In the End

The best part of my job is the interaction with patients. Every day, I talk to a variety of people, and some are very interesting. It’s fun to administer cognitive tests to highly functioning people. Many view the tests as a challenge and I enjoy their enthusiasm as they surprise themselves with their performance. But there are far more patients whose memory has deteriorated to the point that they barely remember their own name, much less that they’re at a doctor’s office and that they’re undergoing memory testing, not being subjected to randomly assigned torture.

Dementia, evidently, does not discriminate. While it’s heartbreakingly sad to see any person lose their memories, I’m particularly struck by those who were highly educated or incredibly successful. I can’t help but wonder how much information was packed into the brain that is currently rendered useless by time, Alzheimer’s, Lewey bodies, or any of the other awful conditions that deteriorate our nervous systems.

One thing that I’ve noticed from all patients, though, is that they ask similar questions. During the hour or so that I’ll spend in a testing room with someone, I’ll try to make small talk so that they feel more comfortable. Memory testing can be very stressful, so I do my best to put them at ease. This, combined with the disinhibited nature of many dementia patients, can lead to some humorous situations. Many patients will ask how old I am – “you look like a baby!” (I’ve been told that since I literally was a baby, so I’m used to it by now). Many inquire after my marital status, and then segue into telling me about their own romantic pasts. I love when this happens. Nothing improves a gloomy Tuesday like an adorable elderly gentleman telling me how much he loves his wife of fifty years… every ten minutes.

From that comes my own completely un-scientific observation. When the brain is fighting to stay whole, people lose a lot of themselves. Dementia bears the hallmarks of personality changes, forgetfulness, moodiness, and other sad changes. However, the one thing that remains until the end are those memories and experiences forged by love. You might not be able to count backwards, to draw a clock, to copy a drawing of a cube. Driving is out of the question and no TV show ever feels like a rerun. But you remember who you loved, and who loved you back.

Sometimes I feel frustrated by things that are out of my control, but when things get stressful, I try to remember that. Everyone wants to succeed in life: we hope to have a successful career, live comfortably, travel, buy things. But there will come a time, if we are lucky enough to live that long, when none of that will matter. We’ll just be old people asking strangers if they’re married. Of course, my generation is much younger than the majority of patients who come into the clinic, and our lifestyles have changed with those fifty years. So we must adapt accordingly, and here is my unsolicited one-size-fits-all advice of the day: be nice to people. Cherish your relationships, be they with friends, family, or significant others. Whether you get married or not, it’s the people in your life that you’re going to remember, not your iPad or Android. Trust me on this. I talk to old people every day, and nobody waxes poetic about the lava lamps or record players that made their life complete. In the end, we only care about each other.

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