Stroke Smart Alexandria — a campaign to stop the scourge of stroke
By Kris Gilbertson
When Alexandria business owner Alan Stillman was 24, he rode a bicycle around the world to promote world peace. He didn’t achieve that goal, but in three decades since, he has improved the lives of millions of people by developing and producing his “iconic communications” known as Kwikpoints.
Alan’s goal now is to eradicate the death and disability caused by stroke, community by community. He will do it through the universal language of pictures, and he has started with Stroke Smart Alexandria.
The numbers don’t lie
Stroke is among the top five leading causes of death worldwide. One in six people lifetime will suffer a stroke. For women, it’s closer to one in five. Some 80% of Americans will have someone in their direct circle—their spouse, siblings, parents, or children—will suffer a stroke. But when treated rapidly, ideally within one hour (“the Golden Hour”), but definitely within three hours, stroke victims can recover with no or few residual effects. When he was a young teenager, Alan Stillman lost his grandmother to a stroke that went untreated for three days.
The vast majority of Americans don’t know how to spot strokes. “We’ve had all these programs, like videos on TV to educate them,” says Stillman, “but unlike the Heimlich maneuver, it hasn’t stuck, and they’ve been pretty darn ineffective.
“What happens is people are just like, I’m a little bit off, let’s see how I feel tomorrow, I’ll call my doctor and get an appointment in the morning. They have all these thoughts, It’s such a bad decision.
“If people can just get it burned into their brain that an asymmetric smile, a drooping arm—if all of America knew this,” he adds, “it would save hundreds of thousands of lives.” This is where the visual language of pictures that is understood by speakers of all languages comes in.
In 2011, Stillman developed initial materials depicting the outward physical signs that a person is having a stroke. He gave 100K copies to the Prince Georges County fire department for distribution among the many non-English speakers living in the county. But Alan didn’t have resources to track the material’s effectiveness, he says, “so it became just a one-time deal and, with my business to run, got kind of got back-burnered.”
A TED Talk opens doors
There are two basic kinds of stroke: ischemic and hemorrhagic. Ischemic means that a blood vessel is blocked, like a hose having a blockage. Hemorrhagic means there is bleeding in the brain. About 90% of strokes are ischemic and there are two treatments: a blood thinner that will dissolve the clot (t-PA) or thrombectomy, a procedure that pulls the clot out.
In a study conducted in Norway* last year, of 613 people who suffered strokes, the 73 who got to the hospital within the first hour, called the Golden Hour, had no residual effects. All 73 went home the next day like it didn’t even happen. “If you can get help right away, it is so treatable,” says Alan. “As you get into the second and third hours, there’s a little bit of issue, but when you go into the fourth, sixth, or eighth hour, that’s when you’re going to live in a wheelchair. Two million brain cells die every minute, so minutes are so important.”
In May 2017, Stillman got an opportunity to give a TED Talk about stroke, and he refocused his efforts on the issue. “The value in having a TED Talk is that people will watch it because it’s a TED Talk,” says Alan, “and that opens doors.” He made two vital connections: Mayor Allison Silberberg and Ann Harbour, Director, East Region Government and Community Relations for the Inova Health System.
Through Ann Harbour, he learned that Alexandria has one of the best primary stroke centers in the country. Inova Alexandria Hospital was awarded the Joint Commission’s Gold Seal of Approval for stroke care and recognized for its outstanding specialized stroke treatments by the American Stroke Association.
Alexandria Senior Services has been presenting stroke awareness talks at senior centers for years. In October 2017, Mayor Silberberg proclaimed a citywide health campaign, Spot-a-Stroke, Stop-a-Stroke, Save-a-Life, to protect Alexandria from the devastation caused by stroke. The goal is to teach every person who lives, works, and spends time in the city how to spot a stroke and that it is critical to call 911 immediately. Local hospitals have made impressive improvements in reducing the door-to-needle time, but it is up to us to lower the onset-to-911 time to give victims the best chance of survival and recovery.
Alexandria Living Legend Rosa Byrd knows the importance of acting fast. She was home alone one summer day in 2016 when she felt a tingling in her left arm that moved up to the side of her face.
Two months earlier, Alexandria Senior Services had given a stroke awareness talk at Charles Houston Senior Center, at which Rosa memorized FAST (F: face; A: arms, S: speech; T: time). Recognizing the onset of stroke, she called 911 and was swiftly transported to Inova Alexandria Hospital. Rosa went home the next day, fully recovered.
