David Sedaris in the Reminiscence Neighborhood

 

My daughter Ellen with her grandmother in 2005

Would you like to laugh, for a change?

Read this little story by David Sedaris on The New Yorker website about his last visit to the assisted-living place in Raleigh, North Carolina, where his 98-year-old father was living.

It's subtitled with a quote from the essay: “Who are you?” I want to ask the gentle gnome in front of me. “And what have you done with Lou Sedaris?”

It's about memory loss and the Trump years and the police officer killed by a car ramming a barricade on Capitol Hill, April 2, 2021.

In a wacky conversation, his father asserts, “One of the things I like about us as a family is that we laugh,” he says. “Always! As far back as I can remember. It’s what we’re known for!”

Yes, both David and his sister Amy publish and read aloud hilarious personal stories, often about family life.  But that's probably not what his father was referring to.

Here are my favorite lines, toward the end of the piece:

"For our natures, I have just recently learned from my father, can change. Or maybe they’re simply revealed, and the dear, cheerful man I saw that afternoon at Springmoor was there all along, smothered in layers of rage and impatience that burned away as he blazed into the homestretch."

My mother, too, mellowed as she lived her last eight or nine years.  That hard edge she needed to get through family crises and her years as a working mother just melted away.  

I used to call it fierce determination, her pursuit of an immediate goal, whether driving from our door a Fuller Brush salesman or making sure my father took the civil service exam and regained steady employment.

But part of dementia can be an occasional flash of rage.

One evening I arrived in the Reminiscence Neighborhood about 5 pm, as usual, and began chatting with the caregivers, who were serving meals to forty people sitting at several tables.  

"How are things going today?" I asked.  Every day was different, and anything could have happened.

"We're all good," smiled Marnie Reid, the gentle Filipina leading the evening shift of caregivers.  

I greeted my mother and sat down at a table to talk with her, Marnie, and the other residents and caregivers before pushing Mom in her wheelchair to her room.  

An hour later I returned to the dining area to get a glass of ice water.  Marnie was still cleaning up the kitchen and gave me the real scoop.

"Your mom got upset at the table tonight while they were waiting for dinner," she told me. "She smashed her glass of ice water down on the table."

"Oh no!" I gasped.  "She smashed the glass?  I'm so sorry.  And you cleaned it all up?  Why didn't you tell me?"  I couldn't help giggling as I imagined the scene.

"You don't need to worry about that," laughed Marnie, one of the kindest people I know.  

A visit of a few hours doesn't begin to capture the complexity of life on a floor that is indeed a neighborhood but one where reminiscence is scarce.

The day Robin Williams would have turned 70

Robin Williams  (1951-2014)

Today would have been Robin Williams' 70th birthday.

Instead he died at age 63 by suicide with depression caused by Lewy Body Dementia.  

He didn't know that he was in the early stages of this kind of dementia.  He had been diagnosed only with Parkinson's Disease, a related condition in which Lewy Bodies (a protein deposit in brain cells) are also present.  

On the occasion of this birthday, the podcast Genius Life released a video of Robin's son Zak Williams talking about his father's suffering in the last year of his life.

Robin experienced great frustration because his diagnosis of Parkinson's didn't match with the symptoms he was going through both physically and mentally.  

He had more anxiety and depression than what would be typical of Parkinson's alone.

We all think tremors are the main signs of Parkinson's, but some people don't get the tremors.  Robin instead had loss of memory and episodes of extreme anxiety.

"It's a unique form of suffering in the family context," explains Zak in the Genius Life podcast #191.

"Lewy Body Disease is akin to having Alzheimer's Disease and Parkinson's Disease at the same time," says Max Lugavere, who produces the Genius Life podcast and whose mother had LBD.

Robin Williams probably had LBD for about two years before he died.

My own mother's dementia in the last ten years of her life was hard for doctors to diagnose.  

I took her to exams where doctors asked her to walk in a straight line, raise one arm above her head, draw a clock, and answer various questions to determine what type of dementia she might have.  

Because of her gait and other physical symptoms, as well as occasional hallucinations, they said the most likely diagnosis was Lewy Body Disease.  They treated her accordingly, but only an examination of her brain cells after death could reveal what disorders were occurring in her brain cells.

In her case, the post-mortem exam in 2008 revealed amyloid placque deposits around her brain cells, as well as tangles of another protein within some brain cells.  These are symptoms of Alzheimer's Disease.

In other words, she had Alzheimer's, not Lewy Body.  Her father had died of Parkinson's Disease, similar to LBD, so it was not easy for doctors to diagnose her illness while she was alive.

What can we do today?  

• Seek medical help for signs of depression in one's sixties.  
• Be sensitive to friends suddenly developing physical symptoms and mental illness later in life.
• Learn as much as you can about various kinds of dementia that can occur with aging.

