What on earth did he mean? If he meant a person who operates a lighthouse, he would have emphasized the word light. If he meant someone who cleans a little, he would have emphasized the word house. If he meant a light-haired domestic, he would have emphasized the word light and paused before saying housekeeper.
“Is it a person?”
“No . . .” He slapped the couch impatiently.
“Does it have to do with you?”
“Yes.” He leaned forward, and I had the sense that we were closing in on it.
“Your pills?”
“No . ..”
“Food?”
“No . .. inferior . . .”
“Is it a feeling?”
Now his face twisted a little in a mobile expression that usually means “sort of,” and he stretched his fingers wide on both hands and waved them back and forth.
“An object?”
“No . .. light house keeper . . .”
Roundabout, we finally drew closer to what he meant, maddeningly closer, with Paul making do at last with a synonym rather than the exact word. How close he came, I couldn’t know, except by how triumphant he looked after uttering the word “replica.” All I could figure was that his brain felt like a replica of its old self. Or: once a lighthouse keeper, it now was reduced to doing light housekeeping. The exchange made him concentrate so hard that he worked up a sweat.
“Are you too hot?” I asked.
And to my delight he answered: “No, a tiny zephyr roamed through the yard for about a minute and a half and it felt good.”
I laughed, and he laughed too, but only after a pause, when he realized that he’d said something amusing. I squeezed his arm appreciatively.
All he meant was that a breeze had wafted through the screen door. Unable to say that, he made do with kindred words—any he could grab. What a picturesque tumble of words, I thought. As a poet, I’d have to labor for an image like that. Looking out at the yard, I imagined a tiny humanoid zephyr, a barely visible wind with eyes.
I felt tired as wet sand, but that didn’t matter. Few things are as delicious as sitting quietly under a canopy of stars and opening your senses to the world. The moon was lighting lamps across the eastern sky. As more stars blinked on, the black velvet sparkled with their diamond-backed catastrophes. When I heard a tapping, I traced the sound through the wall to the bedroom on the other side with its two large windows. Branches were rapping against the glass like poltergeists. In my mind’s eye: a crooked bony finger, a twig, a finger, a twig, tapping, tapping, tapping. A cat stole like wind through the bushes. Or maybe it was the wind conjuring up a cat. Hard to say, when the sun fades and the brain loses its brilliant lens on the world. We weren’t born to roam at night; our senses falter. Not like the yard’s covenant of garter snakes, sporting long red ribbons down their backs, nesting somewhere between the warm pool liner and the food-fragrant soil.
I wondered what Paul was thinking, and sensing, but didn’t bother asking him. He’d fought hard enough for words all day, and deserved to rest a spell. Fortunately he loved to sit and stare, too, and never grew bored. In Life with Swan, a novel loosely based on our life together, he once wrote:
A couple who can spend half an hour watching a female cardinal sit inside a bird-feeder . . . can do other things too, such as sitting by a table covered with amaryllises and dahlias, pretending it is already spring, or staring at the curvature and convolutions of a nail clipping.
This contemplative savoring was always ours, not something we aspired to or had ever read about, but a natural twitch to be reckoned with, its main implication a simple one: There will always be more to gaze and marvel at, even on the level of the commonplace, than we will ever be able to attend to. For us both, it was a matter of being plonked down amid an ongoing miracle whose component parts could not be counted. Staring at stuff, I always called it; the account of this activity needs no fancier phrase. So we could often be spotted staring overlong at sheep, birds, grasses, or a harvest mouse. . . .
Staring together was easy, communicating was brutally hard, and not just with me. After a few weeks, I acquired Durable Power of Attorney so that I could speak legally on his behalf and help him pay his bills. He’d completely forgotten how to write checks, so I wrote them for him, and he signed, left-handed, in a strange craggy scrawl. It brought back memories of my father teaching me how to write my first check when I was college-bound. All one day, Paul tried, in increasingly agitated ways, to say that he expected a check to come in, a reimbursement from his medical insurance company, but he didn’t have the words. I finally understood when it arrived days later. Addressing an envelope, paying a bill—all posed fatiguing challenges. And when he spoke—to me or to a bank teller—any random word could dash out of his mouth before he had time to find the right one.
