I glanced at my schedule and saw that my 10:00 same-day slot had been filled by an elderly patient. The complaint read, “worsening mental status.”
My nurse shook her head, “I’m not sure why they put him on your schedule. He normally sees Dr. W.”
I tried not to think about the fact that this (a complicated patient unfamiliar to me) would surely cause me to run behind for my last five patients. When 10:00 rolled around, I reviewed his chart. I could see that this patient had an advanced case of dementia, which was surprising as he was only in his 60’s.
I walked in the room and was greeted by the patient and his lovely wife. He was well-groomed and pleasant. Only upon direct questioning did his memory problems become apparent. He smiled at me, complied with my exam, and deferred to his wife when she began talking about his recent issues.
She, too, was exceptionally well put together. Her smile was radiant and full. She had a lightness about her that surprised me given their situation. Caregiving is not an easy task in any situation, and I imagine that that would only be compounded by the fact that your relatively young husband was the one slowly losing his grasp on your history.
She remained upbeat as she told me that his current state was reflective of how he was during the day, but that at night he was a much different person—angrier, more confused.
“Last week, he accidentally broke the kitchen door,” she confided.
I thought to myself, ‘Wow..sounds like things are getting pretty bad.’
But then they looked at each other and chuckled. Giggled. ‘Conspiratorial’ was the word that came to mind while watching them.
“Yup,” she said smiling, “We’re breaking doors now.” She goodnaturedly relayed the details of the accident, while he listened in.
And it struck me as the most amazing thing I’d seen all week.
How the power of their shared memory was overcoming the difficulty of a terrifying disease. How the love and the knowing that a long partnership creates, was enough to restore some of the deepest losses disease can inflict.
I thought about what a remarkable gift it is to give someone: to say, “If you forget, I’ll remember.” Even when the going gets rough.
Not all of us are faced with the body’s ability to betray us in such a way. But it seems to me that one of the most powerful things about having someone witness your life, is to say, ‘if I forget how I am when I’m not sleep deprived, you remember.”
Or: If you forget how you were before this illness or that stress, I’ll remember.
I guess the point is to still appreciate someone’s presence, even when life has altered the parts of them that we’d taken as permanent.
To accept, smile and move on. To laugh at the parts that can be laughed at. To deal bravely with new realities.
But always: to honor the past. To remember.