What’s Inside Her Head?

I try to see my mother every other day, and each visit is different. Sometimes I’m her boyfriend; sometimes her husband; sometimes her son but the wrong one, my twin brother John; or I’m just a guy who smiles at her and she smiles back. When I first enter the house where she lives with six other dementia patients, she looks up and pauses, her face blank until something inside her decides who I am. Yesterday it was me—tomorrow . . . we’ll see.

She’s 90 but still mobile, so I can take her outside and lead her on the walker as she concentrates on each step and mumbles the day’s motif. A year ago the theme was usually a real thing, such as the many hours walking up and down Russian and Nob Hills, which she and my father did before we were born. Or it might be my dog Finn, at whom she would giggle nonstop when she lived last year on my ground floor. Now, though, it’s all imagined. Last week she informed me that John was fleeing the police. “Why?” I asked (I correct her only when she’s over-agitated). But “why” questions don’t work very well with her, so I got John on FaceTime and she brightened at the sound of his voice. Two minutes later, though, after we’d hung up, she was sure that he’d been caught and killed.

The goal is diversion: Get her out of her own head. A little sun and air and exercise, and keep those oddball thoughts from winning. She won’t last much longer, the mind will be gone soon, but the spirit can be replenished. She was in the hospital last week with an E. coli infection, and the nurses worried it would take her. I held her hand when the doctor came in with lab results, a grim expression, and queries about pain, thirst, and whatnot. My mother frowned at each one, muttered a puzzled yes or no, and the doctor spoke with me for a moment and left. My mother tenderly squeezed my hand, made eye contact, and said, “Who the hell was that?”

I don’t care about the medical details, only a few moments of enjoyment I might provide one way or another. The quality of life is almost at zero, and one must be inventive. For a time I could use visuals—postcards of the Stanley Hotel where she and my father worked summer 1950, photos of grandkids when they were babies, glamour shots (“Remember Tyrone Power, Mom?”). At this point even those memories have mostly faded, but music still works: a video of my son on the cello playing Humoresque, or Bing Crosby telling Marjorie Reynolds in Holiday Inn, “Be carefulllllll, it’s my hearrrrrrrrt,” which she sang in the hospital as I played the YouTube clip. She glowed with pride at knowing the words.

Alzheimer’s is one of the major facts of our time, and still a mystery. My sister is an expert in the public health side of the disease, and she fills me in on what can and can’t be done. For me, it’s all immediate. My mother is now a surface, and she’s hard to interpret. Alzheimer’s has turned her mind into a dark continent. I hear her try to form a sentence and I wonder, “What’s going on in that simmering brain?” “Where in the world did she come up with that one?” I often ask as I leave her, though I don’t say it outloud. She tells me she’s 30 years old, which is the notion of one whose awareness has shortened to the present moment and sensory details, so why not be 30? On the drive home, the crowded Beltway doesn’t bother me. There is too much to consider.

Is her self going away, or is it the world that is going away and only herself remaining? She can’t communicate with others very well, but I bet she communicates with herself nonstop. There’s a lot going on inside that head, I’m sure. As I watch the slow process of decay, speculations continue. What about this one: When that final breath comes and a blessed ascendance (one hopes) follows, will God restore her? Will she get her mind back?

That question occurred to me last week, and my first response was, “Of course.” But then, I thought, does she really need all that stuff once her mortal career has ended? Alzheimer’s patients are confused and distressed, they worry and fret, they know they’ve gone terribly wrong, and that particular pain certainly has to stop. But surely it’s true that once they land in the Beyond, the places they lived, their childhood friends, the jobs they had, and a calamitous love affair from 1995 don’t much matter anymore. They’re in eternity now, a self only, or a soul. The circumstances of a biography are over. The soul doesn’t need them.

I’m rambling, I know. I do it each trip home until I park—a habit, I assume, of children who can’t connect with a parent anymore. She’s always thinking, it seems, and if she doesn’t get very far, if it doesn’t come out in coherent words, if the outer world doesn’t match her inner stream, that’s okay, as long as one can get from her a smile.

Mark Bauerlein is contributing editor at First Things.

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Photo courtesy of Pierre Poschadel via Creative Commons. Image cropped.