STROKE ODYSSEYS DERRY
Singers: Laura Sheerin, Kathryn O’Callaghan, Eoin O’Callaghan, Stroke Odysseys Chorus
Band: Ruth McGinley, Michael McGinty, Sean McTaggart , Kevin Murphy, Seamus Devenny, Sarah Murphy
Music Director: Sarah Murphy
When Ken was a ploughboy he would shout ‘hough’ and ‘heigh’ to get his horses to pull more to the left or the right. Fifty years later he recalled hough and heigh, when they took away his driving the license because a stroke had caused him to steer to the left.
A trip to Lourdes offers Christine and Jamsie a surprise cure for the depression and tears wrought by stroke.
Jamsie does not like getting help with putting his coat on. He’d rather do it himself, however long it takes.
Helen’s stroke left her unable to walk, until she recalled the prize-winning Irish dancer she had been as a girl.
When Seamus lost the use of his left hand he named his cramped fingers after his boyhood family so that he might get to know them again.
When the man in your life can no longer fix things around the house you suddenly miss the male skills you had come to depend on. Seamus and Marie’s story.
Coming to terms with the changes wreaked by stroke. Jamsie’s story as told by Christine, his wife and carer.
As Heather lies in a coma on Altnagelvin Stroke Unit, a Catholic family in the next bay offers her husband John a small relic of St Columb to help speed Heather’s recovery. How does a Protestant respond to this healing gesture?
The Salmon Fintan:
When Betty was a girl she would row her brothers across the loch as they dapped for salmon. Fifty years later she draws on the salmon’s energy and determination as she strives to overcome the worst consequence of stroke.
HOSPITAL PASSION PLAY
Performers: Melanie Pappenheim, Rob Gouldon, Jeremy Avis, Liz Mansfield, Jawad, Spiros, Heidi, Stroke Ambassadors Chorus, Shout@Cancer Choir, Garsington Chorus
Direction Karen Gillingham
Video Projection Magali Charrier
A half-hour opera. Three stories of people who have lost their voice – two of them with aphasia after stroke and one having had a laryngectomy after throat cancer - and are searching for it: Jawad who worked for human rights in Iraq, Sandy a tourist guide, and Spiros a champion swimmer and costume-maker.
My ears still have
The echo of my voice
I’m willing to try
I’m still willing to try
The piece featured the extraordinary Shout@Cancer Choir, run by Thomas Moors, a choir of people who have had throat cancer and whose larynxes have been replaced by machines.
They took my larynx
Broken lines chased me
In my nightmares
THE DISMANTLED CLARINET
Performers: Sarah Homer, Liz Mansfield
An attempt to look at what a stroke does to the brain by dismantling a clarinet. Too literal? Certainly disturbing.
STROKE ODYSSEYS LONDON
Directed by Ben Duke
Video by Magali Charrier
Costumes by Charlie Cridian
With Lil Sullivan, Jawad Mohammed, Haide Rollo, Pauline Boye, Marek Dziurman, Melanie Pappenheim, Sara Augieras, Rachele Rapisardi, Lea Cornthwaite, Jonah Brody, Sarah Homer
Watch a trailer here.
I’m working with the choreographer Ben Duke and the video artist Magali Charrier on the latest manifestation of Stroke Odysseys. I’ve been working, on and off, on this project for four years, making performances with people who have had strokes, but never before with Ben. He has a very frisky way of working, provoking the performers by setting them a series of challenges. The stroke survivors we’re working with are Stroke Odysseys veterans, and they have a wonderful confidence and swagger when confronted with these challenges.
There’s Marek, severely disabled physically, partially deaf, with great difficulty in moving and speaking, but with an extraordinary determination and spirit. Challenges make him laugh. The more severe the challenge, the more he laughs. And he throws himself into it, often at great risk to himself, expending massive amounts of effort. It’s alarming to watch, and glorious. It turns out he used to be a scuba diver, so we challenge him to give a lecture about scuba diving, which he does with great aplomb, using sign language to make the meaning clearer.
There’s Lil, who was - still is - an artist. She’s clever, charming, witty, and talkative, even though she has some difficulty in finding words (partly because she’s always looking for the exact word – she’s never satisfied with a substitute). She’s a prima donna, and she’s aware of it. She writes songs, with some help from me. I keep track of the lyrics, provide a chordal structure, make the arrangement. Our relationship is good-humoured, though she gets irritated with me if she thinks I’m hijacking her song (understandably). In our piece she sings a beautiful song that she wrote, I Dream Able-Bodied, which is a wonderful take on the relationship between her past and present selves.
