The Secret Language of Sisters by Luanne Rice

Sixteen-year-old Ruth Ann (Roo) McCabe is on her way to pick up her younger sister Mathilda Mae (Tilly) at the river museum. It's four o'clock on a February Saturday afternoon. The Connecticut River is almost frozen over and Roo wants to get a few pictures of the beautiful scene for her portfolio for a scholarship contest. She desperately wants to attend Yale University, where her father studied years earlier. Roo and Tilly's father died last summer from a massive heart attack.Tilly is waiting impatiently and continues to text Roo as does Roo's boyfriend Newton and her best friend, Isabel.

After taking a few photographs, Roo gets in her Volvo and while driving towards the bridge leading into the town of Black Hall, she picks up her phone and sends a text: "mins away." In the three seconds she's looked down at her phone she finds her car has drifted off the road and into the path of a woman walking her dog. Attempting to avoid hitting both, Roo swerves, causing her car to somersault down the bank and lands on its roof in the frozen creek. Hanging upside down in the car, bleeding, Roo passes out.

Tilly is eventually picked up at the museum by Newton who informs her that Roo's been in a car accident. When Tilly sees Roo in the ER she is conscious but nauseous as well as complaining about her head hurting and her neck feeling stiff.  Suddenly Roo has a seizure and suffers what doctors diagnose as a "brain stem stroke affecting the basilar artery system." Roo's doctors tell her family that she is comatose. Roo's eyes are open and protruding, her face covered in bruises and dry spittle and her mouth pulled back, frozen in a silent scream. Doctors say she is "incapable of emotion" and she's on a ventilator to help her breathe. A newspaper story states that Roo who is not named, is "expected to remain in a vegetative state" and that the accident is being investigated to see whether drugs or alcohol were a factor. This upsets Tilly but Isabel tells Roo's mother that she was taking pictures and that they were texting about this. This leads Tilly to wonder if Roo actually pulled over before texting her that afternoon. Could she have been responsible for Roo's accident.

Unknown to Roo's family however, Roo can hear and understand everything but she is unable to respond. "I commanded my limbs to move, but they didn't. How bizarre. I was trapped, mummified." Roo finds she can't speak and she cannot move her limbs. "Then I realized, No, there are no straps. It's me -- I can't move. I can't speak. I can't get anyone to hear me. I must have looked like a lifeless lump, but inside my mind I was wild, alive, in agony, going crazy." Even worse for Roo is "not having my family realize that I was awake and completely conscious, hearing everything. How could they not know?"

Neither her family nor the doctors are aware that Roo is conscious. Dr. Sarah Danforth, a specialist in pediatric neurovascular disease isn't and neither are her nurses. Eventually Roo begins breathing on her own and is taken off the ventilator. Tilly expects that this will mean a big change in her sister but when she arrives at the hospital she finds Roo still unresponsive. Dr. Danforth tells Tilly that Roo still doesn't feel emotion. Tilly struggles with guilt because she believes she is responsible for Roo's accident and she asks her sister if she is guilty of causing her accident. But Newton tells Tilly the accident was partly Roo's fault leading Tilly to become extremely angry at him and getting herself placed on probation at the hospital.   Roo sees all of this but cannot respond.

Being trapped in her body leads Roo to reminisce her how she and Newton first became friends, began dating and planned to attend college together. She wonders what she looks like to him now.; She also remembers how her father died suddenly last summer on a perfect summer day when he came home and went to lie down before dinner and never woke up. As the days wear on, Roo has time to think about the accident and realizes that she was texting before the accident and that she has done this to herself.