See also:

https://www.cnn.com/2020/09/01/health/lewy-body-dementia-explainer-wellness/index.html

https://www.independent.co.uk/arts-entertainment/films/news/robin-williams-death-parkinsons-zak-b1888385.html

https://www.statnews.com/2016/09/30/robin-williams-dementia/

Fugue in Death: April 9, 2021

T-shirt bought in Leimert Park, Los Angeles

Today is 13 years since my sister and I sat at my mother's bedside, holding her hands, while she took her last breaths.  April 9, 2008.  

It's also 10 years since my friend Nancy Hardesty died, a few months after her diagnosis with pancreatic cancer.

I was already in a sober mood when I turned on MSNBC and found Dr. Martin Tobin testifying in the trial of Derek Chauvin for the murder of George Floyd in Minneapolis, May 25, 2020.  

The doctor was explaining that the video of Floyd's death shows that at one point you can see him taking between 6 and 7 breaths in 19 seconds.  The scene replayed as Dr. Tobin counted the breaths taken and showed jurors and television viewers how to observe the shoulders moving.  

George Floyd's respiratory rate was about 22 breaths per minute--much higher than someone sitting in a chair, but normal for someone working hard to breathe, Dr. Tobin said.

My mother, Evelyn Eggebroten, in May 2007

Working hard to breathe... the scene of my mother's difficult breathing played as a counterpoint theme in the fugue of Floyd's death.  The hospice nurse had told me to expect this labored breathing, the "death rattle."

Fentanyl slows down breathing, Dr. Tobin continued.  The autopsy showed traces of fentanyl, but it was having no effect on George Floyd's respiratory rate.  In other words, Fentanyl was not the cause of death. 

"There's not fentanyl on board that's affecting his respiratory rate," he concluded. 

Furthermore, heart disease could not have been the cause of death.  A death from heart disease shows a build up of carbon dioxide in the body or in arterial blood, typically to around 89. 

But George Floyd had a normal amount of CO2 in his body and blood--a value of 35 to 45.  Thus, he did not die of heart disease.  

Next Dr. Tobin explained that George Floyd's last effort to breathe occurred at 20:25:16 (8:25 pm and 16 seconds).  "He was rocking his body, using his entire spine, cranking up his right side to get air into the right side of his chest."  His left lung was completely flattened between Chauvin's knee and the street.

By this time my tears were flowing.  April 8 had been fully turned into a day of witnessing death as well as remembering the deaths.

Graphic testimony continued.  George Floyd can't raise his chest to get air because of the chain on his ankles, the handcuffs, and the knee on his neck, said the doctor.

Chauvin "has his whole weight on him.  You can tell because his boot is not even touching the ground."  (Dr. Tobin later revised the statement to at least 50% of Chauvin's weight being on Floyd's neck.)

"His airway was being narrowed more than 85%.  His body is contorted by handcuffs behind his back.  You need your arms and legs to push up, but he is not able to lift up his rib cage."

George Floyd loses consciousness after 1 minute of the knee on his neck. 

Then he has an anoxic seizure.  You can tell this has occurred, said Dr. Tobin, because his right leg jumps up.  It's an involuntary reaction to asphyxia.

He's dead at four minutes of the knee on his neck, but he stayed pinned to the street for a total of 9 minutes and 50 seconds.  Then a medic tried to insert an airway tube.  

An EKG in the ambulance showed that Floyd's heart muscle continued trying to beat abnormally, but the rapid fluttering could not move any blood. This condition is called PEA, Pulseless Electrical Activity. 

As Dr. Tobin replayed the video taken by Darnella Fraizer, he pointed out the "slight flicking" of Floyd's eye.  But then it stops flicking. 

"That's the moment the life goes out of his body.  One second he's alive, one second he's not.  He's alive though unconscious, then he isn't."

I'm lying on the couch, crying and hugging my chihuahua.

"But the knee remains on his neck for another 3 minutes and 23 seconds," he continued.  Then the officers check his pulse and determine that there is no pulse.  

After there's no pulse, Chauvin doesn't roll Floyd over or try to revive him.  Instead his knee remains on Floyd's neck for another 2 minutes and 44 seconds.  Nine minutes after the paramedics arrive, a breathing tube is finally inserted down his throat.

The cause of death is asphyxia: oxygen deprivation resulting in cardiac arrest.  

Anyone would die from this kind of treatment, says the doctor.  It had nothing to do with Fentanyl or heart disease.

Watching this horrific death flooded my mind, but the scene of my mother's last moments also hovered in the background. 

She lay in her own bed, ten years after a diagnosis of either Alzheimer's or Lewy Body Dementia, being comforted by family.  She was 89 years old.  

He lay on a public street just a few minutes after being accused of passing a fake $20 bill. Four passersby tried to intervene.  Instead of comfort or medical care, he was murdered.  He was 46.  

She lived as a Caucasian female and public health nurse.

He lived and died as an African-American male, perceived as a threat, working as a security guard.  His race and gender caused his death in the racist, gender-obsessed United States of America.

Actually, he was a gentle man, friendly and filled with good humor.