The Secret Language of Patients and Caregivers

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Living With Cancer

Patients with tender caregivers often speak a little language of their own devising. It’s not unusual for people dealing with illness to use quirky dialects and inside jokes to attempt to maintain a sense of connection with their intimates or to revive unextinguished emotions.

Upon returning home from an operation for ovarian cancer a few years ago, I relied on this sort of shared allusion when I repeatedly asked my husband, Don, “What watch, Liebchen?” It was a coded way of asking if it was time for my next dose of pain medication.

I knew he’d understand that I was channeling the couple in “Casablanca” at Rick’s Moroccan cafe, practicing fractured English in the hope that they could reach America. They used the term “what watch” for “what time is it?” Don shared my sense of our being immigrants in the world of cancer. Fearful of time running out, we wanted above all else to find safe passage.

Of course, perfectly healthy companions frequently cultivate a private lexicon. Before the philosopher Iris Murdoch experienced the onset of Alzheimer’s, her husband, John Bayley, has explained, he and his wife shared “a whole infantile language of our own.” After she became debilitated, he said, they communed in “snatches of doggerel, song, teasing nonsense rituals” that functioned “like underwater sonar, each bouncing pulsations off the other, then listening for an echo.”

For many patients and those who love them, recycled lyrics, punch lines and jingles elicit the associations of a shared past. They function as shortcuts that can affirm and enliven a relationship imperiled by disease, especially if it threatens the mind.

Marion Coutts, in her memoir “The Iceberg,” needed to learn a new idiom while she took care of her husband, Tom Lubbock, a prominent British art critic at the newspaper The Independent, and their 18-month-old son whom she calls Ev. A tumor was growing in the speech and language area of Tom’s brain, and he started to say “hand” when meaning “head.”

Two brain operations brought home the humbling realization that memory, understanding, humor, tact and sensibility have a physical root. Seizures causing verbal lapses riddled Tom’s vocabulary; however, he continued to labor over his columns throughout various chemotherapy regimens, as Marion determined to “devise another language.” In it, they would accept “a percentage of nonsense in the interests of volubility,” just as their toddler did.

Although Tom stumbles over bedtime rituals — “Get your teeth,” he says to Ev, meaning “Get into your bed”— he rejoices at his wife’s ability to “undercept,” and she savors his portmanteau of understanding and intercepting. Yet she realizes that she must face the future extinction of their unique vernacular: “How can a language endure if it has only one to speak it and another to give it context? We are a people of two and ours is a dying tongue.” Once her name vanishes, he identifies her as “Ev — near that.” It is a strenuous effort on his part to come up with a name as he found himself entering the forest of no-names.

After Marion Coutts locates a hospice facility for Tom, she finds that “Language splits, folds, diversifies again and becomes a repertoire of tone and touch and pitch mapped by light pressure to the skin or a hand circling the face.” At the end, tone and touch and pitch sustain their bond: “My hand is in his hand. Go. I hum something, not anything.” The last two words hint that she affirms her presence with a specific, undisclosed tune, one with special meaning for him. Hearing, hospice counselors tell us, is the last sense to fail.

Despite the barrier of death, the overwhelming need to converse with a beloved does not simply disappear in a widowed partner. The urgency of that longing fuels the elegies Donald Hall composed not about but to his wife, the poet Jane Kenyon. They appear in a series of verse-letters published in his brilliant book “Without.”

After her death from leukemia, Donald Hall feels that he still has to fill her in on the news, which consists of his continuing to “talk to you crying,” his coming “back to this house / to talk to your photographs.” He must update her with information about her garden, their relatives, the weather, and his ongoing desire. Can he express their lost sexual languages?

In “Letter With No Address,” he recalls his wife’s last days when he lifted her wasted body onto a commode: “Faintly you repeat, ‘Momma, Momma.’” To her, he recounts the funeral as well as his frequent visits to her grave and his returning home while picturing that she has independently also arrived: “bags of groceries upright / in the back of the Saab, / its trunk lid delicately raised / as if proposing an encounter, / dog-fashion, with the Honda.”

“Bear,” I say to my husband Don, “listen to this wonderful poem.” Sometimes I use sillier monikers for him without an inkling of their origins. While I read aloud, I can imagine Jane Kenyon relishing her Donald’s small talk. As about other poems Donald Hall recited, she might have exclaimed, “That’s it, Perkins. You’ve got it.”

What a boon to recall, approximate or conjure a cherished pet name.