“Force always attracts men of low morality.” ~ Albert Einstein.

Many years ago, I briefly worked as a case manager.  It was a Monday – Friday office job, which for a nurse can seem like heaven!  We even wore ‘street’ clothes! It involved a lot of telephone calls, wheeling and dealing between the insurance company and health care providers to try to get a better deal on services.  The best part of the job (for me) was talking to the patients with their complex needs and worries, but unfortunately that was the part that was least productive (financially at least) to the company.  You could not charge the insurance company (in increments of fifteen minutes, like a lawyer) for that time.  And thus, my boss didn’t make money.

But one fascinating case stayed with me.  A professional man with a great career had suffered an unfortunate complication while recovering from elective surgery.  It had left him with brain damage, but after some time in the ICU he eventually recovered enough to go to a very specialized brain injury rehab center.  There he was evaluated by a team of rehab experts, and they met with his wife to review his situation and their plan of treatment.  The meeting was going well until one of the experts reported that the patient, a former lawyer, was reading at an eighth-grade level.  The wife erupted.  How dare they say that when her husband had graduated top of his class at an ivy league school? She later called me and demanded that I find a different rehab center (the specialized ones were few and far between) since this one obviously could not care for her husband.

I spent a lot of time on unbillable phone calls, trying to mediate between the wife and the center.  She was resistant to all of the amenities they could provide for her husband, who had short-term memory loss in addition to many of his other difficulties adjusting to everyday life.  I resigned from the job before closing the case (that whole billing for hours was something I could not get used to), so I never did find out how it all worked out.  But it was an example of how difficult it is for families to cope with any new reality that occurs suddenly and without preparation. 

In one of my university courses some years ago, we were asked by the professor, what did it mean to be whole, to see our patients as whole, even if they had significant disabilities, or even were missing limbs.  I thought of my father, a man whose intellect had always been sharp, as he descended into the fog of dementia.  A lover of story-telling, his wisdom used humor to enhance his messages.  As his memory became less reliable, it was harder to hold a conversation with him.  As he became less himself, I shared with the professor, he became less whole.  No longer wholly him.  She reprimanded me.  Her own mother had dementia, she told me, and she certainly was no less whole than she had been before.  But, I thought, but to me…

And that is the sadness of losing that connection with someone through dementia.  So many of our shared memories provide the entertainment at family gatherings.  Siblings tease each other with repetitions of old stories, old punishments, accidents and injuries.  Remember that time?  Some stories can be recalled with only a few words.  So it is indeed a challenge, especially for the caregivers and loved ones, when those stories are lost.  I have always had a little fear, that if I developed dementia, I would become mean, cruel to those who tried to care for me.  But it has been reassuring, in dealing with those with dementia, to find that they often retain some of their best features, being unfailingly polite, concerned for those who care for them, even when they don’t recognize them as their own daughter.  And, I have observed, they seem to develop an intuition into the true feelings of those caregivers, able to detect insincerity while sensing true caring, true love in those who are authentic.  Which is reassuring.

I have observed that in a relationship was dysfunctional before an illness, it is much harder for the caregiver to let go of old resentments to be authentic, to be empathetic.  If, while we are healthy, we deposit as much love and kindness in our treatment of those around us, especially our nearest and dearest, then when we need to withdraw, when we are not able to care for ourselves, that love and kindness will be returned with interest.  And since none of us knows how our life will turn out, we need to be more thoughtful of how we treat each other.

Which brings me to the current state of our world and its leaders.  There are those who are concerned that the erratic and unstatesmanlike behavior of the current occupant of the most powerful seat in the world is symptomatic of some kind of cognitive decline like dementia.  Unfortunately, like the snake in the story he loves to tell, he has been showing who he is for many years.  It is too depressing to list the many examples of misogynistic (actually convicted of sexual abuse) and racist acts over the years, but the present abuse of power and disregard for societal mores, laws and morality displayed on a global level leave us numb.  And since he has been given presidential immunity by the highest court in the land, he is free to say and do what he wants.  For now.

The nurse is challenged to see all people as whole, as worthy of respect, and to be treated with dignity, even when caring for criminals or even the ‘worst of the worst.’ It has been challenging to try to apply that philosophy when faced with some of the acts and policies of the current administration.  We have entered bizarro world when the leader of the US backs the oligarchic leader of a communist nation (or two or three) over a democratically elected leader who has been invaded.  When a man known as a murderer and committer of war crimes against civilians, against children, is called a ‘humanitarian’. 

There is, however, hope on the horizon as the millions of people who showed up at the latest ‘No Kings’ protests showed last weekend.  By focusing on helping people to register to vote, on mobilizing such efforts, they reminded us that democracy works when people are engaged.  Everywhere people are exercising their rights to vote early, and are on the lookout for potential ‘glitches’, and we can only hope that the power of the people will overcome the power of the few to determine outcomes.  It is an exciting time to watch as people are energized and motivated to make a difference.

On this cool Friday morning (always wonderful when the temperature dips those five or ten degrees and the humidity eases in South Florida) I look forward to the evidence that this nation is a nation of good, kind people with respect for the rule of law and for moral and ethical treatment of its citizens.  I look forward to a time when the US can come to terms with its history, and resolve to chart a new future with liberty and justice for all.  A time when our allies can depend upon this country to join with them in forging world peace, and systems which care for the most vulnerable among us.  And if you happen to be caring for someone with dementia or other chronic illness, please remember to also take care of yourself. 

Have a wonderful weekend, Family!

One Love!

Namaste.