musingsonwomenshealth.com

Reflections on 40 years as a doctor in Women's Health

Only when you drink from the river of silence shall you indeed sing


Words are important, but sometimes it is silence that is more eloquent; often, to sit in silence takes courage, and yet it sometimes communicates more than sound. It allows the listener to anticipate and you, the speaker, to think; it is not always awkward…

And yet, there are norms: whose turn it is to listen, and whose it is to speak; silence can be uncomfortable in a conversation when the norms are broken -especially if unnecessarily, or unexpectedly. There is a cadence to most conversations, a rhythm established almost from the start, and if it is breached, it can become uncomfortable unless explained. If it is prolonged, it often compels the listener to interact with the silence -the pressure to speak impels them fill it with their own words to re-establish the dialogue, to reinstate the more comfortable norm: taking ‘turns’ again.

But is unexpected silence always a worry, or just a space -a needed gathering of thoughts? Could it suggest something else entirely, something more easily communicable by the absence of words? Context is important, of course -knowing the silent person, or that the sensitivity of the subject matters to them- but even then, the suspicion that the silence may be nuanced can be troubling.

Even more troubling perhaps, is when the conversation is mediated by a phone call. Verbal expressions are important clues of course, as are voice modulations, expressions used, or even the speed with which their words greet your ears. But words are like the people who use them: often poorly readable without the body language that accompanies us through our lives; like adjectives, they contextualize meanings, clarify pauses…

I was walking down a rather busy country road recently, careful to keep to the shoulder on my way to a familiar trail. Cars and the occasional large gravel truck rumbled noisily past, usually giving me a wide birth when they could, or at least slowing down when they faced oncoming traffic that restricted their choices. Most of the car drivers recognized me and waved or smiled behind their windshields, some just roared past, obviously annoyed that someone was trespassing close to their side of the road.

The road near my house is narrow and there are no sidewalks, so the trip to the forest trail requires my undivided attention so I can see, or hear anything approaching. Answering my phone is fairly low on my priority list, so I keep it buried in my jacket pocket and rely on the vibration setting alone to alert me. And anyway, unless I were to walk with it in my hand, I doubt if I could hear it given the traffic and the sound of my feet crunching on the gravel shoulder. No, walking a country road requires vigilance… courage.

I felt vibration as a large cement truck groaned its way uphill towards me, and frankly, the last thing that occurred to me was that it was my phone. It was early in the afternoon and the few elderly friends I have left are usually enjoying a postprandial nap after lunch and would likely assume I’m doing the same.

The vibration soon died away after the truck passed me, so I thought no more about it until I reached the trail head, when it happened again. I reached into my pocket for the phone, more annoyed than anything at the disturbance, and glanced at the name on the screen. It was Charlie.

I hadn’t heard from him for almost a year since he had moved out East to live with his daughter in Winnipeg. We’d been close friends for years but because of his worsening health problems he found it difficult to talk on the phone; even his Emails were short on words and long on spelling mistakes, so I supposed he wasn’t getting any better. The last I’d heard, his daughter, Cindy, had arranged for him to move into some sort of elder-care facility just a block or two from her house so she could visit him daily.

She regularly used his phone to contact me so I would recognize the name on the screen and not ignore the call thinking it was another old folks scam. She usually phoned me every few weeks with a report.

“G?” she started, her voice sounding unusually hesitant. “Charlie told me I should call you…” She was silent for a moment and so I thought I’d give her some time to organize her thoughts about how he was getting along. By the initial sound of her voice, I could tell things were not improving.

“How’s he doing Cindy?” I could hear her breathing heavily as if she was trying to find some hopeful words for me.

She tried to disguise a sigh and then was silent again. Then she took a deep breath and let it out slowly. “He… He insisted I tell you he was finally going on a long trip…”

That sounded like the old Charlie I knew from university. He’d become a home-body after his wife died, though; his sense of adventure had always included her. Over the last few years after both of us had retired, since neither of us still had partners, we enjoyed meeting for coffee  several times a week and he would always ask me if I were planning another trip anytime soon. He knew that was a way to start the conversation; in a way, I think he enjoyed my adventures vicariously. He loved the way I described the things -even ordinary things- that made them seem alive for him. I could usually be relied upon to exaggerate the dangers of trips to South America, or the way people seemed to think differently about life in New Zealand.

He enjoyed my adventures so much, that he never failed to promise me that we would go together on a long trip when he got better. I suppose it was a standing joke between us, but it never failed to get his spirits up. If I developed health problems, he promised to regale me with his adventures when he got back.

These things skittered through my mind as I waited for Cindy to continue. But the phone line was so quiet, I thought for a while that she’d hung up. “You still there, Cindy?” I finally asked after a minute or so of silence.

It was obvious when she finally spoke, that she’d been crying. “I’m here, G…” I could hear her trying to swallow a sob.

“How’s your dad…?”

A stuttering sigh greeted me in reply, and it took her a few stertorous breaths to regain her composure before she could answer my question. “Dad died last night, G…” She managed another deep sigh and was silent again for a while to let her news sink in. “He said he’d wait for you at the end of the trail…”

She started to sob, and then I heard her phone click off, and my world click back on -but muted, as my tears seemed to obliterate the traffic on the now-faraway road, and as my footsteps crinkled in the September leaves that coated the trail. Then, slowly, the branches stirred with a gentle breeze, and a crow called hoarsely to his flock that were evidently scattered in distant trees. A brook babbled merrily through the underbrush nearby, and a dog barked somewhere as I wandered on…

And yet, I couldn’t help but wonder if Charlie had actually got it wrong this time: he said we were going to meet at the end of the trail; but… good old Charlie, he was with me already…

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