Learning to sing again after a brush with death
A stroke almost killed her. Now an unusual choir has given her voice back.
The night my mother's brain blew up she'd been out at midnight collecting snails from her flower garden and flinging them over the fence onto her neighbour's lawn because she couldn't bring herself to kill them.
She went to bed, felt weak, lost her balance. When she woke up in hospital the next afternoon she was unable to talk, unable to walk and her right hand was already starting to curl into itself, like she was holding a handful of grain for scattering to the chooks.
She can't remember more than fragments of the intervening hours, but I can: the gathering of my sisters and father at North Shore Hospital; Mum on a gurney behind a curtain; the lift down to radiology; the IV drip and the ID wristlet; the doctor who, as the sky slowly lightened outside, showed me and one of my sisters the huge ink blot on one side of the CAT scan of Mum's brain, where the blood from a broken vessel was flooding the cranium and putting huge pressure on the brain tissue, rearranging the soft structures like an egg being whisked. The pressure may still be building, said the doctor, and in the worst cases the pressure gets so great the brain starts to squeeze out the hole at the base of the …
"Stop!" said my sister. "We get the picture."
In fact Mum's brain chose to remain inside her skull. She lived. She spent the next four months in a residential rehab unit, progressing from bed to chair to walker to stick before eventually returning home to a house full of handrails. There was physio for her dead leg and arm, vocab lists for her mangled speech.
There was another woman in her rehab ward who couldn't speak either - though the pair of them still chatted.
"We'd yabber away with no words, just 'hmm-hmm-hmm-hmm'. It was funny, really," Mum said to me earlier this month.
Some of her words returned within days, but they were slippery, untrustworthy things. One afternoon I dropped in just after an earlier visitor had left.
"Who was it?" I asked.
The visitor had been her younger sister Corinne, but at first Mum couldn't remember the name. After much stammering, she finally located the part of her brain where she had once stored names of sisters and other important people, and returned with a word.
"Omelette," she told me confidently. "Omelette."
That was 11 years ago. She's 81 now, a reasonably merry widow who endangers pedestrians in her mobility scooter, goes to art classes and can cook for herself one-handed. Her speech has improved hugely but she still has significant aphasia: you never know when the flow of words might stall or when she'll randomly swap the word she actually means with some word she found lying around in her head.
When we were kids, Mum sang all the time. Our favourite bedtime song was a setting of the Walter De La Mare poem 'Five Eyes':
In Hans' old mill his three black cats
Watch the bins for the thieving rats.
Whisker and claw, they crouch in the night
Their five eyes smouldering green and bright …
It's a great little song, with a spooky minor-key melody that switches to jaunty major as the cats start pouncing around slaughtering the rats, and a satisfying final line where you come to understand why a song about three cats is called Five Eyes.
For years after the stroke Mum didn't sing at all, even as her speech became more fluent.
"I think it was because I was so angry. I didn't think I could do it properly."
A few months ago, though, my sister started taking her to a choir run by Auckland University's Centre for Brain Research. Modelled on similar choirs abroad, the CeleBRation Choir is designed for people with neurological conditions. Mostly that means Parkinson's disease and strokes.
Singing, researchers are finding, may help the brain to rewire itself a little, working round the damage that caused a patient's aphasia (difficulty understanding or producing speech). One of the choir's long-standing members is entirely incapable of speech, yet when she sings she is perfectly fluent.
A study of the choir's members has shown improvements over time in their communication even when not singing, including subtle characteristics such as the ability to perceive "emotional prosody", the emotional content of speech that's conveyed through pitch, volume and timbre.
Suzanne Purdy, professor of speech science with the school of psychology, says theories vary as to why singing can help restore speech. It might be the beat that works the magic, or it could be the familiarity of a melody or lyric. Tempo probably matters. It could be that the singing directly aids recovery of a damaged area of the brain, or perhaps it merely "recruits" areas of undamaged brain to get involved in speech-related activity.
"When you're singing you're engaging a pretty far-reaching and complex network," says Purdy, "especially if it's something you knew in the past. Music we're familiar with activates emotional and memory circuits, as well as higher-level cortical circuits."
There's evidence from this choir and others that group singing can also help breath control, speech volume and facial expressiveness, all of which can be diminished in Parkinson's sufferers in particular.
There are also all the usual benefits of being in any social choir: interaction with other humans, a reason to get out of the house, a chance to fill your lungs and belt out a familiar tune.
Last month I went to watch the choir during a Monday afternoon practice at the university's Tamaki campus in Glen Innes.
