The unbearable loss of words

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Everyone has a private terror—often abetted by a checkered family medical history or having witnessed the torment of a loved one—of being struck with some particular affliction. For some, it's the ravages of a slow and painful cancer. For others, it's being caught in a freak accident that renders them quadriplegic in their prime. For me, it's the fear of surviving a stroke that blasts away tracts of neural tissue in the left hemisphere of my brain, leaving me with profound aphasia.

As usual, the degree of fear is based on a calculus of probability and of loss. In my case, there is the specter of probability: My father suffered a fatal stroke in his sixties. His own father, unluckier, was bedridden after a stroke in his early forties until another one finished him off a few years later. But it's the prospect of the loss that is overwhelming. How could I, ardent worshipper at the altar of language, ever cope with being left unable to talk or write fluently about language or anything else? For that matter, would I even be able to think about language? Or think in any meaningful way at all? It's the afflictions that strip you of who you are that seem most unthinkable.

So it was a sense of morbid attraction that led me to Diane Ackerman's newest book One Hundred Names for Love, in which she documents the stroke and subsequent language deficit suffered by her husband, novelist Paul West.

West emerged from his stroke with a near-total obliteration of language—his response to his wife's greeting of "Hi, honey" was to stare at her, "his eyes declaring: What on earth are you driving at?" He could utter a single syllable ("Mem! Mem! Mem, mem, mem!") and was sometimes bewildered that others seemed not to understand him. It's hard to imagine a person—or couple—for whom this turn of events could be more catastrophic. Ackerman describes a pre-stroke marriage whose intimacies were entirely centered on the nimble use of language. The two writers shared a broad and idiosyncratic marital lexicon and the proclivity to launch into impromptu language games. West, we're told, was a man who "had a draper's touch for the unfolding fabric of a sentence, and collected words like rare buttons."

In the end, it was West's dazzling collection of words that provided a way out of muteness.

In talking to some of my less-verbally inclined family members, I've occasionally found myself having to defend the purpose of hoarding an oversized vocabulary. Why, they want to know, does anyone need to know, let alone use, a word like excoriate when criticize will do quite nicely? Why discuss a person's proclivities, when habits or, if you must, tendencies does the trick? Why use obscure words rather than plain ones, other than to imply intellectual superiority? Perhaps some speakers or writers wield a bulky vocabulary as a blunt tool for humiliation. But I suspect that most are driven by the pleasures of being able to dip their brush into a nuanced linguistic palette. I explain to the skeptics that having a collection of seven near-synonyms allows you to pick out just the right one for the occasion—the one with exactly the right connotations, degree of formality or crudeness, the right history of use sticking to it, even the one with the right rhythm, vowels or consonants. If you're using language as paint, why in the world would you want to be limited to just the primary colors?

No doubt, Paul West was also driven by similar pleasures, devoting sprawling acres of neural real estate to his vocabulary. Ultimately this meant that, devastating as the stroke was, there were many preserved pockets left to be unearthed. Oddly, it was often the most obscure words that were easiest to recover. He struggled with words like blanket or bed, or his wife's name Diane, words that you would think over time should have seeped into his genes. Nevertheless, he could recruit words like postillion or tardigrades to get an idea across. This led to some counter-productive interactions with a speech therapist. Since aphasics often produce nonsense words without realizing that they aren't real words, one of the goals of therapy is to give the patient feedback on which words are real. But West would often produce bona fide words that were unknown to the therapist. For example, when shown Raphael's familiar painting of two baby angels propping their heads on their chubby arms, he offered "chair-roo-beem." To which the therapist patiently responded: "No. These are angels, AINGELS." Ackerman had to intervene, explaining that cherubim was a real word.

At times, his speech sent even his verbally-endowed spouse scrambling for a dictionary. When trying to ask her whether she'd received a check as payment for some work done, he resorted to the word spondulicks, which prompted the following exchange:

"What's a spondulick?"
"Money."
"Really? Truly? Spondulicks?" In my mind's eye, I pictured a spastic duck.
"Yes," he said emphatically.
"Spondulicks?"
"Spondulicks. It's British."
Surely he was pulling my leg. I breezed into the library to look it up in an etymological dictionary, where I found this entry:

1856, Amer.Eng. slang, "money, cash," of unknown origin, said to be from Gk. spondylikos, from spondylos, a seashell used as currency (the Gk. word means lit. "vertebra"). Used by Mark Twain and O.Henry and adopted into British English, where it survives despite having died in Amer.Eng.

