CHAPTER 23

I DECIDED TO FOCUS ON HELPING PAUL LEARN TO SPEAK, because that would most color the flow and fabric of his life. But he longed to write again, to enjoy the bump and clash of creating people who never were—a young woman armed with a bow-shaped mouth and a quiver of impulses, an old man with a forehead lined like a bad stretch of dirt road, a sailor with sword-shaped eyebrows, a Mediterranean beauty with pale skin and nuthatch-brown eyes. He took a twisted pleasure in baiting and goading his characters, hearing their backchat, filling their minds with whims and memories and crazy looping lanyards of obsession.

Battling hard just to speak, why did creating again matter so much after his stroke? Years later, he would tell me that it was because of the huge gap between what he could say and what he could think. Ideas inched through his speech, but they whipped around his thoughts like ice yachts.

“The contrast reassured me as to what lay ahead. It was merely a matter of lining up the two in sync, making a match between my pall-mall thought and aphasia. Would it take six months or a year, or never happen at all? This was the great unknown of my life.”

I watched him each day, laboriously trying to assemble words on a page. The penmanship grew a little better, and he knew what he wanted to say, he even seemed to know the words, but the message to his hand resulted in a stream of gibberish.

“I was extremely pissed off, unable to do a single letter, which I mauled anyway. My penmanship, that used to delight me as a masterstroke of all the ages, had dwindled into an uncoordinated heap of blurred fragments, false starts, and untidy balderdash. In a word, I was frustrated beyond belief, there were no letters left on earth for me to use.”

I mulled over the problem for a while. I wanted him writing to improve his language skills and help clarify his thoughts. But how we define an activity tints how we feel about it and what energy we’ll spend on it. Instead of homework, maybe what Paul really needed was a project.

“You know,” I idly suggested one afternoon when he was feeling especially down in the dumps, “Maybe you want to write the first aphasic novel, or a memoir.”

He looked at me with a sudden sprig of light in his eyes.

“Good idea!” he said so excitedly that the old “mem, mem, mem, mem” spilled out, too. I’d seen him pounce like this before, chasing something hare-like and hazy, sparked by the idea of a new book. It meant he was able at least to see a path before him, however meandering and uncertain. Paul writing much or writing well was beyond my expectations. But I hoped the effort would provide a lifeline to his former self, an exciting form of therapy, something to lift his mood and propel us both forward.

After Liz had left for the day, and the speech therapist had come and gone, and I’d taken Paul to the clinic for his regular blood work, followed by the bank, Paul and I finally slouched on the living room sofa, both of us tired from trying to communicate with strangers all day, including the semi-stranger he had become.

“Want to try writing about the stroke?”

He nodded yes.

When I handed him a lined tablet and pen, he struggled to scrawl something, anything, legible, drawing loose loops and wayward squiggles. A roil of anxiety and annoyance swept across his face like time-lapse photography.

“Maybe a flat surface would help? Let’s go to the table,” I suggested.

Sitting at the kitchen table, even with a firmer hand, he fared no better. For an agonizingly long minute, he twitched his hand across the paper. His pen jerked like a pointer over a Ouija board, until at last he gave up in disgust. Then, banging the pen down in frustration, he leaned back, defeated.

“No use,” he spat out.

Combing my thoughts, I tried to soothe him. “Maybe we’re asking your brain to do too much at once.”

With a pang of contrast, I remembered Paul happily writing the novel Gala (a tale of a man who builds a mock-up of the Milky Way) in the damp, cool, millipede-bedeviled basement of a house he’d once rented at Penn State. During that blisteringly hot summer, car metal burned to the touch. Water from a garden hose spurted out hot. Students submerged their hips in shallow creeks and drank cold beer. A few stores lured people in by promising gelatinously cold air-conditioning. On the door to each shop, a decal showed Willie the Penguin, the Kool cigarettes mascot, standing on a blue-white ice floe, below a banner that boasted: It’s Kool inside! We could only afford a small window air-conditioner, which we installed in the bedroom. In the rest of the house, the stagnant air flattened you like a case of the grippe. But as he listened to Paul Hindemith’s opera The Harmony of the World, splashing off the naked cement walls in the relatively cooler basement, Paul had barely noticed the incessant heat. The music had been inspired by Johannes Kepler’s 1619 book of the same name, in which Kepler decoded the harmonics of the spheres, and Paul was imagining the sound of Kepler wheezing in tune to the sublime mystical notes of Hindemith’s opera.

Wishing to taste the raw collision of the spheres rotating in their musical rounds, Paul was traveling through the absolute zero of deep space as he nailed strips of balsa wood into a four- by two-foot rectangle, which he covered with a sheet of sky-blue paper. Then he opened up his star atlas and studied his favorite constellations—Lyra, Betelgeuse, Coalsack—as if they were nudes posing for a life drawing class. With a steady hand, he painted the color of each star onto a push pin and stuck it in place. Between episodes of galaxy-making, he wrote at a large oak desk.

“Cold drink?” I’d called down the steps, and arrived with a glass of chilled lemonade.

“Listening to Hindemith?” I’d asked, stepping over a centipede on the cracked gray cement floor.

