Tuesday, December 16, 2008
People who have aphasia often have difficulty with language fundamentals (e.g. that a "cup" equals "c-u-p" equals the thing made out of paper that you drink with), but even as that improves they also have difficulty with the "extras" of language... the subtleties, niceties, and ability to code switch, or talk to your mother differently than you talk to your girlfriend and your girlfriend differently than you talk to your boss.
I had a really amazing conversation today with someone who is living this.
I've written about her before -- I've known her for over a year now and have seen her grow from someone who couldn't read or write a single word and struggled to pull a sentence together to someone who can read and send an email and tell a pretty good story. She is a young woman who had a bleed in her brain from a strange medical problem that she'll have for ever, but is well managed. She's a hoot.
She was telling me that she was at a bar a few nights ago where some friends and friends-of-friends were gathering. She was talking to the wife of one of her husband's friends, with whom she's never really gotten along. This woman was going on and on about how hard her life was with her busy career and her spoiled kids and the taxes on the boat and all that still had to be done before Christmas could come, etc. etc. She turned to my friend and asked her if she had finished her Christmas shopping, and my friend surprised herself by spewing out a stream of "you've got to be kidding me every day is Christmas after what we've been through maybe you never got the f'ing message that I can't read or write anymore because my head blew up you think you've got it tough go look at how people live in other countries where you don't have clean water and have to pee in a hole". The woman blinked at her and said, "Excuse me, it looks like we're ready to leave" then walked across the bar and stayed for another two hours.
My friend wanted my professional opinion on why she did that. I told her it might be because she was mad and that she doesn't have the access to flexing her language around to say something in a diplomatic way. She thought about it, then thought of ten other examples of how that's a problem for her. She can't tell a white lie. She can't be nice on the telephone 'cause she's working so hard to keep her thoughts together. She can't make a gentle request and feels like she nags her husband. She used to be funny, now she can't crack a joke.
We talked long and hard about the fact that this isn't a sign of getting worse, it's progress to the point that she doesn't have to worry about the little junk as much so she's noticing the more contextual issues. We talked about ways to practice. She understood but was visibly upset. She's trying to let go of the old her and accept the new one, but is mourning herself.
As our conversation (and our hour) was wrapping up, she said to me, completely straight faced, "You know, this is mind blowing. No pun intended".
That was it. I had to take my glasses off to wipe my eyes from the mix of laughing hysterically and crying.
This not so subtle picture is from here.
at 8:27 PM