Saturday, October 6, 2018

The Saturday Snapshot #9

    Faithful reader Tony Galati sends along this snapshot of two New England salts, along with this explanation:
     I've been transferring some old Kodachrome slides to digital. I just did these from a 1972 trip to Nantucket that I took with a buddy the summer I graduated. The town of Nantucket was filled with really old people, hippies, and other assorted characters. We were somewhat of a minority. What better reason to travel?
   While this pair of gentlemen look as sharp as tacks, they offer an opportunity to plug a marvelous article in this week's New Yorker, "The Comforting Fictions of Dementia Care," by Larissa MacFarquhar. The story represents top notch reporting and beautiful writing about a vitally important subject, and I can't recommend it enough. It's almost a philosophical work, focusing on the untruths told to dementia patients to make their lives more endurable, and f you want to make the story even more unsettling than it already is, ask yourself, as I did, what it might suggest about the lies we tell each other and ourselves to get through our days.


  1. About a decade ago, my wife and I worked for an Ohio magazine that catered to the building trades, as well as architects, construction companies, and design firms. She was writing a story about the layouts and floor plans of those facilities, and I was assigned to shoot photos. We did not visit the Chagrin Falls facility, but instead went to a similar one in another Cleveland suburb, where the residents are mostly Jewish. It was a Sunday afternoon, and there was live jazz in what they called the "town square."

    Yes, the hallways DO feel like streets after a while, and the porches and the doorways resemble those you might see in a small Midwestern town, circa 1940, and the blue ceiling can even pass for the sky, when the light is right. But there are no vehicles, of course, and if you glance at the outer walls, it begins to feel more akin to a Hollywood soundstage, and the residents almost come to resemble actors on a set. This made us feel rather uneasy, even sad. Taking pictures proved to be difficult, especially when residents asked when they could "go home"...and, yes, they DO have bus stops for the buses to "the old neighborhood"...the ones that never arrive.

    Some of the residents passed the time at "outdoor cafes' with patios, and seemed to be at peace with themselves and in good spirits. I certainly wasn't, though. Just reading about these facilities still haunts me. That could easily be "my little town" in another ten or fifteen years.

    But it sure beats what used to be. I briefly worked in a "nursing home" right after college, back when patients were routinely restrained...tied into big chairs. I couldn't do it, and left the ropes a bit slack. A couple of them escaped on my watch. One got outside through a fire door and nearly froze to death before being found. Another was not so lucky. He was run over and killed while trying to hitchhike "home"--back to his old farm. They fired me soon afterward, from the most miserable job of my life. If merely being old with failing health is hell, then being old with a sound body and memory loss has to be the lowest circle of that same hell. I've seen both, and the former is vastly preferable to the latter.

  2. I occasionally have dreams (not exactly nightmares, but scarier because of their banality and plausibility) in which I lose things, forget where I parked my car and can’t remember phone numbers. Can’t say that the dreams presage an inevitable future, but can’t say they don’t either.


  3. Thanks for using the photo, Neil.
    It's both eerie and satisfying, to see a photograph that I took 46 years ago, published today. "Man, who was that guy who took this picture?" So much life has been lived since then. It's difficult to bridge the gap.

  4. That really is an exceptional article; thank you for bringing it to our attention. It really brings into focus the ethical dilemmas that can accompany caring for someone with dementia. As I was reading it, I remembered a segment I heard on This American Life some years ago about a woman who decided to draw on her improv skills to interact with her mother, and sure enough, she was mentioned further on in the essay (Karen Stobbe). Here's a link to that episode:
    The segment is titled Rainy Days and Mondys.

  5. I just finished that New Yorker article, and you were right to recommend it so strongly.

    I was a little startled about the phony bus stop thing, because not so long ago I read about that online, being used at a place in Germany. It was presented as an innovation. Now apparently it's widespread.

    Mortality sucks. OTOH, who would want to live forever? All you can hope for is that the end is quick, painless and generally merciful.

    1. "And the best that you can hope for is to die in your sleep..."
      --Kenny Rogers, 1979 ("The Gambler"

    2. The phony bus stop was without question the most resonating detail of the piece. I couldn't help but personalize it, and wonder if I've spent my life waiting for a bus that isn't coming.

    3. Eventually, as I transitioned from middle age to geezerhood, I went from waiting for the bus that didn't arrive to the realization that I'd missed the bus a long time ago, and that no more would follow.

      When I revealed this to my wife, she admitted to feeling the same way. Both of us came from large urban areas. Makes me wonder what sort of analogy a non-city person would use. It helps to have a traveling companion, but having a seatmate on the bus stop bench helps even more.

  6. A dozen or so years of dementia wards taught me some realities about crushed hope and the incredibly charitable heroes, the caregivers. If lying improves the experience for either side, I'm all for it. My father was highly functioning as he approached 90 and then starting showing the signs. I was in the room when he had his first evaluation. With just a slight hitch he was able to repeat the three unrelated words for the doctor, but the next test was the stunner. Asked to draw a clock face he was stumped. Prodded to draw a circle and write in the numbers, he got to seven by 3 o'clock. He'd worn a watch every day of his life and couldn't reproduce something so simple and familiar, that he'd seen it almost a quarter million times. I knew at that moment how real dementia is. Alan Alda playing a doctor diagnosed with Alzheimers says, "I want to enjoy every conscious day I have left, but I'm afraid I will forget when the day comes when I want to kill myself. Seeing someone trapped in a reasonably healthy body for years after she has truly lost her mind is heartbreaking. If the treatments described in the New Yorker improve on the drab institutions I've witnessed, I would guess most family and caregivers would accept some failure along the way.


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