Book Review: Beyond the Words by Andrea Durbin

Reviewed by Erica Ball

A poignant collection depicting the shared human experience of ill health and old age

The people who work in healthcare settings are witness to daily crises, illness, and trauma. Beyond the Words: Exploring the Edges of Language and Life offers a glimpse into what some of these days might be like and the kind of thoughts such experiences leave behind for those who take on duties of care. 

In concise but moving prose, the author, a speech-language pathologist (SLP), tells of some of the people and conversations she took home from her work at a skilled nursing facility. Previously a long-time writer and editor, she explains she began writing this book as a way to process the ups and downs she was experiencing in her new career. 

The short vignettes she recounts are full of wit, wisdom, and gentle humor. They touch upon incredibly difficult moments for her and her patients, from those unable to swallow food and water due to accident or illness to Alzheimer’s patients who cannot grasp where they are or why, from cooperative patients to those so nasty the nurses avoid them. It’s a quick read, but it covers an array of the stark and raw human experiences that are daily life for professionals such as her. 

Professionals like Durbin are entering people’s lives in the middle of a crisis when their health is at a low point or at the very end of their lives. This book shows how differently people can react to these situations and the people who are trying to help them. At the same time, it touches on how they all share the same physiology and same physical weaknesses. 

Anyone who has worked in the helping professions can relate to the phenomena of being allowed a certain intimacy with someone for a short period of time only for them to disappear when your time with them is done. The author recounts being left wondering what came of these people and whether or not she was of any help. 

She also includes the unfortunate level of power within the American medical system of problematic insurance companies and administrators as well as the push for “productivity,” as though these people in need are parts on an assembly line that are to be put back together in as timely a manner as possible. 

Due to the concise yet powerful writing, and the universality of the experiences recounted, this book is strongly recommended not only for general readers but especially for those interested in the work of an SLP or other medical and helping professions, those concerned with the challenges facing nursing homes in the US (and elsewhere), and those who have cared for older people or had loved ones in care homes, or who are just generally aware of the inevitabilities of the aging human body. 

Everyone’s health has been rocky at times. Those of us who are lucky enough will grow old. In this book, the author recounts for us what that might look like and how she herself tries to imagine being in her patient’s place. It is about these small dramas (that are monumental to the people living them) unfolding in unremarkable buildings all over the world, in unremarkable rooms within these buildings.

These are people experiencing painful and debilitating physical issues or fighting huge battles to recover and return to their homes and lives. They are surrounded by professionals striving to help however they can, despite their personal burdens, the broken healthcare system, administrators with misplaced priorities, and, sometimes, the patients themselves. All the while, the outside world has no idea.

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