One Hundred Names for Love: A Memoir (29 page)

“If you’re not too tired, tell me more.”

For nearly an hour, Paul groped for the right words, which always seemed to hide on the tip of his tongue, and I tried to understand, prompting him with questions. Dictating sentences isn’t easy, even for seasoned non-aphasic writers; it takes a special knack. I know several writers who prefer to dictate into a tape recorder, which they say feels more like lecturing; they bloom when thinking on their feet. Paul had always been aces at lecturing, regardless of time of day; with a few notes on an index card, he could improvise an engaging talk that—most remarkable of all—came out in complete sentences. But dictating now meant using his broken short-term memory for words. Yet somehow his brain slowly spelunked for his literary self, and found the rappel of sentences, the traverse of paragraphs, the slingshot of grammar, how clauses might be felicitously rigged.

It was a painstaking process, and I quickly learned not to interrupt him or else his train of thought would jump off the tracks. He’d sometimes pause in the middle of a sentence. If he paused too long he might forget the beginning of the sentence, and on cue I would reread it back to him so that he could reorient himself.

Often his sentences merged. Or he’d omit the small articles, prepositions, and linking words. His brain found content words easier, not words whose only function was syntactical. However, much of the time, struggle plain on his face, he’d eventually hook the word he was fishing for, or at least one that would serve. Not having to guide his hand movements reduced his brain work, so that
all
he had to do was hunt through the Grand Central rush hour of words. More often than not an inexact but apt substitute worked surprisingly well. Then came pronouncing it, not a small feat.

In a formal idiom, he declared (and I inscribed): “There is. vovo-voice of rhetorical . . .
artifice
say. just. about. anything I want without ff-ff-fear . . . fear of contra—. contra—.
contradiction
, and other voice . . . which ff-ffear. is. much a burr, no blur. When. I’m on firm. form the two hundred, while staying separate, overlap.

“When one is . . . out of contra-
control
. . . and should be asleep, this out of control vo-voice which savages any.thing. you want to say . . . In almost every say . . . stone. cir-cum-stance . . . provides the wrong words . . . and even. exerts a deadly compulsion to stab, no sink, no
say
, say them incessantly. And noth-nothing you can do to cork, cork, cork,
correct
it, so you might as well shoot up shop and g-go sleep because sleep you are not com-mun-i-cat-ing on a human level. at all . . . though for me there still remains the vovoice of rhetorical
artifice
which enables me. to make slow but intelligent conversation . . . with my . . . my . . . my coevals.”

Coevals
, I thought,
why coevals, which means contemporaries, instead of a word like
friends
or
others
?

Before I could ask, he reflected: “Don’t know oth-other people experience this, but I do know what oth-other people’s life like without . . . It’s a benefit gift . . . enabling those. who. lucky to survive. Feel grateful, because I don’t think it’s una-una-uni
que
gift. but pre-precious as rubies to me.”

For a moment his voice seemed to have left his body and was standing outside himself, looking down at his effort.

“It’s bowlegged but it’s l-legible, whereas the other mostly nonsense. Sometimes I forget w-words, and one of these . . .
people
. . .

The dictation continued until, an hour later, Paul gracefully thanked me for my help: “I’m impressed with your god-given ability . . . to put these . . . random. random. thoughts in order, and with your patience.” Then, with monumental effort, as if he were a spring unwinding to its last rusty creak: “That’s enough . . . I can ...
do
it.”

I couldn’t believe it. Where on earth had that relative fluency come from? Forehead glistening with sweat, and his mind a blunt instrument, Paul slumped back into the couch like a baggy heap of clothes.
Quite a marathon
, I thought, both astonished and overwhelmed, as he rolled onto his side, nestled his nose into a cushion, and plunged into a deep sleep.

Hearing voices—a cardinal symptom of schizophrenia. Seventy-five percent of schizophrenics are badgered by edicts and jeers, spooked by conspiratorial whispers, infested with perpetual judges and wardens they can’t run away from. For an unsettling moment, I wondered if I should be concerned.

And yet, even as I thought those words, I heard them
spoken
in my mind as part of the auditory hallucinations we all live with
normally
, because the brain is a born tour guide, pitchman, and jabber box. It blesses, it boycotts, it scolds.
See here!
It silently fumes, or:
I’ll show you! If only
. . . it sighs.
Why did you have to
. . . it recriminates. The brain prattles nonstop to its lifelong listener: itself.

Before his stroke, Paul had often communed with his dead mother, and
heard
her answering back, her voice sparkling clear, even when there was nothing special that needed saying. He once told me of this ethereal exchange:

“Are you all right?” he’d asked her.

“So-so,” came her reply, pervading the crevasses of his mind, and intoned in her perfectly unchanged, maternal way, soft and lambent with a North Country accent.