Most confusing, perhaps, he didn’t use pronouns correctly, and they’re often the first word in a sentence. I would try to interpret what he was saying, only to discover in time that he was referring to a woman, not a man. Or that he was referring to himself as “he,” not “I.” Was this merely a language problem, or was it something graver, a loss of a coherent sense of self? What with feeling foreign to himself, and all the people dealing with him as a thing to be fixed, was his sense of self flickering from “me” to “him”?
When the speech therapist visited to do her initial evaluation, she recorded the following among her notes, underscoring Paul’s limits by repeating the single word severe, until it lost its impact and she had to fortify it with bold type:
The patient presents with severe verbal expression deficits . . . The patient presents with severe reading comprehension deficit. Given large print single words the patient was able to read words out loud, however he was not able to demonstrate comprehension of the words. The patient presents with severe written expression deficits.
Paul’s speech therapy followed a standard program which included sounding out letters and syllables, learning the names for common objects, communicating basic wants, reading short sentences, and comprehending talk. But as I quickly learned, it’s designed for acute problems, in the hopes of teaching stroke patients how to navigate the chief activities of everyday life. It’s not intended to help aphasics regain their lost treasure of words, express subtleties, or be nuanced listeners. I understood the therapists were trying to rebuild Paul’s vocabulary, beginning with the rudiments, but Paul found it taxing, boring, and disturbingly condescending. His loss of language didn’t mean he was any less a grown-up with adult feelings, experiences, worries, and problems. After all his years of education, Paul was now toiling over the equivalent of a first grader’s lesson book, which he found demoralizing. And yet, because of where his brain was damaged, he couldn’t connect even simple objects to their names. At night, in the familiar refuge of his study, he labored over the day’s homework.
As I peered in at him, unobserved, the light fell across his desk from the side. It looked like a scene in a Dutch master’s painting, of a man cramped over his workbench, struggling to master a few stubborn diagrams. So engrossed was he, he didn’t sense my presence, and he could no longer see things off to his right, anyway, so I craned my neck a little closer. Solemnly, as if they were sketches of family members he used to be able to recognize on sight, he considered the drawings of a chair, a lamp, a dog, unable to match them with the words in a column on the opposite side of the page. At last, with strain cutting shadowy creases on his forehead, he connected the chair with the word “dog.” Looked at it a moment. What was it, the four legs, that confused him? It reminded me of René Magritte’s painting The Key of Dreams, in which three out of four objects are incorrectly labeled, with a horse called a door, a clock called the wind, a pitcher the bird, and only a valise the valise. Magritte meant to confuse viewers, on purpose, by connecting unrelated words and images.
On the next page, some c
ategories made sense to him, while others (“name five fruits”) proved such a bugbear that when I quietly stole away and returned in half an hour, he had only thought of four, three of which were wrong. Half an hour later, I returned to discover that he had revised the four, nearly mummifying them with Type White and strips of correction tape, and the revised versions were still wrong.
He reluctantly turned a page to even more categories, as if slaying one dragon only to engender a dozen offspring. Sighing, he rubbed his eyes with both hands, then picked up the felt pen, whose barrel had been widened with a rubber easy-grip saddle. In two determined swipes of black, he mismatched “Monday” with “month” and “August” with “day,” and turned the page.
The brain’s sorter was injured and off-duty, making thinking in categories a nightmare; and yet categories are essential for language, which otherwise would be a stream of nouns and verbs without any conceptual lakes uniting them. We’re not alone in this. Other animals—from chimpanzees and parrots to border collies, chinchillas, macaques, and quail—group important things, too, obsessively sorting the chaos into helpful mental bins. A brain stores those bins in different physical locations, where a small lesion can wreck havoc. Some patients have startlingly specific category deficits: they can’t say colors, or the names of animals, fruits, famous people, vegetables, flowers, or tools.
