I Had a Stroke and Didn't Know It: A BC Nurse's Story of Anosognosia
Connie Jorsvik, founder of PatientPathways.ca
Before we begin, I want to reassure you: I am completely and utterly well. I've hesitated to share this story because I know how deeply empathetic the Patient Pathways community is. Please know I am healthy, well-rested, and in excellent physical shape.
However, I come from a family tree with so much cardiovascular disease that I like to say the branches keep falling off. I am sharing this so you can learn from a subtle, life-threatening phenomenon you may have experienced without knowing how to describe it, or perhaps have witnessed in a loved one stubbornly refusing care.
Whether you're managing your own family history of heart and vascular disease or supporting someone else through one, our Patient Pathways navigators are here to help BC families — across Metro Vancouver, Vancouver Island, and beyond — make sense of what comes next.
It isn't standard "denial." It is far more deceptive.
The Sunday That Felt “Off”
One Sunday a year ago, I woke up feeling off. Not flu-like—no aches, pains, or stuffy nose—just off. A colleague later described the feeling as "having your head in a fishbowl," where everything feels heavy and distorted. That was exactly it.
I couldn't concentrate, and a headache was brewing. By 10:00 AM, I needed an unprecedented nap. When I describe this to health professionals, they often say denial was setting in. But after witnessing this in myself and others, I know that isn't quite the right word. It was a total physical inability to perceive what was happening objectively.
The Name for This: Anosognosia
We often assume people in medical crises are just in psychological denial: emotionally avoiding a scary truth. But a distinct medical phenomenon is at play here, often called anosognosia (a "lack of awareness of disease"). Unlike psychological denial, this is a physical short-circuit. When the organ responsible for evaluating a threat is the very organ experiencing a lack of blood flow (ischemia), your internal diagnostic system physically breaks down. You aren't emotionally resisting the truth; your brain simply lacks the operating circuits required to recognize the emergency.
I'd Seen It Before
As a retired cardiac nurse, I saw this bizarrely calm, hyper-rational behaviour dozens of times. I had patients drive themselves to the hospital with crushing chest pain, only to call me from their stretcher, laser-focused on what to do about their parked car. Their brains simply couldn't process the gravity of their situation.
It's a pattern I've seen play out again and again, including in Carolyn Thomas's story, where a friend and heart attack survivor described that same instinct to explain away her own symptoms.
Back to Bed
When I woke from my nap, I felt worse. The headache had escalated, and nausea set in. But my entrepreneurial brain insisted: I have to work. I sat at my desk, but the letters on the screen doubled.
I didn't panic. I briefly considered the emergency department, but the thought of sitting in a waiting room for something a nap would surely fix felt too overwhelming to truly consider. I took two Tylenol, a Gravol, and went back to bed.
My Inner Observer Finally Speaks Up
I woke up feeling completely well. Only then did my Inner Observer finally kick in.
"You had a TIA (transient ischemic attack, or mini-stroke)," my slow-poke Observer announced.
The trouble with being a former critical care nurse is that you can talk yourself out of anything. I ran through the stroke checks: symmetrical smile, equal arm lift, clear speech, equal grip strength. Everything seemed fine. Since I had a rare in-person appointment with my Nurse Practitioner the next morning, I told myself, that will do.
Sometimes the System Moves Quickly
I often talk about the healthcare system failing people, but when I told my NP what happened, the system moved like lightning. Within 30 hours, I was sitting across from a stroke neurologist who asked, "What are you doing tonight?"
"Whatever you tell me to do," I replied.
He called Vancouver General Hospital's CT department and requested an immediate CT angiogram for a "red-hot patient." One hour later, I was on a gurney having the scan. Thirty minutes after I got home, he called: "You didn't have a TIA." A long pause followed. "You had a small stroke."
One Year Later
From there, the wheels turned rapidly: an echocardiogram, a 7-day Holter monitor, and a blood pressure monitor - tests that usually take months. Though my numbers were barely elevated, I was started on a low-dose statin and blood pressure medication.
Today my numbers are fantastic, and I feel like I avoided a very serious, disabling - if not life-threatening - trajectory.
Advocacy Starts at Home
Every day at Patient Pathways, we advocate for people navigating complex health journeys. But this experience was a powerful, humbling reminder that advocacy starts closer to home: listening to the subtlest cues our bodies give us, and trusting the people who care about us when our own perception falters.
Our healthcare system isn't always perfect, but when the right alarm bells ring, it can perform brilliantly. Give yourself - and the people who love you - the chance to let it work.
For me, this is the anniversary of an event I'm grateful for, and I dedicate it to Matt Jodion, NP; Dr. Jonathan Gorman, Stroke Neurologist at VGH; and all the skilled professionals in the cardiology, neurology, and medical imaging departments at Vancouver General Hospital.
With care,
Connie
Key Takeaways
If nothing else, what I want you to take away is this:
Trust the quiet alarm bells. If you have the slightest inkling that you need emergency care, do not logic your way out of it. When your brain is compromised, your perception lies to you.
If you live alone, have a zero-tolerance policy. When you don't have a spouse or housemate to look at you and say, "Something is wrong," you are incredibly vulnerable to this phenomenon. If you experience sudden, unexplained symptoms like vision changes, sudden exhaustion, "fishbowl" head, or chest pressure, do not go to sleep. Do not wait to call a friend. Call 911. Be embarrassed if it turns out to be nothing; absolutely no one in the ER will judge you for being cautious.
For care partners and bystanders: Take the wheel. If you observe a loved one acting strangely, looking unwell, or experiencing symptoms, do not ask for their permission to seek care. If they are suffering a cardiac or neurological event, their alarm system is broken. They will tell you they just need to rest or will hyper-fixate on trivial tasks. Recognize this for what it is: a symptom of the crisis, not a rational choice. Override them, tell them what is happening, and call 911 or drive them to the ER yourself.
Know your lineage. Your family history is your most vital medical baseline. Know it, respect it, and act accordingly.
Frequently Asked Questions
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Anosognosia is a physical inability to recognize a medical emergency, caused by the same lack of blood flow that's causing the emergency itself. Unlike psychological denial, it isn't an emotional choice — the brain simply lacks the operating circuits to register what's happening.
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Call 911 immediately — don't wait to see if it passes, and don't drive yourself. Once you're in BC's stroke system, care can move very quickly, as Connie experienced firsthand. If you need help navigating specialist follow-up or next steps afterward, Patient Pathways' BC-based navigators can support you and your family through it.
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Without someone nearby to notice something is wrong, there's no second set of eyes to override the quiet, hyper-rational thinking anosognosia can cause. A zero-tolerance policy — calling 911 at the first unexplained symptom — matters most for people living alone.