“Is it sunny where you are?”

“No.”

“You haven’t much to say for yourself.”

“What’s the point?”

“Do you want for anything?” Ever the protective son.

“Why should I? I’ve all I need.”

“All?”

“Yes, all.”

“I better say goodbye, then.”

“Look after yourself.”

“I do.”

In such cozy chats, he’d joined 13 percent of people, so-called “grief hallucinators,” who find talking with a dead loved one helps to soothe their grieving mind.

Did it matter if the voices seemed to originate outside or inside the head? The line between the two can blur, and some studies suggest that hearing voices is really a form of subconscious whispering. Researchers at NASA have been perfecting a way to hear what people are thinking by placing tiny electrodes under the chin that will pick up “sub-vocal signals” from the brain; what we call our
inner voice
works the nerves in the speech muscles, whose subtle firing a computer can decipher. Useful in space, but maybe more so for military purposes, to avoid eavesdropping. There’s no plan to adapt the program for stroke victims, let alone the hoi polloi, but maybe that day will come. Then what? Suppose we shared our inner voice with others, faster than we could censor it, piquant lust and unbridled temper blazing? Using the skill recreationally might lead to serious mischief.

Years later, I would ask again about the three voices who spoke in his head right after his stroke.

“Did your three voices ever talk to each other?”

“No, they ran distinctly separate operations.”

“When did the three voices merge into one again?”

“They didn’t.”

This surprised me, which I tried not to show. “All three are
still
with you?”

“Two of them not used much. But I can tell they’re home-free, free-born . . . still
there
somewhere. Like sensing someone in the room. Mind you, hearing tones of voice is like handling quicksilver. They blur somewhat. My own sable is that I’m speaking quite normally for the most part.”

“For the most part.”

“Depending on time of day.”

Was this an invitation to romp? “And food.”

“. . . And weather.”

“And sleep.”

“Tell me something new!” he demanded.

“Really? Am I boring you?”

“Nooo. I didn’t mean to say like that, but . . .” Paul dipped one hand, maybe to mimic a sigh. “You’re listening too hard.”

“I have to . . .” Long pause. “I’ve grown used to it.”

“I know. Big change for you. I wish you could relax your. wawa-watch over me. I’m sorry. . . . I could leave, and . . . furlough your life back.”

A noble offer, and genuinely felt.

“This is my life. And I’d miss you terribly.”

“More than the hardship of bivouacing
with
me?”

I thought about the comparison seriously, then took his hand. “Much more. We’re joined at the heart.”

“Bad luck for you, I’m afraid. My ticker’s pretty wonky.”

“Too much boozing.”

His eyes twinkled, and he drew me close. “Not enough kissling.”

CHAPTER 24

S
URPRISED AND THRILLED BY PAUL’S DICTATION ON THAT
summer day, we continued the following afternoon. I welcomed hearing from his “voices” again, those ghostly speakers haunting the mansions of his mind. Dictation had made me once again feel like the old Paul was peering out from within, clear as a porch light through timberland, in a way he somehow couldn’t manage in conversation. We weren’t calling the project a memoir yet. Neither of us, because who knew if or what the coming efforts might bring. At the moment they were only sighting shots, trial balloons of thought, any of those metaphors humans use to convey hope, tentativeness, and not foreseeing the what-will-be. As Paul and I both knew, the main thing was to keep him tailoring language.

Again he opened his mental book of voices and spoke haltingly, sometimes cryptically, for nearly an hour. This time he wasn’t quite as fluent, and he battled more to find words, which came slowly, but he pressed on anyway and together we created his second journal entry.

“The second d-day in the Rehab Unit, I h-heard. heard. this v-voice,” he said tentatively. “And it was not the v-voice of the flimflam, but the v-voice of pellucid flim . . . no, not
flim
. . . pellucid, articulate . . . reason . . . droning. droning the absence any s-s-sound, and. and . . . I knew. at once. that I was g-g-going to be anchors, axels, all right. even then, in s-spite of the ersatz, no,
evil
-seeming th-things that . . . happened . . . to me.”

He paused, yawned his mouth wide open without uttering a sound, and seemed to compel the next words to come out: “I mean that . . . though I hadn’t
tried
to speak yet . . . and the whole whirwhir-world was sink bottle some kind of abstract fanfare. waiting. to be led. on or off. I w-would be all
right
because my language . . . even if even if even it led to. ee-mean, emen, im
men
sely private universe . . . or . . . or . . . full panoply of speech.”

His
language
? I guessed he meant that at least he could form cohesive thoughts internally, in his private universe, even if he couldn’t convey them with the “full panoply of speech.”

“So, that side of him . . . remains,” he reasoned, surveying himself in the role of doctor-inquisitor.

