Two minutes ago (at the time I wrote this), I signed the evaluation note of a woman I will be seeing for speech therapy. She is a well-educated woman who, at a not very advanced age, has been experiencing cognitive decline – not seemingly Alzheimer’s per se, but surely something.
Imagine for a moment that you have spent your entire adult life using your higher level thinking and speaking skills for a successful career, that you’ve got a great marriage, grown kids…then suddenly you find you can’t remember certain words that you’re trying to say. You begin losing your sequence of thought and having difficulty understanding complex ideas and instructions. You look fine on the outside, but you can’t write checks any more because you can’t remember how to get the information into the right spaces.
She said “it started just like cracks in the ceiling.”
I spent several years working in a neurological rehabilitation hospital. The typical patient had had a stroke or a brain injury or was otherwise failing because of neurological disorder. This patient was like many I have seen who alternately tell you what they are having trouble with and in the next sentence deny it’s that bad. Like many, this woman proposed other reasons why she was unable to perform the tasks in the evaluation – for example, the furniture in the office didn’t look “medical” enough. As a clinician, I need to help people understand their patterns of strengths and weaknesses in order to help them. So, I am put in a position frequently of having to correct their mistaken notions of why they are having trouble and lay bare for them the things that they are not able to do any longer. I have to “help” them “accept” their problem.
Why the quotes?
Well, it’s just that as I was considering this evaluation, scoring the tests and writing the report, I started reflecting on the nature of prajna, impermanence and groundlessness. I started considering that it might be helpful if she were a Buddhist, as she would then have a framework with which to understand and “accept” what is happening to her.
I had to say to myself.
I am so full of it!
The truth is, I am terrified of the possibility that this could happen to me. Shenpa arcs out of the walls like nails in a medieval torture chamber when I think about it. Despite all of my understanding of groundlessness and the unsolid nature of “me”, I am not convinced I could go through this without becoming angry and dismayed. I’m not sure I could easily allow my”self” to dissolve in this manner without wallowing in my own suffering. Death is seemingly easier to accept than watching the identity you’ve created in this lifetime be slowly erased. The bottom line is, I’d probably try to make up excuses as well.
I must honor the inner strength this woman is going to have to have in order to go through this and her husband’s as well. Furiously, I bow and bow and bow and try not to chastise myself for being a “bad Buddhist” for praying as hard as I can that I will never have to know this level of self-destruction. Tonglen, tonglen tonglen. For all who are facing this kind of living death, all who must watch it and all who fear it.
And now, I must get over it. I must assemble my plan of things I can do that might improve her quality of life for as long as possible. I must get ready to see her each week, to watch her go through cycles of good days and bad, voyage with her on this journey and watch her slowly disappear.
Now buy the Book!