SPEECH PAT­TERN

The late Ge­or­gia Blain on the loss of her words

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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.

Ge­or­gia

Blain and her daugh­ter, Odessa, in 2005.

GE­OR­GIA BLAIN was an award-win­ning nov­el­ist, and a colum­nist for The Satur­day Pa­per. She died on De­cem­ber 9, 2016.

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