Meanwhile at school, Tilly struggles to cope with her sister's situation. This is further complicated by Isabel who takes Tilly to the place where Roo had her accident and reveals that she has found Roo's missing cell phone. Isabel tells Tilly that she felt guilty because she had been texting Roo when she had her accident so she came out to look for Roo's phone. When she found it she took it home, charged it and discovered that it was not her text that caused the accident but Tilly's text. Roo's last text, "5 mins away" was sent to Tilly. Isabel insists that they need to tell someone and Tilly reluctantly agrees to tell her mother. The two girls meet Martha Muirhead who is the woman who was walking her dog Lucan the night of the accident. Martha tells Tilly that she is just like her sister who was concerned for the her dog. Martha asks Tilly to let Roo know Lucan is doing just fine.

Tilly takes Martha's advice and decides to tell Roo that the dog she hit is now doing fine. But she also wants to tell Roo that she was the cause of her accident. As Tilly is talking to Roo and closely watching her sister's face she makes an astonishing discovery. It is one that completely changes the doctors diagnosis and gives tremendous hope to Roo, her family and friends. Life will never be the same, but maybe Roo has a chance to reclaim some of what she lost in the accident with the help of those around her and the bond she shares with her sister Tilly. And at the same time, maybe Roo's tragedy can save others from the danger of texting while driving.

Discussion

A major message that Luanne Rice conveys in her novel is that texting while driving can lead to unimaginable consequences forever affecting your life and the lives of those around you. In the province of Ontario, distracted driving now outnumbers impaired driving as the leading cause of accidents.Rice pulls no punches in demonstrating just how devastating a few seconds of inattention can be. Roo is an accomplished young woman with a brilliant future ahead of her. She is smart, attractive and accomplished. She has a boyfriend, Newton who adores her. She planned to gain early acceptance at Yale and was in the process of developing her photography portfolio for the Serena Kader Barrois Foundation Photography Contest. This award offers a thousand dollar scholarship which would help her get into Yale.; After her accident readers learn that Roo's photographs are especially captivating, making her injury seem all the more tragic. Dr. Howarth, a specialist in facilitated communication who will help Roo learn to communicate with the world around her, views Roo's photographs and tells her, "Your photos say so much about you Roo. You have a beautiful soul and a brilliant eye. You capture the perfect instant of beauty and action, and somehow you translate that exact moment, and the feeling that goes with it, to the viewer." Yet in mere seconds, Roo loses all this because of texting while driving. The message is not lost; distracted driving kills and ruins lives.

The second issue to be explored in this novel involves an unusual neurological disorder. Although initially it seems that she's just banged up from the accident, Roo has a stroke and passes out. It turns out that although her doctors believe Roo is in a coma and refer to her as being in a vegetative state ( a horrible term to use regarding any human being) she is actually conscious but completely paralyzed and unable to talk.

In Roo's case she cannot blink, but as her sister discovers, Roo is able to move her left eye up and down.
" 'Can you please just,' she began, and I must have been exasperated, because all I could do was look up at the ceiling, a heaven-help-me moment. My eyeball flicked up and down. Tilly stopped mid-sentence, mouth dropping open. And then...
'Roo?'
I'm here!
'Oh God,' she said. 'Did you just look up? Did you just move your left eyeball? If you did, and you hear me, do it again.'
I did it again."

This condition of being fully conscious but unable to move or speak is called locked-in syndrome (LIS). In LIS, a person loses the ability to voluntarily move with the exception of vertical eye movement as in Roo's case or blinking. It is extremely rare and is caused by damage in the brain stem as a result of head trauma or a stroke. Generally it is family who makes the discovery that their loved one is aware and capable of understanding everything happening around them. Sometimes neuro-imaging tools such as functional MRI scans are capable of showing that a person may be conscious but locked-in. If a person is medically stable, LIS patients can live for ten to twenty years, although recovery from LIS is rare.

As Rice showcases in The Secret Language of Sisters, those with locked-in syndrome are able to communicate with the world in a few ways. Roo begins with simple yes answers and then onto using a letter board. Also portrayed in the novel is the use of brain-computer interface technology which at this point appears to be an unusual option for someone with LIS. Because she is capable of moving her eye up and down this means that Dr. Howarth can develop an operating system to her Roo communicate. He tells her "...instead of your eye movement telling me which letter you want, your brain waves will speak directly to the laptop, and the words will appear." After Roo has a computer chip implanted in her brain she is able to quickly learn how to communicate. It is this new ability to communicate that really helps Roo because she has many issues to deal with as a result of the accident.