There’s Pauline, originally from Ghana, who used to be a nurse and a midwife. She speaks fluently, but she moves stiffly and with difficulty. When challenged to demonstrate a remembered movement from before her stroke, she comes up with a lovely graceful gesture, and expands it into a dance. The range of movement is limited, but there’s no mistaking the quality of it. Turns out it’s associated with a song, and she begins to sing it – ‘what you are, what you are’. So we expand this into a dance routine for the whole ensemble, echoing her moves.
There’s Jawad, who used to work for an NGO fighting corruption in the oil industry in Iraq. One day several goons walked into his office, and shot him and his colleague many times, at short range. Miraculously he survived, escaped via Jordan to Britain. And, soon after, had a severe stroke. Jawad’s movement is stiff, and he speaks tentatively and hesitantly – which is ironic because he used to speak seven languages. (Now his Arabic is much more fluent than his English.) He remembers words by writing the initial letter on his hand, a habit he shares with many stroke survivors. He is handsome and frisky and flirtatious. We challenge him to recreate a speech he once gave, and his performance is charismatic, full of expansive gesture, even though his voice is hardly more than a whisper.
And then there’s Haide, originally from the Phillippines, who wants to be a midwife. She used to be a nanny, and tells a bizarre and complex story about escaping from Beirut in 1984, when she was looking after the children of a rich Lebanese businessman. Her way of telling this story is vivid but confusing. It’s very difficult to understand what country she’s in at any particular moment, whether she’s in a taxi or an aeroplane, who she’s with. The story has the quality of a dream. Haide is reticent, quiet, a natural carer. Her stroke has affected her speech, but not her movement – in fact she is extremely able. When challenged to balance on one leg, she is like a ballet dancer.
These five people are joined in the piece by two dancers Sara and Rachele, two singers Melanie and Lea, and two instrumentalists Sarah and Jonah. The piece constantly wrestles with the challenge of presenting disabled and able performers together in a way which is honest but doesn’t expose the disabled performers by comparison. What makes this possible is that the stroke survivors approach the piece with such relish, such chutzpah. There’s a section in which Sara and Rachele improvise a movement sequence, and Jawad and Marek must imitate the movement. And so they do, approximately, sometimes chaotically, occasionally dangerously, with great humour, giving it a curious clumsy grace of their own. The aesthetics of clumsiness…..it’s interesting territory.
The piece, as it evolves, faces two of the usual problems of devised pieces without narrative. You start with an idea, you explore the idea, you gradually find out what interests you about the idea, and you accumulate promising bits of material.
The first problem is that material that was, when it first emerged, fresh and spontaneous, can easily atrophy when repeated. (This problem is exacerbated in our project because the stroke survivors often have difficulty with remembering what they did, and, being amateur performers, difficulty with reproducing it even when they do remember it.) One way round this is to base the material on games, and to change the rules of the game every time, so the material never gets stale. It’s a risky strategy.
The second problem is to find a structure which holds all this promising material. If there’s no narrative, this structure is tends to be based on emotion and texture and pacing – nebulous ideas. You try out the structure, and – dammit – the result seems inert, dull. The bits of material fail to illuminate each other, fail to produce a satisfying journey. And then you ask yourself, is it the structure that’s the problem, or is it the material? And you drive the performers mad by futzing around with the order, and making new transitions between the bits of material. There’s a lot of trial and error, and when there are eleven performers involved that’s a lot of relearning.
In principle it feels better to have a structure in mind to begin with – but then you are foregoing some of the exploratoriness of the process. Or perhaps to start working from the beginning of the piece, and let the next bit of material emerge from the last one. The composer John Adams often works like this (though he is working alone, not in the rehearsal room like most choreographers), starting with a tiny germ of material, and making it grow, like a biologist growing a culture in the lab. I usually work like this too, but in this piece we don’t know in advance what the beginning is: we want to base the piece on what the stroke survivors have to say, and of course to begin with we don’t know what that’s going to be, and which parts of it are going to interest us.
We go to visit two neurologists who work in rehabilitation after stroke.
