Crossword editor Will Shortz shares how he's recovering from stroke

Will Shortz had always thought of himself as pretty healthy. The crossword editor for the New York Times and puzzle master of Weekend Edition Sunday on National Public Radio (NPR) worked out daily, didn't smoke or drink, and had no significant family history of heart disease.

He did have one worry, though. For years he'd had high blood pressure, with an upper (systolic) reading of 160 or even higher. After an appointment with his doctor in December 2023, Shortz changed his diet in an effort to reduce his sodium intake and lower his blood pressure. He cut out his daily can of soup at lunchtime and avoided eating at restaurants with sodium-packed menus. “A single entrée at many of the restaurants we frequented can have more than 100 percent of the suggested daily sodium intake,” Shortz says.

Changing his eating habits was a good start, but Shortz's hypertension likely played a role in what happened on February 4. Shortz was in his home office in Pleasantville, NY, pondering the next Times crossword puzzle, when he leaned to his left and suddenly realized he couldn't lean back to the right. “I had drool coming out of the left side of my mouth,” says the 72-year-old. “I knew immediately that I was having a stroke and would have to go to the hospital.”

Still in a T-shirt and shorts from playing table tennis (his other great passion), Shortz knew he'd need to put on long pants to go to the hospital, since it was February in New York. He managed to stand, walk into the bedroom, and put on the pants. Then he went to the bathroom: “I realized I couldn't flush the toilet, because my left side had become incapacitated. I couldn't use my left arm and leg at all. I sort of crumpled to the floor.”

For the next several minutes, he lay in the bathroom desperately trying to figure out what to do, unable to get on his hands and knees to crawl. His phone was still in his office. “It took me about 15 minutes to squirm my way back into the office, get my phone, and call my partner,” Shortz says. “He was there within three minutes.”

By the time the ambulance came, Shortz's initial symptoms had improved marginally. His three-story home sits on a hill with many steps down to the street, and he was able to stand up mostly on his own and walk almost 20 steps from the second floor to the street. But as he was waiting to be evaluated at Northern Westchester Hospital, Shortz's speech became slurred—he was having a second, larger stroke. After a CT scan of his brain confirmed the diagnosis, Shortz was given an intravenous thrombolytic medication designed to dissolve blood clots that cause acute ischemic stroke, restoring blood flow to the brain and minimizing the risk of damage.

It has long been known that “time is brain” when it comes to stroke, and the guidelines from the American Heart Association stress that eligible stroke patients should receive IV thrombolysis as soon as possible, ideally within three to four and a half hours of the stroke. In Shortz's case, the IV clot-busting therapy relieved the blockage that had caused the second stroke, but he also experienced mild bleeding in his brain, the most serious complication associated with the treatment.

“The initial trials of these drugs back in the 1990s found a 6.1 percent risk of symptomatic hemorrhage, but over time many things have improved with care after a stroke, so now we believe the overall risk of hemorrhage is about 3 percent,” says Amrou Sarraj, MD, director of the Cerebrovascular Center and Comprehensive Stroke Center at University Hospitals Cleveland Medical Center.

Although Shortz's bleeding resolved after a day of close monitoring with CT scans, he had to spend 10 days in the intensive care unit. “All things considered, it could have been worse,” he says.

Following his hospitalization, Shortz began physical therapy at a rehabilitation facility. “When I was first discharged, I had recovered a little bit but was still mostly incapacitated,” he says. Because the strokes had damaged the right side of his brain, the effects involved weakness on his left side. “I could barely move my left arm and had a little more movement in my left leg. My speech was still slurred and slow since the left side of my tongue and cheek were still numb. I consider myself fortunate, though, that the strokes did not affect my cognition or my language function.” (Speech and language problems typically result from a stroke on the left side of the brain.)

To his surprise, Shortz was helped to his feet the first day at the Burke Rehabilitation Hospital in White Plains, NY. “I thought, ‘Wow, that's so aggressive,' but that's what they're supposed to do,” he says. “They get you feeling like you can walk again. I was so impressed with their encouragement and the therapy they gave me.” While at the center, he was outfitted with an ankle and foot orthosis that lifts up his left toe when he steps. (A droop in that toe makes it harder for him to walk.)

The recreation director even constructed a makeshift table tennis setup for Shortz—who had once played every day for 4,141 days—using a regular table with books across the center to substitute for a net. “Knowing how much my streak meant to me, my partner had actually asked the staff if they could bring in a table,” Shortz says. “You can imagine how they reacted to that!”

While at Burke, Shortz resumed creating puzzles, writing them on sheets of paper which he later took home with him. Because he's right-handed, the strokes had minimal effect on his ability to write.

In early March, Shortz left Burke for a subacute rehabilitation facility close to his home. “They promise you two hours of therapy six days a week, and it's one of those rare places where you get more than what you're promised,” he says. “I did two and a half to three hours of therapy seven days a week for almost a month, and it helped me get a lot stronger and improved my walking, my strength, and my balance.”

Shortz would have stayed longer, but an important event was drawing near: the American Crossword Puzzle Tournament, which he founded in 1978 and has directed ever since. “It's the world's largest and oldest crossword event, and I have never missed one,” he says. “I was really eager to go.” On April 5, still in a wheelchair, Shortz opened the three-day tournament in Stamford, CT, and received a standing ovation from the crowd of nearly 1,000 people.