Drawing in a breath, Paul puffed his cheeks out like the North Wind on an old map, and then exhaled thoughtfully. Next to “opaque” he circled the category “color.” A color? It could certainly function as one, just as glare seemed to paint a new color in the Antarctic, and that’s something he might once have fancied. But he wasn’t playing with ideas now, he was groping for words in a mental blizzard.
Paul finally stopped from sheer fatigue, his mind blunt as a pencil after a long exam. The homework drained his whole brain of spare energy; he couldn’t speak as he tottered down the hallway and into the bedroom. Normally, sleep after study helps to seal facts in memory. But in his case, he barely had enough wattage left to run the city-state of his body. Instinctively, the way a whooping crane seeks home, he sought the tonic of sleep to revive him.
While he catnapped, I paged through his corrected workbook in disbelief. Told to circle the right word, he’d put an X over it instead, gotten three out of five wrong and hadn’t even guessed at four others. On another sheet, he had mismatched “radio” with something to be watched, “weatherman” with conducting traffic.
Yes, he had marked, salt is green.
He wasn’t sure if one could see through a mirror.
No, he had answered to “Can you see your shadow at night?” I smiled wryly. No was the correct answer. But something can be accurate without being true. There are moon shadows. And night itself is a shadow, nothing that falls, but the darkness that gathers as the rolling earth turns its face from the sun. These were subtleties he once might have sported with, maybe in a yarn, certainly in our mealtime chitchat. Now he struggled just to fathom the basics.
“Say an appropriate word to complete the phrase,” another exercise instructed, offering the first half of well-known sayings:
“Time waits for no —.”
“Look before you —.”
“The early bird catches the —.”
“Practice makes —.”
“Don’t put all your eggs in one —.”
“You can’t see the forest for the —.”
“A dog is man’s best —.”
Paul had dutifully filled in blanks with misspelled clichés which, before the stroke, would have horrified him to repeat. Now they came easily to mind, because they’re usually stored in the right hemisphere’s library of overly familiar expressions, the verbal automata of everyday life, which may also include the Pledge of Allegiance, Christmas carols, favorite curse words, and advertising jingles. The oddest relicts may be preserved in an uninjured right hemisphere. “The golden touch of the Pennsylvania Dutch,” Paul would suddenly singsong in a Pennsylvannia Dutch accent, remembering a commercial for egg noodles he used to hear when he lived in State College, Pennsylvania.
THE FOLLOWING DAY, he found me in the kitchen and pointed into his open mouth.
“Hungry?” I asked.
He nodded yes and parted his lips to speak, but nothing came out. Two more false starts. Then he took my hand, as if steadying himself on a narrow path, and shaking it gently for emphasis, said: “Nice ice.”
At first glance, or listen, nice ice may sound rather cute, whimsical, childlike—which feels more comforting than the truth, that he was a very intelligent adult compensating as best he could for lapses, finding ways to make up for what wasn’t available. Thus he drew on a word for a feeling, nice ice, and used rhyme to remember it. I brought him a small cardboard dish of sugar-free lemon sorbet.
“Thank you . . . you . . . ah . . . ah . . . oh . . .” His voice dropped down into a deep sadness.
“Diane.”
He shook his head in shameful disbelief, and repeated “Diane.”
Names of people—including mine and his mother’s—were devilishly hard for him to lasso from the arroyos of his brain: a furtive herd of mustangs that kept bolting away.
Later he would tell me how “on rare occasions, the word I sought lay like an angel, begging to be used, even if only to be used in spirit ditties of no tone. I had the beginnings of a word. Was I merely deluding myself with this childish phantom, or was there something to it, maybe miles away, maybe too far for customary use, and it would remain, a delusive harbinger of night, a word unborn, doomed to remain unsaid as humm—or thal—unable to complete itself because of my aphasic ineptitude.”
