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Medical Humanities

Signing In

Pritha Subramanyam

May 13, 2016

His pen swerved on paper, as if painting a sky full of stars. Jay finished writing and slid the piece of paper towards me. It read the following: I need to tell you something. You must coming back so we talk. It is important. Jay’s handwriting was childlike: his letters were large and his sentences delicately meandered off the paper onto the wooden table. Jay had so much to say, but I wondered if the best way to communicate with him was through writing. It was six o’clock in the evening and the sign language interpreter had left for the day.
That was Jay’s first day in the psychiatric ward. He was the newest patient on the unit and after spending 24 hours in the emergency room, he was visibly anxious, pacing the room and sweating profusely. Jay’s psychiatric medications had run out months ago and he was trapped in a manic state.

Four long weeks passed. On a humid Wednesday afternoon, Jay and I were writing to each other in the hallway. We had met with the interpreter that morning, but Jay wanted to continue our meeting. I asked him how he was doing. He nodded excitedly and wrote, I am great. I need to leave soon. Get my affairs in order.

What do you mean by affairs? I wrote back.

He looked at me with a dignified look and printed on the page, I need to run for city councilman. I can’t stay here. My Dad put me in hospital he is mad with me.

Why is your father mad at you?

As I finished writing, Jay pulled the piece of paper towards him. He scribbled fervently, My father and I don’t get along. He always never cared for me.

It sounds like you’ve had a difficult relationship with your Dad, I wrote.

There was a pause. As Jay’s hand glided across the page, I realized I had hit a nerve: No! When mom died, dad put me in a group home. He's never learning sign language!

Jay’s writing started to jumble. I could see the ideas whirring in his head, all connected by a withering thread that was fraying at the edges. He was frustrated and didn’t know where to begin.  He banged on the table and a muffled NO! burst from his lips. It was as if the walls were closing in around him and he had to do something, keep talking, throw a tantrum.
I had brought up something about his childhood that was upsetting to him. Why couldn’t I decipher the story behind our conversation? What was the missing link?                              
I found out that underneath all the chatter was a neglected boy who never got the attention he deserved. Jay had congenital deafness. While he was bullied at school, at home he was treated with affection by his mother. She was the only person who had learned sign language in order to communicate with him. When Jay was ten years old, his mother died and Jay’s father struggled to raise his deaf-mute son. He placed him in a group home, a decision which marked the beginning of several relocations and cultivated a mistrust of people. For a decade, Jay was in and out of six group homes and ten psychiatric hospitals.
Because of the challenges he had faced, Jay was eager for human conversation and attention. Every time Jay caught me in the hallway to talk, his brown eyes melted into liquid melancholy when I told him I had to see other patients. When we did spend time together, he often would tell me about his mother, and I watched as he signed to her even though she wasn’t there.                                                                                                     

One day, I saw a beautiful reaction when my resident signed goodbye to Jay. Jay’s eyes widened and he beamed, his teeth sparkling as the sunlight hit the open window. Someone was speaking to him in his language, in his voice. Perhaps Jay was reminded of his mother, the one person who had ever made him feel important.

And so a ritual began wherein we learned each other’s languages. First, Jay and I sat together and wrote. With his lanky arms stretched across the table, he crafted his speech while I waited, ready to decipher its meaning. Then it was my turn.

What sign are you going to teach me today, Jay? I wrote to him. Jay squinted his eyes, pensively rubbed his chin, and jotted down a new word.

President Obama, he wrote. I watched as his index finger floated into the air and made a slight curve in the shape of an O. His other fingers bent slightly and rippled like the American flag beating against the wind. As I repeated his gestures, our faces met with a smile. We would go on to practice the various signs he had taught me until we had exhausted them all. Learning about Jay’s mother was such a pivotal moment, and by her example, I used sign language as a message that I was invested in Jay. We signed to each other and as the seasons changed in the outside world, the wall between us started to crumble.

See you tomorrow, Jay, my fingers twirled delicately in the air. I caught a glimpse of Jay’s pearly white smile as he signed back, See you tomorrow.