Indulging myself

I splurged last week. A small splurge, but on what appears to be a totally unnecessary purchase. I think of it, however, as an important indulgence. What kind of splurge inspired this posting? I bought a skinit for my work phone.

I could argue that I needed it to distinguish my phone from all the other phones on those rare occasions when we're all in the office, but that isn't the reason I bought it. (Although I think that was part of the reason I gave myself.) I could say it was because there was a special deal with free shipping, but if I hadn't bought one I would have not only not paid for shipping, but I would have also not paid to buy it. My real reason for buying it was that I could choose and upload my own picture.


In the past four months, we've had a number of family simchas. We've also had one very difficult, untimely loss. The picture on my skinit is a joyful, smiling photo from one of the simchas. I can't look at it without smiling. I look at it and remember how happy we all were. I look at it and I remember that the pain of our loss was also a part of the day. The photo reminds me that a month after one of the worst days in our lives, we celebrated one of the happiest.

When I see this photo as I'm working, I'm reminded that all of us have mixtures of love and loss, celebration and loneliness in our lives. It reminds me not to take my blessings for granted. It reminds me that joy may be followed by sorrow and then again, God willing, by joy. The photo helps me remember that I want to work to live, not live to work. It reminds me to turn off the phone when the day or the week is over.


The photograph is not a talisman. It won't protect me from the pain that comes with my work or the pain that comes with life. But I hope it will protect me from becoming callous or indifferent. I hope it will always make me smile. When I think about the joy the photo gives me, it is clear that this splurge was not an extravagance and not really an indulgence, but another important weapon in my battle against burnout.

"I'm going to put on my dress and go dancing."

A lot of time when people talk about memory loss and Alzheimer's or other forms of dementia, they talk about losing your memory backwards - losing what is most recent first and holding on to earliest memories the longest. We usually use this simple explanation to talk about short term and long term memory. But when we do this, we often ignore the fact that there are many types of memory (or many components to a single memory.) There is body memory, sense memory or emotional memory, working memory, episodic memory and more.

As I continue to work with this population, I keep reading and learning about memory. Two books that I found very helpful are John Zeisel's I'm Still Here and Forget Memory: Creating Better Lives for People with Dementia by Anne Davis Basting. But book learning only takes you so far. Much more of my learning is experiential and comes from spending time with my patients.

Every time I think I understand dementia, I have an encounter with someone that teaches me that I only know a little bit. I meet a woman and say, "It's nice to meet you." She responds, "I'm happy to meet you." This is going well, I think, and I continue, "My name is Chana Sorel." She says, "Chana. That's a nice pumpkin. I go walking. My stone is my daughter, my friend. And you? Who did the plant go?" And she continues. It sounds like speech. There are words I recognize. She looks like what she's saying makes perfect sense. And I have no clue. So I respond to the tone or to a word or phrase that maybe makes sense to me. And she smiles. And I smile. And we talk. Finally I say, "Thank you for talking with me. May I come visit you again?" And she says, "It was nice to meet you." Her social memory is intact (at least in the moment) even if her words are incomprehensible.

One woman's words are clear, but not responsive. "Hello. I'm pleased to meet you," I say. "Oh," she says. "You play the piano? Play something for us." And I'm dumbstruck, without a response.

Someone else mostly hums. Some days she says a word or two, or she laughs. I start singing "Michael Row the Boat Ashore" and suddenly she's humming "Michael Row the Boat Ashore." I search my brain for every song I know that might get a response. Soon the whole room is singing. Other patients are asking, "What are we going to sing next?" And my patient is humming along to every song we sing.

I walk by a room and a gentleman has a sewing machine. In other room a woman pulls out her knitting and another crochets an afghan just like dozens she has already made for her children and grandchildren. The commonality: they all have dementia. And they are all human beings making connections with us any way they can.

As I visit with a woman, she looks down the hall at something only she sees and says, "I'm going to put on my dress and go dancing." I hope when my turn comes I'll be going dancing too.

Seeing ghosts

As I travel around town I often have the feeling that I'm seeing ghosts. Perhaps "ghosts" is not the right word. I'm seeing memories. I look off to the side as I barrel down the highway and there is M's house with the big picture window where she watched the snow and the birds and the dog. I go under an overpass and remember the road to R's small house. I think about his caregivers and the "family" he brought together and wonder how they are doing. I travel a road that I think is new - but wait - if I turn to the right doesn't that bring me to . . . what-was-her-name's house? I was only there one time but I can picture the couch where she rested, just inside the front door.

I remember the places, the roads, the furniture, where we sat and what we said, but I can't remember all the names. I remember this one's name and that one's caretaker. I remember the cat that sat and purred and cuddled up to my patient and the dog that barked as if I was the enemy coming onto his turf.

In the nursing home I pass by the rooms where I spent so much time. Now there are different names on the doors. The family pictures have been replaced by sports banners. The stuffed animal is gone. It doesn't look the same, but out of the corner of my eye I think I see . . . no . . . he's gone. It's an illusion, a wisp, a memory.

I don't really believe that the spirits of my patients are hanging around waiting to manifest themselves as I drive by, but my memories of them remain a part of my life. This is the road. There is the house. That was the room.

I remember. May their memory be for a blessing.