One Hundred Names for Love: A Memoir by Diane Ackerman Read Free Book Online Page A

eel. If she scrunched up his lips he held a pucker, but he couldn’t pucker his lips by himself.
    On her chart, Kelly noted that Paul answered simple yes/no questions—“Are you in bed? Is this a hospital?”—by nodding, with 80 percent accuracy. But his responses were accurate less than 25 percent of the time when she asked him to do simple things. When he was shown two objects and asked to point to one of them, he always pointed to the object on his left. If she asked him to say “Aah,” he followed the command only 30 percent of the time. She jotted down:
    Unable to repeat single syllable words.
    Did not name common objects.
    No functional verbal communication.
    When asked to sing/count along with me, opened mouth very
    wide, intermittent voicing, but no articulation despite some
    movement of the lips.
    His inability to respond seemed unreal, and though I wanted to cry, I forced myself to watch. She handed him an 8-by-10-inch communication board, covered with drawings of common items or actions, and asked him to point to the objects she named—a key, a clock, a child—but he was unable to. She showed him an alphabet board and asked him to spell his name. Mutely observing his struggle, I felt my hope dissolving, as if touched by acid. His Oxford First and fifty-one published books meant nothing now. He couldn’t spell his own name. When she wrote down Raise your hand , he opened his mouth wide and made a strange low murmuring as if trying to read out loud. Most poignant of all, when she handed him a pen, the tool he’d wielded with mastery throughout his career, one I’d associated with him the way one links seahorses with ocean, he tried to hold it in his weak right hand and it slipped from his grip. Kelly suggested his left hand, but he didn’t try. She offered him a thick crayon and blank sheet of paper.
    “Can you write your name?”
    With difficulty, starting and stopping several times, Paul scrawled P-O-O-P.
    Somehow managing to look both nonplussed and mystified, Kelly asked: “Do you need to use the toilet?”
    He tilted his head blankly, the way animals sometimes do when they’re puzzled. So I pointed to the bathroom and asked slowly, “Toilet?”
    Surprised, he shook his head no.
    Her evaluation read:
    Oral apraxia. Severe apraxia of speech.
    Expressive and receptive aphasia.
    Dysphagia with risk of aspiration.
    Translated, it meant: my Paul couldn’t coordinate the movements of his jaw, tongue, and lips ( apraxia ). He had the worst degree of trouble saying what he wanted to, or understanding what people said to him ( expressive and receptive aphasia ). And a swallowing problem put him at risk of aspiration ( dysphagia ). Soon after his stroke, an X-ray video evaluation of Paul swallowing barium-coated fruit, crackers, and apple sauce had shown that he was silently inhaling particles into his lungs. When asked to cough, he couldn’t flex his throat muscles enough to cough the particles out. Silently aspirating. Sowing the seeds of possibly deadly pneumonia without any feeling that food had gone down the wrong pipe.
    Kelly explained he could rule the liquid only when it was in his mouth. After that pure reflex is supposed to take over. When we swallow normally, a valve opens, allowing food to enter the esophagus, while closing the windpipe to prevent food from blocking the airway. This reflexive combo happens in less than half a second. But a stroke, especially one that produces slurred speech, can weaken the throat’s muscles. Thicker fluids or solid food flow lava-slowly and are easier to guide with drab muscles and dulled reflexes, lessening the chance of dripping fluid into the wrong tube. The hospital’s levels of thickened liquids were termed: nectar, honey, pudding .
    “Pudding-thick only,” Kelly decreed. For a while at least, all liquids would be mixed with a powder called Thick-It, that smelled like a dry cast-off chrysalis and tasted gray, added until a spoon could stand up in the