Mediums obtain messages from the spirit world in different ways. Some receive intuitive information, in which images and words appear as mental impressions that are then relayed along to the living. In other cases, a medium may hear actual auditory messages or see actual images of these messages. Many people who do spirit communication regularly find that the dead can be quite a chatty bunch sometimes. If they've got something to tell you, they're going to make sure you get told. What you choose to do with the information is up to you, but a lot of mediums, it can feel like they've got someone's dead granny screaming in their ears, and if they don't pass that message along to you, she's not going to shut up.
Like common playing cards, the tarot has four suits (which vary by region: French suits in Northern Europe, Latin suits in Southern Europe, and German suits in Central Europe). Each suit has 14 cards, ten pip cards numbering from one (or Ace) to ten and four face cards (King, Queen, Knight, and Jack/Knave). In addition, the tarot has a separate 21-card trump suit and a single card known as the Fool. Depending on the game, the Fool may act as the top trump or may be played to avoid following suit. These tarot cards, without occult symbology, are still used throughout much of Europe to play card games.