Nakata, Aphasia and Sylvia Plath

I am working my way through Kafka on the Shore.

I’ve read it before, yet, for whatever reason, I seem to have forgotten most of the plot.

Yesterday I was re-introduced to Nakata.

He is the character who was strangely affected by an event in the mountains in Japan during the war. He, alongside 16 other children were knocked unconscious by a certain force. All the others recovered, although it took Nakata much longer to come-too and unlike the others he suffered long-term complications – firstly he developed what might be called a learning disability, losing the ability to use abstract thought, talking about himself in the third-person and, he was able to speak with cats.

It isn’t that unusual to hear about people who have a special connection with dogs and horses – we usually refer to them as whisperers. Yet, cats are somehow different.

Murakami loves cats – they are represented as characters and symbols throughout his writing.

Imagine being able to converse with a cat.

That’s what Nakata can do.

I won’t say more – you’ll have to read the book if you want to find out what happens.

It was this connection that made me think about the way I interact with some of my patients.

Those who have difficulties with communication.

This whole field, or, at least, when it goes wrong is the realm of a group of people called Speech and Language Therapists – SALT or SLT for short.

They tend to be called if a person has experienced a stroke and their language ability has been affected or for another reason a person has difficulty with swallowing.

I usually consider Speech and Language Therapists to be the cleverest of therapists as language is so very complicated.

At university I took a class in Psycholinguistics. I thought I was being clever learning about something so seemingly obscure – the psychology of language. Suffice it to say, I was lost and didn’t do any well.

I remember they talked a lot about something called ‘parsing’ go figure.

Anyway.

Communication is really the sine qua non of being human.

It is what separates us from other animals.

Sure, cats and dogs, primates and parrots can communicate, whales and dolphins can sing across the ocean, yet, the nitty-gritty of language, talking, chatting, enquiring, analysing and so on, blog-writing for instance is a human thing. (Setting aside any ideas by Douglas Adams)

And, with this, is the critical injury to what it is to be human if this ability is damaged or lost.

I remember in incredible book I have somewhere called, ‘The Man Who Lost His Language’ by former Sheffield Speech Therapist Sheila Hale. In it she describes the experiences of her husband, Sir John Hale, the historian, after he had a stroke which damaged his ability to communicate.

I wrote a long time ago about my mum’s experiences with communication. After a stroke she developed what is called expressive dysphasia – this means, the part of her brain controlling her ability to produce certain aspects of language was damaged. She could still speak – she didn’t have aphasia which is complete absence, but more subtly, she would be lost for certain words or at other times confuse names or places.

In her living room we used to have pictures of me and my siblings on the wall with our names printed on the frame to help her navigate during phone conversations.

All this more complicated as even before her stroke she would mix-up our names. (My sister, with three brothers always came off the worst for this).

Even before mum’s stroke and certainly afterwards, she and I were able to communicated by looking at one another; our eyes conveying agreement, happiness, frustration or sorrow.

And back to my patients. People I never know that well.

Admittedly, thanks to my career change a few years ago, with my move out of the hospital, I have developed relationships with patients that are far deeper than anything I achieved in the 20 years prior, now I know whether someone is Mr or Mrs or they prefer their first name, or whether instead of that first name it is a nickname or another.

I have gained an understanding of my patients that is deeper than that of most hospital doctors when they transiently assess and intervene during a critical component of a person’s life.

And yet, if they lose their language, I am usually lost too.

There is one woman in the care home who has lost her ability to speak. This, through Alzheimer’s disease. She has never said my name, although I can usually get her to engage, to smile, that is, unless she is feeling unwell. I have a kind of telepathy with her.

I did briefly consider what would happen if we had a Nakata who could communicate with my patients who have lost their language, or at least their ability to speak.

What would they say?

Sure, it is more complicated than this.

Aphasia, or the ability to communicate is more than a mechanical disorder.

People who have had laryngectomies can still communicate with gesture, sign-language or tapping-out on a keyboard, aphasia is more profound, this is not having the words.

I have never read any accounts of what it is like to have aphasia and then recover – I imagine this has happened; I’ll have to research.

And yet, most people do not recover, particularly when the initial loss is profound.

How are dreams or memories affected by aphasia? What do you remember when the language that describes the past is gone? Do pictures still appear? Do images translate into actions?

I think of Sylvia Plath’s Bell Jar.

Trapped inside.

The world moving, people going about their business, but no transfer of air or sound.

Of course all of this was much worse during Covid as we couldn’t make physical contact; there was no hand-holding. The people who knew my patients best were barred from access.

Imagine being inside that bell jar and the lights turned-out. That is what has happened over the past 18 months.

I thank John’s Campaign for fighting the bureaucracy.

All we can do is our best, use our imagination, our creativity to lift ourselves and others out of the constraints, the restraints.

Here is to the summer.

At least being able to feel the warmth of the sun is a form of communication.

Sensory engagement.

Let’s do that.