Nick Ward is very interesting on the subject of neuroplasticity, the ability of the brain to heal itself. Until recently the accepted idea was that the brain was not able to heal itself (unlike other parts of the body); so the only real hope you might have after having had a stroke was to have surgery. This idea has been rubbished, and the current idea is that the brain finds new pathways to rediscover functions which have been lost: neuroplasticity. The Canadian psychiatrist Norman Doidge is a great evangelist for this idea, and has written several very readable books promoting it. Nick Ward says, yes, fine, nothing wrong with that, but of course the brain can heal itself. We all know the brain is capable of life-long learning and relearning. That’s all that’s happening in the so-called neuroplastic brain: learning. And, by the way, it takes repetition, and it takes skilful teaching; it’s not something you can do in a hurry, or by yourself.
Nick fights for the idea that rehabilitation from stroke can go on not for a few days, or a few weeks, but for the rest of one’s life. Yes, the rate of rehabilitation is greatest in the first few months; but that’s not the end of it. It’s an endless process of relearning. I get the feeling that everyone knows he’s right, but no one wants to commit resources to it.
Alex Leff is very interesting on different kinds of aphasia (language loss). He divides the problem into four areas: writing, reading, speaking, understanding speech. He talks about the search for a word - the tip-of-the-tongue problem (which of course is a universal problem, but usually less acute) - and makes the distinction between a semantic problem – confusion between two words which are similar in meaning, such as sheep and goat – and a phonological problem – confusion between two words which are similar in sound, such as sheep and sleep. (I go home and write two songs, one very disturbing, one playful – a semantic-confusion song, and a phonological-confusion song.) Alex points out that the problem of finding a word is most acute when that word is someone’s name. With most words there are possible substitutes: ‘sheep’ instead of ‘goat’ is not a disaster. But with a name there is no substitute. (My favourite joke – in fact the only joke I can ever remember: Two old couples are having lunch together. The men are talking in the dining room. The women are in the kitchen. One man says to the other, We went to a wonderful pub last night. It was called….oh….a bush….thorns…..smell….. Rose? Says the other man. Yes, says the first man. And calls out to his wife, Rose, what was the name of the pub we went to last night?)
Alex says that the problem for aphasic people when searching for a word is that the word is there in the brain but won’t reach the mouth. I try to analyse this problem when I next have a word on the tip of my tongue; my impression is that the word is not in the brain – perhaps some pointers to the word are there, or an image related to the word, but the word itself is absent. This introduces the question: how are memories constructed?
It’s been often noticed that some people who find difficulties with speech are able and confident when singing. (For example, Doctor P, the subject of Oliver Sacks’ study The Man Who Mistook His Wife For A Hat.) On the face of it, that is a surprising fact – singing is surely a more complex activity than speaking, an expression of words and music rather than just words.
How surprising is it?
A naïve question: what are the differences between speaking and singing?
Consider the words ‘blackbird singing in the dead of night’ – try saying them to yourself; then listen to Paul McCartney singing them in The Beatles’ song Blackbird1. There’s probably not a huge difference. The natural intonation of the words has become melody, and the natural rhythm has become musical rhythm. The last two notes of the singing are probably the most different from natural speech: they’re high in pitch, and the last note is surprisingly long.
The move from speech to song involves a formalisation of rhythm and pitch.
The natural rhythm of the spoken words, which is subtly different every time you say them, and is extremely complex – each syllable has a similar but slightly different duration; to write spoken speech in musical notation is extremely difficult, in fact doomed to failure. In the sung version, the rhythm is a transformation and simplification of the speech rhythm. The relationships between the durations become simpler fractions. In its sung version ‘blackbird singing in the dead of night’ uses just three durations: black (1) bird (1) sing (2) ing (2) in (2) the (2) dead (2) of (1) night (3). Duration 1 is twice duration 2. Simple!
The natural intonation of the spoken words, which is, too, subtly different every time you say them, uses marginally different pitches on a continuum of pitch – again, very difficult to notate. In the sung version, this variable, fuzzy pitch structure becomes a melody with defined pitches on a grid. In its sung version ‘blackbird singing in the dead of night’ has just three pitches: black (1) bird (1) sing (1) ing (1) in (1) the (2) dead (1) of (3) night (3). Simple!
So it’s possible to think of singing as being like speech but with the help of a two-dimensional grid (rhythm and pitch) as guide. Of course this doesn’t say anything about the aesthetics of the singing, only about the formal structure. But, bearing in mind that, for example, people with Parkinson’s Disease often find it easier to walk with the help of a grid on the floor, it may be that this singing grid can be a help to people with aphasia, a way of working towards a fluency which normally eludes them.
