High Performance Communication

Bruce Powell • February 26, 2026

Sometimes the hands hold stories that the mind can not carry.

I met a young woman the other day who interprets for the Deaf.

I expected Auslan to be something functional and efficient, translating every word.

Kind of like manual subtitling.

But it isn’t.

It’s artistic. Emotional. Contextual. Personal.

“Signs are not just words shifted onto the hands,” Lily explained. “They are social and often faintly autobiographical.”

Lily showed me.

The sign for a librarian is a gesture that mimics a hair clip. Not a definition. A recognition. A stereotype. How librarians are seen, remembered, caricatured into something instantly legible.

I watched Lily colour her ideas with instinctive, minimalist hand gestures of place and time.

“How do your friends who are Deaf sign your name, Lily?” I asked. “Do they have a secret Auslan name for you?”

Lily smiled, a favourite image forming.

“I had a severe bob haircut once, so ‘Lily’ became an L-shaped hand moving down my hair, followed by a chopping motion at the shoulder.”


When a Name Becomes a Story


A shared, affectionate observation. Funny and intimate.

A name turned into a story.

A story turned into a gesture.

Something you only understand if you know her well enough.

I found myself tearing up.

Names are a slippery struggle for me. An embarrassing weakness. Words too, sometimes, hovering and dissolving as I reach for them. It creates a quiet reluctance to socialise, to test myself, exhausted by the effort of seeming normal.

Our children can sign hunger and thirst long before they can speak. The comprehension is more fundamental than words.

I have built my own improvised system to sidestep the shame of forgetting.

Michelle, my OT, is a marathon runner. I wiggle my fingers like running legs, triggering the memory of the double “l” in her name.


Auslan and High Performance Communication


Auslan is not a crutch to lean on.

It is high performance communication.

Signs are dense and economical, loaded with imagery, history, and shared understanding. They do not politely queue like spoken words. They arrive whole. Visual. Spatial. Embodied.

Speech now seems oddly fragile by comparison. Linear. Sequential. Dependent on flawless retrieval. One missing word and the entire sentence stumbles.

Auslan reminds me of how I write: determined to create an impression, to evoke emotion rather than punctuate perfectly.

Like speech for the Deaf, enunciation is irrelevant. Meaning and context are everything.


Rethinking Communication After Brain Injury


The abrupt, traumatic changes in my life have opened unexpected ways of seeing.

I have learned that in Deaf culture:

Pointing is not rude.

Banging a table is not aggression.

Attention is negotiated physically, visibly, collectively.

Meaning lives in the body as much as the mind.

Lily introduced me to the phrase Deaf Gain, a provocative reframing suggesting deafness is not simply a loss of hearing, but a different sensory orientation bringing its own richness: visual acuity, spatial awareness, expressive nuance.

I watched the film CODA last night.

The finale.

The daughter sings while signing.

Voice and gesture layered together.

Music audible. Emotion visible.

Communication interpreted rather than merely translated.

Auslan feels strangely familiar. Less about correct vocabulary. More about conveying an idea.


Memory, Identity, and Visual Language


A feeling. A recognition. Memorably human.

I left the conversation knowing Lily not as a sequence of letters, but as a playful chopping motion at the neck.

How else would I remember a haircut I have never seen?

An abbreviated biography.

A visual shorthand.

A name less likely to drift away when my attention does.

Speech still matters. Of course it does.

But there is something quietly beautiful in discovering that meaning does not belong exclusively to the voice.

Sometimes the hands hold stories that the mind cannot carry.


The Lancet Global Health logo in black and magenta text on a white background
By Bruce Powell July 13, 2026
An ICU doctor who became a brain injury survivor on why the world must finally count TBI as the chronic, lifelong condition it is.
Abstract portrait of a man with gray hair and beard, surrounded by chaotic scribbles, arrows, and geometric shapes
By Bruce Powell June 30, 2026
A traumatic brain injury exposed the ADHD that once powered my career. A raw, honest story about when a superpower turns curse
Red math book titled “The Book of Mathematics” standing on a wooden floor by a window.
By Bruce Powell June 23, 2026
A restless boy, nuns, Christian Brothers and a mind that refused to sit still. A childhood story about intelligence, shame and difference.
Sunset over a sandy beach with silhouettes of people near the waterline
By Bruce Powell June 16, 2026
An ICU doctor becomes the patient after a brain injury, and finds the language of burnout and trauma too thin for what's actually been lost.
Sketch of a man wearing headphones and glasses, seated and labeled “Bruce”
By Bruce Powell May 26, 2026
Former intensive care doctor turned brain injury patient and advocate reflects on recovery, identity, rehabilitation and life after survival.
Headway logo with a face in hands and the text “the brain injury association”
By Bruce Powell May 19, 2026
A reflection on caring, exhaustion and survival, and how writing, poetry and creativity offer carers a quiet place to put things down.
Waterfront city skyline across a calm blue bay under a clear sky, with a railing in the foreground
By Bruce Powell May 13, 2026
A near-fatal crash, a stranger by the river, and the uneasy recognition that sometimes survival depends on someone stopping to ask if you’re OK.
Fluffy brown dog with a dark face sitting outdoors on green grass, looking left
By Bruce Powell May 12, 2026
A brain injury survivor reflects on friendship, identity and uncertainty after trauma, where survival can feel lonelier than loss.
Red question marks blocking a blue arrow path between two rows of directional buttons
By Bruce Powell May 6, 2026
Experience teaches doctors how to stay calm when everything feels chaotic. High performance is often just structured thinking under pressure.
Hospital room with two beds and beige privacy curtains, white walls, and bright overhead lighting
By Bruce Powell May 5, 2026
A patient who can’t speak communicates perfectly. A reminder that listening is often the skill clinicians misunderstand, even when words are absent.
Show More