I remember when I was a lot younger and my grandmother was still alive, her flat became increasingly filled with small pieces of paper attached by tape to an apparently random collection of things. On each paper was written the name of the object it was stuck to; ‘toaster’, ‘cooker’, ‘sink’, ‘chair’ and so on. Over time, as she forgot the name of more and more things, so a growing number of labels spread across the kitchen, bathroom and living room. The progression of her dementia seemed to be marked by the proliferation of these scraps of paper, and the ever more shaky handwriting that spelled out what these everyday items were called.

Labelling things in this way must have taken quite a lot of effort. But I am not so confident that one can assume what exactly the labelling was for. After all, she lived alone (her husband had died some years before), tended to stay inside her home, and rarely had visitors. So knowledge of the names of these ordinary and unremarkable objects was not essential for her daily living. And when family members came to visit, we just got on with the usual family interactions over a cup of tea, which never required her to know the names of the things around her.

However, thinking with her dementia, rather than trying to explain it, suggests ways to understand my grandmother’s actions, which might never emerge by asking about her motives and what ‘rational’ basis there might have been for them. Rather than any practical explanation, it’s likely that, in part, labelling provided a sense of order; a sense that she was still in command of the world around her by holding on to the names of things – marking them, if you will. And perhaps this also mitigated a general fear of being embarrassed and feeling frustrated – not with regard to others, since they were seldom there, but to herself, on her own. But there are two other ways in which labelling the world might have offered her reassurance and stability.

The first concerns the relationship between the labels and my grandmother’s changing sense of self. The story often told of someone with dementia is a story of increasing withdrawal; of retreating or contracting into a private and incomplete world only inhabited by the past. Such descriptions are often full of tragedy and fear that this can (and will) happen to many of us. I certainly remember my mother’s growing distress when confronted with a room strewn with these pieces of paper. Exasperation, even. For her, the narrative of the unrelenting advance of dementia in her own mother became too visible, too tangible, too baffling, to bear. And the very fact that the objects labelled were so mundane, so everyday, so unexceptional, was itself part of the pain my mother felt.

The sense of decline is derived from the idea that the labels functioned as substitutes for my grandmother’s own cognitive abilities. But there is a different way of thinking things out. The ‘extended mind’ theory refers to a range of quite varied scholars who argue that human thinking always and inescapably enlists things beyond the head – to include objects and skills, such as computers and writing. These things are as much where thinking gets done as in the firing of synapses. From this argument, my grandmother was extending herself into the world through these little scraps of paper by adopting a strategy to think differently, but to think nonetheless. So rather than decline, perhaps the labels suggest an account of expansion.

The other related idea comes when one tries to understand, but not explain, her use of sticky notes by thinking about the power of the labels themselves. There is, of course, a long tradition in anthropology exploring how words not only categorise, but mould and fashion, the world into particular forms of experience. The problem with all this is that discussing language in the abstract can rapidly lead to somewhat tired arguments centring on the meaning words have independent of their use. However, for my grandmother, words were not just concepts: through the notes, they were given a material form, as visible and tangible as the objects they were stuck to. In this way, perhaps her actions were not simply about pinning down meaning by attaching words to the things themselves, but were also about providing little surfaces of familiarity between herself and her surroundings. To furnish the world by making it home, if you will. In this way, the webs of significance, that Taylor so tenderly wrote about when discussing her own mother’s dementia (2011), were not derived from the meaning of words and how they related semantically, but from the simple presence of the words that surrounded her.

So although at times my grandmother was evidently distressed by the experience of things, which became ever more unsettled and blurred, labelling all those objects in her small flat may well have created a kind of stability in response –  first by extending herself into the world, and then by making that world part of herself. This, then, is not an account of merely thinking, but thinking with. And as I remember my grandmother and those sticky labels, I, in turn, am compelled to reflect on my own words, and what they can do. We all know that, in any ethnographic writing, explanations will only ever be partial; perhaps part of the reason for this comes from the very fact that meanings are never singular, fixed or definitive. Yet my recollection of my grandmother reminds me that it is possible to suggest other, complementary, kinds of understanding, which are less strictly fastened to the precision of words, and instead offer meaning from the life they have when they are made present.

References

Taylor, J. (2011). Beyond Words Traces of Meaning in an Abandoned Kitchen. Anthropology Now, Vol. 3, No. 2, pp. 62-64

Simon Cohn is Professor of Medical Anthropology at the London School of Hygiene and Tropical Medicine (LSHTM). His research focuses on issues related to diagnosis, contested conditions, and chronic illness in the UK and other high-income societies. He is interested in the role of fluids, both inside and outside the body – how they relate to health, their general absence in medical anthropology and sociology accounts, and the extent to which their constant movement and flow might demand a new way to think about old problems. He is currently PI on the ‘Forms of Care’ project on ‘active non-interventions’ in palliative care practices in the UK.