In The Man Who Lost His Language (2002), a memoir about her husband’s aphasia, Sheila Hale explains that ‘unless complicated by other neurological disorders, aphasia does not usually affect personality.’ I first read the book in April 2019, when my father was in a stroke ward in Madrid. The only sounds he could manage were ‘yuh’ (which often meant ‘no’) and a few grunts and warbles. When he tried to write, it came out as squiggles. I wanted to share Hale’s belief that personality could survive in the absence of verbal expression, but it wasn’t easy. Before the stroke, my father got his point across with epigrammatic oomph: advice from him seemed conclusive, arguments rigged. Now, when he wanted to communicate, a game of charades began: the only meanings we could find in his gestures were the ones we knew how to look for. I remember one occasion, shortly after the stroke, when he pointed at his chest, cupped his hand to the side of his face, and then pointed at my mother with an anxious look. He repeated this sequence several times. My mother took his hand in hers: ‘Are you saying you love me?’ There were tears in her eyes. To my father’s credit, he waited a couple of minutes before trying again to ask if she had his phone.
It’s strange that Jon McGregor’s new novel – which deals with a case very like my father’s – doesn’t take care to establish the way its main character speaks before his stroke. We’re introduced to Robert ‘Doc’ Wright in Antarctica, where he works for several months each year as a technical assistant and guide to geographical researchers. The first thing we hear from him is a phatic murmur delivered into a faulty radio: ‘Thomas? Luke? Come in? This is Doc. Hello, hello. Thomas? Luke? Hello?’ After this, he communicates by non-verbal means – ‘making a face, like: what time do you call this, lads?’ We’re given a few snatches of reported speech but they offer little sense of his character. Someone asks why he’s called Doc, and he explains that ‘it started somewhere along the line, and it just stuck.’ We aren’t knocked sideways by the loss, or even particularly surprised, when the next thing he says is: ‘Wh, whuh. Whuuuh.’
As it turns out, few of the characters in Lean Fall Stand are brought to life through dialogue. Even those without brain injuries fluff their lines. When Doc arrives in Antarctica, one of his colleagues ‘wanted to make a joke about a small step for mankind, but he couldn’t work out how to phrase it’. The same character ‘didn’t know how he would tell people about it when he got home’. After Doc’s stroke, his wife, Anna, receives messages of condolence from friends and colleagues ‘searching for the right words, and not always finding them’. When her daughter asks if she can move back into the family home, ‘Anna was appalled by how fiercely she wanted to say no. She said yes.’ Anna remembers that on their first night together, she told Doc he had ‘the nicest penis she’d ever seen’. He didn’t seem overjoyed. ‘You idiot,’ she thinks, ‘you were supposed to say biggest.’ Since we rarely manage to say what we mean, how much can personality have to do with language in the first place?
McGregor has been posing versions of this question since the start of his career. His first novel, If Nobody Speaks of Remarkable Things (2002), is full of characters whom words fail. The unnamed young woman who narrates part of the story can’t bring herself to tell her mother that she’s pregnant; elsewhere there’s an old man who can’t tell his wife he’s been diagnosed with cancer, a boy who can’t tell the girl across the road that he loves her and another man who can’t speak to anyone about his dead wife. The novel takes a panoramic view of the residents of a single street over the course of a day, encompassing many of the small pleasures that often go unspoken: from students on a comedown silently enjoying one another’s company to a mother unobtrusively watching her children play. The novel was longlisted for the Booker, but some reviewers complained about its ‘pretentious parade of heavily intense gestures’ and ‘fatal lack of humour’. The exuberant detail and snazzy construction certainly aren’t well served by the rather mushy tone, or by descriptions of ‘rain falling … like missed opportunities’ and ‘alarms … crying their needs to the night like an understaffed orphanage’.
By the time he published his third novel, Even the Dogs (2010), his sentences had become less showy. The book is another portrait of a voiceless community: an urban network of drug addicts, drifters and the long-term unemployed. Narrated in a slippery first person, it details the life and death of a chronic alcoholic in a gritty vernacular. The novel’s montage effect (achieved through the expert handling of overlapping timeframes) was proof that McGregor could be experimental but unpretentious. In his next novel, Reservoir 13 (2017), his blend of formal virtuosity and unstinting empathy found its most successful expression. An account of the life of an English village in the thirteen years after a teenage girl goes missing, the book returns, in some respects, to the God’s-eye perspective of the first novel. But Reservoir 13 gives a much deeper sense of its characters’ lives and achieves a better balance between the mundane and the remarkable. The girl’s disappearance is slowly absorbed by the community, but even in its immediate aftermath the villagers can’t bring themselves to discuss it: ‘Everything that might be said seemed like the wrong thing to say.’
Compared to its predecessors, Lean Fall Stand – written in a conventional close third person – is technically unassuming. There are points when the subject matter calls for something more inventive, however, as in the series of diminishing paragraphs that depict Doc’s stroke: the first runs for six and a half pages, the last consists of a single word. We’re shown the exact moment when, sheltering in the field station from a storm, Doc’s grip on language begins to fail:
His head felt wrong. There was no pain but a weakness. The feeling came and went. There were lights flashing on the radio but there was no sound. He poured a drink and emptied his glass. He rawed the rum nubness of his face. No. Rubbed. Rubbed the rum rawness. No. Radio. Something was rattling against the door. The light brightened and he went to the window. There was something he should. Something was wrong.