(It’s worth noticing that Blackbird is pop music. In classical music there is likely to be a much larger difference between speech rhythm and sung rhythm. For example, in Baroque music there are often long melismas, where one syllable is sung to many notes; the shape of the words is highly distorted, e.g. Every Valley Shall Be Exalted2, from Handel’s Messiah. In 20th century music, sung words are sometimes fragmented, completely deprived of their natural rhythm, e.g Berio’s Sequenza 33.)
Most speech is improvisation – you have the vocabulary, you have the knowledge of syntax, and it’s a moment-to-moment decision how you use them. (Not true, obviously, if you’re reading from a script, but most of us don’t often read from a script.) Stories and ideas are translated into extemporized speech: ‘I was out last night, late, smoking a cigarette. It was dead of night. The silence was amazing. And then I heard a blackbird singing.’ These words – I, was, out, last, night, late.....- have to be accessed from the vocabulary and shaped, with the help of the syntax, into sentences with meaning, sentences that are comprehensible.
Singing, on the other hand, for most people, is the recreation of something that exists already, the song Blackbird for example. The challenge of singing a song, for an aphasic person, is of memory, of reconstruction, not of construction. People with aphasia often have problems with memory, so the challenge is not necessarily easy, but it’s a different kind of challenge. And it’s often helped by the association of a particular song with a particular event or person or emotion. (Most of the songs chosen on Desert Island Discs are chosen for their associations.) Access the event and, perhaps, you access the song.
On the other hand, singing offers a possibility that speech seldom, if ever, does: the possibility for the playful exploration of sound, detached from meaning.
Aka pygmy music is of this kind4. There are no lyrics. The singing is often an imitation of natural sounds – birds, insects, thunder, wind. These sounds find new structures in the music. There’s no semantic meaning. The meaning exists entirely within the music.
Berio’s Sequenza 3 is of this kind, too. The text is so fragmented that the semantic meaning becomes unimportant. So the piece can explore sound and emotion in a much freer way than a normal song.
Listen to Bobby McFerrin’s version of Blackbird. He uses fragments of the original song, and wraps them in a frisky improvisational web which includes imitations of musical instruments (most obviously the double bass) birdsong itself, and audible breathing as well as abstract exuberant noises of his own creation. The words are like provocations to his invention.
This freedom from the requirement of meaning, this invitation to play, may have possibilities for people with aphasia.
2 For example, https://www.youtube.com/watch?v=7NCO6UzZ2R8
3 For example, https://www.youtube.com/watch?v=33--d1zdZl8
4 For example, https://www.youtube.com/watch?v=FkQTEqwTs7Q
The piece opens in London, and then tours Britain – a wildly ambitious project in itself. There are low points – getting off a bus in the middle of the countryside in Cumbria (a complex, time-consuming process, guaranteed to drive the rest of the passengers up the wall) and having to wait in the rain to be picked in a series of cars - and high points – a glorious wild evening of dancing in a pub in Belfast.
In Belfast we premiere a flute duet The Art of Recovery for Sarah Murphy and Zoe Douglas. Sarah is a professional flautist. Zoe was a professional flautist, until her stroke. She has adapted her flute so that she can still play it, and she works with a mirror that allows her to monitor her disabled right hand.
* * *
What I have tried to do as a composer working on Stroke Odysseys, in collaboration with everyone else working on the project:
To talk to the participants and to be alert to what they say, and how they say it;
To record these conversations, if possible, with the permission of the participant.
To turn what the participants have to say into song lyrics,
intervening as much or as little as is necessary (mostly by editing),
where possible using the words as the participant said them;
To turn these song lyrics into songs for the participants to sing together
taking into account how they were said - the hesitations, the
circumlocutions, the idiosyncracies, the means by which the
participant is dealing with his/her aphasia,
while bearing in mind that the song should be enjoyable to sing……
in fact, including the odd anthem.
To be looking at the experience of stroke, both physical and psychological, and to be searching for ways to convert that into music, in a way that is sympathetic, unpatronising, but revealing. In particular, to be looking at the clumsiness, in speech and movement, which arises from stroke, and expressing it in music.
To invent games (guided improvisations) which result in vocal events.