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Journeying to undiscover’d country

Ilean over the hospital bed on which lies my dementia ridden wife.

“I’m going downstairs to read,” I say. “Now, you stay right here until I get back. No partying, right?”

Her face breaks into a smile, followed by a laugh.

Other times, when I am holding a fork laden with food in front of her mouth, I have to say her name with sharp emphasis several times to get her attention and direct her back to the task at hand. She starts as though being brought back from someplace else.

These contrasting situations invite my speculation as to what is going on in her brain. I make no claim to having studied the medical literature on this subject, nor do I want to suggest that what I observe, and what conclusions I might reach, have application beyond our situation.

Yet, I believe it worthwhile to offer my thoughts. Perhaps they will be instructive; maybe others will see their own situation; or still others take note of different experiences. Concerning any disease, especially one as widespread and as yet so little understood, all information is useful. And in any case, writing about our situation helps me deal with this maddening, hideous disease.

Even the term dementia is imprecise. I use the term because it seems to gather together under its umbrella various symptoms exhibited by someone whose brain is not functioning correctly due to an excess accumulation of protein. Those symptoms vary according to which part of the brain is impaired.

When my wife’s cognitive impairment was obvious enough to demand our aggressive attention, at the recommendation of her physician we consulted with a highly regarded neurologist. He administered numerous performance tests, and in addition ordered a long list of blood tests.

After all that, he declared that he could not with assurance pin down exactly which part of her brain was being affected since the blood tests apparently provided no clue, and the performance tests offered results that fit several possibilities.

So dementia it is.

What I witness every day are those symptoms, which have worsened since that visit to the neurologist. My focus here is on what I see as an exaggeration of an ordinary mental occurrence wherein an individual, while fully awake, seems to be in his or her head someplace else.

We call that daydreaming.

In my wife’s dementia, it seems fairly constant. And the fascinating part is to try to imagine what she is thinking about when she is not focused on the here and now. Of course, I can only guess, but since she was an award-winning short story writer, I assume that wherever her mind is taking her is vividly imagined, peopled by characters we would like to know better in situations that resonate with our own deepest thoughts and aspirations.

Every once in a while, a window into that world opens, announced by either a raucous laugh or one side of an intense conversation that she gives voice to.

At such times, it seems disrespectful to pull her back into the practicalities of the everyday. But I do precisely that because in the face of her implacable disease our lives go on as best as we can manage.

She will retreat into that other place, and I can only hope that from time to time she will continue to return from it to where I await to greet her as a traveler returning from a different sort of, in Hamlet’s words about death, “undiscover’d country.”

step h en l e w is

Local columnist

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