“Hindemith-ently . . . You know, what always strikes me is the silence of the universe—but when you approach its component parts all you hear is roaring cacophony!”

How easy it had been for him, then, to mix the flame of this or that composer into the celestial stew.

Compared with the fix he was in nowadays. Neither hand really functioned, and his mind kept drawing zigzags. His brain didn’t know what it was doing, or if it knew, it wouldn’t tell him.

To write, Paul’s brain needed to organize his thoughts, connect what he was thinking to the right words, figure out how to spell those words, then instruct the hand how to move to make the letters for each word, as well as tell the eyes to compensate for the now-invisible right edge of each page. That required so many different processes. I wondered if it might help if he cut out some of them.

“Let’s go back to the couch and I’ll write it down for you,” I offered, “and I’ll ask you questions.”

Then all he would need to focus on was tethering words to thoughts. If that didn’t work, maybe it was too early, and if he liked he could try again in a few weeks. Or maybe it wasn’t such a good idea after all.

Paul nestled into his favorite corner, and I stretched out facing him, holding one of the many journals I collected for note-taking. One with a soft, velvety purple cover. Purple, like the purple prose that used to flow from his pen. But how well could he think without language? As different as it is from the outside world, language provides a guidebook and streamlines our observations. The Korean language, for instance, uses different words, depending on if an object fits snugly inside something (letter in an envelope) or loosely (golf balls in a pail). And, as a result, Koreans are better than other cultures at discerning a tight fit from a loose one.

Not that language can express everything we mean to say. Nature flows indivisibly as one stream of atoms; we divide and structure it with our words. But at the end of every utterance, however eloquent, remains a silence buzzing with everything we’ve omitted.

“When you’re silent, I know you’re still thinking—are you thinking in words?” I began by testing the waters.

“Yes,” Paul said decisively. “Head full.”

“Head full,” I wrote on page one of the lined journal, and gently riffled its otherwise blank pages—around fifty, I reckoned.

Since the stroke, I’d often wondered if he still had a running interior monologue, the way people normally do. It seemed as good a time as any to ask: “What do the words in your head sound like? A voice speaking?”

I followed his gaze to the ceiling where a small spider was descending hesitantly on a fine-spun thread.

Paul thought a while, then said: “No, three voices.”

“Three voices?” I was floored. How strange. Where did the different voices come from? “What do they sound like?”

He screwed up his forehead in thought, then after a few moments, face clouding, he moaned, “I can’t explain.”

“Who do they sound like?”

His eyes drifted to the right as he concentrated. “One . . . a BBC announcer,” he told me.

“A BBC announcer?” I thought to myself: Now that’s an answer I didn’t expect!

“Yes.”

“And the other voices?”

As if opening a rusty tap, he said in a slow, jumpy spurt of words: “F-f-first there was t-tone . . . alluvial. and well-bred. of BBC announcer . . . John. John. John . . . Snagge, who regaled him w-with won-wonders. wonders. of world in distant, correct . . . accent. word-perfect. and slight-slight-slightly snooty. This f-followed most cases by the voice sp-spouting gibberish. Then there was voice. of himself. almost . . . lost . . . ampule, ampersand, amid barrage of suppressed verbiage. But re-re-gained as other two hundred, no, two, receded into blank of servitude. He had. leer . . . learned to speak again by some m-m-magic. which. owed . . . owed . . . oh, something ff-first men . . . planet, and would parsnips, no, p-perhaps be the b-birth-birthright . . . of all those . . . sufferers from aphasia to f-fol-follow.”

Paul fell silent. This was the most he’d spoken since his stroke, and I wanted to let him rest. But I was stunned wordless, holding my breath, wondering if he could possibly rattle on. Even though he stumbled and faltered, and needed help capturing some words, his tale would have been striking in anyone, let alone an aphasic. That three people haunted his thoughts was certainly surprising. He always did have an inner word-slinger busily spinning long sentences and dialogues, and I assumed that was the voice he identified as “himself. almost,” who, long ago, needed more elbow room and leapt onto the page. But, more puzzling: Who was speaking so well about the three voices? For that, Paul had to be engaging yet a different spectre in his head. That had struck me as especially odd, and I couldn’t resist asking him about it.

“Why are you talking about yourself in the third person?”

“I sounded . . . different from myself. The people who spoke in my head weren’t me.”

“Can I hear a voice?”

“Saying what?”

“Anything you like. How about Snagge?”

In the diction of a BBC announcer, he smoothly said: “The Royal Air Force in this operation lost eleven fighters.”

“What did Snagge sound like inside your head saying that?”

He paused. “He spoke . . . spoke . . . as if denying the right of the bombers to. to . . . exist, relegating them to chandelier stab, no correctly intoned v-v-voice of the lost. So didn’t seem plants, no, planes had been lost. at all. but were p-prom-promoted to the haughty, no, high, no, highest ring. range. of mystical beings.”

Then, commenting on what he’d just said, he added: “H-hhow’s that for burr-burr-brand of speech which denies. what it presents? S-s-snagge really. really. spoke like that . . . achieving . . . speech mannerism . . . clo-close. to. dizendisembodied . . . without . . . any any any . . . mustard, prettiness. or effervescence.”

“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-unique 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.”