Stroke Warrior

When Marian Rubenfeld ’76 suffered the worst migraine of her life, she was forty-seven years old, a highly trained neuro-ophthalmologist, and the mother of two young children. She had just finished undergoing a routine cardiac stress test and was recovering at the hospital when she called her husband to cancel their evening’s anniversary plans. Rubenfeld told him she would soon be driving home when her husband, himself a neurologist, insisted on picking her up instead.

By the time he arrived at the hospital, she was unconscious. A CT scan revealed that Rubenfeld had suffered a hemorrhagic stroke—a bleed—on the left side of her brain.

And so began the second part of this physician’s life, when she grew to understood in a far more personal way what so many of her patients were experiencing. It would take nine months of intensive rehabilitation before Rubenfeld could return to work on a part-time basis, and even today—fifteen years after that catastrophic event—her right side remains weak and she struggles with expressive aphasia, the loss of the ability to speak fluidly. Those early months after her stroke, says Rubenfeld were “a very bleak time.”

Neuro-ophthalmologists like Rubenfeld deal with complex, systemic diseases that manifest in the visual system. A significant percentage of her patients are themselves stroke survivors, struggling with problems in their visual fields, eye tracking, and other ocular disturbances. “Today, any stroke survivor sent to my office is a blood brother or sister,” says Rubenfeld, who has a four-month waiting list for new patients. “They get the royal treatment, and we get them in as soon as we can.”

Although she doesn’t immediately tell patients that she is a fellow stroke survivor, she usually confides in them at some point, especially if they are frustrated by their own aphasia. If Rubenfeld witnesses them struggling and anguished during an appointment, “I take them by the hand and tell them, ‘I know how it is, and I will wait for you to get it out. I know what it’s like.’ It’s in those intimate moments that I make a connection.”

Longtime patient and stroke survivor Robert Gerloff has experienced that connection. “When Dr. Rubenfeld told me she’d had a stroke, that immediately made me comfortable,” he says. “She is warm and kind and outgoing, and she talked all the way through my eye exam. That made me feel good.” Adds Janet Mills, the wife of another patient, “Her strength is her true understanding of the patient’s inability to communicate with words. She knows they understand what she’s asking, and are thinking of the answers, but they just can’t easily bring forth the words to reply. Her empathy is her greatest asset.”

Rubenfeld’s recovery was likely aided by the fact that she is no stranger to working hard and overcoming obstacles. Part of the third generation of a Russian Jewish family living in the Bronx, she was the first person in her family to attend college, earning a scholarship to Barnard after graduating from the Bronx High School of Science.

Even with a generous scholarship, Rubenfeld needed several campus jobs to pay for housing—which she could still only afford for half of each semester. “After I paid tuition and fees I was broke,” she says. “So I lived at home for the first part of the term, then moved into the dorm when I’d saved up enough.” Because living in the Bronx meant a two-hour daily commute to campus, says Rubenfeld, “it felt like deliverance when I could move into the dorm.”

But the biology major never felt set apart by her financial struggles and working-class roots. “Nothing was ever made of it,” she says. “Barnard was very big on scholarships and on seeking out girls from all backgrounds. I was one of a proud group of city girls and first-generation students.”

As for her memories of those four years, says Rubenfeld, “I had a wonderful experience at Barnard. The teachers were just divine—so into teaching. They were right there with you on the front lines of learning.

“What I took from it,” she goes on, “is a confidence in myself that my professors gave me. The feeling that I could do anything I wanted to do. I’ll forever be grateful to Barnard for that.”

She proved those professors right, staying in the city to earn a medical degree and a PhD from Columbia and to complete a residency in neuro-ophthalmology and oculoplastics (eye surgery). While in medical school, she met her husband, neurologist Frederick Langendorf, who had grown up in Chicago.

When Rubenfeld was ready to apply for her final fellowship, Langendorf surprised her by announcing that he no longer wanted to live in New York City. “It was quite a shock,” says Rubenfeld, who, like many lifelong New Yorkers, had never considered living anywhere else.

Nevertheless, she gamely set about visiting medical centers west of the Hudson, ultimately choosing the University of Minnesota because of Dr. Jonathan Wirtschafter, the extraordinary man who would become her mentor. “He was a brilliant and loving human being,” she says, “and I was a member of his family until the day he died.”

The next few years raced by as Rubenfeld completed her training and she and Langendorf adopted two children from South Korea. Joshua and Maya, now college students, were just five and four years old when Rubenfeld suffered what she calls “my unfortunate incident.”

When she returned home from the hospital after five weeks, utterly altered, her preschool children “didn’t want to come near me,” she remembers. “I could barely speak. I slept an immense amount. And the kids talked to the nanny instead of to me. I thought, ‘What havoc have I wrought on our household?’ ” She became so depressed she questioned why she hadn’t died from the stroke.

Then one day in rehab, the speech therapist said she was making great strides, and Rubenfeld told herself, “ ‘I am going to get over this.’ I have lots of positive willpower, it turns out!” says Rubenfeld. “I never really knew it until then.”

Today, despite her busy patient schedule, she still needs more sleep than most people, drags her right leg when she’s tired, and speaks somewhat slowly, occasionally searching for words. “And I can’t rollerblade or serve in tennis anymore!” she laments, although she continues to travel, most recently to Hawaii.

At age sixty-two, Rubenfeld has no thoughts of retiring, despite the fact that her husband recently did. “Some Fridays I’m exasperated, especially with coworkers who talk so fast they leave me in the dust. But by Monday, I’m all right again,” she says. “I get so much enjoyment from my patients, from fixing each person who comes to see me. I feel as if I’m making a difference in their lives.”

Like so many others who have been through a near-death experience, Rubenfeld has found the devastating stroke she suffered in her forties has changed her in ways less apparent and more profound than a weak tennis serve. “My husband says I’m mellower and more patient,” she says. “I know I listen better, and I think before I speak.

“But the thing that has changed the most in my life is how grateful and happy I am. I got to raise my kids to adulthood, spend more years with my husband, and go back to work. Anything else is gravy.” •

Lynette Lamb is a Minneapolis-based writer and editor.