The disconnect: A professor’s loss of reading

Professor M. lived surrounded by books, in a house lined with ancient volumes and dictionaries. Reading and teaching were his life, language was his home, as familiar to him as the walls he lived in. Until the day words began to slip away. One morning, while preparing a lecture, something gave way. The words hovered before him, stripped of meaning. Letters seemed to float, overlap, shift out of place. He could see the characters, but no longer recognize the words. He could no longer read.

At first, he tried to explain it away, perhaps he was just tired, or maybe the light was poor. But as days passed, unease thickened. He could still write, producing elegant, structured sentences. But he could no longer read them back. Writing remained intact, while reading had seemingly vanished from his brain.

This story is inspired by clinical observations of patients with pure alexia, also known as verbal blindness, a rare neurological disorder in which reading becomes impossible, even though both vision and language remain unaffected.

To the outside world, Professor M. appeared unchanged. He was neither blind nor aphasic, but he had lost the vital bridge between vision and language. A small lesion at the junction between visual areas and language centers had severed the fragile connection that allows the brain to extract meaning from written text. For him, the rupture was not merely neurological, it was existential. “I can write thoughts I can no longer read,” he once said. “It’s as if my past self sends me letters I’m now incapable of opening.”

How reading rewires the brain

Reading is not an innate function of the human brain. Unlike spoken language, which is genetically embedded and supported from birth by specific brain regions like Broca’s area (linked to language production) and Wernicke’s area (key to comprehension), reading is a relatively recent cultural invention, just a few thousand years old. This means no brain region is originally dedicated to reading in a newborn.

Instead, the brain adapts by repurposing a region specialized in recognizing complex visual forms, such as faces, to accommodate reading functions. This region, known as the visual word form area, is located in the left fusiform gyrus. Once adapted, it connects with the language areas of the temporal lobe to convert visual signs into sound and meaning.

This reading circuit involves intricate coordination between visual perception, orthographic recognition, phonology, and semantic comprehension. In skilled adult readers, these operations occur within mere hundreds of milliseconds. However, this apparent fluidity masks a delicate neural architecture, one broken link is enough to collapse the entire system. This is precisely what occurs in pure alexia, a rare syndrome where patients can see, speak, and understand, but cannot read.

When letters speak no more

Pure alexia typically results from a stroke affecting the left posterior cerebral artery. This artery supplies blood to a strategic region responsible for processing complex visual shapes, including written characters. The visual word form area lies within this territory. For proficient readers, this area enables the instant recognition of whole words, without the need to spell them out.

When this region is damaged, something remarkable happens: the brain continues to see letters, their shape, alignment, even color. Visual perception remains intact. However, these letters no longer carry meaning. The visual signal no longer reaches the language-processing centers that convert signs into sounds and meanings. It’s as if an invisible wall now blocks the pathway from image to understanding.

In such cases, patients often retain the ability to write. Their linguistic capacities are intact, as are the motor areas involved in writing. They can compose coherent, well-structured sentences. But in a striking paradox, they are unable to read them afterward. What they’ve just written becomes foreign and inaccessible, like a message in an unknown language. This unusual condition stems from a selective disconnection between visual input and written language. The patient is, quite literally, cut off from the alphabetic code that once felt so familiar and fluid. Words remain visible, but no longer open any doors.

Reconstructing the code: Coping with a lost skill

Despite the sudden loss of reading, the brain is not entirely helpless. Thanks to its plasticity, the ability to reorganize neural connections, some patients manage to develop compensation strategies. However, these adaptations are often slow and never fully restore the original fluency.

One common approach is to reconstruct words letter by letter. The patient mentally vocalizes each character in a conscious decoding effort and then tries to reassemble the overall meaning. This method, called serial reading, demands constant attention. What once took a split second becomes a slow, exhausting process, often frustrating. For many, it echoes the earliest stages of learning to read, but in reverse: a regression experienced in an adult body, both cognitively and emotionally taxing.

To support this effort, neuropsychologists often introduce grapheme-to-phoneme conversion exercises, designed to reestablish the connection between letters and their corresponding sounds. These repeated drills engage memory, attention, and perseverance. Results may be modest, but they can provide partial access to reading once again.

Other patients turn to technological aids. Some use optical character recognition software to scan handwritten texts, followed by text-to-speech systems that allow them to listen to their own writing. This workaround restores auditory access to their written expression, a roundabout but effective way of reading through listening.

Some adopt global reading strategies, learning to recognize certain words as visual wholes, much like familiar images, without relying on phonological decoding. This method depends on memorizing high-frequency words and requires repeated exposure, limiting its scope.

A recent, well-documented case by Fitri and colleagues (2022) illustrates the implementation of such strategies. They reported on a 30-year-old man who developed pure alexia following a stroke. He underwent a structured program combining reading exercises with oral repetition and visuo-tactile strategies (such as tracing letters with a finger). After six months, his written comprehension had significantly improved, even though reading fluency remained partially impaired. This case highlights the effectiveness of certain compensatory techniques, as well as the importance of early diagnosis and tailored intervention, even in young patients. It demonstrates that functional reorganization is possible, provided the brain’s plasticity is actively engaged within a structured framework.

However, beyond these tools, whether cognitive or technological, a patient’s quality of life often hinges on their ability to embrace a new reality. For many, the loss of reading is not merely a functional impairment; it strikes at the core of self-continuity, autonomy, and the connection with others. Reading once allowed them to name, understand, and transmit their thoughts. Now, in this long path of readjustment, psychological support is as essential as cognitive exercises.

To relearn reading, sometimes letter by letter, is not just about reactivating a neural circuit. It’s about reclaiming an inner voice. Reconstructing a sense of presence.

When reading disappears, an entire world may fall silent. Nevertheless, within the hush of lost words, some find new paths, less direct, perhaps, but filled with renewed meaning. Learning to read again is not a step backward. It is a different way forward.

References

Cohen, L., & Dehaene, S. (2003). The visual word form area: Expertise for reading in the fusiform gyrus. Trends in Cognitive Sciences, Jul;7(7):293-299.

Fitri, F. I., Pranata, H., & Nasution, I. (2022). Alexia without agraphia in a young adult with ischemic stroke: A case report. International Journal of Case Reports and Images, 13(2), 91–95.

Gaillard, R., Naccache, L., Pinel, P., Clémenceau, S., Volle, E., Hasboun, D., … & Cohen, L. (2006). Direct intracranial, fMRI, and lesion evidence for the causal role of left inferotemporal cortex in reading. Neuron, 50(2), 191–204.

Roberts, D. J., Woollams, A. M., Kim, E., Beeson, P. M., & Rapcsak, S. Z. (2013). Efficient visual object and word recognition relies on high spatial frequency coding in the left posterior fusiform gyrus: Evidence from a case-series of patients with ventral occipito-temporal cortex damage. Cerebral Cortex, 23(11), 2568–2580.