Shortz's return to NPR on April 14 was greeted with even more enthusiasm, including a flood of emails, gifts, and well-wishes. “That made me feel really good,” he says. Listeners have encouraged him with praise for his recovery progress. “People write in to NPR saying, ‘Will's speech gets better every week,'” he says. Shortz is also back to creating and editing puzzles for the Times.

People who listen closely to Shortz's speech today—especially those used to hearing him on the radio every Sunday—might detect a slight slur, but it's becoming less and less noticeable. “I can walk decently now, too, although slowly and with a cane,” he says. “What I can't do yet is actually lift my left leg. I sort of throw it forward so I can walk.” He's determined to improve that leg's mobility via a rigorous schedule of outpatient therapy.

Twice a week, Shortz goes to occupational and physical therapy at nearby Phelps Hospital, and on weekends, a physical therapist comes to his house for two more hours of therapy each day. Three days a week, he goes to Rehabologym, a neurorobotic rehabilitation facility. “Many of the exercises there involve machines that measure my capability at particular tasks, and the next time I use them they measure my progress,” says Shortz. “They're also motivating because most of them consist of games that I like to play.” With his arm strapped into the device called Smart Board, for instance, he can play table tennis, drive a race car, or ski downhill in virtual reality. The machine is used to strengthen his left arm and improve its range of motion; his arm covered only 6 percent of the board the first time he used it, but recently he's been able to cover 13 percent.

“I've always considered myself a good problem solver,” he says. “If you present me with a problem, I try to come up with three, four, five different solutions and then figure out which one is the best. I like to think I'm using that ability in my stroke recovery. For example, I've gotten an aerobic stepper, and I place my left foot on it and then raise my body, which strengthens my left side. I hope it helps me improve my hip flexor muscle, which will allow me to actually lift my left leg.”

Shortz's commitment to his recovery—through exercising on his own and working with physical and occupational therapists—is an excellent model for stroke survivors. “Studies have shown that patients who receive regular, consistent rehabilitation after a stroke do better than those who do not,” says Dr. Sarraj. “Most studies have looked at outcomes with rehabilitation at 90 days poststroke, but we just reported on one-year results from a major stroke trial and found that a good proportion of patients can continue to improve for up to at least one year. That's why rehabilitation and social and family support are so important.”

Support is something Shortz has in abundance. “My partner, who had slept next to my bed every night while I was in the hospital, spent the time while I was doing inpatient rehabilitation figuring out ways to make my life livable when I got home,” he explains. “He installed ramps on the steps, and he got an ingenious device for the shower, which I sit on and it slides into the bathtub and swivels around so I can take a shower. And he turned our office basically into a home gymnasium, outfitted with all sorts of physical therapy equipment. It's made it possible for me to be home and enjoy myself.”

Another thing he's been able to enjoy? “When I got home, I started playing table tennis from a wheelchair almost immediately,” Shortz says. “Now I can stand at the table. I crouch and get in the proper position and have a spotter at my side to make sure I don't fall, but I'm able to hit again.”

Even before he had a stroke, Shortz was aware that table tennis could help improve gait and balance control in people with neurologic conditions, as small studies have indicated. In 2017, he co-founded the nonprofit group PingPongParkinson at the Westchester Table Tennis Center, which he owns. The group now has more than 300 chapters around the world. “More than 25 people with Parkinson's play every week at our club,” Shortz says.

It makes sense that table tennis could benefit stroke recovery as well, says Rebecca DiBiase, MD, a vascular neurologist at Yale–New Haven Hospital in Connecticut. “There is so much hand-eye coordination involved and multiple pathways in the brain that have to be firing at the same time. Anything that involves complex patterns in the brain and reinforcing them over and over again can be beneficial for neuroplasticity and rerouting pathways that may have been damaged by the stroke.”

While Shortz admits he can feel frustrated about the rate of his progress, he's buoyed by encouragement from other people who have had strokes. “One listener wrote in and said that he had a stroke 10 years ago, and he is still making improvements in his recovery, so that makes me hopeful,” he says. “Where I am six months after my strokes is not where I will be next month or in a year.

“There are so many things I can do now. I can walk decently with a cane. I can raise my left arm a little bit; I can pinch my left thumb and index finger and hold things. Last week, we had a buildup of dishes in the sink, so I washed them using my left hand as much as I could. It's very hard to put on your pants when you can't use your left arm, but I've gotten very clever about it, and I'm able to do it.”

Shortz's commitment to his rehabilitation definitely increases his chances of continuing to improve over time, says Sara Rostanski, MD, assistant professor of neurology at NYU Grossman School of Medicine and medical director of the stroke program at Bellevue Hospital Center in New York City. “Early, intense, and prolonged rehabilitation is the best way to achieve the greatest recovery. Not every stroke patient is going to have the same trajectory of recovery, of course, but I have patients coming to see me a year, two years, or three years poststroke who feel that with ongoing occupational and physical therapy, they continue to improve. It's a long, hard road, but the more you work, the more potential for recovery there is.”

For fellow stroke survivors, Shortz advises starting therapy as soon as possible and working at it as hard as you can. “But don't do anything too risky,” he adds. “You hear about people falling and reinjuring themselves, which is a setback that delays recovery. I do wish I had paid more attention to my blood pressure earlier so this wouldn't have happened. But I can only change what I can change now, so I'm taking blood pressure medication now.”

He also urges stroke survivors to remain upbeat. “I've always had a good attitude. I want to enjoy myself and to make the world a little better for having been here. Those have always been my two primary goals in life, and they remain the same after the strokes.”