It’s difficult to know if this is an accurate account of what it feels like to have a stroke, but McGregor has worked to make it seem plausible. Novels that deal with the breakdown of language (Samuel Beckett’s Malone Dies; Russell Hoban’s Riddley Walker) aren’t usually so concerned with realism. When Anna flies to Santiago – Doc has been airlifted to a hospital there – the details seem authentic enough for us to assume that if McGregor hasn’t been through something similar, he at least did his research:
On the ward, a nurse showed Anna how to spoon food into Robert’s mouth. The food was mashed, and smelled of banana … Robert looked at Anna, and at the bowl, and raised his eyebrows. He made a noise in the back of his throat … He made a puffing sound, biting at his bottom lip… He looked at her, and screwed up as much of his face as he was able to move.
After the high drama of the opening section, with its exotic scenery and life-or-death stakes, the story shifts to England, where we follow Doc’s long journey towards an uncertain recovery. The steps along the way are at once depressingly small and forbiddingly vast. Learning to swallow again. Learning to match the word ‘cat’ with a picture of a cat again; learning to say the word ‘cat’ again. Learning to write his name again. When my father was at the start of this process, my wife and I took our two-year-old son to visit him in hospital. I watched as Dad struggled to say ‘hello’, encouraged by the child whose own recent breakthroughs in speech had been a source of uncomplicated pride. It can be difficult to remember that someone whose linguistic skills compare unfavourably to a toddler’s is still an intelligent adult, as Doc finds one day when he returns from the toilet. ‘You managed everything by yourself then?’ a nurse calls out. ‘Excellent, well done!’ For a man who, weeks earlier, was riding a skidoo through a ‘surge’ of polar weather, it seems an underwhelming achievement. By this point, Doc has regained enough vocabulary to articulate his feelings: ‘Me. Fucking. Me, med, medal!’
McGregor’s empathy extends to Doc’s family members. Anna is a Cambridge academic (her field is oceanography), and their marriage is a sometimes tricky partnership between two hard-nosed professionals. She valued the time Doc spent in Antarctica because it prevented them from becoming ‘one of those couples where the wife sees all her ambition shrink in the shadow of her husband’. But that’s what happens after he comes home from hospital, unable to meet the most basic of his own needs:
She had to change the bedsheets in the morning because he’d made a mess of using the pan. She had to help him roll out of the bed and lever himself into the chair. She had to put a towel on the armchair because his pyjamas were still wet. She had to get him out of the wet pyjamas and wash him down with a soaped flannel and a bowl of hot water. She had to get him dry and into warm clothes before his temperature dropped. She had to get down on her knees to put the socks on his feet, and his feet into the trousers. She had to cajole him into pulling the trousers up by himself; hooking his thumbs into the belt-loops, wriggling them up from side to side. She had to help.
‘I don’t want to be a carer,’ Anna tells a friend. ‘I never even really wanted to be a wife.’ Later we’re told that ‘she resented the time she’d lost’ looking after Doc: ‘This should have been the high point of her career.’ We don’t begrudge her these moments of self-pity, but McGregor makes less effort to help us understand the couple’s son, Frank. The only time he visits Doc in hospital, he struts around ‘doing something on his phone’ and then abruptly leaves for ‘a work thing’. He has an ‘infuriating’ tone when he’s been proved right about anything. When Anna says she doesn’t want him to worry about Doc’s health, his response is petulant: ‘I’m worried already, Mum; this worries me, you know? This whole Dad’s-had-a-stroke thing?’ We don’t find out much about Frank’s recent relationship with his father, but we do learn that he filled his childhood room with Antarctic memorabilia – ‘the compasses and ice axes, the maps and charts on the wall’ – and that he grew resentful of Doc’s long absences during his teenage years.
In the final part of the novel, Doc joins a group that aims to help its members develop ‘communication strategies’. What started out as an adventure story ends up, in classic McGregor fashion, as a portrait of a community. The third act is much quieter than the second, which itself unfolds at a slower pace than the first. Doc settles into the kingdom of the sick and end up less isolated than he was in Antarctica. Some of the group have fluent aphasia (in which perfectly clear words are arranged in a nonsense order – think Lucky in Waiting for Godot); others have expressive aphasia (problems getting words out at all, like Doc or my father). But all are having to relearn how to interact with the world. Their sessions don’t concentrate on language-learning in a strict sense, but on other modes of expression, such as movement, which they explore with the help of professional dancers.
She asked him to show her how it felt to be cold, to be outside in Antarctica … He mimed putting on a coat, and gloves, and a balaclava.
‘Wear this. Warm. Coats. Head, coat. Hand, coats. Christ! No. Hmm, hmm. Hand, hand.’
‘So you’re wearing protective clothing, lots of clothing.’
‘Yes, obviously. Of course.’
Rachel echoed his mime of putting on the clothes, and as she did so her body expanded with the extra layers.
Communication, McGregor suggests, is less about putting the right words in the right order than about context, tone and active interpretation. It’s an idea I’ve come to accept. I’m no longer inclined to view relationships as primarily verbal, defined by the things we say, or fail to say, to one another. Two years on from his stroke, my father’s speech is far from perfect. He takes time to find words. He makes mistakes. But in all the most important ways – his intellect, his temperament, his sense of humour – he’s much the same as ever. These days I’m grateful for the things about him that used to wind me up. Perhaps this won’t last. The website of the Stroke Association warns that although aphasics may not recover the ability to speak in full sentences, ‘it’s usually possible for other people to understand what they mean. This can be very frustrating.’