Impending Doom

You know that feeling you used to get when you were a student and had a project hanging over your head?   It was always in the back of your mind; whether the due date was in three months or three days.  It sat there, festering; the prospect of SOMETHING needing to be done; gnawing away at you even when you weren’t consciously thinking about it.  That ever-present, oppressive, weight-on-your-shoulders, impending doom sort of feeling.

I have that feeling now.  In fact, I’ve had it for years.  I first became aware of it when my mother was dying, so I attributed it to that.  But it didn’t go away after she died.  Now my father is dying.  Maybe it will finally go away after he dies.  I hope so, because the weight of it (whatever IT is) is overwhelming.

 

To be perfectly honest, I have considered the possibility I may be on the verge of having a nervous breakdown.  While I had intended to keep this revelation a secret, it suddenly dawned on me 99% of the population is on the verge of having a nervous breakdown right along with me.  There must be millions of people who are hanging by a thread; millions of people whose parents are dying; millions of people who are scared; millions of people who are wondering how they’re going to survive the next 30 years; millions of people who lie awake at night worrying about their children’s future.

I’m tired of feeling sad.  I’m tired of being afraid.  I’m tired of thinking about life’s bleak outlook.  Just when it gets to the point of being all-consuming, I step back and take a breath.  I am not willing to succumb to this.  I’m not willing to sink into the abyss of depression – I’ve been there and I have no intention of going back.  I've been able to avoid it for the past five years partly because I am (some might say, perversely) comforted by the knowledge that I'm not alone – no one likes the thought of teetering on the brink in solitude – and partly because I think I've hit upon the solution.  (One which doesn't require therapy or medication.)  It is an astonishingly simple solution, but I have found it to be remarkably effective:
DON'T THINK ABOUT IT. 
Yep.  That’s it.  Don’t think about it.

I’ve come to the conclusion the only difference between people who are able to keep living their lives and those who become paralyzed at the prospect, is the fine art of denial.  It is denial which keeps me sane.  If I don’t ruminate about it, it won’t suck me in and destroy me.  There's something to be said for those blissfully ignorant souls who look at life through rose-colored glasses and naively think everything's going to work out.  I take back all the nasty things I said about them.

I will deal with whatever today brings me.  I’ll concentrate on what Dad needs and I’ll concentrate on what my son needs.  I have a job to do.  I will do my very best for them and no matter what happens, I will not be reduced to wallowing in a puddle of useless emotion.  I will not give in to sleepless nights worrying about the future and above all, I will not lose myself.  I simply won't think about it.  Denial?  Definitely. Self-preservation?  Unquestionably.

There's something vaguely familiar about all this, and it just occurred to me what it is:
             "Oh, fiddle-de-dee," said Scarlett through her tears.  "I can't think about
              that right now.  If I do, I'll go crazy.  I'll think about that tomorrow.  After
              all, tomorrow is another day."  
            
This doesn't bode well, does it.   My memory may be a bit hazy, but I think the last we saw of Scarlett, her house burned down, her mother died, her father lost his mind, she no longer had a husband, and she was weeping on a staircase in a dress made out of draperies.

Hmm...  There's something vaguely familiar about all that, too.  Oh well.  At least I've never worn a dress made out of draperies.  

If He Knew

I feel a certain uneasiness whenever I think of how Dad would feel if he realized what has become of him.   If he could see himself he would be appalled.  But even worse, he would be absolutely mortified that we allowed anyone else to see him in this condition.  

I try to push those thoughts aside.  My father – my brilliant, confident, dignified, independent father is long gone.  The man who sits before me now has but a few simple remaining pleasures – like going to church and being surrounded by the very people he would never have wanted to witness his demise.  He doesn't go there for religion; he goes there for socialization – which is quite a stretch considering  no one is comfortable talking to him anymore, and fewer and fewer brave souls bother to make the attempt.

Dad has become the man he would have had no patience for; the man who would have been invisible to him; the man he would have avoided; the man he would have pitied.  He has become the pathetic, feeble, doddering old man with a little bit of dried egg on the corner of his mouth who doesn't realize he's still singing after the song has ended; doesn't realize he's holding up the line; doesn't realize he's interrupting the conversation; doesn't realize he's making inappropriate comments; doesn't realize he's repeating himself over and over and over again; doesn't realize he's not making any sense, and doesn't realize people are politely trying to extricate themselves from his company.  He is the antithesis of the man he used to be.

I am haunted by the knowledge that my fiercely proud father would be profoundly embarrassed, humiliated and disgraced if he was cognizant of his plight.  If he could have, he would have begged us not to let anyone see him like this.  But what are we to do?  Keep him locked away because when he was still himself that's what he'd have wanted?  No.  Of course not.

    

I try to assuage my guilt by telling myself he doesn't know – and he never will.  But it is of little comfort, because I know.  I know he would hate it with every fiber of his being.   

I’m sorry, Dad.  Please forgive me.       

The Diagnosis

I’d seen reports on the news about people who got lost while driving and ended up hundreds of miles from home.  I’d read stories about people who went for a walk and were found days later wandering in the woods.  Worst of all, I’d heard about the people who no longer recognized their loved ones.  So when my father was diagnosed with Alzheimer’s disease, I girded my loins in anticipation of the devastating day when he would look at me with a blank stare and not know who I was.  That day has come and gone, and believe it or not, it turned out to be a minor event in the big scheme of things.  To be honest, I find it more devastating that he cannot remember how to flip on a light switch.