Partly through the force of his will and partly through his wife's insistence that he remain constantly immersed in a bath of language, West eventually recovered sufficiently to write three books after his stroke, with the help of an assistant. One of these, The Shadow Factory is his own account of his stroke. A brief excerpt illustrates how West was able to leverage his off-kilter language and sense of humor to vivid and appropriately disorienting effect. Here, West describes how the stroke left him with difficulty swallowing liquids, which needed to be thickened into semi-liquid form:

If I were to take a drink from the wrong kind of liquid, I would in all probability aspirate and, having filled my lungs with fluid, choke and die. This unseemly possibility has three stages. The first is pudding, which in no sense imperils you; the next is honey, which puts you in less jeopardy; third is nectar, and finally water, when you are dicing with life and death. If all this sounds mumbo jumbo to an educated audience, it should not. For anyone intending to drink beyond his means, the risk of suffocation is high. For my own part, being on pudding as I was, I was consigned to eat chocolate pudding but shrank from eating the obscene mixture called pudding water, by which a mixture was made of water and thickener until the spoon was standing straight up. Such licentious behavior on the part of English pudding makers may surprise no one, but it may reveal to countless consumers of coffee, tea, and other drinks the perilous condition that they are subjecting themselves to if they drink water that goes down the wrong pipe.

The intimate wordplay between West and Ackerman also eventually resumed, with West fashioning novel terms of endearment as gifts to his wife. The offerings were delightful. Deprived of the usual routes to language, and along with them, the common clichés that many of us struggle to shed, West bestowed on his wife exquisite pet names such as: My Little Bucket of Hair; Commendatore de le Pavane Mistletoe; Dark-Eyed Junco, My Little Bunko; Diligent Apostle of Classic Stanzas. And at one point, the man uttered what has to be the most searingly romantic sentence ever uttered in history, by anyone, in any language:

"You are the hapax legomenon of my life."



28 Comments

  1. W said,

    January 12, 2012 @ 1:43 am

    "You are the hapax legomenon of my life."

    That's enough to make any linguist swoon! I'm all aflutter.

  2. Antariksh Bothale said,

    January 12, 2012 @ 1:45 am

    This was beautiful! Thanks a lot for sharing it.

  3. Bob Ladd said,

    January 12, 2012 @ 4:34 am

    What Antariksh said.

  4. Eric P Smith said,

    January 12, 2012 @ 6:09 am

    What a moving article. Thankyou.

    I’ve placed an order for a copy of The Shadow Factory, for the insight into the relation between language and thought that I am sure it will bring.

  5. Markg said,

    January 12, 2012 @ 7:18 am

    Fascinating, thanks for this. Interesting that many of the more obscure words survived. I wonder if one of the reasons might be that in order to be fully absorbed initially they required more concentration and so perhaps developed… I don't know… a tougher neural root? (if that makes any sense).

    [(js) I'm not a neurolinguist, but everything that I know from psycholinguistics suggests that it's the more common words that should have a "tougher neural root"—we talk about frequent use "strengthening the memory trace" for a word. For example, when most people have that sense of groping for a word that's just on the tip of the tongue, it's most often one that is less common than a frequently-used one. It's hard to know, without a detailed analysis of West's pre- and post- stroke speech, whether it was really so much that the unusual words were spared. It may just be that many of the rare ones also remained out of reach, but that he had so many words that even when he couldn't access the more common words, he was still able to rummage around for some related word, and many of these happened to be fairly obscure. On the other hand, there are cases where a person with aphasia has lost access to very specific subsets of words – for example, predominantly the words of one language but not another, or even words belonging to a specific semantic field such as vegetables. So it is possible that, for somewhat random reasons, the collection of unusual words – which may have been laid down at a different time in life than the common ones – remained relatively more accessible. I don't think I would predict that to be the general rule though. I'm sure there are readers with more knowledge and experience of aphasia who could speak to this better than I.]

  6. Meanings: Hapax Legomenon | The Observatory said,

    January 12, 2012 @ 8:58 am

    […] meant it as a very special term of endearment for Ackerman, as Language Log's Julie Sedivy explains. Advertisement GA_googleAddAttr("AdOpt", "1"); GA_googleAddAttr("Origin", "other"); […]

  7. Grace Carpenter said,

    January 12, 2012 @ 9:29 am

    I had a stroke two years ago, and I'm still crawling my way back to language.

    Aphasia is more common that people realize. The National Aphasia Association estimates that more than 1 million people in the US have aphasia. For more information, see http://www.aphasia.org/

    I also blog about aphasia and other stroke-related subjects: http://myhappystroke.blogspot.com

  8. KA said,

    January 12, 2012 @ 9:49 am

    I've never had the courage to comment on a Language Log post before. Just…Thank you.

  9. Ran Ari-Gur said,

    January 12, 2012 @ 10:16 am

    That is beautiful!

