of Alberta, Northwest Territories and Nunavut.
One day, at an event, she bumped into Michael Hill, the director of the stroke unit at Foothills who had treated her years earlier for her stroke. "It was happenstance," he said.
The two got to talking and, when Dr. Hill realized she was a science student with experience working in a lab, he offered her a job doing research. "Then we corrupted her to get her thinking about neurology as a career," he said with a laugh.
During the year she worked in the lab, Dr. Nadeau was accepted to medical school, which she has since completed. She has also finished the first year of a five-year internship to become a neurologist.
Dr. Hill - who was given explicit permission to talk openly about his former patient to The Globe and Mail - said that, because of the stroke, Dr. Nadeau has some limitations and additional hurdles that her fellow interns don't face.
She still has weakness on the right side, walks with a slight limp, and has some numbness in her hand, meaning a future as a surgeon is out of the question. Like all stroke survivors, Dr. Nadeau also suffered some brain damage and still has some cognitive problems.
"Janel doesn't read as fast as her peers and that's a real challenge because you have to ingest a lot of information during medical training," he said.
However, Dr. Hill added that her experience as a stroke survivor will give her a distinct advantage of empathy and understanding.
"Janel is a very determined young lady and she will be an excellent neurologist," he said.
Dr. Nadeau recognizes her strengths and weaknesses. She believes her ability to empathize with stroke survivors will be an asset but worries that, given her journey, she may get too emotionally attached to patients.
While the training to be a neurologist is demanding, so too was her recovery from stroke, so she is not daunted. In fact, the only lingering worry Dr. Nadeau has about her future is the knowledge that stroke survivors are at much higher risk of a subsequent stroke.
"It's a weird feeling knowing that your head could explode," she said.
But, after a short pause, Dr. Nadeau noted wryly that this has already happened once and she emerged from the experience with a "post-stroke life that's richer and fuller."