The article presents an analysis of the means and processes through which an aphasic speaker with severe limitations in spontaneous speech production is able to make a self-initiated, substantial contribution in interaction with a non-aphasic interlocutor. The analytical process is based on the principles of conversation analysis, and the study draws on insights from interactional linguistics. The analysis illustrates the aphasic participant's ability to make himself understood by using several methods of communication and by situating his parts of the contribution in relation to the sequential context. Hence, the analysis reveals an essential form of orderliness and complementarity in what may initially seem like a disorderly piece of interaction. The analysis highlights the need for systematic, functional assessment of communicative and linguistic abilities in aphasia, a perspective with possible consequences for the training and practice of speech and language therapists.