As I noted in a recent post [A kitchen accident, November 13], I discovered that my short-term memory is even less reliable than I had assumed. The accident, which ended up destroying a large Pyrex lid, was recalled by Paula and me in very different ways. In my version, it was Paula who discovered the red-hot burner, turned it off, and poked the Pyrex top with a dinner knife, causing the top to disintegrate. But Paula was not even in the room at that time. She had helped out with the peeling and cutting of a small pumpkin, the central ingredient in our dinner, then left the room to attend to other matters. The glass lid had shattered in the kitchen sink when I apparently immersed it in cold water.
When Paula proofread the blog post a couple days later, her reaction to my memory of events was halfway between amusement and horror. The most charitable interpretation is that a prosecuting attorney might want to think twice about calling me to testify–unless his intent was to mislead the defense.
One of the odd things about Alzheimer’s is that someone can have a piss-poor short-term memory and still write as well as ever, though at a slower pace. This is less surprising in my case, since I’m still at an early stage of the disease. But the book I recently read by Greg O'Brien, On Pluto: Inside the Mind of Alzheimer’s, is a revelation and an inspiration.
The revelation is that as this illness follows its meandering path, some people are able to tap into what is called “cognitive reserve” – the ability to maintain core professional and vocational competencies. In O’Brien’s case–and in mine–that core competency is writing.
This can be true deep into the middle stage of the disease when certain everyday activities become challenges, if not adventures.
O’Brien describes an unsettling trip through an automated car wash and, in the same afternoon, his decision to use his lawn tractor in the Cape Cod town of Brewster not only to mow his own land but also the properties of his neighbors.
The confusion didn’t end there.
“As I headed down the steep hill on Stony Hill Road, whizzing by, often at close to 50 mph, something in the deep recesses of my brain told me this was a bad idea, a very bad idea,” O’Brien writes. “My attention was then drawn to a neighbor’s lawn through the back woods behind our house where a delicate man in his 70s was placidly cutting with a push mower. The old way. Without rational thought, I took a hard right into the scrub pines, blades aglow, cutting through the underbrush—saplings of oaks, pines and a few maple trees. The piercing grinding echoed throughout the neighborhood. Sounded like screams of mercy. My neighbors must have thought I was Freddy Krueger from Elm Street. I never made eye contact with my elder neighbor, just trimmed his lawn in perfect parallel lines, then sharply hung a left back through the woods, the grinding of the underbrush again intense. The poor man fled into his house, probably scared shitless.”
I quoted this lengthy passage for two reasons. The first is that it’s an example of vibrant prose. Everything is vividly specific—the types of sapling trees, “the piercing grinding” of the mower, the old man fleeing to the shelter of his house.
The second reason is that it demonstrates how Alzheimer’s, over the years, corrodes judgment, sometimes in bizarre ways. Elsewhere in his book, O’Brien describes episodes of mistaking a stranger for a friend, and his wife for a stranger. “I knew I was supposed to be in the bed with this attractive woman,” he writes, “but I wasn’t sure who she was. She looked familiar, but I had no understanding for several minutes of the relationship with the woman I have slept with for 37 years.”
This is evidence that, despite experiencing hallucinations and bouts of confusion, it is possible to write well deep into the middle stages of this disease. As O’Brien observes, “The writing makes me whole again—until the confusion takes over.”
The explanation for this disconnect—lucid prose on the one hand, dementia on the other–can be described as a kind of mental bank account, or tank of gas, that allows some people to continue to function at a high level in certain realms, even when short-term memory and executive functions are deeply compromised.
What a strange, vaguely comic disease I have.