Diary

Sheila Hale

This sociable stranger with the donnish manner would like to know who you are and what interests you. He will listen attentively and respond enthusiastically. Whether you speak English, Italian, French or German you will have no doubt that he follows your meaning. The trouble is that however hard you try you will not be able to understand a single word he is saying. He is speaking some language – that’s obvious from the pitch and rhythm of his voice – but what language? Listen closely and you will hear that it is a language without words and with an extremely limited phonetic range, relying mostly on the syllables da and wals – dwals for short.

It is more than five years since my husband, a Renaissance historian, lost his language following a stroke. So far as I know, nobody in that time has taken him for an idiot or a wag. Everybody seems to be convinced that he is saying something. But brave though his confidence may be it is also one of the more worrying symptoms of a bizarre and poignant neurological disorder. John suffers from dysphasia – or aphasia as it is also called; and it is one of the many paradoxes of his condition that although he can hear perfectly, he cannot monitor what he is saying, or rather not saying. The buffer which in normal speech-processing checks the assembled components of language just as they are emerging as speech is missing from John’s brain. He is therefore unaware of the fact that he has lost access to his semantic memory and that when he tries to talk he is not using real words and syntax. His thoughts are so clear and well-ordered and ready for expression that he can neither believe that he is not getting them across nor stop himself trying. He throws himself into the conversation with such verve and conviction that people tend to blame themselves for his failure to communicate.

Dysphasia is a consequence of damage to the language centre of the brain, which in most people is situated towards the front of the left side, on the borders of a deep cleft called the Sylvian Fissure. The cause can be a stroke, a blow to the head, a tumour or a cyst. It is by no means rare. And it can happen to anyone at any age. The 150,000 or so dysphasics in Britain represent about the same proportion of the population as the victims of Parkinson’s disease or multiple sclerosis.

Unlike other neurological diseases that can affect language – Alzheimer’s, for example – pure dysphasia spares cognitive functions that are processed in other regions of the brain and that are not language-dependant. Like dyslexia (which is often one of its consequences), dysphasia can coexist with high intelligence. John’s memory, like that of most dysphasics, is unimpaired. He can play chess, hum a tune, plan a day or a journey, read or draw a map, find his way around a strange city. He can add and subtract but not multiply – because multiplication tables are learned verbally. He can write (in numbers not words) any historical date he ever knew or the price he thinks you should pay for your house. But he cannot write a cheque because he cannot write the words for numbers. He finds it difficult to remember phone numbers because, like most people, he would do this by repeating the numbers to himself verbally.

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[*] Talking about Aphasia: Living with Loss of Language after Stroke by Susie Parr, Sally Byng and Sue Gilpin, with Chris Ireland. Open University, 160 pp., £45 and £12.99, 14 October 1997, 0 335 19937 2.