Then again he abruptly changed point of view. “I can t-t-urn it on whenever I want speak. It’s. very. eerie. You might say almost like having second language f-forced upon one, one the lackadaisical, partly formal voice of BBC announcer, other . . .”

He paused only an elongated breath’s worth, but I wondered if his brain was going to change gears and narrate events again. It didn’t. Instead it alluded to the Shakespearean characters of his youth.

“. . . oth-other the
rapscallion Calibanesque
la-language, or substitute Falstaff . . . No need say which one I prefer.”

I smiled at the exotic twosomes, rapscallion Calibanesque, which I took to mean “mischievous ranting,” and
substitute Falstaff
, meaning “imitative fool,” and he smiled back, catching that his brain had dished up something amusing.

He pressed on. “Three voices really. One, ff-faint intellectual voice of speaker.. who. until I broke to this clutch of fortune . . . didn’t know whether he exited. existed or not. . . . somersault executing virtuoso . . . of my hours daily, if I’m lousy, no l-l-
lucky
... of joyous harmony. Second the extinct radio voice of Snagge. Third . . . rough country incoherent you already know too well. for his for his crude nonsense. and almost defiant . . .”

The sentence fell off a cliff. I watched him trying to crystallize the right word in his mind.

“I’m stunned,” he suddenly said from yet another remove. “I’ve proven . . . that I have two three voices.”

So, the voices remained. Inside his head, Paul still seemed to harbor a trio of speakers from different parts of his life: the formal BBC broadcaster John Snagge, whom he had heard on the radio during his childhood and Oxford days; the tongue-tied aphasic, who frustrated and shamed him by speaking gibberish; and the language-loving scribe with American turns of phrase. All worked to support him like durable friends, or maybe like the strongest sides of his personality. The Snagge voice, he would tell me much later, “
spoke into my inner ear, Lord knows why, and sometimes handed me the right word
.” I found it fascinating, if a bit confusing, and although the speakers seemed different, he clearly wasn’t experiencing multiple personalities. No, the diction was continuous and, if anything, a bit flat in tone, spilling very little emotion. While dictating, he seemed to focus deep within his head, where all the action lay and the invisible people took turns doing his internal monologue, or really, his internal trialogue. What he uttered came from that three-man theater, and could be spoken of by yet a fourth voice.

It brought to mind a book I’d read ages before,
The Origin of Consciousness in the Breakdown of the Bicameral Mind
, by Julian Jaynes. There was a time eons ago, Jaynes suggests, when we
all
heard voices inside our head, not as chat from a familiar brain, we thought, but from otherworldly beings telling us what to do. Jaynes speculates that in the days before people had modern minds capable of self-reflection, our instincts spoke to us with commands on how to survive. We believed the internal voices to be from gods because they seemed wise, stayed invisible, and yet invaded the interior mind. “At one time, human nature was split in two,” he controversially suggests, “an executive part called a god, and a follower part called a man. Neither part was Consciously aware.”

We forget that in ancient texts, hearing voices was commonplace—especially divine voices. Not only did the Greek and Roman gods speak to people, even their statues spoke. All of the monotheistic religions were founded by people who swore their god spoke to them, issuing bans, rules, and proclamations (and, of course, Joan of Arc’s famous call to battle). Genesis proclaims: “In the beginning was the word,” the word of a god who knew every dialect and engaged worshippers personally, moodily, sometimes in the give-and-take of conversation. Today we’d most likely deem mad anyone who said he heard God speaking to him from a burning bush. In a courtroom, a defense lawyer bidding for an insanity plea need only prove that his client hears voices, and that’s enough to sway the jury. So, claiming to hear three voices in his head, Paul might well raise eyebrows.

Jaynes’s theory argues that these vividly distinct voices arose in the right hemisphere, in the convolutions that are counterparts to the left hemisphere’s language centers. After all the damage Paul had suffered to the left, in precisely those regions, could it be that his mind was compensating by unleashing the usually stifled voices in his right? To keep a continuous sense of self alive, perhaps? After all, someone had to call the shots, tell him what to do, even if his longstanding, carefully whittled “self” was temporarily fractured into several voices, not many compared to the mob reported by some folk.

“I had been splintered into a million beings and objects,” Vladimir Nabokov wrote in an essay on sounds. “Today I am one; tomorrow I shall splinter again. . . . But I knew that all were notes of one and the same harmony.”

“The head we inhabit is a haunted house,” philosopher William Gass once wryly observed, full of “the words which one burns like beacons against the darkness.” At heart lies “this secret, obsessive, often silly, nearly continuous voice . . . the silent murmur of us, our glad, our scrappy, rude, grand, small talk to ourselves, the unheard hum of our humanity.”