    I wonder to what extent the speech therapist was really wrong about "cherubim". I mean, I'm sure it's very important (for diagnostic purposes if nothing else) to distinguish between rare words and nonsense, but it also seems important to distinguish between rare words and normal ones. I don't think West's recovery would have gotten so far if he couldn't learn to produce words like "angel".

    (I also wonder if the word "cherubim" was really completely unknown to the therapist; it's not that rare a word, after all. But if the therapist was primed to expect either "angel" or gibberish, then it's easy to see how the rare word "cherubim" might not even register.)

    [(js) I suspect you are right about this. Certainly, there was quite a bit of gibberish produced in those sessions as well, and also quite a lot of difficulty simply articulating the sounds. Ackerman would have been in a better position to recognize some of his words by being more acclimated to his articulation, and also by sharing a personal history of vocabulary.]

  10. Joel said,

    January 12, 2012 @ 10:37 am

    This account echoes my own experience with a stroke, which occurred three years ago (is it that long already?). Mine was, happily, not really severe, but I had the same path of struggling with basic words and having to use more complex ones, and people not realizing the words I was producing were indeed actual words. I even had the problem of difficulty swallowing, resulting in am embarrassing scene in a Thai restaurant that my brother had taken me to as a treat. (I still choke unexpectedly at times.) I am grateful that my disability has subsided over time, though I still have difficulty with walking, balance, and short-term memory, and I thank Ms. Sedivy for her thoughtful exposition of this phenomenon. Her husband is lucky to have her; I had no spouse to help me through the worst part.

    [(js) I should clarify: My husband is indeed lucky to have me. But in this piece, I was simply recounting Diane Ackerman's story of her husband's stroke. Ackerman's book is well worth reading. And yes, no doubt, her husband benefitted greatly from her support—she took a very active role in Paul West's therapy, tailoring games and exercises to his creative and eccentric personality, and she recognized as well that the best language rehab for him would be to make an attempt to resume writing, at first by dictating to an assistant.]

  11. The unbearable loss of words | English Teaching Daily said,

    January 12, 2012 @ 11:28 am

    […] The unbearable loss of words […]

  12. Paul said,

    January 12, 2012 @ 11:56 am

    This was one of the best LL posts ever, and I will order that book immediately!

  13. kmurri said,

    January 12, 2012 @ 2:40 pm

    Beautiful article. It so perfectly describes how it feels to love words.

    My middle-aged brain loses words pretty often, sadly. Almost always, the word that jumps into my brain instead will be polysyllabic (and often exactly wrong). This is bad enough, thankyouverymuch; it's hard to imagine losing my language so completely.

  14. Chandra said,

    January 12, 2012 @ 2:51 pm

    This may be the first LL post that has brought me to tears.

  15. Bobbie said,

    January 12, 2012 @ 5:15 pm

    As a former speech therapist who worked with aphasic patients, some of my most touching moments were my patients' grasping for the precise word. I was trying to get a Mother Superior (Yes!) to say the word "flower." She looked at me sternly and said (correctly) "Marigold!"
    When asked a question from the Stanford-Binet Test for Adult Intelligence, "Why do we have child labor laws?" , there was a very long pause before another patient responded, "Exploitation."
    And when asked what the liquid was in her recipe for cranberry bread, my third patient could not respond immediately. Thirty minutes later she came wheeling down the corridor shouting, "Eggs!"
    I'm off to buy those books!

  16. deet said,

    January 12, 2012 @ 5:32 pm

    I'm placing an order for The Shadow Factory, for the exposure to all these words I'm sure it will bring.

  17. Rod Johnson said,

    January 12, 2012 @ 6:05 pm

    @Grace: your blog is fascinating and moving. Thanks for sharing it.

  18. Mark Mandel said,

    January 12, 2012 @ 11:01 pm

    Oh. My. God.

    I have the same fear, though not so strong. I have called myself "hyperliterate".

    I lost my wife three months ago. We had been together for 43 years, married for 39.

    The refrain of the song that I wrote for our thirtieth anniversary:

    Some things are once in a lifetime,
    Miracles, wishes come true.
    But once in a lifetime is all that I need
    If I'm spending my lifetime with you.

    Is it any wonder, then, that I reacted so to your last line?

  19. Gustovcarl said,

    January 13, 2012 @ 8:57 am

    Wonderful post!
    My mother had a series of strokes near the end of her life. She often had difficulty getting her point across, but she would often have to work through various synonyms before she would get to the word she wanted.
    After her last stroke, she was seen by the speech therapist at the hospital. He reported her as "aphasic". This puzzled the rest of us. We eventually discovered that the problem was that she simply disliked the therapist and wouldn't talk to him!!
    Now I have to find the Ackerman book.

