All the Little Bird-Hearts by Viktoria Lloyd-Barlow

Peter Lindsay survived and enjoyed 44 years in General Practice with an interest in children, teaching, MSK and learning disability – now a portfolio GP working as a locum.

We all need to help each other, especially our students and trainees, to understand how neurodiversity makes people feel and this is the ideal book to do that. Written in the first person, Sunday describes routine activities and life events affecting her as a single mum and her child in relation to family, extended family, neighbours, home and work. Sunday describes how she feels, what she hears, what she sees and how she reacts. The text describing the complexities of relationships, which we all encounter, describes them in the way that Sunday sees and hears them and describes the problems she has with them. Sunday’s parents don’t understand her -“you aren’t wired right, you”. Her sister tolerates her and even reassures her that she has a pleasant smile whilst her parents tell her she is not doing it right. Her daughter sees her difficulties without comment until she, herself, reaches young adulthood when she fails to understand her and moves on to living her own life, blessed with being gifted in looks, social skills and talents. The person who understands her best has no language and uses signing to support and comfort her and she in turn, sympathetic to his disability, is able to reciprocate with comfort and support and becomes fluent in signing, teaching it to her daughter.

At present, the number of people affected by neurodiversity is increasing or, in an increasingly complex society making increasingly complex demands of each of us, we are recognising it more. It is highlighted in the media as affecting celebrities and successful entrepreneurs who, because of their giftedness, are able to cope with any difficulties others have in understanding them. Sunday describes the life of the majority with neurodiversity who, rather than each being given a diagnostic label, need to be accepted as an individual with certain characteristics. Sunday is only comfortable eating white food and drinking cold fizzy drinks. She can enter into conversations armed with quotes from the text of a storybook of Sicilian Fables she clung to as a child. She has received guidance on how to conduct herself in social situations from a prewar single author volume on etiquette and good manners. She works in a garden centre spending as much time as she can potting seedlings with her “hands muted by soil.” Sunday masks her discomfort by mimicking the behaviour of others even to the point of practising their styles of speech.

The author, herself being affected by neurodiversity, places Sunday as living next to neighbours with wealth, ability, confidence, apparently ideal social circumstances and an easy ability to make friends and influence people. They also show how Sunday can be taken advantage of. There is a sense of dependence created between Sunday and those who would support her as long as they benefit from her. In this case it is up to the point of taking away what Sunday feels most proud of – the relationship she has with her daughter and the success of her daughter. Sunday does reflect on her situation and makes a very sensible comment that in lots of families, there are people “who are different and yet are accepted” and, most importantly, thinks Sunday, loved. Sunday reflects what many of us feel – we love someone with neurodiversity, not in spite of them being as they are but because they are who they are.

This book calls out for understanding and the need for us to think for each patient we see, “Is this person hearing what I think I am saying and how can I check that? Am I seeing things the same way?” We also need to consider that when Sunday is left alone she recognises her difficulties and that she could be helped by “drugs and therapies ….that would focus on normalisation” but these would cause her to “disappear inside” and lose “the bliss of sensory experience” even though retaining that means she has to “accept the price of it”.

The whole story is wonderfully realistic. It describes scapegoating in the family at the time of a bereavement with associated guilt, anger and denial. It narrates consequences of marriage breakdown and the complexities of the transition from childhood to adulthood. The author lets Sunday describe not only how neurodiversity can affect these but also how Sunday feels during and after them. This makes it an unforgettable, page turning, read which informs more than any textbook can.

Featured book: Viktoria Lloyd-Barlow, All the Little Bird-Hearts, 2023, Tinder Press, ISBN 978-1472288004 £16.99

Featured photo by Sorasak on Unsplash