Talk we must, we haven’t any choice. As babies we babble, and we keep right on babbling as grown-ups, too—but silently, to ourselves. The words in the haunted houses of our minds never stop, even inside the head of someone with aphasia. Not speaking to someone you barely know is considered a slight, and if you know them well it’s a blind arrow of anger or cruelty. Not talking to someone is regarded as passive violence, which is why we call it “cutting someone” or “cutting someone dead.” We remember who we are, what we did, how we felt in words, even if most of the time we-don’t-know-who is saying we-don’t-know-what to we-don’t-know-whom. We talk to ourselves all day, even while eating or making love, and at night we talk to ourselves in our sleep. We talk to cooperate and exchange ideas with others—it’s how our species survived—but also to commune with that compound ghost, our so-called “self,” and know how we feel, consider what we’re doing, analyze whether someone may be a killer, a rival, a mate.

Some unlucky stroke patients are haunted, not with alien voices but with alien limbs, a rare neurological condition when a hand seems to have a will of its own, reaching out and grabbing things (or, most embarrassingly, body parts) unbidden, and needing to be wrestled down by the other hand. Sometimes called the “Dr. Strangelove syndrome” (after the Peter Sellers character in the movie of the same name, whose arm would suddenly shoot up in
Heil Hitler!
salutes), it makes the limb seem foreign to its owner, so beyond conscious control that patients usually give it a name, or refer to it as “It.” “It” may even try to strangle its owner. The cause remains a mystery, but seems to stem from multiple lesions in the brain that, in effect, separate it from itself in too many places, more than it can overlook and still feel whole. It made sense to me that lesser lesions in Paul’s brain might do something similar, not with limbs but with the speechifiers inside, the homely ghosts we talk to when we talk to our “selves.”

“
THREE DAYS OUT
of seven, I can zoom,” Paul stage-whispered the next day, “the others no,” by which he meant speak, converse. His verbal ability also seemed affected by how much he’d slept, and even by the whims of weather and the time of day. True for all of us, as our brain cycles and rests. The best time of day for brainwork changes with age. A child’s internal clock naturally summons it to sleep at around 8 or 9 p.m. Teens tend to grow sleepy later, at around 11 p.m.; need nine hours of sleep, even if they rarely get it; and are notoriously hard to wake up. College students often report feeling brightest at night, and the elderly say they’re sharpest in the morning. Negative ions—molecules naturally produced at cascading waterfalls, beaches loud with heavy surf, or after a spring thunderstorm crackling with lightning—create more oxygen in the brain, which makes us feel exhilarated and more alert.

It made sense that his “dictating” ability might vary from day to day, just as his speaking did. Also that it would provide invaluable speech therapy, if he continued to prod his brain to craft language until it wore itself out. And he’d be focused on what had always made him happiest: being immersed in a writing project, something creative and constructive which he was motivated to continue. I know now, as I sensed then, that it’s essential to tailor rehab to what impassions someone. The brain gradually learns by riveting its attention—through endless repetitions, alas.

Right after breakfast, Paul felt most fluent, and that’s when he usually met me on the couch with a short list of notes on a small scrap of paper. Sometimes he sat down and studied his carefully prepared scribblings, unable to decipher his own craggy handwriting no matter how hard he tried. Other times even I could read the list, which might include a one-word cue such as “Morpurgo,” and sure enough, at some point during the hour, he would slip out a phrase like the “pitter-patter of Dr. Morpurgo’s feet.”

The dictation was exhausting for both of us. For the hour or so I needed to concentrate hard on deciphering errant, often-wrong words, using my own language skills to do overtime, climb cliffs of possible meaning, looking for any toehold. After years of writing poetry, odd combos of words didn’t faze me, and I knew Paul’s habits of word and mind, so I could catch his dictated curve balls, but it became clear to me that I couldn’t be his secretary. It would sap all my writing energy, change our relationship, erase my creative self, bruise my own voice, reduce me to excavating when I needed to be freewheeling. And so I gently suggested that Liz be recruited to help transcribe his outpourings, and fortunately she agreed.

Day after day, Paul continued dictating, sometimes with mountain-moving effort, and others sailing along at a good clip, freeing an account of what he’d gone through, what the inner world of aphasia felt and looked like. It was Paul’s chosen regimen, a struggle that helped him to organize his mind, which also impressed upon us all just how wounded his brain had been. Composing his narrative—and relating it to someone while doing so—was the best speech therapy anyone could have prescribed. For an hour of animated slogging every day, he stubbornly forced his brain to recruit cells, build new connections, find the right sounds to go with words, and piece together whole sentences. Painstakingly reviewing the text with him the next day helped Paul clarify his thoughts and gave him the opportunity to repair some of aphasia’s fingerprints in the prose. In those moments he transcended his brain injury, and was able to repossess himself, narrate and reorder his life. At times, what he said sounded nonsensical, but Liz and I were both punctilious about recording him exactly, whether he made sense or not.