  20. Barbara Partee said,

    January 13, 2012 @ 2:20 pm

    Julie, I also found that a most wonderful post. Not only did you bring me to tears, so did some of the comments your post inspired, including Mark Mandel's.
    When my father started having memory problems, including increasing word-finding problems, he showed me one time a list he had written out of words he often had trouble retrieving – he hoped having the list written down would help, and I guess for a while it did. But then a couple years later he reported with dismay that he no longer knew what some of those words meant — they had also disappeared from his recognition vocabulary. By the end of his life, in his 90's, he still had normal language, but a lot of memory loss concerning past events and a near-total short-term memory loss; as Julie said she would be inclined to predict, his vocabulary loss seems to have been limited to rarer words, because no one talking with him would notice any language loss at all beyond occasional word-finding problems of the sort all of us experience (and all us seniors experience increasingly frequently). And some of his memory loss had language consequences, like not remembering the names of family members sometimes.
    I would hate to lose language and would hate to lose memory, but seeing how my parents were still so in love with each other even when my father sometimes couldn't answer the question of who he was married to and she could no longer see his face clearly gives me hope that when we lose some of the faculties we value so much we'll still be able to be grateful for what and who we have left.

  21. David Policar said,

    January 13, 2012 @ 2:48 pm

    Yes.

    Add me to the "regular reader, first-time commenter, recovered aphasic" list; I suspect there are rather a lot of us here. After my stroke my aphasia wasn't nearly _that_ profound, for which I'm thankful, but it was severe enough to terrify and frustrate.

    I also had the experience of having the high-falutin' lexical entries be more accessible (sometimes) than the ordinary ones, which puzzled several speech therapists. I interpreted this as a side-effect of those words having been learned more explicitly and formally, and thus accessed through different channels than their quotidian counterparts. I have no idea if that's neurobiologically plausible, though.

    Once I had enough distance from the experience to develop a sense of humor about it, all of this was actually somewhat entertaining. I still fondly remember a speech therapist, after I'd said something about sitting in my "not a washing machine, not a dishwasher, not a skateboard, not a microwave, not a — right, a wheelchair!" commenting that clearly someone had already taught me about circumlocution strategies. "No," I replied, "I just talk like this." We were both amused.

  22. Julie Sedivy said,

    January 13, 2012 @ 6:53 pm

    Thank you all, for the warm comments and especially the moving personal stories. Thank you also to several readers who got in touch privately with their accounts. The common thread to them all is how much is preserved, even in the face of devastating loss.

  23. Ellen K. said,

    January 14, 2012 @ 10:38 am

    Re Cherubim: One could argue that, for the particular angels described, cherubim is a more accurate term than angels. It's a more precise term, anyway.

    @Markg: My impression was it had to do with where in the brain the words are stored. Or maybe like David Policar suggests, different pathways. Seems plausible from what I know, though I'm nothing close to an expert.

  24. Marti said,

    January 14, 2012 @ 2:35 pm

    I just recently read a book called "My Stroke of Insight", written by neuroanatomist Jill Bolte Taylor about her experience recovering from her own stroke, which she suffered at the age of 37. She presents in the book scientific information on what causes such aphasia, presented along with her own account of what if felt like to descend into an aphasic state. In her case she had the help of her mother to help her regain her language and other abilities. One such example I recall is when her mother began to attempt to teach her simple arithmetic, she was asked, "What is one plus one?" After several moments of thought, her response was to ask, "What is a one?"

  25. Bud said,

    January 15, 2012 @ 1:21 am

    I'm over 65 and find myself struggling for words. I don't know if it is Stroke, Stress, Fatigue, Dementia or Alzheimer's…

    I find that I can recall the language lessons that I learned in the 50s and 60s, while I struggle for more modern language. It may be akin to the loss of Short-Term Memory. It is said that one may recall the past while forgetting the present!

    I have observed the substitution of the word "pretty", for "quite".

    Additionally, there is a growing amount of personalization toward sympathy through the use of "I had", as in "I had this guy almost hit me on the freeway this morning".

    I have to restrain from saying, "Why would you have someone attempt to hit you?", knowing full well this is not what they mean to indicate.

    Yet, the molten state of our language continues, as it has for centuries, no whut I'm sayin' dude?.

  26. Rick Ladd said,

    January 17, 2012 @ 2:23 pm

    As one who has been struggling with the ever-so-slow, yet uncomfortably perceptible, decline of my virtual Thesaurus I found this story both touching and heartening. Did I mention well and beautifully told? Thank you, Julie.

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  28. The unbearable loss of words | My Blog said,

    September 22, 2013 @ 3:34 am

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