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A Shout From The Attic: The Esmé Years - 6

...Family members in despair often relinquish interest in the stranger who no longer recognises them, and whose memory of their years of love, intimacy, and common pursuits has been plundered by unseen hands that erases the marks of their unique personalities just as completely as a teacher wipes clean a chalkboard at the end of the days lessons...

Ronnie Bray recalls working in a large psychiatric hospital.

George was a big Irishman with the gentle brogue of the South and a pleasant way of interacting, although when we first met his interactions with his fellows was severely limited by that robber who takes what does not benefit him but deprived the one robbed of some essentials of their individual humanity.

I often sat next to George on Male Ward Eighteen dispensing cigarettes to patients who would smoke twenty in under an hour if left to their own devices. Mr Conway was one who would, not because his nicotine addiction was severe, which it was, but because once he had finished a cigarette he could not remember having it, even though the stub was smoking in the ash tray besides him.

“Nurse,” he would say. “I haven’t had a cigarette all day.” His tone was pleasant but pleading. If the magic thirty minutes has passed since his last extinguishment, I would dole out another cigarette and strike a match as his effusive thanks interfered with getting the end lit, such was his excitement.

I learned that he had once been a friend of my Father, who spoke warmly and well of him for having been, as a husband and father, all that he himself was not. But he would not have recognised the man by whose side I sat engaged in futile conversations laced with confabulations that seemed accurate to George, but were remote, if at all connected, to his life experiences.

I knew that I was in the presence of tragedy. Not entirely for George’s loss of selfhood, because in whatever world he then found himself, it seemed settled and tranquil. His tragedy was that he was deprived of connection to his family and former friends. I say ‘former friends’ because very few associates continue to take interest in or visit a patient considered ‘lost’ in the mists and vapours of Alzheimer’s Disease.

Family members in despair often relinquish interest in the stranger who no longer recognises them, and whose memory of their years of love, intimacy, and common pursuits has been plundered by unseen hands that erases the marks of their unique personalities just as completely as a teacher wipes clean a chalkboard at the end of the days lessons, leaving no trace behind.

And yet George continued to exist. He was changed, but he was still George. Not the George everyone knew and loved, but still George. He was the George I knew and appreciated. A man whose end years I could sweeten by little acts of kindness and an almost continuous flow of hospital cigarettes.

It occurred to me as I listened to him day after day, interacting with him, joining in his conversations as seemed appropriate, that perhaps dementia has a language and semantic vocabulary all its own, that we must learn to get back on terms with our loved ones and former friends when they are led down that path by processes we do not understand but rightly fear.

Perhaps then, we shall see the reason and sense in confabulations when they are set against the background of who the George were, and become capable of understanding them as they have become. Until then, let us neither forget nor abandon them. Who knows what they comprehend but are unable to express?

“Cigarette, George?”

“Thank you, nurse. I haven’t had one all day!”

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