We investigated strokes' effects on awareness and cognition from the participants' perspective in four case studies, ages 37-50 (mean = 45). Data is comprised of standardized and open-ended interviews, medical chart reviews, literature reviews, and professional consultations. Although the participants sustained various types of injuries, they reported similar patterns of awareness, perceptions, emotions, and thoughts. These case studies endorse the idea that stroke victims are far more aware of their surroundings than they appear. Their reports indicate active mental processes, such as emotion and thoughts, occurring even while their bodies were unable to respond appropriately. We discuss four areas of interest: awareness during stroke and recovery, state-dependent effects in experience and emotion, memory formation during stroke, and effects of communication deficits.