I knew I was in the right place before I'd left the carpark, where a man with a strong tremor had parked his car and was inching his way up to the front entrance.
Inside, about 20 women and 10 men gradually filled the rows of chairs in a large lecture room. Up front, music therapist Alison Talmage had her acoustic guitar and electronic piano set up. There were a couple of wheelchairs, a Zimmer frame and a small forest of walking sticks.
After the welcomes and apologies and an announcement by a choir member that there were still tickets available for his local theatre's production of Last of the Summer Wine, Talmage led the group through breathing exercises and scales and warm-up action songs. She asked everyone to "hum in the middle of our voices" and the room buzzed like a hive.
"What are you doing when you sing loudly?" she asked no one in particular.
"I start losing my teeth," called out a wag in a wheelchair in the fifth row, to general applause.
This is a non-audition choir, and the songs are mostly simple, either a unison melody or a round. They sang Haere Mai, the African folksong Banuwa, a round that sounded a bit like 10 Green Bottles, Edelweiss from The Sound of Music. They sang the New Zealand national anthem in honour of the All Blacks' recent World Cup victory. There was a request for the Maori Battalion song, and Talmage promised to have it ready for the next week.
Mum sang some of the songs with gusto, though she looked a little disdainful at the lyrics "wriggle your arms" and "give your shoulders a shrug". Mostly, though, everyone seemed to be having a ball. They were tuneful and loud and smiled and laughed. The stroke sufferers cradled their bad arms, and the folk with dyskinesia shrugged their shoulders without needing to be asked.
The facial contortions and shakes of Parkinson's are involuntary, but at times they seemed totally appropriate – one man's expression was just like Joe Cocker hitting the high notes of With a Little Help from My Friends; another gently waggled his head like an ageing David Gray.
It was a gathering of the neurologically diminished and the diminishing, and it was sad and funny and moving. Halfway through 'God Defend New Zealand' one singer stood to make it easier to remove his jacket. For a moment he swayed alarmingly, but the two men sitting next to him, each with a sway of their own, leapt to his aid and the three of them embraced in an intimate, sinuous, jacket-removing dance that lasted most of the anthem.
During the coffee break I talked to one of the jacket assistees, Roger Hicks. He's 69, and was diagnosed with Parkinson's in 2004 after noticing he was having trouble controlling his legs and his facial expressions.
This is the first choir he's ever joined, and he enjoys it a lot, even though he claims to be not much of a singer. Parkinson's has made his voice faint and croaky and left him short of breath, but the singing has improved all those things since he joined a couple of years ago.
Ross Lambourn, 71, joined the choir because he has Alzheimer's disease. He's a lifelong singer and there's nothing wrong with his voice or his breathing. Instead, the choir benefits him because "it helps me with my confidence, which I'm told I used to have. I don't remember a lot of things".
After coffee, a few more songs, including The Happy Wanderer, with its silly chorus – "Val-deri, Val-dera, Val-deri, Val-dera-ha-ha-ha-ha-ha …"
It's one of the songs we used to belt out in the car when we were driving when I was a kid, and sure enough, when I look over to where Mum's sitting, she's putting her heart into this one.
My mother says she has no idea if her months with the choir have improved her speech or not. She still has good days when she's pretty fluent, and bad days when she's utterly tongue-tied.
It doesn't matter – the choir is rewarding all the same, for the company, for the music, for the fact that she could join without being self-conscious about not being able to sing half as well as she could before the stroke. It's the first organised singing she's done since she was in school in Cambridge, when she and three friends formed a little group and entered singing competitions.
Since she joined the choir she's found herself singing along with the radio in a way she hadn't for years.
I ask her if she can still sing the Walter de la Mare song, and she gives it a go:
"In Hans' old mill his three black cats
Watch the hmm dum dum dum dum dum …."
The whole song's there in her head, note-perfect, but she simply can't summon the words fast enough.
I Google the lyrics on my laptop and blow them up to 24 point. Can you sing it with the lyrics in front of you?
She tries again. It's croakier than I remember it from 40 years ago and a few syllables turn to mush, but mostly she keeps up with herself.
"Squeaks from the flour sacks, squeaks from where
The cold wind stirs on the empty stair,
Squeaking and scampering – everywhere."
My mother's a singer once more, and she scampers to the end and to Walter de la Mare's gentle punchline.
"Out come his cats all gre-e-ey with meal:
Jekkel, and Jessup, and one-eyed Jill."
- Sunday Star Times