Since then, Rosa Byrd has suffered two more strokes. In each case, she or her husband Jack got her to treatment rapidly and she lives with only a little residual effect from the third incident.
Byrd attended the City Council meeting when Mayor Silberberg presented the Stroke Smart Alexandria proclamation. “I am so grateful to Alan,” she says, “because his message is so powerful.”
On Alan’s epic 2-1/2-year bicycle journey, he needed 22 different language dictionaries. It occurred to him one day that if he had just one picture dictionary, he could communicate in any language anywhere in the world.
Kwikpoint visual language translators
Kwikpoints are laminated, accordion-fold cards that present pictures (or icons) signifying specific situations. They enable people speaking different languages to communicate, e.g., travelers, troops on deployment, health care personnel, disaster relief workers. Full size, the cards are around 11” x 24”, but they fold up to 5-1/2” by less than 4”, taking up very little space in anyone’s gear. “It’s called Kwikpoint,” says Stillman, “because if you want to get your point across quickly, you quickly point.”
Because he knew travel best, Alan first developed a Kwikpoint for travelers that depicted the most common situations where language could be a barrier and included translations of common phrases.
The travel Kwikpoint sold well. Then a physician friend who volunteers in sub-Saharan Africa told him that health workers going abroad had a real need for medical Kwikpoints. “And then we thought that there’s probably a need in the U.S. as well, because 10 percent of America doesn’t speak English very well, and that got me into the medical area,” says Alan.
He also developed a Kwikpoint for TB clinics that was adopted by WHO, CDC, and USAID, and is used all internationally for better TB diagnostics. “It is my best example of how this really simple idea thought out and executed can be impactful.”
Red Cross disaster volunteers carry Emergency Assistance Kwikpoints. When your home is destroyed by a catastrophic event and you don’t speak English, relief workers need to understand what you’ve lost: your roof, your bed, your hearing aid, or your teeth in the flood, etc. It is used in all chapters of the Red Cross.
September 11, 2001
When the 9/11attacks took place, the great bulk of Stillman’s business involved consumer travel, people going to Europe, Africa, and the Middle East. He thought he was going to go out of business because he knew that travel would dry up for the next year or two.
Three days later, a Marine Corps Major in Hawaii emailed Alan saying that he had been traveling with a Kwikpoint and asking if it could be modified to include military images. This opened the door to working for the USMC, the Army, and eventually more than six million Kwikpoints were distributed to our troops.
In Afghanistan, where local people speak Pashto or Dari, soldiers used phonetically spelled key phrases to ask where the bomb, the IED, the land mine might be. A local resident can point out the location on a landscape picture and provide details (characteristics of the explosive). In one instance, a cache of 500 IEDs were discovered in a basement through the help of a resident and Kwikpoint.
“When the actual combat was going on, I had a 25-person staff and a full floor of a building on King Street. When the military mostly pulled out, I decided to downsize and become what is called a lifestyle entrepreneur,” says Alan.
“I’d rather have a smaller business but do something that is really important to me, because this is about half my life, about 20 hours a week giving talks and getting materials out, so I chose to have a much smaller business so I can have this charity,” he adds.
NOTE: Stillman is funding Stroke Smart Alexandria himself, so he doesn’t need to take donations and hasn’t formed a 501(c)(3). He would like donations, but they will not be tax deductible.
“Mostly what I need,” says Stillman, “is sweat labor. Someone to help me go around to all these places and say can we put it out at your store or can we hang it on your wall?” Senior Services of Alexandria has put it out to all their locations, and Alan gives talks frequently to places like Martin de Porres Senior Center and Charles Houston Senior Center.
Getting into doctor’s offices has been “tricky” he says, because it’s hard to get doctors’ attention. But pharmacies, like Neighborhood Pharmacy in Del Ray, and Giant pharmacies stock posters, wallet cards, and magnets. Burke & Herbert has a Stroke Smart Alexandria poster in all their break rooms, but a lot of other big companies in Alexandria have hundreds of employees. Just getting a poster into their kitchens could save lives. Any help will be welcome because there is so much to run down: churches, schools, businesses.
“Stroke’s been called the most preventable cause of death in America,” he adds. “Just knowing the signs and calling 911, you’re good! Giving up cigarette smoking, not so easy. Losing weight, not so easy. But knowing how to spot a stroke? Very easy!”