Therapy

Therapy, once initiated, is assumed to lead to an end - the hoped-for rehabilitation or something less perfect - thus reversing the disability and, as such, prescribing the conclusion of this blog. It is not so clear cut. Therapy starts as soon as you come out of the operating theatre. It has an immediate primary objective and a more ranging secondary objective which, in the case of an amputated tongue, is unending and limited in scope only by the attitude of the afflicted individual. Therefore, therapy co-exists at all times with the disability and its diverse manifestations which, by reason of this co-existence, should tend to diminish in intensity and give way to more amenable traits. Therapy is a slice from the same pathologic cake - so I can introduce it at this point in time without preempting an end.

I also introduce it here since it is the clearest expression of a positive attitude. I am thinking about partial recovery - not permamnent disability; about "aligerar la pesadumbre de vivir" (Miguel Delibes).

The primary purpose of therapy is to reduce the distress provoked by such a traumatic surgical intervention (ten-and-a-half hours of hacking about in my mouth is fairly traumatic to my mind). There is nothing magical about it and is much the same as for any trauma - pain reduction, rest, the proper cleansing of wounds and a quiet supportive environment. This phase endured for two weeks, and I have never been so damned bored in all my life.

The secondary purpose of therapy, and which may endure a lifetime if you so wish it, consists in educating my new tongue and jaw and re-educating my old mouth and throat to recover an acceptable degree of buccal dexterity. My debility is exasperated by a deformed jaw - when they put it back together I was missing a thin slice corresponding to the saw-cut, so the fit was different from before, and the saw pulverised a tooth so that my bottom teeth are distorted.

I engage in two complementary but distinct activities. One, I go for periodic sessions of manual lymphatic drainage since a whole bunch of lymph nodes were removed from my mouth and neck and I am unable to drain lymphatic fluids in a natural way. This gives rise to the accumulation of fluids in the neck and throat, and the consequent physical distortion. Two, I engage in speech therapy exercises with a group of people. Therapy specifically intended for people who have lost their tongue does not exist, at least in Spain (so the surgeon informed me with a wicked smile on his face). The group I attend is made up of people who have lost their vocal chords while conserving their tongue. However, it is an opportunity to practise talking - which is the only real therapy - in a supportive context. It does wonders for my morale - I am among people who, in the worst of cases, cannot make any understandable sound, while I at least can formulate a series of semi-intelligible phrases. The conduct of the group is chaotic, consisting in the most part of semi-literate throw-backs to a remote past, raised in a short-fuse 50-decibel culture. But it is about talking, not about taking sides in a political dispute (and since it is about talking, I can be whatever I want - socialist, fascist, maoist, gay, low-flying eskimo or whatever in order to animate the therapy). You can call it whatever you like - the speechless corner, or AA ('abladores anonymous, in Spanish). It is about practising pronouncing letters, especially letters such as j, k, g, q and t that require a tongue to be properly articulated, and repeating them to the point of dimentia; and sounds such as qu and cu; and words and phrases, in English and Spanish (or Chinese if I knew any Chinese - 'ne ho ma'). It is about making an effort to exercise the mouth and compensate the jaw - to learn a new way to formulate sounds and make yourself understood.

I also engage in a series of 'extra-curricular' activities. I read aloud to myself, I talk to the television, I converse with my plants - activities which, taken out of context, would get me locked up.

I also try to fortify my throat. I gurgle my food, I spit and suck, I clear my throat with raucous grumphs, I crush down my sludge and take pride in gulping down the ever-bigger lumps that remain after liquifying. The objective is to graduate from sludge to semi-solid - to get my degree in food consumption.

And then there is my right leg; roughly a kilo of meat is missing, extracted to mould a primitive replacement tongue. I walk for hours and miles to build strength in my leg. But I will conserve a limp for quite some time. I asked the surgeon if, since he stuck a piece of hairy leg in my mouth, I should have to depilate my tongue. He suggested laser depilation. And it is curious - every time I flex my right leg my new tongue pricks up...