À la recherche du temps perdu is a novel I have wanted to read for years. One volume of it sits and mocks me on a bookshelf in my bedroom along with the other thirty or forty books I would really like to read. In English, Remembrance of Things Past by Proust is a classic novel about involuntary memory–the act of remembering events in the past brought on by something in one’s present. This weekend was filled with “memory”, dealing with the beginning consequences of my mother’s worsening memory as well as the remembrance of when she had this issue involving her mother, and the fear of my own children dealing with the same in the future.
Like all physicians, the issues that I face at home are frequently the same issues my patients face in their lives. Having many patients around the same age that I am, my empathy can be very acute, even painful. Sometimes I am caring for both the declining parent as well as the child, usually a daughter or daughter-in-law. Over the years I have watched Alzheimer’s disease take away the intellect and independence from a patient and helped the caretaker deal with the grief as mom or dad is whittled away to nothing. It’s a painful, frightening process, well-illustrated by William Utermohlen‘s portraits, as he traveled this dark path.
The most frustrating part of the dementia process is the frequent refusal of patients to take any of the meds that help slow the process down a bit. No cure, but sometimes a medication will keep the patient at a plateau of functioning for a period of time longer than if the patient takes no medication. Typically, it is a very hard sell. Perhaps some of the problem is that no one wants to admit it exists. Agreeing to take the medication means they have to face a fear-provoking diagnosis. My own mother becomes vehement in her refusal to take anything. She won’t even let me help her get a medical alert necklace or bracelet in case she falls. What is with that? The reasons vary from “they are ugly” “my friend had one and when she fell she was out of range” to “I’ll take care of it”. Meanwhile I feel as helpless and frustrated as the caregivers I see in my office every week.
Some days, the Serenity Prayer is the only thing that keeps me sane.