First she must come to terms with the fact that she is partly responsible for the situation she now finds herself in. But she is also angry at her sister. "If I hadn't texted Tilly back, that wouldn't have happened; and if Tilly hadn't barraged me with a thousand impatient texts, I never would have reached for my phone."
She is also upset that what happened to her is in the media and her tragedy is being used in an awareness campaign by her mother and that Isabel has changed her portfolio submission to feature her situation. The pictures of how she now looks horrify Roo. Dr. Howarth puts things into perspective for Roo when he tells her, "As much as it hurts, Roo, this story will help others, keep them from texting behind the wheel. You have to know that. People's lives will be saved because of you." Roo also observes a growing attraction between her sister Tilly and her boyfriend Newton, making her angry, "crazed and jealous." Although Isabel and Newton both deny this possibility, Roo is certain of what she sees.

As Roo struggles to cope with significant changes in both her life and the lives of those around her, Dr. Howarth understands, telling her, "It's very hard to let go of things we love most, to accept that life changes." Roo remembers a line from her favourite poet, Rainer Maria Rilke, "We need, in love, to practice only this: letting each other go. For holding on comes easily; we do not need to learn it." Roo has done this with the father she lost last near and now must do it with Newton.

One of the themes The Secret Language of Sisters focuses on is the special bond sisters have with one another. Roo and Tilly had a special bond before her accident. Roo was the big sister, popular, pretty and smart who always looked out for Tilly. After the accident their roles are reversed as it is now Tilly who must advocate for Roo. Tilly who is wracked with guilt over texting her sister, believes that bond no longer exists. Her guilt over the text is also compounded by her growing attraction to Newton, whom she becomes close to and eventually kisses. Distraught over what has happened between herself and Roo, Tilly goes to see Martha Muirhead. Martha feels they have a connection because they both have sisters and they both feel responsible for what happened to them. She tells Tilly that a person has to use their talents to heal and survive and that it is the same with Roo. For Martha and her sister Althea, their love of singing was their secret language. She tells Tilly their bond may be damaged but it is not broken.

When Martha goes to visit Roo she reveals how similar she and Althea were to her and Tilly. She tells Roo that their relationship can't be broken because they are sisters and they speak the same language - they care about each other. "You get to be a sister only because you have Tilly. Without each other, that goes away. You're still beautiful and talented, but you're not a sister. It's the alchemy of sisters, Roo."

Rice ends her novel in an upbeat way, with Roo focusing on the positive, on what she still has and not on what she has lost. She forgives her sister and Newton, understanding that the relationships between her, Tilly and Newton have changed. Like Martha and Althea situation, Tilly and Newton realize that maybe because they both love Roo, they were hurting and sought solace in each other. Tilly begins to recognize Slater's interest in her and his support of Tilly draws her away from Newton. Meanwhile Newton demonstrates to Roo that he still deeply loves her and he is not planning to abandon her. He tells her, "You are my north star. Will you try to keep going with me?" He recognizes the girl he loves is still there, "Inside, you're the same as ever, so beautiful and smart, making me keep up with you."  and he makes it possible for Roo to continue to use her talent for photography.

The Secret Language of Sisters is a beautiful novel about the connections sisters share, and about how those connections can endure through even the worst of times. It is also a timely warning about the dangers of texting and driving and how life can change in the span of seconds.

The following resources may be helpful:

CAA Distracted Driving Information

The locked-in syndrome: what is it like to be conscious but paralyzed and voiceless?

Book Details:

The Secret Language of Sisters by Luanne Rice
New York: Point, an imprint of Scholastic Canada 2016
336