19.5.18

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?