It’s almost haunting, the vacancy I’ve come to recognize in her eyes.
I’m in the room with her, but she’s not in the room with me. Every Thursday it’s the same: the same place, nearly the same time, no real surprises on my part, and yet, I never know what to expect from her.
First come the vain necessities, “Hello, again. How are you? Remember me? I’m here to check on you. I’m your nurse practitioner.”
Her eyes flicker in my direction at the sound of my voice, but her focus is elsewhere, far away from here. Sometimes she tells me where she is, sometimes I just wonder. Today, she is at home. Supper is on the stove, and she’s watching the door for her husband, long since dead, to come home. She looks right through me to a screen door that hasn’t been opened in more than fifty years. The babies around her feet are now 66 and 70 years old with children and grandchildren of their own. The window opens up to a corn field, not the parking lot I can see. She hushes me and pushes away my stethoscope as I bend to listen, because I am disrupting her domestic chores this afternoon.
Rather than tell me how she is actually feeling, she tells me how she remembers feeling- possibly the way I feel at this very moment, with my own children in the next room playing, my husband watching television, and chores waiting to be done. Maybe she remembers feeling the way I do, a young working mother trying to do the best she can for her family. Today, she is no longer burdened by old age, weak muscles, fatigue, and pain. No, today, she is worried about putting supper on the table and getting the laundry done.
I sit down beside her and look into those eyes, the windows to a mind long since gone, and I wonder, what will I remember when I can’t remember? What is so important to me that when all other thoughts fade, it will push itself to the forefront and take precedence over all other memories?
The mind is a mysterious thing, a powerful and mysterious thing.
I touch her hand, and she’s back. For just one minute, she remembers she’s not 28, she’s 98. She remembers my face, just for a moment, and smiles politely. I ask again, “How are you?” She hesitates before she says, “I’m ok, dear. How are you?” Before I can even respond, she wrinkles her brow, and like a mist being pulled away by a breeze she’s gone again, leaving behind the empty eyes I’ve come to know so well.
The black and white photos on the wall help me piece together the setting for the story she’s telling when she talks about her husband who’s coming home today after working for three months with the railway crew. Her wrinkled hands are working constantly, repairing the quilt the dog pulled off the clothesline and dragged through the yard yesterday. When her call light drops to the ground, she jumps, and says, “Oh, dear. Can you please hand me that thread? I keep dropping it.”
I smile, hand the call light back to her, and tell her goodbye. “I’ll see you next week. I’m glad you’re doing well.”
“Oh, but can’t you stay for supper? It’s almost done. I’d hate for you to leave hungry.”
“I’m alright. Thank you anyway. I’m sure it’d be delicious. Goodbye, now.”
I leave the room, get out her chart and flip through the seemingly hundreds of pages. Her diagnoses are many, chronic kidney disease, chronic diastolic heart failure, hypertension, and oh, there it is, alzheimer’s dementia. Of all the diagnoses, this one is the most devastating and exhausting of all. It robs us of our loved ones, slowly, so slowly. It’s unpredictable, insidious, and bewildering all at the same time. It complicates all other diagnoses tenfold.
Perhaps one day I will be diagnosed with Alzheimer’s dementia.
My personality will change, perhaps. Maybe my best qualities will be amplified, or maybe my worst. I may be comical, or maybe sad. It’s possible I’ll never be the same from one day to the next. Until I’m there, I’ll be thankful I’m here. Until I’m there, I’ll hold her hand and help her remember who she is until she’s ready to let go.