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A loud ringing and bright light jolted Adam English awake. Then he felt the bizarre sensation of a zipper closing from ear to ear across his face.

English tried to call out, but he could only make sounds.

Then he tried getting out of bed. He fell, hitting his head on the iron bed frame.

His wife, Joanne Pera, was in the bathroom around the corner. A high school English teacher, she was running late for work when she heard what sounded like a scream. Then a thud.

She walked into the hallway and found English crawling toward her. He looked at her but couldn't talk.

This is what a stroke must look like, she thought. But she also thought strokes happen to the elderly; English had just turned 50.

Pera called 911.

As the ambulance was in transit, the dispatcher took Pera through a list of questions to relay to her husband.

"Can you smile?"

English smiled.

"Can you stick out your tongue?"

He could.

"But he still can't speak to me," Pera told the dispatcher.

The ambulance was there within minutes to take English to the hospital, which is less than a quarter-mile from their home in Tonawanda, New York, outside of Buffalo.

Doctors quickly determined English was having a stroke. A clot obstructed blood flow in his cerebellum and brain stem. The cerebellum plays a major role in motor movement and balance.

Within 15 minutes of Pera finding him, English was being given intravenous clot-busting medication.

English was then transferred to a more specialized hospital. There, doctors performed a thrombectomy, a minimally invasive procedure to remove clots. By the time the clot-grabbing tool reached the area, the clot had already dissolved.

Still, despite the speedy treatment, doctors warned Pera that her husband might have permanent physical and cognitive damage.

Walking into his room, she braced herself for the worst.

Seeing her, English smiled.

"Are you there, Adam?" Pera asked.

"I'm still here," he said. "I'm still Adam."

While he could talk and process information, his speech was severely slurred. He couldn't walk and his vision was impacted. His eyelid muscles also didn't work properly. His eyes would stay closed unless they were secured in an open position with tape. (Surgery later repaired them.)

"Most of your recovery will be in the first six months," the doctor said. "After that, you might get better, but you can't expect much more healing."

When he began in-patient rehabilitation, English – who has been paid to draw caricatures since he was a teenager – asked to make art. Nurses set up his travel easel in the occupational therapy room and he worked on sketches every day.

"Everyone there loved me because I sketched them all about 18 times," he said.

His drawing improved by the day, but English – who'd also been a musician before the stroke – could no longer play guitar or piano.

In seeking a cause for the stroke, doctors found that English had a common congenital heart defect, a hole between the upper chambers of his heart. Known as a patent foramen ovale, it exists in everyone before birth, but usually closes naturally shortly after being born. The hole may have allowed a clot to travel to his brain. He later underwent a procedure to close the hole.

English went home in mid-March in 2020 – just as the world shut down during the COVID-19 pandemic. He arrived home in a wheelchair, but soon switched to a cane indoors and a walker outdoors.

He received in-home physical therapy and did exercises on his own every day. The pandemic forced Pera to move her classes online, so she was home to assist him.

By the summer, English was back at work at Buffalo's waterfront drawing caricatures.

"My sketches actually look extremely similar to the way they did before the stroke," he said.

Talking to customers was challenging because he would slur certain words to the point that he sounded intoxicated. He had to deal with people complaining to management that he had been drinking.

"I ended up making a couple little signs that said, 'Stroke survivor, please excuse any slurred speech.'"

Because of his impaired vision, English couldn't drive for about a year after the stroke. It improved with the use of prism glasses, therapy and a series of surgeries on his eyes.

English was especially grateful for his speech pathologist, Amy Olsen, because they shared a love of music. (She's the musical director at her church.) By singing together, as well as talking, he regained much of his articulation.

He improved so much that 18 months after his stroke, English performed with his barbershop quartet when it opened for 1950s star Bobby Rydell in Buffalo. Olsen attended the concert.

"That was a once-in-a-lifetime experience, and having Amy there made it feel like a personal triumph," English said.

Pera, family and friends were also in the audience, cheering him on and crying.

"He nailed it, and he's only gotten better from there," Pera said. "I'm so amazed at Adam's bravery for getting back out there, both on the stage and at work."

English continues to face some challenges with walking, balance and speech, but he also keeps slowly improving.

"My can-do wife would not allow me to do anything but," he said. "Joanne's relentless positivity is the No. 1 thing that allowed me to keep going and get through this."

Stories From the Heart chronicles the inspiring journeys of heart disease and stroke survivors, caregivers and advocates.