One of the arguments Arthur W. Frank makes in his book The Wounded Storyteller–and in his subsequent books about “illness narrative”–is that there’s a compelling ethics for medical diagnosticians and caregivers involved in just listening to the other person’s story. The difficulty emerges when the storyteller cannot put his or her story into words or lacks enough objective distance from the illness to narrate the kind of story that others are expecting.

When people’s circumstances push into the chaos realm, they’re in the midst, overwhelmed; few of them can construct a cogent and concise narrative. In their pain, in their grief, everything seems equal–no beginning, no end, all middle.

The listener expects: a beginning. a middle. an end.

The listener expects: chronology. a goal. a desired outcome.

If the listener’s job means determining a course of healing, the listener requires history, onset, comparisons. Truly good diagnosticians therefore need more than sleuthing skills, experience, and education. They need to listen well in the midst of the storyteller’s chaos; Frank calls this listening with.

That often means taking a deep breath and endeavoring to change perspective.

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[Which, by the way, is excellent practice for poets.]

Himalayas: view from a high lake plateau (Snow Lion tours)

Himalayas from satellite: a fractal view

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We cannot climb into an airplane and get an overview of a human being’s situation. Nor can we get into another person’s thought processes to determine what’s going on. Listening without rushing the person, without offering advice, without finishing the sentences with what we expect to hear–that’s a hard task.

In a previous post, I tried to replicate what it was I could hear when someone I cared for experienced cognitive damage.

It was very, very difficult to listen. For me, heart-breaking because of my previous understanding of who the person was. It was only in her final days that I started to realize I’d needed to change in my relationship with her in order to get some idea of what she wanted to say. And it was too late, really.

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As another Best Beloved is now experiencing significant cognitive changes, I want to do better. I need to acknowledge the chaos narrative, the interruptions, the lacunae in the person’s story. It’s important that I develop a new perspective on what a conversation entails, too; my expectations surrounding a conversation no longer hold, and both of us will get frustrated if we stick to former habits.

If sometimes a visit feels a bit like the Mad Hatter’s tea party, so be it. There’s a story in that, after all, thanks to Charles Lutwidge Dodgson.

Tenniel’s sketch for Alice’s Adventures in Wonderland

And, just as an aerial view of the Himalayas alters the perspective of what the mountains are and how they appear, an altered perspective of a loved one keeps the person, as a human being still in the world (no matter how changed), in view. True, perhaps with changed patterns and unexpected gaps that we who love them may grieve the loss of. The conversations may be interrupted and chaotic, or full of long pauses and grasping for words and concepts. It is just a different kind of human communication.

Not what I expect, but what I am given. I’m trying to listen with, before it is too late.