Saturday, 6 June 2015

The Woman Who Woke Up Chinese

Waking up Chinese?
A woman did not wake up "Chinese", needless to say. It's just one of those headline grabbing documentary titles. A few years ago, Sarah Colwill suffered a severe migraine which left her with Foreign Accent Syndrome, a rare motor speech disorder which affects ability to control speech prosody in such a way that listeners perceive the speaker as foreign. Normally, when patients sustain neurological damage after a stroke or head trauma, their speech sounds obviously disordered. But the neurological effects of Foreign Accent Syndrome are more subtle, possibly because a smaller part of the brain has been affected.

In Sarah's case, no damage to the brain has been detected at all, even by state of the art scanners. This is why she was diagnosed with severe migraine rather than stroke. In fact, the boundary between the two is rather blurry, it would seem. Her migraines are hemiplegic and absolutely crippling. The poor woman has several a week, but only two have landed her in hospital. The first of these gave her the Foreign Accent Syndrome, and the second affected her mobility on her left side. It seems nothing can be done to prevent or help her with the migraines, and she is unable to work at the age of 38. Her husband is at his wits' end with worry.

Sarah's acquired pattern of speech makes her once Plymouth accent now come across as Chinese. She has a monotone, staccato rhythm and utterance final lengthening and inappropriate pitch rises. She simplifies consonant clusters ("hopital") or uses schwa epenthesis to help her articulate them, so "spider" becomes "s-e-pider". She drops plural [s] and has some mild agrammatisms and word-retrieval difficulties.

Goodness me, does it sound like I know what I am talking about? Well, I should, because I spent all of 1998 in Newcastle studying a lady with Foreign Accent Syndrome. She had a couple of minor strokes (TIAs) which replaced her mild Derbyshire accent with one that sounded distinctly French. She had been an accomplished singer, but now had difficulty controlling her breath and holding a note well. She was such a lovely person, and it was so sad how little we could do to help her. I say "all of 1998 studying a lady" - in fact, I only spent a couple of hours with her. The rest of the year was spent listening to recordings and staring at spectograms and pitch contours on phonetics laboratory software. No use to the patient at all.
The university bookbinder's line endings made me become a subtitler

Exaggerated pitch contours in Foreign Accent Syndrome

Anyway, lo and behold, off goes Sarah to see my former thesis supervisor, Professor Nick Miller, in the Department of Speech at the University of Newcastle upon Tyne. So nice to see him again after all these years. It looks like he has a bigger and better office now. When I was working for him, he was in very cramped conditions in the King George VI building and used to have all his children's clothes drying on the radiators. Scary to think that those young toddlers are probably at university themselves now.
Glorious Newcastle-upon-Tyne
Foreign Accent Syndrome also has a profound social effect on the people who acquire it. Suddenly someone loses their whole identity and effectively becomes foreign in their own country. Sarah says others treat her like a tourist, or even an alien. They make at best unfunny jokes or at worst racist comments about her Chinese accent. No one believes she is who she says she is. Sarah barely feels she knows who she is. On request, her car insurers send her some recordings of her voice in calls to them made before her migraine. Sarah is crushed to hear her true accent again.

Sarah undergoes some intensive speech therapy with Martin Duckworth, which she finds exhausting and frustrating. She has to repeat words over and over, trying to retrain all the tiny muscles involved in speech articulation. She does eventually considerably improve her pronunciation of "chips" and "chopsticks", though these may not have been the best choice of words for someone people (unhilariously) think should be ordering a Chinese takeaway. And there are so many more words in our rich and complex language left to work on. (Ironically, if Sarah had actually woken up Chinese, she may have found that easier, since there are far fewer possible consonant-vowel combinations in Mandarin syllables.)
There may be help for her terrible migraines in the near future. But there is no magic pill or miracle cure for Sarah's Foreign Accent Syndrome, despite all the research done into the condition over the past 20 years, in which I played a very insignificant part. However, over time and the course of her speech therapy, Sarah finds a growing acceptance of her changed voice, and she starts to regain her confidence and be happier about who she is. Happier is all we can hope for. For now.

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