Lost for words
When I came out of surgery after the removal of my tumour, I was in the hushed, underground world of the ICU. An elderly Chinese nurse gave me sips of water and encouraged me to eat. She called me sweetie and washed me down with brisk but kind efficiency. I couldn’t stop crying.
My partner, Andrew, sat by my side, with our daughter, Odessa. They told me I was doing fine.
It was hard to speak.
Sometime later, I woke to see the surgical team by my bedside. They said the operation was a success. They had removed as much of my tumour as was visible. They were full of good cheer, too bright for the subdued world of intensive care.
I tried to reply, but my words were halting, difficult to hold on to.
“It’s early days yet,” one of the doctors told me. “There’s been trauma.”
Andrew tried to reassure me by saying that my sentences were only a bit slower and slightly slurred. They would be bound to improve. The doctors recommended a speech pathologist and an occupational therapist, who would both visit me on the ward.
I met the occupational therapist in a makeshift exercise/storage room. She asked me if I would mind running through a few questions with her, just basic ones. They were similar to the ones that my mother, Anne Deveson, had had to answer when she was diagnosed with Alzheimer’s: fill in the numbers on the clock face; draw this shape; remember a sequence of words and later you’ll be asked to repeat them back; count backwards in multiples of seven. She used to hate doing those tests. Once, she even cheated, writing down the season, the month, and the day on her arm, which I hoped would score extra points for ingenuity. My brain was tired. I failed miserably at the clock face (strange how a clock face is still a part of these tests; I wonder whether anyone younger than me would be capable of drawing one). I also had trouble with the simple arithmetic, but my memory was fine. The woman assured me my results were normal, considering my surgery.
The speech pathologist came to my bedside. She was young and softly spoken. Initially, she asked me to name objects that she held up for me – a pen, a cup, a watch – then she gave me cards with illustrated scenarios on them. They were old-fashioned, like the “learn to read” books I’d had in my childhood: a woman in a frock doing the dishes, while outside her husband is pulling up in the driveway, a cat about to dart across the path of the car.
She asked me what was happening.
No, I tried to say. This isn’t the problem. But I obeyed, spelling out the story for her.
Then she asked me to name all the words that I could think of beginning with “f”.
All I could think of was “fat fuck”, a term of abuse I’m ashamed to say I’d once used on a man after a heated exchange when he’d kicked my dog.
I couldn’t think of any other words.
She tried various letters of the alphabet – each was only slightly better.
But still I didn’t think this was getting anywhere near the heart of the issue. She assured me my vocabulary would improve, and I believed her. Even in those early days, I already had enough words at my command; I was able to duck and dart when the right word didn’t come to mind immediately. I was nowhere near my full power, but I had enough.
Again, I was reminded of my mother. As her Alzheimer’s progressed, I was amazed at how she remained verbally agile, weaving stories, fishing out words from the recesses of her mind, always wanting approval – “That was a good word,” she would say – and even having a passable command of her schoolgirl Latin and French, which she loved to show off to Odessa.
I tried to articulate what was going on. The filing cabinets in my brain, the ones that contained the building blocks of sentences, were scrambled. I now had to hunt for the right clause, the right tense, whereas once they were all there, at my command, without having to think.
But even that didn’t quite get to the nub of it. I became particularly stressed when I had to issue instructions, or plan. I knew what should happen next in my head, but the words started to crumble away.
The speech pathologist told me that I should try and articulate chains of actions. How would I make a cup of tea? Every step of the way.
I didn’t drink tea. Never have.
Remembering both Odessa and Anne, who loved tea, I tried to explain how to make a pot. It wasn’t hard, but the speech pathologist was kind and didn’t make me particularly stressed, which certainly helped.
Saying that the language centre is in the front left of the brain is a bit like saying Australia is in the southern hemisphere. It doesn’t give you all that much information about Australia itself, a land that encompasses so much: deserts, cities, beaches, country towns. It is only if you zoom in that you’ll get the finer details, the stuff that matters.
MRI technology is constantly improving (although, as my oncologist regularly reminds me, it is still far from an exact science), and work is being done on mapping out which areas of the brain affect which parts of our speech. The shape of the trauma, the size and location are all important, and all interrelated. Like real estate, however, location is of fundamental importance. The effect of damage to one brain region is dependent on whether or not other parts of the brain are also damaged – just like the effect of a fractured thumb will depend on whether or not the fingers are also fractured.
I knew, and still know, that my capacity to cope with stress has been considerably lowered. It impacts on my ability to think logically, and also to speak. It is order that has been disarrayed. But in retrospect, I think my distress was not commensurate with the affliction I was suffering. Even at the time, I was aware of this. It was just that what had already happened to my friend, Rosie [Scott], had made me wary about what could happen, how much worse my speech could get – and who would I be without words?
This is an edited extract from The Museum of Words: A Memoir of Language, Writing, and Mortality by Georgia Blain, published on Monday by Scribe.
Her column for The Saturday Paper was The Unwelcome Guest.
This article was first published in the print edition of The Saturday Paper on Aug 26, 2017 as "Lost for words ". Subscribe here.