Many of the speech therapy exercises—matching word with object, filling in the blanks—emphasized the detailed, linear thinking that meant visiting the gaping ruins of Paul’s private hell, his damaged left hemisphere. Good practice, designed to exercise his weakest areas, they nonetheless brought a steep sense of failure.
A lifelong overachiever and exceptional student, he knew that half wrong was a dismal result. And failing so miserably at simple exercises, he began to sink into a depression again.
Walking into the living room on a dazzling blue day fleeced with fair-weather clouds, I found Paul staring dismally at the floor. Earlier that morning, we’d lost patience with each other. I was dashing out for an appointment when he waylaid me with a request.
“Bring . . . bring . . . thing . . .” His face glazed with concentration, then he drew a square in the air. “. . . a long horse . . . no! not a long horse, the other thing . . .”
“Envelope?” I asked hurriedly.
“. . . No .. . no . . . the other thing . . .”
I interrupted him. “We’re not out of Slim Bears. I know that. Stamps?”
“Too fast!” He collected himself slowly, as I felt the minutes evaporating. I began edging toward the door, and he followed. “No . . . you know, the . . . the . . .” Again he traced a small square in the air.
“Paper?”
“No!”
“Cheese?”
“No!”
“Can you draw it on a sheet of paper?”
“Too fast! . . . What?”
I slowed way down. “Can you draw it on a sheet of paper?”
“No!” His eyebrows rose like brown smoke, and I could almost see steam venting from his ears, but I couldn’t linger.
“I’m late. I’ll be back in two hours. You can tell me then, okay?”
“WFFH!” He waved me away with an angry glower. “Women!”
I’d felt annoyed, but also guilty about foiling his effort. Indignant as he’d been, Paul felt even angrier with himself for failing to connect with me.
By the time I’d returned he’d completely forgotten what he’d wanted me to pick up, but not that he’d unsuccessfully tried to tell
me something. I apologized for my rush. He nodded a resigned, gloomy yes. As we sat together on the couch, silence settled everywhere like frost. According to an old adage, the secret to a good marriage is communication. How do you manage that when your loved one has lost most of his language?
I took his hand and said in a measured voice, “I know you’re trying hard to communicate.”
Desperate to buttress his spirits and buoy up my own, I had a series of points to make, and I didn’t want to confuse him.
“But talking and communicating aren’t the same thing,” I went on. “We can communicate even though your talking doesn’t work. . . . Yes, it takes longer, it’s harder, it’s not as complete, but it is possible! . . . Improving means staying together, and staying together means communicating, even if all the parts don’t get said. . . . Who you are isn’t tied solely to what you say, even though it may feel that way to you now. . . . We’ll work this out together.” Lurking unsaid was the fear that if he didn’t improve he’d need institutional care.
My script, inspired by a residential aphasia program in the Midwest, was supposed to bring comfort. I’d borrowed it from Coping with Aphasia. But Paul’s sense of identity as a writer and a professor required words. Over a lifetime, he’d clung to them for solace, worked them to earn a living, juggled them to express himself, pinned them like butterflies to capture fleeting ideas and feelings. Via letters and phone calls, words always connected him to his family an ocean away, and to me, whether by his side or at the end of a phone line. Words were how he had always organized his world. He had chosen to live the proverbial “life of the mind” to the exclusion of all else, reserving his energy for writing and for his equally word-passionate wife. Taking words from Paul was like emptying his toy chest, rendering him a deadbeat, switching his identity, severing his umbilical to loved ones, and stealing his manna.
Words are such small things, like confetti in the brain, and yet they color and clarify everything, they can stain the mind or warp the feelings. Novelist William Gass, speaking to the students at Washington University (where I once taught), had extolled “the words the poet uses when she speaks of passions, or the historian when he drives his nails through time, or when the psychoanalyst divines our desires as through tea leaves left at the bottom of our dreams.”