Dad was diagnosed with mild cognitive impairment (MCI) in 2002, however he’d been exhibiting signs for several years prior to his diagnosis.  One of his business partners vividly recalled Dad’s inability to calculate a 20% tip at a luncheon in 1997.  That would be a stunning revelation for anyone, but for a CPA, it was extraordinary. 

While MCI doesn’t always develop into Alzheimer’s disease, in Dad’s case it did.  We took him to a neurologist and he was put on medication.  According to the National Institute of Health:

http://www.nia.nih.gov/Alzheimers/Publications/medicationsfs.htm

Several  prescription drugs are currently approved by the U.S. Food and Drug Administration (FDA) to treat people who have been diagnosed with Alzheimer’s disease (AD). Treating the symptoms of AD can provide patients with comfort, dignity, and independence for a longer period of time and can encourage and assist their caregivers as well.

It is important to understand that none of these medications stops the disease itself.

Every 6 months we returned to the neurologist for a checkup.  ‘Checkup’ is a bit of a misnomer – it proved to be nothing more than a method of documenting Dad’s decline.  The doctor conducted the Mini-Mental State Examination:

    “I’m going to tell you three words.  I will ask you to remember them later: tree,     blue, pencil.”

    “Who is the president of the United States?”

    “What is today’s date?”

    “What day of the week is it?”

    “What month is it?”

    “What state are we in?”

    “What county are we in?”

    “What were the three words I asked you to remember?”

    “What year is it?”

    “What season is it?”

    “What floor are we on?”

    “Draw a picture of a clock with the hands indicating 10:30.”

    “Spell the word ‘WORLD’ backwards.”

    “Count down from 100 by 7s.”

    “What is this object I’m holding in my hand?”

    “Copy this shape onto that blank piece of paper.”

    “What are the three words I asked you to remember?”   

    “Repeat the following phrase: No ifs, ands, or buts.”

    “Read the sentence written on this piece of paper and do what it says: Close your eyes.”

    “Take this piece of paper in your right hand, fold it in half and lay it on the floor.”
    “Write a complete sentence.”

    “What are the three words I asked you to remember?”

At first Dad could do most of it.  Within five years he couldn’t do any of it and the neurologist advised us there was no point in coming back - that was in 2007.

No point in coming back.     

Nothing more can be done.  We helplessly watch Dad continue to lose ability and function.  We witness his frustration, his struggle and his anxiety – and we are powerless to help him.   It’s an odd sensation; a sickening sensation – like watching someone being tortured to death in a horror movie.

If he becomes too distraught, we could try medication to ease his mind.  (Ease his mind?  Now there’s a politically correct euphemism….)  Let me put that another way: If he becomes too distraught, we could try medication to dope him up so he isn’t aware of his fate.  Unfortunately, medication would increase his risk of falling and it would be awful if he was injured in a fall – though physical pain pales in comparison to the mental anguish he suffers.

So now we wait.  That's it.  That's all there is.  We watch him continue to disappear and we wait for him to die.  Just like Mom.   

Clock

Today, I stood on a chair and took down Dad's clock to change the time.
     "Don't fall down."
     "I won't, Dad.  I'll be careful."
     "If you fell down, who would take me to church?"
     "Kris and Karen would take you, but don't worry.  I won't fall down."
     "Kris and Karen?"
     "Your other daughters."
     "I have five daughters."
     "There are three of us.  You have three daughters."
     "I do?"
     "Yes."
     "Get down from there.  Don't do danger."
     "I won't do danger, Dad.  I'm just taking down the clock.  See?  Now I'm off the    chair and I'm fine."
     "Don't do that again."
     "Okay, Dad.  I won't."
     "Why did you change the clock?"
     "The time was a little bit off."  (I knew better than to bring up the baffling concept of Daylight Savings Time.)
     "What time is it now?"
     "It's ten to two, Dad."
     "What?"
     "It's ten minutes before two."
     "How can you tell?"
     "Because the big hand is on the 10 and the little hand is on the 2."
     "Hand?  Whose hand?"
     "The long black line is pointing to the 10 and the shorter line is pointing to the 2."
     "How do you know?"
     "Because I'm looking at it and I can see what it says."
     "It doesn't say anything."
     "No.  You're right; it doesn't.  You just have to look at the lines and figure out what time it is."

(I know what you're thinking; he should have a digital clock.  But he forgot how to read digital clocks long before he forgot how to read analog clocks.  I toyed with the idea of showing him the time on my cell phone - thinking that might help - but it would have said 1:50 and that would have really muddied the already murky waters.)

He asked, "How did you get so smart?"  (My god.  He thinks I'm a genius because I can tell time.)
     "Dad, you taught me everything I know."
     "I don't think so.  I never knew about clocks."

I want to scream, "YES YOU DID!  YOU USED TO KNOW ABOUT CLOCKS!   YOU KNEW HOW TO COUNT, YOU KNEW HOW TO USE SILVERWARE, YOU KNEW HOW TO PUT ON YOUR CLOTHES, YOU KNEW HOW TO WIPE YOUR BOTTOM, YOU KNEW HOW TO READ, YOU KNEW HOW TO WRITE.  YOU USED TO KNOW EVERYTHING.

When I was leaving for the day, one of the aides stopped by.  Dad pointed to me and said to her, "Do you know who this is?"  She replied, "Yes.  This is your daughter."
He laughed and said, "No, no.  This is .... "   His voice trailed off and he stopped.  He stared at me for a minute and asked, "Who are you?"

YOU USED TO KNOW WHO I WAS.