Tuesday, June 14, 2022

The dark path in the forest

 The three words were picture, captain, and garden. I was instructed to remember these words as the nurse would ask me to repeat them again in a few minutes. So I formed a mental image of a framed picture where a sea-captain was walking in a garden. I know my limitations. If I can’t picture it, I forget it.

She then gave me the clock-test, a blank sheet of paper with instructions to draw the face of a clock and mark 10 minutes after 11. I had no problem drawing the clock with evenly spaced numbers. But it took me a few seconds to get the hands to the right time. The little hand on eleven. Right. But 10 after? Using my logic I counted ten digits after the 11, which actually set the clock for 11:05. I handed in the paper. She quietly walked out the room.

In a few minutes The Nurse came in and asked me the three words. I had to first bring up the image, see the captain smelling the roses; then I gave the Right Answer. The Nurse smiled. Then she frowned. She told me I had messed up the clock test and she showed me my drawing. I instantly recognized what I had gotten wrong and proceeded to explain my logic, flawed as it was. I suppose I was a bit defensive. But The Nurse was definitely defensive and cut me off by stating, “No! You failed the test! This is a strong indication of cognitive impairment.”

Well. That shut me up. For a few seconds. Then I protested. How could such a flimsy silly little test lead to such a serious diagnosis? She wasn’t even a doctor! Fortunately, I had the sense not to spout my academic degrees, professional accomplishments, and other such nonsense. But I did protest and she came back insisting I go to a specialist for further testing. All on the basis of the clock test.

That was my annual wellness exam, just a few days ago. I left the clinic less well than when I went in.

I’ve been stewing about it ever since. Hal assures me, “No, Nancy. You are not cognitively impaired.” But off and on, those nasty words, cognitive impairment,­ run through my brain, turning somersaults around my common sense, ricocheting off the walls of reason.

In short, I’m mad. And when I get mad, it’s not pretty. I’m mad at The Nurse. I resent the presumption and the stereotyping. I hate the memory of the pity in her eyes as this demented old lady left her office. I hate it when medical professionals see bodies and cases, not people.

Reflecting on the incident in a calmer frame of mind, three things are coming clear. The first is my need to forgive The Nurse. That doesn’t mean excusing her behavior. Less presumption and defensiveness, more sensitivity and a bit of common sense are good qualities in nurses and doctors. But she’s only human. Like me. So I’m saying the words of forgiveness and trusting that eventually the emotions will follow.

The second thing I’m realizing is that of course I’m cognitively impaired. I’ve been cognitively impaired all my life, and it has little to do with growing older. Some people call the condition dyslexia. And while I have only a mild case, it’s always made it difficult for me to do certain things. The alphabet, for instance. I can’t for the life of me get the letters in the right order unless I sing the silly little ABC song I learned as a child. I have to do that when filing documents, which can be embarrassing if other people are around.

I have trouble telling right from left. When asked to turn to the right, I have to literally focus on my writing hand and make the translation from write to right. (Fortunately, I’m right-handed.) The other thing I have trouble with is telling time. I have little exercises that compensate and get me to appointments on time. The before and after parts always confuse me (e.g., “10 after 11”). The Nurse didn’t know that. Would it have made a difference? Possibly not.

The other thing I’m realizing is that all this anger is really a cover-up for fear. The real emotion.

Cognitive impairment, memory loss, Alzheimer’s, dementia—all of this is the dark path in the forest of growing older. Will it happen to me? Will it happen to Hal? Will it be gradual? Will I know it’s happening? How old will I be? What will I be like? Will I be a burden, or worse, an embarrassment to my family? Is the clock test really a sign on the trail?

Or maybe it won’t happen to me. After all, it’s not inevitable.

I can’t picture myself as demented, but I have to ask, “Why not me?” It has happened to many of my friends and loved ones. Intelligent people. Strong people who made significant contributions. People who had adopted admirable life-styles, ate nutritious food, exercised their brains as well as their bodies, and enjoyed reasonable good health. “Why them?” is a question without an answer. As is, “Why not me?”

I had the blessing of not seen my parents go through any kind of cognitive impairment. That would have been an agony to witness. But the blessing is mixed. They missed this experience because they both died young. On the other hand, both Hal and I suffered alongside his parents as they lived into their 90s and had a very difficult last few years. We trust they are whole now, enjoying all their God-given capacities.

But we’re still here, facing an uncertain future. So, we juggle fear and faith. Even as we trust God, we face the nagging possibilities that loom in front of us on the path.

I’m not certain how to handle all this. I will affirm the Scriptures that talk about the righteous living long and fruitful lives. I will remind myself to make the most of the present time, to love my family well, to read good books, to pray, to attend to the needs of others as I am able. And to have fun. Fun is good and laughter heals the body as well as the mind.

As someone has said, “Wherever you are, be there.” I try to do that.

Plus, it really helps to hear Hal say, “Nancy! You are not cognitively impaired!”




4 comments:

  1. This is my favorite post so far, Nancy. It hit a sensitive note in me and I could feel your anger at her. She obviously doesn't know about dyslexia. You are NOT cognitively impaired, Nancy. At least, not yet!

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  2. Thank you, Francie. I had to write as the best way I know how to process. I'm more calm now, but the fears are real and affect us all.

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  3. Surprise, surprise, Nancy. I was finally able to comment even tho I have tried many times before. We are each one facing this as part of the "old growth forest." Having ALZ in our family makes it even more relevant. Oh, and by the way...I would love to be at least half as smart and creative as you!

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  4. You encourage me. You are more than "at least".....

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