People : Voice

Yosemite Valley, October 2012

Long before the age of email, I preferred communicating through writing over spoken conversation. As a kid I'd type stories on a typewriter and share them with my brothers as a way of sharing myself.  I wrote stories about girls named Abby and Lydia (I liked the way the letter "y" looked typed), who I modeled after the girls in the Babysitters' Club, who I basically wanted to be.  During summers, I'd write letters to my friends from school.  Because we lived in the same city, it would take only a day for mail to travel from one house to another, so in a week we could exchange nearly half a dozen correspondences.  When my brothers went away to college, I'd write them weekly letters (when you're young you think everyone will be enthralled by your stories of elementary school experiences).

Then when email came around, I felt like it was pretty much the medium made for me. I'm good at keeping in touch with people mainly because I love writing and reading emails.  It's also easier for me to have emotional conversations through email because I get worked up really easily talking about anything in person, whether it's something that makes me sad or angry.  I remember having an argument with my brother when we were living together, and I'd furiously type out an email to him even though he was sitting in his room across the hall from mine, and he'd write back telling me to just come over and have a real conversation, and me writing back telling him I'd just either blow up or burst into tears if we talked aloud.

In some ways, I think this comes generally from being a shy bookworm who often just looks quiet even when I feel like I speak a lot.  I've always found my more comfortable voice in writing things out because in writing you're on the same footing as anyone else who might be taller or louder.

Victoria, Canada. June 2010.

Today my last patient of the day was a man who, due to his medical condition, had long lost the ability to speak. He communicated with me by typing (with one hand) into a machine that displayed his text, and then spoke it aloud.  It was faster for me to read his text than to wait for the voice to read it aloud.  I found myself trying to speed through some of what I had to say, and not always waiting enough time to see if he had a response before moving onto something else. The visit itself took much longer than usual, and despite having double the time as another appointment, we probably talked about half as many issues.

It reminded me that as much as I love being able to communicate through writing, my voice is something I take for granted.  It made me reflect on the day of speaking to one patient after another, and how much is given and received by tone, vocabulary, noise, laughter.  Because I had to really watch this patient type his words, I was forced to pay attention to his process in speaking to me, and noticed a lot of the expression that's often just intuited from hearing a person's voice.

And I think that one of the wondrous things about getting to know so many patients is learning that communication changes with each person.  It's made much more concrete and obvious when someone has to type to speak to you, but really, everyone has a different mode of relaying themselves and different preferences for how to accept information.

As challenging as this can be, I love that this work constantly reminds me that caretaking is a dynamic thing, whether it's for yourself or for someone else.  Our needs and our abilities are constantly changing, and hearing what those are, and listening to how best to cater to them, takes a lot of attention--and gives a lot of voice to everyone in the conversation.

Amsterdam, Netherlands. April 2014.