The first one happened in 2011, while Clarke was in the middle of a personal training session. "My trainer had me get into the plank position, and I immediately felt as though an elastic band were squeezing my brain," she wrote in The New Yorker. She collapsed in the locker room and started vomiting, while drifting in and out of consciousness. She was rushed to the hospital where an MRI revealed she had subarachnoid hemorrhage (SAH), which is bleeding in the space between the brain and its surrounding membrane, caused by head trauma or other blood vessel problems.
This type of brain aneurysm is extremely dangerous: a third of patients survive with “good recovery,” another third survive with disability, and another third will die, according to the Mayfield Brain & Spine Clinic. "If I was to live and avoid terrible deficits, I would have to have urgent surgery," Clarke wrote. "And, even then, there were no guarantees."
The first line of treatment for an aneurysm is surgery to stop the blood flow, which Clarke opted for right away. Afterwards, when a nurse asked for her name, a usual cognitive exercise involved in recovery, Clarke couldn’t remember it. As an actor, she panicked. It turned out she had aphasia, which is a language disorder that’s a side effect of brain damage.
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"In my worst moments, I wanted to pull the plug. I asked the medical staff to let me die," Clarke wrote. "My job — my entire dream of what my life would be — centered on language, on communication. Without that, I was lost." A week later, the aphasia subsided, and a month later she returned to the set of Game of Thrones.
Although Clarke was back at work, she was taking morphine to handle the debilitating pain, and told her bosses about her condition with the understanding that she didn’t want "to be a subject of public discussion and dissection," she wrote. Meanwhile, although she was on the up and up, she was nervous that another smaller aneurysm on the other side of her brain was growing and could rupture. So, after a routine brain scan, they decided to perform the same surgery on this twin aneurysm.
"When they woke me, I was screaming in pain. The procedure had failed,” Clarke wrote. Doctors told her that they would need to do another operation through her skull immediately. "I looked as though I had been through a war more gruesome than any that Daenerys experienced," she wrote, describing her skull after surgery.
Recovering from the second surgery was much more difficult than the first, Clarke wrote. Clarke said she suffered anxiety attacks while in the hospital. "I felt like a shell of myself. So much so that I now have a hard time remembering those dark days in much detail," she wrote. "My mind has blocked them out. But I do remember being convinced that I wasn’t going to live."
This is the first time Clarke has ever spoken up about her experience. Now ahead of the season premiere of Game of Thrones, she's launched a charity called SameYou, which provides immediate rehabilitation for young adults after leaving the hospital due to brain injury and stroke. "In the years since my second surgery I have healed beyond my most unreasonable hopes," she wrote. "I am now at a hundred per cent."